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813 780 -oo'n City of Zep hyrh i l is - Fire: Fax- 813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> •, w ?'+._:¢� 11.. -' -�.s. , 'Y,_... .;>..c._ -' -°.....,. h._..... �_ .- ..- _�...fi....- ....s.,, .< ...��.S r- i�..3 - .....ri_. -.vr •- ... u� X:..,. 5.' • - " - Y...,'.. <br /> wax -.��_ <br /> .,ae a <br /> Owner's Name STMPT.FXGRINNELL Owner's Phone Number 813 626 5 4 8 2 <br /> Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address . <br /> t7::'1.5Y. �- i.,,s1P`..,. V.%.:.r..,:e ,., `_';'a' ial >°t '":. ' a-" 4-'•` . mo m,S• �xe..nM"".'�� -,:. tti ... s u <br /> Job Address 3151 L (&) (e.\ iGt\keg <1lV 0 ZePh if l(b1',t 'P1- 33 5<i Lot# <br /> Sub Division Parcel # <br /> ,,.r., . °: �^ :.✓ a':"M arc M∎AT''sx...- 7*: ..U..r.. -... - ...m..w,' `ate.... - 3 .:r ,.:..,. , ,.r:� " - _ .p ,, .a: - ," .•�"x"'s. "" s'... - <br /> I Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> I . Controlled Bum I Hood installation <br /> I Emergency • Generator < 30 kw I LP /Natural Gas - Installation <br /> - .I I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale <br /> I . I • Fire Protection Maintenance - ANNUAL I Places of Assembly - ANNUAL <br /> iV JSemi I IAnl I Other <br /> Sprinkler. Oa r; • ❑ ❑, I I Recreational Burn <br /> Fire Alarm I I ❑ ❑ ❑. I • I I I Sparklers <br /> Hood Cleaning I I O ❑ ❑ I I I I Sprinkler' System Installations <br /> : Hood Suppression I I ❑ ❑ ❑ I f I I Standpipes (Sprinkler Sys) <br /> I I: Fire Alarm Installation Torch Rooun /Tar Kettle <br /> I.; I Fire Pumps I • I . Waste The Storage ANNUAL <br /> . V, I Fire Works . <br /> rti I FfammableApplication- ANNUAL I I Valuation of Project <br /> l'', T <br /> I.. I Other: I ' .. <br /> • <br /> Contractor /% Company cti rrr't L( <br /> Signature 3 N (�F <br /> Registered Y / N j Fee .Current I. Y / N <br /> Address I .. I License # I <br /> ELECTRICIAN . <br /> Company <br /> Signature Registered Y / N. J .. Fee Current I.. .. Y/ N . I . <br /> Address I , . ( License # I <br /> PLUMBER <br /> Company <br /> Signature Registered Y / N - j Fee Current I Y / N ' <br /> I <br /> Address I <br /> I License # . • I <br /> MECHANICAL Company <br /> Signature Registered Y/ N J Fee Current I ¥ / N I <br /> . Address I. , .. . . <br /> I License # I <br /> OTHER Company . <br /> Signature Registered Y/ N J Fee Current I Y/ N <br /> Address License # <br /> . �. <br /> Directions: " -°- - <br /> . Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> if over $2500, a Notice of Commencement is required (Mechanical work over $5000) . <br /> - Supply two (2) sets of drawings with applicable documentation <br /> - Allow 10 -14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br /> • <br />