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813 780 -780 City of Zephyrhills - Fire <br /> ` vOi Permit Application Fax- a137ao -0021 <br /> 7 <br /> Date Received L11;?"/12 - <br /> , �w ,- Phone for Permit r.F _ _ 1 <br /> T,FXGR INNELL 1 Owners Phone Number 1813 ` 626 115 4 8 2 <br /> Owner's Name 1 S TMP <br /> Owner's Address 1 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name I - f Titleholder Phone Number I 1 1 1 1 <br /> Fee Simple Titleholder Address I <br /> ra- --,1 ,1 .p_ : -,- ' - -- — - A: , -=--- t' <br /> moo. fr.- _.. x.4* -X' <br /> :'+��'e�' ---^' �^ ` 1 ' '_ __ }3`.3e u '' e nd�F�• `'�S�:— `..vr�i'��,� ate-° �v"�. <br /> Job Address 13 i8� filed Lc .1V So CI-- - ZeeMr h•,ti s 1' 53,54 1 1 Lot# I <br /> Sub Division I <br /> Parcel # <br /> -,-.,�,= . - , , z -2a :– - �> zb, - . , - -- .. - - -,,,-,- -4. --, 40- , ---- , 0- . - ,- .K- 0 . 5 " , :;.��.--. --,_ Wiz; <br /> I I Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> I I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier !for RQ Facility) ANNUAL <br /> I Controlled Bum Hood Installation <br /> 1 1 Emergency Generator < 30 kw LP /Natural Gas - Installation ' <br /> _ - I- I Emergency Generator > 30 kw LP /Natural Gas- ANNUAL Salk' /0 / 6/1 <br /> 3 <br /> I . I Fire Protection Maintenance - ANNUAL Places of Assembly- ANNU5ti. / <br /> IQtny''Semi) IAnl <br /> Sprinkler. ❑ ❑ ❑. 1Other 1 - I I Recreational Burn <br /> Fire Alarm ❑ ❑ <br /> 1 I I Sparklers <br /> Hood Cleaning I 1 ❑ ❑ ❑ I I I I Sprinkler System Installations <br /> • Hood Suppression I I ❑ ... 0 _ . ❑ 1 1 . I ! Standpipes s (Sprinkler <br /> Fire Alarm Installation <br /> Torch Roofing/Tar Kettle <br /> I I. Fire Pumps <br /> • Waste The Storage ANNUAL <br /> I 1 Fire Works <br /> 1 Flammable Application- ANNUAL <br /> 1 1 Valuation of Project <br /> I • I , Fuel Tanks <br /> L- I Other I <br /> "..:'"°kA. 4.-3 ,z ..m skate "r%` Y, bt 5 -F2 d: ..— o [2 A3 --i... ',1. : .otea ,,:' s'i5..,- 1- .1,..; ', <br /> . MaLtF `-- °':.° %C :- RR:§{.;tom... ;°K'4`it —s4`%.t.'t +... "s:3 t_'°P. ":'at4.#5ti <br /> Contractor i <br /> Company <br /> Signature <br /> 3 !Y� 3 L <br /> ered Y / N Fee .Current Y / N <br /> Address <br /> License # <br /> ELECTRICIAN Company <br /> Signature - �_ <br /> Registered < Y / N _I Fee Current I Y / N . <br /> Address I 1 .. 1, <br /> License # I <br /> PLUMBER I 1 <br /> Signature <br /> Re ` <br /> Company <br /> Registered I Y/ N ] Fee Current I ¥ / N I .- <br /> Address I I <br /> I License # . I <br /> MECHANICALI <br /> i • <br /> Signature <br /> Company <br /> Registered I Y/ N 1 Fee Current I Y/ N, <br /> Address I, <br /> I License # <br /> OTHER i <br /> Signature Company <br /> Registered Y/ N I Fee Current I Y/ N I <br /> Address <br /> License # <br /> Directions: - -� -L � <br /> Fill out application completely. <br /> - <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 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice htf //a <br /> ( p: ppraiser.pascogov.com) <br />