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� , a�s-�ao-oozo ���C._ City of Zephyrhilis Fire Fax-813-780-0021 <br /> 2 .� � � Permit Application <br /> Date Received ' Phone Contact for Permit �� �� � <br /> Owner's Name Owners Phone Number �� � [�D� <br /> Owner's Address � , 'a <br /> Fee Simple Titleholder Name TiUeholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> . - .e=�. .:'��,` 'e - -% � _ .an��.=.'e"^�..t+.; =:,:} s,s.'w,b'�.°�S'X- �.a�+ =' � - ._,1.� <br /> Job Address 3 �C 1 � <br /> Lot# <br /> Sub Division Parcel# <br /> ' •� � .S�t��.R'.� �'�'��:..6. - . .." '` ,v.,4...f@+ya�:, a"/�A` .. ' .�., -.`.4.a,4� . .« s�s � " � - <br /> . . , x�:_ . .__,.., r.�.e�s•�•, . ;:.•,�•., .aai°$Y'¢' �4' .0 t _ <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Ha2ardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL n �`\ <br /> Places of Assembly-ANNUAL <br /> ❑ ry emi An t er � � <br /> Sprinkler ❑ ❑ ❑ Recreational Bum / `� <br /> � � c� <br /> Fire Alarm � p p ❑ � � Sparklers � J <br /> /�Cleaning � ❑ � ❑ � � Sprinkler System Installatio <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fme Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Other� <br /> :•� <w.. � � ., .x�:� .��._ �.,.. . �,�.�. - <br /> c - <br /> Contractor ���� Company <br /> Signature Registered Y/N Fee Current N <br /> Address 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 Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Curcent Y/N <br /> Address License# <br /> Directions: ' <br /> Fill out application completely <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 /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:l/appraiser.pascogov.com) <br />