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813780 -0020 City of ZephyrhillS Fire. Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> i .:r .u. , -..,. < .-- .,,,- ,,,, .C^ �_ a- - .l.-.as=..+'±; .,-2n- _._�._. r � "..av:a.' :: 5`'., .,.,._- ....,.... .._.rn..-..._ -.�. . C _.... _ ..1 ,....... • <br /> Owner's Name S TMPLRXGRTNNELL Owners Phone Number 813 6 2 6 5482 <br /> Owner's Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name L - Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address IO So C ql( t)tl� • ZeR V1 ,k6 V1/ 3e5Li ' Lot# <br /> Sub Division Parcel # <br /> r _tea . ....w ;,k...-..ry :" _....r... .∎ - : - .',s" ' ,:... - m .. ,.,..�>..a'. - . .s ,; .7.0 . - 's;:. - . .<,x.... - 4,:... - vaa c7. <br /> I 1 Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier I1 or RQ Facility) ANNUAL <br /> I I • Controlled Bum 1 Hood Installation <br /> I I Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> I I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale <br /> I . Fire Protection Maintenance - ANNUAL I Places of Assembly - ANNUAL <br /> =I ISemiiJ'Anil Other <br /> Sprinkler. U n V ❑. - I I Recreational Burn <br /> • Fire Alarm 1 I ❑ ❑ ❑ 1 I I I Sparklers <br /> Hood Cleaning I O ❑ ❑ 1 I I Sprinkler' System Installations <br /> - Hood Suppression I I ❑ 0 ❑ I I 1. I Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation Torch Roofing/Tar Kettle - - <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> • I Fire Works . <br /> I Flammable Application- ANNUAL I I Valuation of Project <br /> I Fuel Tanks <br /> Other: .Yr {e-1-e e CA • % i hS Or+ C1e_0.. ' ' - .auta('— ,rh <br /> E.,,, `"• .,,,,, cis j 6, . --, „,,....,: az', w v:� ',..”. , -2 4 a ;:.: ....� = .v s> '. ., .:. _`a.... r„ssa:: ie <br /> Contractor Company -. ( N K .vii( <br /> Signature Registered Y / Fee Current I. Y / N <br /> Address I License # I <br /> ELECTRICIAN - .; _ Company . <br /> Signature - Registered Y / N I Fee Current I Y / N - I <br /> Address 1 .. 1 License # . <br /> PLUMBER Company <br /> Signature Registered Y/ N LI Fee Current I Y /• N .I <br /> Address I - 1 License # . ' I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current Y / N - I <br /> Address I 1 License # I <br /> OTHER - Company . . <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I License # -1 <br /> Directions: <br /> FiII 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-J/appraiser.pascogov.com) <br />