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4 6 1 ° <br /> 813- 780.0020 Cpl)/ Of Z8pF1yr11p1S fIllbc7C+2 °• <br /> Fax -813- 780-0021 <br /> Permit Application • - <br /> Date Received 1 Phone Contact for Permit <br /> Owners Nana .. - ' 17 • - ' i�'r:&rA rain • 4 (rrrnrs Phorn Number I ' J <br /> Owners Address 6 f7 -4/,„; As / r o / / / " • Fee Simple TMlIho der Name 1 Titleholder Phone Number 1 1 I • 1 <br /> Fee Simplef'Meholder 1 I <br /> Job Address 4,117 1 <br /> Sub Division I Parcel 0 • <br /> A• <br /> 0 Bbrd Waste Storage - ANNUAL. • a Fumigation Tent • <br /> D Corm Edsaust Kitchen HoockD„c a Hazardous Meterlel (Tier 11 or RQ Fealty) ANNUAL <br /> 0 Cnfro$sd Bum 0 Hood won <br /> Emergency Generator < 30 kw LPIWairsel Gms- Iru�letlon <br /> ji, <br /> Emergency Generator > 30 kw LP/Natural Gas- AjNNUAL Sale <br /> Fire Protection Ma1r nce - ANNUAL Places at Assembly - ANNUAL • <br /> ® . <br /> S Mder Li O ❑ ❑ Rec Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers Hood Clearing 0 0 ❑ • BPrinrdar System Instillations . <br /> • <br /> Hood Suppression 0 ❑ It Standpipes (sprirda.r Sys) • , <br /> H Are Mean katsliUon - Tech Roofing/Tar Keels Pumps — - . waste Tie storage ANNUAL ' Valuation of Project <br /> Fire Works <br /> e , , ,- <br /> F Tanks <br /> Signature �J 'T,® ® .. Rephtet�r! [� �tI <br /> Address Ilt+1 .`f 11 ®,ti/�' - d' X1/0. ®.. L .ns..s Wi t' .ro ' <br /> Company <br /> • <br /> Signature S Rib Feb Current - <br /> w <br /> Address I \ r License ft I Roswed Y/ N Fee dn.nt I Y <br /> PLUMBER Company Sign. L_____ /N 1 <br /> Address I <br /> 1 License 8 l I . <br /> Registered I Y/ N 1 Fee Current 1 Y/ N 1 <br /> Address 1 Uwe, tic I I <br /> OTHER . Company <br /> Sigrre� <br /> J Registered Y /N j Fea Current I, Y/N j <br /> omit & Pm l llr#f k ( - 4 contract with ow or) <br /> omit $2 a Not work over $5000) <br /> If over $2800, Note. E46r <br /> supply-trro (nuts for w - 0 - obtakred from Properly Tax Notice p.ecagov care) • <br /> AMem 10-14 days for ., After,suisrlltW date. •• a' <br /> • <br />