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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received , Phone Contact for Permit � � � <br /> f�.v._a_�-... J.__.-_�.-�..--� - - �__..._�_...-_.____=�._=J._..e..�...ee... _-,�_.._.e-�_�.^�_.-..._ �_..__....._..._�,...�=�e_.___�_��-�-.____�._,��.e---.-_�....k.-�_....�..._�.-.e�. <br /> Owner's Name ��.�%�).S�,h� �/� 4 /L-�- Owner's Phone Number ��3 ��� ��Z 3 <br /> Owner's Address ���� �2 S'�L! ,���H Y/Z l�l�-C.-S �L ,3.35`L/Z. <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> C�-------°---',�.�_-- - - -- - -- ° - -- -- - �.�_�e` - — — <br /> Job Address �Lot# � � <br /> Sub Division Parcel# <br /> tY=-v.s.=_�. -__,-�°�___ �- - �_.��___-_.-.,..�--e_.__�_._:�_._._�..__��__.________�- - � �._____.�-�,_..� -=-__=�°-A-___�__.-:.,.._�_,.�____d_a <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)AtdNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Naturai Gas-Installation r„ <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale /�l, //�� <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL '� � J <br /> t y emi �n t er � <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Burn � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) f � <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> N <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � FlammableApplication-AkNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> �.-��_._�__�___.�;_--�_�w._e.�._.-- _�__.��Y____.»._. -.__...m_�__ �_�__-�..��...__�.�.-�:..___�_ - --.��_��..�_ -_�_____ - <br /> Contractor G'�� Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/�1 Fee Current Y/I� <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/1�1 Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/I�l Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> __-__.__ _-_ . .__._.:wr�..__w�. - - - -_ - <br /> : r <br /> _ �._. <br /> _..:.�----.--�,,---��---------._,._..___._,__.__.._____ -_ - - <br /> - - __-�,.._____�.._ �__�_,,_...._�_ <br /> --_-- -_-�.__.-__,__�_.___.�_ <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:/lappraiser.pascogov.com) <br />