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s�saao-oo2o City of.Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contact for Permit <br /> Owner's Name /"�i-/J'/yr ,' ��C/�,Sr%' �'ly/f{�1�� f ���e pN,ner's Phone Number � •7 �, Q' p � <br /> Q <br /> Owner's Address ��1n 3 f{u,/ �I�G,�.�ST ��� �L�1L�ss ,�C ���1L� <br /> (- <br /> Fee Simple TiUeholder Name ' Titleholder Phone Number �� � �� <br /> Fee Simple Titleholder Address <br /> J <br /> Job Address ����7" /��W 7 J ��/�f.�% 2 L^/p� Y/��i7 �t.�.U Y"�[� ���� Lot# � <br /> Sub Division Parcel# <br /> a Bio-Hazard Waste Storage-ANNUA� � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen HoodlDuct � Hood Installation <br /> � Controiled Bum � LP/Natural Gas-Installation <br /> � Emergency Generator<30 kw LP/Natural Gas-ANNUAL Sale �-�~� <br /> � Emergency Generator>30 kw Places ofAssembly-ANNUAL <br /> � Fire Protection Maintenance-ANNUAL Recreational Bum - <br /> ❑[tFftFfrfy ami � er � <br /> Sprinkler ❑ ❑ ❑ Sparklers QG <br /> � � � �� `� � .� <br /> Fire Alarm ❑ ❑ O Sprinkler System Installations 1 <br /> Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) l,� <br /> � � � �j( Z�� T <br /> Hood Suppression O ❑ ❑ ?orch Roofing/Tar Kettle Q� <br /> � Fire Alarm Instailation � Waste Tire 5torage ANNUAL � ^/ � <br /> � Fire Pumps �j � GtP <br /> � Fire Works ��' <br /> � Flammable Application-ANNUAL r—�-1 Valuation of Project <br /> � Fuel Tanks <br /> Q Othef: <br /> Contractor Company <br /> Signature i C{Jqf Registered Y N Fee rre t Y/M— <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER � ._ ' Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL <br /> Signature <br /> Company <br /> � Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Directions: , <br /> Fill out application completeiy <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Suppiy two(2)sets of drawings with applicable documentation <br /> Allow 10-1q days for review after submittal date. Parcel#-obtained from Property Tax Notice htt ://a <br /> ( p ppraiser.pascogov.com) <br />