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813-780-0020 City of ZephyrhiUs Fire; q3 Fax -813 -780 -0021 <br /> Permit Application / <br /> Date Received J e Contact Permit <br /> ,.- - Phon on act r <br /> Owner's Name S TMPLRX(R I NNELL Owner's Phone Number 1813 1 626 1 1 5 4 8 2 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name Titleholder Phone Number I I J 1 <br /> Fee Simple Titleholder Address I <br /> --.. <br /> Job Address ,1 g 2 So \\4 , zeNv`' ( ,i1S L 335y 1 Lot# J <br /> Sub Division Parcel # <br /> I Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier if or RQ Facility) ANNUAL <br /> I Controlled Bum Hood Installation <br /> I Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> I Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale <br /> I . Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> 1 JU !Semi trlyl !Se''Anil Other <br /> Sprinkler ❑ ❑ ❑ I Recreational Burn r- <br /> Fire Alarm r I/ ❑ ❑. I I I I Sparklers /�/ <br /> Hood Cleaning 1 ❑ ❑ ❑ I I I I Sprinkler System Installations <br /> / n f f- k 9 Z 3 g <br /> Hood Suppression I I ❑ ❑ ❑ I I . J Standpipes (Sprinkler Sys) / //` j� <br /> I Fire Alarm Installation • I Torch Roofing/Tar Kettle p [ /— F— f <br /> Fire Pumps I I Waste Tire Storage ANNUAL �,/ O <br /> I ' Fire Works �I`Y <br /> I Flammable Application - ANNUAL ( Valuation of Project <br /> I Fuel Tanks <br /> I Other: <br /> '8,r3:N8 k ,8,- .8'888-- R 1 ,,,','''Y ^:. <`'- ` ',', _ " 2n8' i11 - :. iE8—,. , -A,G =,A.:3 AAA d 3er, ,, _,,, - ',,,x,.: ■ 'dd"4 p _,'._3 _ i 3 1 Y <br /> Contractor Company err tr■v .,� 1( <br /> Registered Y / N } I Fee Current I \ Y ill <br /> Address I `� <br /> I License # - <br /> ELECTRICIAN <br /> Company <br /> Signature Registered Y/ N I ' Fee Current I Y / N . . <br /> Address I I License # <br /> PLUMBER I Company <br /> Signature Registered Y/ N - . I Fee Current I Y 1 N J <br /> Address I <br /> License # _ <br /> MECHANICAL I Company <br /> Signature Registered Y/ N j Fee Current I Y/ N 1 <br /> Address I I License # I I <br /> OTHER <br /> Company _ <br /> Signature Registered Y / N I Fee Current 1 Y/ N <br /> Address <br /> 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 daps for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />