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813 - 780-0020 City of ZephyrhIllslRre 1 '7v Fax - 813- 780-0021 <br /> Permit Application <br /> Date Received 1 - Phone contact for Permit . 1 ! I 1 l <br /> Owners Name I Sb U A \ , \ 1 O w n e r ' s Phone Number 1M1 I — 1% - 2.1 I ! - v z 0 I <br /> Owners Address 1 6 \o l0.■\ \..otQ 7'& &i , I <br /> Fee Simple Titleholder Name I I <br /> Phone I 1 1 1 1 <br /> Fee Simple Titleholder Address 1 I <br /> I <br /> 1 <br /> Job Address f <br /> I Lot# <br /> Sub Division 1 1 Parcel # I <br /> n Bio-Hazard Waste Storage - ANNUAL 1 Fumigation Tent <br /> Q Comm Exhaust Kitchen Hood/Duct r--1 Hazardous Material (Tier II or RQ Fealty) ANNUAL <br /> r Controlled Bum . Hood Installation <br /> r] Emergency Gener - <br /> Generator < 30 kw LP/Natural Gas- Installation <br /> Emergency Generator > 30 kw LP/Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL r1 Places of Assembly - ANNUAL <br /> H <br /> Sprinkler LI ❑ ❑ ❑ Prier r Recreational Bum <br /> Fire Alarm CI ❑ ❑ ❑ I I a Sparklers <br /> Hood Cleaning <br /> [I . ❑ I ( 1 Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ 1 I n Standpipes (Spdnlder Sys) <br /> Fire Alarm Installation a Torch Roofirgfrar Kettle <br /> Are Pumps 1 Waste Tire Storage ANNUAL <br /> Are Works <br /> Flammable Application- ANNUAL ' I Valuation of Project <br /> Fuel Tanks <br /> Qer <br /> CoNracbor 411111t OA <br /> Signature • -.4.4- _ ► a. r:� .► Registered' Y / N I Fee Current I Y / N j <br /> Address n t. 'r,. i. _ i # . I I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Cunard I YIN I <br /> Address 1 1 Lcense # I <br /> PLUMBER Company <br /> Signature I Registered Y/ N Fee Current I Y/ N I <br /> Address 1 Ucense # 1 I <br /> MECHANICAL Company <br /> Signature I Registered Y/ N I Fee Current I Y/ N j <br /> Address I 1 License # I 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.(Mechanlcal 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 (httpJ /appraiser.pascogov.com) <br />