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09/04/2009 10:52 FAX a 010 <br /> q w <br /> , 81378C City of Zephyrhills'Fire Fax- 813 -78D -0021 <br /> Permit Application <br /> Da a Received Phone Contact - fo r Permit <br /> ens -- ,� .�. . <br /> Owners Name fi71YET,FXC, TNET,T, Owner's Phone Number IIIMI ] 626 115482 <br /> Qv, flees Address 4701 Oak Fair Blvd TAMPA FL 33610 - <br /> FeE , Simple Titleholder Name • 'titleholder Phone Number <br /> Fen Simpl®TitleholderAddress 7 • <br /> ea sgenswissigroasamentawastim Am,. <br /> Jot Address I 31 TD 1 1 - QAofc.k Vc1i1'E..4 ?:,i 335"1 Z Lat# , <br /> S ut Division f P arcel # <br /> . = B10-I-lazard Waste Storage ANNUAL n Fumigation Tent <br /> 1:=1 Comm Exhaust Kitchen Hood/Duct n za <br /> Hardous Material (Mar 11 or RQ Facility) ANNUAL • <br /> n , Controlled Bum n Hood Installation <br /> E ., Emergency Generator < 30 kw n . LP /Natural Gas - Installation <br /> Emerge Generator 30 *w • . LP/Natural Gas - ANNUAL Salo <br /> n : a , <br /> - • . 0 -.. , Fie Pnot®etlon Maintenance - ANNUAL • • • n Places of Assembly- ANNUAL <br /> Imo kILIII =II W <br /> ,, , . ,,.. Sprinkler. ❑ D Q. - n Recreational Burn <br /> Fire Alarm ❑ ❑ ■ Sparklers . • <br /> ::'.�: • Hood'Cleeninu ❑ Q • d ❑ 1 I n SpdntderSystem installations • <br /> • <br /> OOd'�UpP��On' <br /> . , ❑ D . p rinkl er Standpipes ( Sp . , <br /> '...r,: . F . - 9rn Alonzo Installation _ • Torch Roofl►.igffai K ttle'' -- . . <br /> •w _ �' .F Pumps Waste Tire Storage ANNUAL •, <br /> x F ire Works . • • . • . • • <br /> x .. Flammable Application- ANNUAL ) :, Valuation of project • ''' • F uel Tanks • ,.- , ..... , ... .. _ <br /> . n Dther: 1 . <br /> • <br /> t <br /> Con rector - • <br /> - <br /> Company . r/ ,vL ♦i <br /> ' <br /> s.. <br /> Sign aim aim .. Registered Y / N Fee Cumant 1' Y / N 1 ' <br /> Address; I : . .rr_. r ,i ... ,.. , .. .. 1. License# . . - .: 1. <br /> gigh ature - . _ �.r •' • . , Registered Y M .l i :.,Fee Cumvttt... ,Y 1 N ' i. <br /> Address I ,; 1 License# <br /> -PLUMB R, ti . _ Company . r <br /> • <br /> Sign iture - " Registered Y / N 1 1 Fee Ciitrent•• 1 Y /- Nl i s ' ; <br /> Address 1 1 License* , I - . 1 <br /> MECHANICAL Company • <br /> Sign Ire ' • Registered Y / N 1 Fee Current 1 Y / N 1 <br /> • . Address I . ... . ' . 1 License # 1 <br /> • <br /> OTH t Company . - • <br /> Sign; •tune , - Registered Y / N 1 Fee Current 1 Y / N . •1 <br /> Address License # <br /> Dirac ions: <br /> ' - Fill out application. completely. - <br /> Owner & Contractoraign hack of application. notarized (Or, copy of signed contract with owner) • <br /> W over$2500, a Notice of Commencement Is requtred.(Mechantaal work over $5000) . - <br /> -_ Supply t o (2) sets of drawinga with applicable documentation <br /> Aliow 10- 14 for review after submittal date. Parcel # - obtained . frvm Property Tax Notice (httpJ /appraiser-pascogov.com) <br /> • <br />