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813-780-0020 City of Ze hyrhills Fire Fax-813-780-0021
<br /> Permit pplication
<br /> Date Recerved Phone Contact for Permit V C��C��J_l�
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<br /> Owner's Name _.r1-Y�.�CL.PI-�J n p��� N 2! L l- Owners Phone Number 'b �?j � 7 I�
<br /> Owner's Address ���-ZC� (�� ��
<br /> Fee Simple Tilleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address
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<br /> Job Address, �� Z-ZQ ���1- �JL- Lot# n�
<br /> Sub Division Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous 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 � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> r y emi � t er
<br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Application-ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> Q Other:
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<br /> Contractor ; � � Company ���=���4��( �lf�-C=
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> ELECTRICIAN Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> PLUMBER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MECHANICAL Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> OTHER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Directions:
<br /> Fill out application completely
<br /> Owner 8 Contractor sign back of application,notarized(Or,copy of si ned contract with owner)
<br /> If over$2500,a Notice of Commencement is required(Mechanical wo k over$5000)
<br /> Supply two(2)sets of drawings with applicable documentation
<br /> Allow 10-14 days for review after submittal date. Parc I#-obtained from Property Tax Notice(http:/lappraiser.pascogov.com)
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