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' 813- 780 -1J02D City ofZephyrh ills Rea . •r / q q Fax - 813 - 780-0021 .I, <br /> Permit Application � 1 � 'flaei es £ 4 J E,ei •r_I f <br /> Data Received 5 � – Phone Contact for Permit .80.- Z y 2 /f 8'r . <br /> _ <br /> p _ . <br /> Owner's Name f pI EF% 8AV # 7S i / 2 Owner's Phone Number 1 e 1 ( 780 /0 It I <br /> Owner's Address 1 7 5 , 6 COPi,k, 5/..LQ <br /> Fee Simple Titleholder Name J Titleholder Phone Number , , I 1 <br /> Fee Simple Titleholder Address <br /> eleINIMPASIIIIIPF '' <br /> Job Address I 7325 6 AL L BL VD _ 1 Lot# <br /> • <br /> Sub Division , _ 1 Parcel # <br /> ❑ Bio- Hazard Waste Storage – ANNUAL n Fumigation Tent <br /> • Comm Exhaust Kitchen Hood/Duct = Hazardous Material (Tier!! orRL2 Facility) ANNUAL. <br /> El Controlled Bum n Hood Installation <br /> ❑ Emergency Generator < 30 kw n LP/Naturat Gas - Installation <br /> n Emergency Generator> 30 kw ED LP/Natural Gas - ANNUAL Sale <br /> Q Fire Protection Maintenance - ANNUAL - n Places of Assembly- ANNUAL <br /> Can] I ®4 / •L <br /> Sprinkler El ❑ ❑ n Recreational Bum �C"/ �li�C <br /> Fire Alarm D ❑ ❑ • 0 ( ii' .----- 0 getfo.! /d .5? f k i <br /> Hood cleaning ❑ 0 0 ❑ ( El SprinlderSystem installations / r <br /> Hood Suppression El ❑ ❑ ( 0 Stardplpes (Sprirtder Sys) insrd ( sw�r .8 r * 2 <br /> El <br /> Are Alarm instailatIon jJ Torch Rooflngfrer Kettle <br /> Fire Pumps n Waste Tiro Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ! I Valuation of Project <br /> Fuel Tanks <br /> E3 Other I <br /> M ) `''' Company ?v r F -wf' -I • Signature 1 /� Registered Y/ N Fee Current f Y/ N <br /> Address 1 Cal$ 5 ?8," $.e .0 r,/4 F< Awry I. Licen ) 1 <br /> ELECTRICIAN Company i <br /> Signature - Registered Y/N j Fee Current I Y/N I <br /> Address 1 J License # J I <br /> PLUMBER 1 Company I <br /> Signature Registered Y/N J Fee Current 1 Y/N j <br /> Address 1 License* 1 <br /> MECHANICAL Company J <br /> Signature Registered Y/ N 1 Fee Current YIN <br /> Address L , . Lloenae # 1 . <br /> OTHER Company NI W„,4-1,\ ( <br /> Signature Registered Y / N i Foe • ..,,. it N <br /> Address License # <br /> Directions: flu out application completely. con Q , " - / � j <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed tract with 'S � ' " <br /> If over $2500, a Notice of Commencement is req./red ./red.(Mechanieal wark over $5000) ,� f: <br /> Supply two (2) seta of drawings with applicable documentation . 4� • / <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained T ' .. ce • :,.0 .:.. - ,pasoogov.coin) <br /> VS C <br /> - fife p6R•✓ 4r 370 ref — in 094eM E•ir Acria7 irr AieE rh Aes Ntr4. <br /> – f>•nE Lier.JsE Ji TZ?eNEv • <br /> ?OD, Pt f 4; f5r 'mowii(b <br />