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813-780 02o City of Zephyrhiils Fire <br /> Fax-813-780-0021 <br /> Permit Application <br /> ate Received � � � � � <br /> Phone Cantact for Pertnit <br /> wner's Name `�S (� l � � � Owners Phone Number �� � �� <br /> vmers Address !� S p ��� � h S ^ <br /> y� <br /> :e Simple Titleholder Name � �� �� <br /> Titleholder Phone Number <br /> 3e Simple Titleholder Address <br /> �b Address �� <br /> Lot# <br /> �b Division <br /> Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigatlon Tent <br /> � Comm Exhaust Kitchen Hood/Duct Hazardous Material <br /> � (Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30�,y � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL le <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-A UAL t <br /> � f�1F7ry emi � � j�� � � <br /> Sprinkler p ❑ ❑ � � Recreational Bum `��j <br /> --� <br /> Fire Alarm ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � p � � ❑ <br /> ❑ Sprinkler System Insta ' <br /> Hood Suppression � ❑ ❑ C� � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar KetUe <br /> � Fire Pumps Q Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable ApplicaGon-ANNUAI <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other. <br /> mtractor � ' � <br /> gnature �� �� Company - S �e <br /> Registered Y/N Fee current Y/N <br /> Address <br /> License# <br />_ECTRICIAN <br /> gnature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# -� <br />_UMBER <br /> gnature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# � <br />=CHANICA <br />�nature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# �� <br /> fHER <br /> 3nature Company <br /> Registered Y/N Fee current Y/N <br /> Address <br /> rections: <br /> License# <br /> Fill out application completely. <br /> Owner&Contractor sign back of appiication,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 appifcable documentation <br /> Allow 10.14 days for review after submittal date. Parcel#-obtained from Property Tax NoGce(http://appraiser.pascogov.com) <br />