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Jy /11J /LUUii U'll 1 :4= r.1V1 L.i'llfKti1LL 15U1L1J1IVlr /IRA 110. d1i r, UUL <br /> 813- 780 -0020 City of ZephyrhilIs Fir ,•:-::!" 49 Fax -813- 780.0021 . !Is 1 <br /> Permit Applicatbn . .; Gthri <br /> • <br /> Date Received '- -_ <br /> ,. ......, * / 7,5 - Z e:r Phorie Confect•for Permit 2 q �t . <br /> Owner's Name ' SW Q 'T Su mcc2 ) E t Owner's Phone Number . I . l 1 <br /> i _ <br /> Owners Address 732_5 G- I t 531 v C'.0 • ZC' ti (' Irrt ; 1 1 S .-R I • 33 $ - <br /> Fee Slmple7ltiehclder Name I 1 Titleholder Phone Number 1 11.....___I I I <br /> FeeSImple`lltiehoider•Addreea 1 <br /> f 73Z.5 Cc4111 �t3i <br /> Job Address ♦ `&) r / IS __ I . 3 3 I I Lot# 1 <br /> Sub 'Division ' Parcel # <br /> a 9to- Hazard Waste Storage -- ANNUAL Fumigation Tent <br /> R - Comm Exhaust tam HoodiDuct Hazardous Material (Tier 1I or RQ Facility) ANNUAL <br /> rJ <br /> L Controlled Bum- n Hood installation <br /> • J Emergency Generators 30 kw n LP/ nal Gas- bnatallatlon <br /> l=::1 Emergenry Generator > 30 kw r-- LP/Natural Gas - ANNUAL. Sale 1 N 7 A T 1 v& <br /> Fire Protect-on Maintenance - ANNUAL El Places of Assembly - ANNUAL a /e , ry I.1J 5 ei4 4" <br /> ' <br /> • _ j Jsem1I r , ,�r .a <br /> Sprinkler Li q&TY1 ( "� ❑ ❑ ❑ r El Recreational Sum S✓ n! Q 9Y trs/ 7/O 5 <br /> Fire Alan ® ❑ ❑ ❑ 1_,.1 . Q Shredders <br /> Hood Cleaning ❑ pi ❑ 1 I R prielder System Installations <br /> ( Hood Suppreeedon 1 ( d (3 ❑ I Standpdpes (Sprinkler Sys) <br /> • Fire Mamt Installation Q Torch Rooting/ Tar Kettle • <br /> Fire Pumps = Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL .r ' . , Valuation of Project <br /> R Fuel Tanks <br /> Other. I <br /> Contractor • company I <br /> Si e "I 4 • SC - Registered Y / N ( Fee Current I Y / N I <br /> Address 17 0 e - . • _, License _ ( , <br /> 1 - <br /> ELECTRICIAN GKI,CE4seNa, Ft 3 ?ha q . : 1 <br /> Company 1 <br /> . ' Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I I - .. ' License # I <br /> PLUMBER - company J <br /> Signature Registered Y 1 N J Fee Current I Y/ N I <br /> Address r I License # <br /> MECHANICAL Company I <br /> Si • Registered Y/ N I Fee Current I Y/ N I I <br /> �� . <br /> Address ! <br /> I 'License* I <br /> OTHER - Company <br /> Signature ..-_ Registered Mani . Fee Current Min <br /> Address I ............... 1 . Ucense# = <br /> bbectlons: <br /> RI' out application completely. <br /> Owner b Contractor sign back of application, notarized (Or, copy of signed contract with owner) • <br /> it aver $2800, a Notice of Cornmencearant Is requlred.(Mechanieal work over $5000) <br /> Supply two (2) seta of drawings with applicable documentation <br /> Alum 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http / /appraiaer.paeeogov.00rn) <br /> • <br /> / "?06 .,9cJy --- P s 7 . <br /> 4 /re /.F .Av cam/ / f—/ . 3 3 fs c <br /> / a2✓c e ,7`r11r���Sc.�/ ...._ .. _ —. _.. - - -- <br />