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00 � <br /> 813780 -0020 City ofZephyrhills - Fire (�? II Fax - 813780 -0021 <br /> p <br /> Permit Application 1 ,� (� J, ^ tr K <br /> Date Received Phone Contact fcr Permit l• I <br /> "F ...-'. :s-^ - .�.•:_a :.:. -:- -- �_ . : -:. . �- _ ..: ,. ^= �."':a�"'.+n' '_ '"'..nom -t..�. ''"a"'"':�'^""_,, «.�....,,s :z +.:ems . _.. _ �F..F.,.� ;.x .., ;s u .=•s+ : <br /> Owners Name STMPLFXORINNELL Owners Phone Number 813 626 5482 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name - Titleholder Phone Number <br /> Fee Simple Address <br /> Job Address — 76 50 el,Q,1J .-- O j V - p 1 tkt5 ' , 1 -2 D3 5c1 J Lot# <br /> Sub Division Parcel # <br /> T <br /> I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum r Hood Installation <br /> I Emergency Generator < 30 kw I LP /Natural Gas - Installation q )/) % <br /> I Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale 9 (� U Fire Protection Maintenance - NUAL I Places of Assembly- ANNUAL <br /> IL2trlyl 'Semil IAN 1 Other <br /> Sprinkler V ❑ ❑ - 1 1 Recreational Bum <br /> Fire Alarm 1 1 ❑ ❑ ❑ 1 1 1 1 Sparklers <br /> Hood Cleaning I 1 ❑ ❑ ❑ I I I ( Sprinkler System Installations <br /> Hood Suppression I I ❑ ❑ ❑ I 1 1 J Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> ' I Fire Pumps I ( Waste Tire Storage ANNUAL <br /> II Fire Works <br /> Flammable Application- ANNUAL <br /> 1 j Valuation of Project <br /> iI Fuel Tanks <br /> I Other: .I <br /> Contractor Company 3 ( Y �^' � �nr�t C( <br /> Signature Registered Y / N Fee Current I• Y / N I <br /> Address I ; I License # • I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N _ _I Fee Current I . Y / N I <br /> Address I I License # <br /> PLUMBER Company . <br /> Signature Registered Y / N '1 Fee Current I Y / Ni '' I <br /> Address I I License # . I • I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> OTHER Company . <br /> Signature Registered Y/ N J Fee Current I Y/ N 1 <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 />