Laserfiche WebLink
813780 -0020 City of Zephyrhllls - Fire' Fax -813- 780 -0021 <br /> Permit Application <br /> `=ate i.e"eived Phone Contact for Permit <br /> Owners Name • S TMPLEXORINNELL Owners Phone Number 813 626 5 4 8 2 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 . <br /> Fee Simple Titleholder Name • Titleholder Phone Number <br /> Fee Simple Address . <br /> t ��'��,� - •r� ..F. _'��`."� $,rm1:.._,a.,atS..: -try . v,:: �"" �- '..�,.pew___�:,c..��'; . <br /> 2 .., �,.�...'�+''... : ��. a.. � ,a...,..4:�'s�....'-t � ,N`��.�..��'.�.. <br /> / � ,a' -�" <br /> Job Address L16 U It V.1. • i 1--a.01( h ;115 "t J' 9-( 1 Lot # <br /> Sub Division Parcel # <br /> ' -, .,., <br /> , : A -,� � . 1.1�"� ';::.a : - ^.;i5 .".' ° °� .. .._. " . _� -.w:« e .._,...,.:a t c .. ,mom =• I ti ° .. , <br /> I • Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhiaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I . Controlled Bum I Hood Installation <br /> I Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> - . 1 . 1 Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Safe <br /> I. Fire Protection Maintenance - ANNUAL ( Places of Assembly-ANNUAL <br /> " L Semi' IAnI1 Othe <br /> Sprinkler. a r ❑ ❑. - I ( Recreational Burn • <br /> Fire Alarm 1 I ❑ ❑ ❑ I • I, I I Sparklers <br /> Hood Cleaning 1 I D ❑ ❑ I ( 1 1 Sprinkler System Installations <br /> : Hood Suppression I I 0 ❑ 0 ( I I ( Standpipes (Sprinkler Sys), <br /> I I Fire Alarm Installation I I Torch Roofing/Tar� Kettle - <br /> Waste Tire Storage ANNUAL <br /> � l Fire Pumps I I_ Ti <br /> I Fire Works <br /> Flammable Application- ANNUAL 1 Valuation of Project <br /> I I` • • Fuel Tanks • <br /> .' I Other: <br /> ,,;.. .. - ,,,,s �, , ,:4tee.&, px • •gam .. <br /> ,- -._ €,...4,4.at, . , ..�..- <br /> Contractor _ Company 3 4 - 71 - - v - t( <br /> Signature / S . • Registered Y / N I Fee .Current I. Y / N I <br /> Address I 6 f . . License # ) • <br /> ELECTRICIAN - , - Company . .. <br /> Signature '. : Registered ' Y / N I Fee Current I . : Y / N I <br /> Address I . , 1 License # I <br /> PLUMBER . 4 Company <br /> Signature Registered Y / N ' I 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 I <br /> Address I 1 License # I <br /> OTHER - Company _ . <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address 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:/<appraiser.pascogov.com) <br /> • <br />