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• 813 - 780.0020 City ofZephyrh IsFiie- 460 1 Fax -813- 780 -0021 <br /> Permft Application ' <br /> Date Received Phone Contactior Permit I <br /> ) ...- . ] /� .+-5,'e »'t: -v.0 .. -�. -� ........ - -.. / .. � j / . <br /> Owners Name - riffi /���.%�i : i �,i I�r _ Owner's Phone Number 1 g 7 � 5 <br /> r�7, — <br /> Owner's Address 1 *oil /4 M 2' ,09 y/ .S -f4T <br /> Fee Simple Titleholder tame TNehaider Phone timber 4 i 1 1 - I <br /> Fee Sim* Ti*ehdderAddress I <br /> -.- -= - , --.- .c.3.`--'. ,'--, Y::: -_ - s-. .z•_..,. ,:Eiz - . ` > - - _5,: .nF: ,- �.;t.„ � ...I :_ .;.k, . ,_._,. ,4x - v?t:- _ _s. ..a,: = ,.:....T .... .e,; <br /> Job Address � � i i Aire _ _ G .', ..� 1 ' �o f� ii } <br /> • Sub Division I 1 Parcel * 1 <br /> D 8io -Hazerd Waste Storage - ANNUAL EJ Fumigation Tern <br /> D Comm Exhaust Klidren Hood Duct o Hazardous Material (tier 8 or RO Fealty) ANNUAL <br /> n Con4oled Barr cJ Hoer <br /> Emergency Generator < 30 kw n u al <br /> LPINN <br /> n ter, <br /> D Emergency Generator> 30 kw n LP/Naimi Gas-ANNUAL Sala <br /> ID Fire Pot:Section Mainknam e - ANNUAL D Places of <br /> P 11® , <br /> Sprit - Mar - 0 0 ❑ n Rases tonal Bon <br /> Fre Alarm H 1 1 ] Sparlders <br /> Hood Cleaning / O ❑ 1 1 L ! Sprinkler System trNalaionss <br /> Hood Suppression h►) 0 V 1 I D standpipe, (SPlillkler S) <br /> Q Fire Alarm kedaNaion = Torah RooinglTar !Canis F Fee Pumcps n waste Tie Storage ANNUAL <br /> Fire Works <br /> Returnable Applicalion- ANNUAL <br /> 1 1 Valuation of Project <br /> Fuel Tanks <br /> D Other' - 1 <br /> Contractor ,Q,, it / p� _ <br /> signature d s'A� //'w (/� usgebiledi Y 1 N 1 Fee Anent 1 Y / N 1 <br /> Address License* . I I <br /> ELECTRUCIAN fj - Company <br /> Signature / d 1 Y! N 1 Fee Current 1 Y / N, <br /> Address 1 1 Ucense I I <br /> PLUMBER Company <br /> Signature Registered I Y/ N 1 Fee Current 1 Y / N J <br /> Address I I License # I I <br /> MECHANICAL! Company <br /> Signature Regislened L___Y/ N. Fee Current 1 Y / N 1 <br /> Address I ( License * I I <br /> OTHER Company <br /> signature Regiatmed I YIN ] Fee Current 1 YIN 1 <br /> Address License* <br /> Directions: <br /> FM out application completely. <br /> Owner & Contractor sign back al appl:aeon, notarized (Or, copy of signed carirac i with owner) <br /> if over $2500, a Notice of Communoen er* is requirod.(Yadwicai work over $5000) <br /> Supply two (2) sets of drawings wily applicable documentation <br /> Allow 10-14 days for review alter submittal date. Parcel # - obtained from Property Tax Notice (hepl/appraiser peacogov con) <br />