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4Ho <br /> I9 <br /> 813- 780-0020 City ofZephyrhAls'FI[rn Fax- 813 - 780-0021 . it <br /> Permit Application - :_ <br /> Date Received �- - - Phone Contact for Perm SWIM g 143,1 <br /> Owner's Name I j I, / dew J I Owne's Phase Number 1 5I ( 3 1 1 7 83 11 t /, f 1 <br /> Owner's Address I <br /> Fee Simple Titleholder Name 1 'Titleholder Phone Number I <br /> Fee simple Titleholder Address I <br /> Job Address 1 7107 64.// A /VA I lot i .: <br /> Sub Division ) I Parcel # J <br /> ED Bio-Hazard Waste Storage -ANNUAL 0 Fumigation rent <br /> E] • Comm E_xhaustietchen Hood/Duct ED Hazardous Material (Ilar Ii orRQ Facility) ANNUAL <br /> Controlled Bum 1E1 Hood Installation <br /> n Emergency Generator < 30 kw LPRJaturat Gas - installation <br /> Q Emergency Generator 30 kw El LP/Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL a Places of Assembly ANNUAL <br /> ®!b <br /> Sprinlder Li ❑ ❑ ❑ a Recreational Bum <br /> Fire Alarm Q 0 i ( ED Spenders <br /> Hood Cleaning <br /> Rel <br /> ❑ ❑ I IA4,ksI n SprinlderSystem installations <br /> Hood Suppression E Q ❑ ❑ f + 0 Standpipes (Spdrider Sys) <br /> El Fire Alarm installation DI Torch Roofing/Tar Kettle <br /> Fire Pum 0 Waste Tiro Storage ANNUAL <br /> Fire Works <br /> Flarrmable Application- ANNUA1 ! : J Valuation of Project <br /> Fuel Tanks <br /> 0 other. , j 1 <br /> Corrtracbor i nY ..I Signature Company 1 Y/ N Fee Cunent I Y/ N I • <br /> Address s . Are r. of 1)/ . �- License # } + i <br /> ELECTRICIAN 1 <br /> Signature - Registered Y / N . 1 Fee Current I Y / N j <br /> Addross 1 1 License # I j <br /> PLUMBER Company 1 <br /> signature ` Co Registered Y/N . 1 Fee Current I Y/N 1 <br /> Address I 1 Ucense # 1 <br /> MECHANICAL Company ( <br /> Signature Registered Y / N ! Fee Current I Y / N <br /> Address 1 I _ • License # I <br /> OTHER Company <br /> signature I Registered l Y/N I Fee Current I Y/N 1 <br /> Address License # <br /> Directions: <br /> Flit 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 le required.(Mechaniml work over $5000) <br /> Supply two (2) eats of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (htip:l/appraiser.pasc ogov com) <br />