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813780 -0020 City of Zephyrhills`Fire. /0 ( Fax- 813 -780 -0021 <br /> Permit Application <br /> Date Received <br /> Phone Contact for Permit <br /> Owner's Name , S TMPLFXGR T NNELL Owners Phone Number 813 6 2 6 5482 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 . <br /> Fee Simple . Titleholder Name • Titleholder Phone Number <br /> Fee SimpleTitleholder Address <br /> 1�.Aa £ - s , - ' %' aW"" E. —_ - - :: ' °: _x -a .O,.— . " . ��za-�°" a e w- ''s�°" " x <br /> Job Address <br /> COt R Sw.e.eti 2eR,'\(h CA. 33 5(42 Lot# <br /> Sub Division Parcel <br /> .mss. - -. .. - ". u , , - . v ,,,, ,. .k:_ . ... r.. �-a°� .: , . _ <br /> 1 •1 Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> 1 Comm Exhaust Kitchen Hood /Duct 1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 1 . 1 Controlled Burn I Hood Installation <br /> 1 Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> - • 1 1 'Emergency Generator > 30 kw 1 LP /Natural Gas - ANNUAL Sale <br /> 1 1' Fire Protection Maintenance - A NUAL 1 Places of Assembly - ANNUAL <br /> Utrlyl'Semil Ani =igm <br /> Sprinkler ❑ ❑ )1. I I Recreational Burn <br /> , Fire Alarm I 1 ❑ ❑ ❑ 1 1 1 ( Sparklers <br /> Hood Cleaning , ❑ ❑ ❑ I , , I Sprinkler' System Installations <br /> • Hood Suppression , ❑ . _ I _ , . ,17 I 1 -_ 1 1 Standpipes (Sprinkler Sys) <br /> 1 Fire Alarm Installation I 1 Torch Roofing/Tar Kettle <br /> 1 Fire Pumps 1 • 1 _ Waste Tire Storage ANNUAL <br /> 1 1 Fire Works ‘" <br /> Flammable Application- ANNUAL I Valuation of Project <br /> 1 : 1' Fuel Tanks • <br /> 1 1 . Other 1 rijct,c t - sl ov...) • <br /> Contractor o r Company D CYi"'/ Kfi+w,.LC <br /> Signature Registered _ Y / N Fee Current • Y / N <br /> Address . License # ( . <br /> -• <br /> ELECTRICIAN Company . <br /> Signature Registered Y / N I Fee Current 1. . Y / N I,. <br /> Address 1 .. . . 1 License # ( 1 <br /> PLUMBER Company <br /> Signature Registered Y / N 1 Fee Current 1 Y 1. N i <br /> Address 1 1 License # . 1 ' <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y/ N, <br /> . Address 1, , 1 License # 1 <br /> OTHER • Company • <br /> Signature Registered Y / N I Fee Current 1 Y / NI <br /> Address 1 License # <br /> Directions: <br /> Fill out application compfetely. - <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 /> • <br />