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s�3-7so-oo2o City of Ze hyrhills Fire Fax-813-780-0021 <br /> Permit pplication <br /> Date Received. • ���T����� _R�_ ��� �� .�i'�'YPhone Contact for.Permit _-� ��� <br /> .r�.:,_._.. M�—_�.,��,.�.. - - - -- _ .� ._.._� _._�. _ _ _ <br /> Owners Name �j Owner's Phone Number � � � <br />�I Owner'sAddress 5� 1 C,��,4� �l V� ' 2 `� 33� �l�Z <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address — �='vY e��� <br /> Lot# � <br /> Sub Division Parcel# <br /> ._.v�__....._.....�._..._.__.:a.,.R__�_.a�,...�y._._,,,..._..�._.__.._.o..._a_>....,n.... �.._�-,.� --°-~-- - .,.a�.�___._�_�-m__�_°�.-r---_°____ -°___�_.__.___--�..._._»..Y-�� <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 , �*"')� 1i <br />� � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � l J � <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL Q� � <br /> tr y emi �n 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 /> i � FlammableApplication-ANNUAL Valuation of Project <br /> � Fuel Tanks <br />' Q Other. <br /> ._..._._...�.:_..,�_,_._._...__.___. r -- -__....__..�.__._,......r,..__=—=--s__ ,.._�.��. �.�...-°�--,-�..�-�--�__�.__._..._..�_.,.._..�._..a�._..��__..a...---_� <br /> Contractor L l/(/ Company <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# <br /> s�-- :�_._.._.�_..._r,_.__.._...._.._-_-__W__..n._-.__e..___....___----Y.-._.... ..__.,_._...._�_.....�.....�.�-__.__�._....,,.__��,.__.._..._..�w.__:._..�.__..�_._.__,.a___�,�__rT��c <br /> Directions: _ _.... _ <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of sig ed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical wor over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parce #-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />