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Z13-780-0020 City of Zephyrhilis'Fire. 1009 Fax - 813 -780 -0021 <br /> • <br /> Permit Application <br /> Date Received <br /> 1 <br /> 1 z <br /> - •- - .�;..:x, • .rte -..� u� - ��..e=- ��: �=N � , .._�C . ,�.Y.. P e s rm .. . �.__..._ _... . <br /> Contact for i <br /> Win- .� :,. - ,.� .�; ..•..,.. , w_.. :_ ..r ,.. ... <br /> Owner's Name STMPT,FXGRTNNELL Owners Phone Number 813 I 626 5482 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> ;�: =' u��•T"�"- - .-..,'4.��r'�� n - + � ' � - . -g . .. - A te" - ^1. , g` - 7 f � . : -�.. .., 'x � '�.- - - <br /> Job Address a q u s 0 �(�. ,� Ptv.e_ . L - -H''r in 1 t 't" L- 33� L 2- Lot # <br /> Sub Division Parcel # <br /> `"- , ' r.---:o-� •,, -- -... . a - , -.... .. r-» _:. . -., - -- ; «�:,,- - "r ,: , - --»� ^ ::-. >. r., •,:3 -1Wr.. sxc ,:., s: . 1 :. • : ,•. _ •° - - .0::.X <br /> I ' 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 . I Controlled Bum Hood Installation <br /> I I Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> . • I. I Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale <br /> I I' Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> . I Lady' !Semi( IAN Other <br /> Sprinkler I VII ❑ ❑ I I Recreational Bum <br /> Fire Alarm 1 ❑ ❑ ❑- I I I I Sparklers <br /> Hood Cleaning I 0 ❑ ❑ I I I Sprinkler System Installations <br /> Hood Suppression ... I 0 ❑ 0 I I I J Standpipes (Sprinkler Sys) <br /> I .. Fire Alarm Installation I Torch Roofing/Tar <br /> I • I Fire Pumps • Waste Tire Storage ANNUAL <br /> I I Fire Works ' <br /> Flammable Application- ANNUAL , Valuation of Project <br /> II i <br /> I' ' Fuel Tanks • <br /> I..> ) Other. I 9 - , AVA .e - (- ‘ 1 7(n•C,VL 10W <br /> Contractor Company - Ct "' K1S rw -a t( <br /> Signature Registered Y/ N J Fee Current I' Y / N I <br /> Address ,. : .. / .. •. I License # ' <br /> I - <br /> ELECTRICIAN :., , C ompany . . . <br /> Signature Registered Y / N Fee Current Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company '` <br /> Signature Registered Y/ N' I Fee Current' I Y/ N I <br /> Address I I License # . • 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 I Fee Current I Y/ N I <br /> P - <br /> Address I License # I <br /> .�_ _�,., ... _ _:- . _« - - -_ . .=. fi= r , -r =: r - _ „• f. ...� <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 /> • <br /> - Supply two (2) sets of drawings with applicable documentation - <br /> _ Allow 1044.. days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br /> • <br />