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.^H,r 00i r, ' RHILLS PI,1ILDINC FAX ,to. 313-730-0021 F. 001 <br /> 813480 -0020 City ofZephyrhil(s'FIro: • 196 Fax- 813.780.0021 <br /> . Permit Application . <br /> Date Rix etvad Phone ContscYfor Permit rr <br /> , - <br /> Owners Nat'l!: , • LOST W //1 SI T e- ■ Own Ph Number , I 8 • .. _ 1 7 8 3 1 ' 'TM-en <br /> , :v:nere Ad 3 / a • d A. ' r 'il - F2. 3 a Q . <br /> • Fee S:mple 71tleholdsr Name Titleholder Phone Number ` 1 1 <br /> Fee Simple Titleholder Address L . • — <br /> • <br /> ' <br /> Job Adaless <br /> e C W/ e / / , ✓id Lot # <br /> Sub Divisior, Parcel # <br /> ,kura -per 6ia }IeYa <br /> rd Waste Storage - ANNUAL ED Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct El Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 0 Controlled Bum Hood installation <br /> ergency Generator < 30 kw ,. LP/Naturai Gas - Installation <br /> Emergency Generator > 30 kw LP /Natural Gas- ANNUAL Sale . <br /> i 1= m Fire Protection Maintenance - ANNUAL Pieces of Assembly- ANNUAL • <br /> ' f aJ EE1 `Other . <br /> S Gh Jlf.4 Sprinkler' ❑ D D Recreational Bum <br /> OCT <br /> 1 Fire Alarm . ❑ ❑ ❑ T Sparklers <br /> J 1 <br /> Hood Cleaning O a Sprinkler System Installations <br /> I . Hood Suppression 0 0 0 Standpipe, (Sprinkler Sya) , <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Tire Storage ANNUAL <br /> • <br /> • <br /> • <br /> Fire Works <br /> • <br /> j Flammable Application- ANNUAL 1....;. , Valuation of Project <br /> Feet Tanks <br /> EJ Other: -- • <br /> i 96 c n actor L./.. / ._1_1,11. <br /> Company • <br /> . <br /> Si;irieture L - • • Registered Y / N [ Fee Current f Y / N J <br /> Adlre W, * G,/07/P/Agfl,1/1W A. License , . <br /> Li.,C::`r R rCIA NI Company <br /> g1g, utu e L Registered Y/ N J Fee Current L Y! N <br /> Address C • ----1 License #. i 1 <br /> PLUMBER Company <br /> • <br /> :::�,na ere r �_ <br /> ( - Registered Y/ N I Fee Current I Y/ N <br /> Address � License # L <br /> MECHANICAL Company • <br /> Signature Registered Y / ,N1 Fee Current pi/ N <br /> Address 7 I License 0 1 <br /> C HE>l Company _ <br /> s +p lure Registered MEM Fee Currant ! N <br /> aEtiss imeame # <br /> A ! r do aahcns: • <br /> F111 out application completely. <br /> Owner & Contractor sign back of application. notarized (Or, copy of signed contract with owner) <br /> i+ over 52300, a Notice of Commencement kr required- (Mechanical work over $6000) • . <br /> Supply two (2) set; of drawings with applloable documentation , <br /> Allow 10 -14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:/ /apprelser,pascogov.com) <br /> VIGIL INC Sic.. <br /> . <br /> Head & Cleaning <br /> P.U. Beet 273 T . VOW. Ft 3 • <br /> P: 113 - 41* F: iii - 1133-10 <br /> gaterai aye -ceta . <br />