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813-780-0020 City of Zeph rhills Fire Fax-813-780-0021 <br /> Permit Ap tication <br /> Qate Received �� phone Contact for Permit � �� <br /> �v*z:.s�r.,. .s . . . � _ ,�a.r= , .... .ak=.m r ,n...s�.-�_-�:»�..�.or a•..t.,»,.r __v-3z.:tt:.se.�^a,_;.y�ew-=cx..�� v ��S�d <br /> Owner"s Name �, r. Owner's Phone Number I 3 ��' �`i (� <br /> o�rs,a�a�ss 3� oo Gt 3 � 5' <br /> Fee Simple Titleholder Name Titleholder Phone Number C� E� �_� <br /> Fee Simple Titleholder Address <br /> p�"'-.�ia,a:,• .`=^ax�..ti :�atG..�a..'-::'�a??°:3Y�.- ;9SS#"�`2--64F=.3�.§�:-, - :'+�,•t - ';3.`"�.. .?ss.*�`_?�4��a.''s�.�._ ,fu: <br /> Job Address 7 (� Q��� 3 Lot# � <br /> Sub Division Parcei# <br /> �•'°�; .r�:,r�� ��;•;�+s3i.'tt�ts.,e.�"eb�.e,.:.%�a. . . tr5s�.�'�4!#i�'d�?-�,'�."�.�'+,;;.:x-: �+n,�..l�;?'-R'.--'^..a's-^� "�wr. �.»i 2�C -.�,. f.e�'��`,xxwm-'°¢Pm��'-a:.,lee,�refi� _- ,. . __ _ .. �.. <br /> _ . . .d=�"ae.s+n;..e y' . . _ <br /> � Bio-Hazard Waste Storage-ANNUAL. o Fumigation Tent <br /> � Comm Eachaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hpod Instaliation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � <br /> � em� n er .i�(j <br /> Sprinkier C) Ci � � Recreational Bum ���� <br /> Fire Alarm C! ❑ ❑ � � Spark�ers '� � <br /> Hoad Cleaning � Q O ❑ � � Sprinkler System Installatipns <br /> Hoad Suppression � ❑ O ❑ � � Standpipes{Sprinkler Sys) <br /> oFire Alarrn Installation � Torch Roofing/Tar Kettle <br /> o Fire Pumps � Waste Tire Starage ANNUAL <br /> � Fire Worlcs <br /> � Flammable Application-ANNUAL r —� Valuation of Project <br /> QFuel Tanks <br /> Q Ot11@r. <br /> �,. ,. ����_: f .��.;���n-��-,���;��;r�_,::���; -�.,z_ �_u.�a:���� ���;��::�����;:��.�fi��.��� <br /> Cantractor Company �„ }�y, ( rv <br /> Signature � Registered 1 N Fee Current Y I N <br /> Address �1„ � License# QQa ( <br /> EI.ECTRIGIAN Gompany <br /> Signature Registered Y/1�1 Fee Currert Y/N <br /> Address license# <br /> PLUMBEIZ Company <br /> Signature Registered Y I N Fee Current Y I N <br /> Address License# <br /> MEGHANICAi. Company <br /> Signalure Registered Y/N Fee Curt�ent Y/N <br /> Address l.icense# <br /> OTFiER Campany <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> r�•: _��� �. . .. .. . .. . ._ . _ _. , _. . _,. s . . <br /> Directions � . , , ,~ . _ <br /> Fill out application completely. <br /> Owner 8 Cantractor sign back of application,notarized(Or,copy af sign d contract with owner) <br /> if over$2500,a Notice of Commencement is required(Mechamcai work ver$500d} <br /> Suppiy two{2}sets oi drawings with appifcabie documeniation <br /> Allow 10-14 days for review after submittal date. Parcel -obtained from Property Tax Notice(http://eppraiser.pascogav.cam) <br />