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813 -X0 -0020 City ofZephyrhills "Fire, Fax -313- 780 -0021 <br /> Permit Application <br /> Date Received -- r �z,. w E � - .`_..._. ,_ w _ .�...�..k .,-, -.. <br /> Phone Contact for Penns <br /> Owner's Name STMPLEXGRTNNELL Owners 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 SimpleTitleholderAddress <br /> Job Address --" 750 \V "vkl(ki (2-A„ - 0h1(hlliS cL 535 ( 40 Lot # <br /> Sub Division roe # <br /> $ <br /> w�> w" �:',- �. �.:.'; �� vu "�..:..::�F- ,�^�"'.z:....•;,,. .. _ ..... -.`. .,�"°° a <br /> Pa te �' -�: s „ak-r 'wr- .^-:s'. —;'•,- v <br /> I -1 Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I. Controlled Bum I Hood Installation <br /> 1 1 Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> _ , I I Emergency Generator > 30 -kw I LP /Natural Gas - ANNUAL Sale <br /> I . (' . Fire Protection Maintenance - ANNUAL • Places of Assembly - ANNUAL <br /> L 'Semi) (Anti tither <br /> Sprinkler. IIN e ❑ ❑ I I Recreational Bum <br /> . Fire Alarm ( ❑ ❑ 0- ( 1 , 1 I Sparklers <br /> Hoed Cleaning ❑ ❑ ❑ I I ( Sprinkler' System installations <br /> . . Hood Suppression l ❑ ❑ ❑ f I 1 I Standpipes (Sprinkler Sys) <br /> I L Fire Alarm Installation <br /> ( Torch Roofing/Tar Kettle ' <br /> I Fire Pumps I • (. Waste Tire Storage ANNUAL <br /> ( I Fire Works • <br /> Flammable Application- ANNUAL 1 I Valuation of Project <br /> l' . Fuel Tanks • <br /> . <br /> • ( Other I <br /> v. - <,,.m rX� „. ^,,,,...,""4' � � s.. M � �. ° �ri. � -'�. s�_ - _ -� � -= ^��,:� as...__ st _ =ts „Z”' <br /> Contractor Company 3 rYri c."1. ---. C ( <br /> Si nature a Registered Y/ N Fee Current L Y/ N I <br /> 9 — <br /> Address I . 6 f . License # ( - - - <br /> ELECTRICIAN <br /> .;. Company <br /> Signature - Registered - Y / N I Fee Current ( Y / N ;; I <br /> Address I 1 License # <br /> PLUMBER Company <br /> Signature Registered Y / N ' 1 Fee Current I Y/ N: I <br /> Address I . • I License # . ( • I <br /> MECHANICAL Company <br /> Signature Registered — Y / N 1 Fee Current Y / N <br /> . Address . .. • . I License # I <br /> OTHER Company - - <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I License # <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: /lappraiser.pascogov.com) <br />