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43 <br /> t, Fsx -813- 780-0021 <br /> 813- 7e04020 City of Zephyrhgls �Mdtx2: <br /> Permit Application <br /> Dana Received -1 I Poona 1 1 1 • <br /> Owners Name .. r i �i ° i Owners Phone Number 1 j ( '1 V i► . <br /> owners Address i �_ Taira �� i !i4WA <br /> Fee Simple Titleholder Name I Titleholder Phone Number I I <br /> Fe. SlmplalLtleladderAddm$$ 1 ... ,l <br /> Job Address Lot F <br /> Sub Division Pastel 0-p <br /> ED Sio -Hmrd Waste Storage - ANNUAL a Fumigation Tent ' <br /> ED Comm Exhaust K0tchen Hood/Ouct Q Hazndous Umbria' (Tier 11 or RQ Fealty) ANNUAL <br /> ED Controlled Bun Q Hood Metellation <br /> Eby Generator < 30 kw LP/Natural Gat -ktlon <br /> Emergency Generator > 30 kw LP/Neural Gu4NNUAL Sale <br /> Fire Protection Maintenance - ANNUAL Q Places of Assembly-ANNUAL <br /> IME1 IM1 IM1 Lee-L-111 s <br /> Sprinkler O 0 0 Recreational Bum <br /> Fire Alarm 0 0 0 _ Spenders <br /> Hood Clewing 0 0 0 _ _ fi Yr� <br /> n 0etloet . <br /> Hood Suppnasion 0 # * Standpipes Sys) <br /> Fb. Atnm keW.tion _ Torch Riming/Tar Kettle ' <br /> Fie Pumps - — - - EEI_ Waste Tie Storage ANNUAL <br /> Remittable Application - ANNUAL 1 .1 Wootton of Project <br /> Fuel Tanks <br /> ® ®' • <br /> co.biaor <br /> ® C , UPW Y raid : 11 7 - 1,2741 r_ --ri e <br /> Signature ® Te®r _ _. I.gr wed [� [i i i <br /> mays* /�Jp1r % l / ® / /�" ":�!1®:`7.. ' �� y . , Uon±» s '.3 o ` ..9. i.y, Z. . ; <br /> ELE any <br /> Signature Registered Y/ N Fs curet J Y/ N I <br /> Addr.a ucsnsa 0-p I I ' <br /> I <br /> PLUMBER <br /> Registered Y/ N Fee COI r ant I Y/ N I <br /> Signature <br /> Address 1 License S 1 1 <br /> NgECFiAFp <br /> Registered L Y/ N J Fee cxeisnt I Y/ N J <br /> Address 1 License A <br /> OTHER . Company <br /> Simian Registered I Y/ N J F.. want 1 Y/ N 1 , <br /> Directions: ,I. . <br /> Lice's, s I - " `1 <br /> Flout apip'option signed embed wtlh owner) <br /> Owner l C.arrtrraolor Slrp nitbr d • (O �' wo ) <br /> 11 ovar $2000. a Notice <br /> cot <br /> 11 <br /> Supply WA (2).sateof p • <br /> Allow 10-14 days for afs s�brA l of**. + 4` ` Parcel # - obtsin.d from Property Tax Notice (httpl/appraiser p.scapov.com) <br /> • <br />