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. r_ :: r. ,r :'. _:a: _1 Aiv: t .rn TNil1LLJ hIIILL1INU , NO, tit j 7M F', r2:[ <br /> • 1 $ 02.2/ <br /> 813- 780 -0020 City ofZephyrhilis 'Flt''e : : t Fax - 813.780 <br /> . Permit Application <br /> Date Re.& • Phorie ContectiorPermit a�1 ) d . <br /> ^ <br /> :W;ncr'es Nary; . .l ' , Kt lam . - Own � phone Number , / � <br /> P <br /> •:rte'e Address _ ^ CjrC 5517 (0 (tom F ► 6) - r 2e )h rh (115 F� 3 <br /> • Fee 5.1nole l Itlehoider Name Titleholder Phone Number L._ <br /> Fee Simple Titleholder Address ( -- • <br /> Job Address K FC — 2 `'"'Ire ht '41, t) s _— Lot # <br /> 5ukr bivislc <br /> 1 Parcel # . 1 <br /> r, _ <br /> -ks.� aaata : . <br /> E-J Bio- Hazard Waste Storage -ANNUAL fJ Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct . Ej Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> • <br /> E . 7 Controlled Controlled Bum El Hood installation <br /> ET Pmergency Generator < 30 kw • .. .. = LP /Natural Gas - Installation <br /> [-] Ernergency Generator> 30 kw • • • . • El LP /Natural Gas- ANNUAL Sale . <br /> Fire Proteetlon Maintenance - ANNUAL • = • Places of Assembly- ANNUAL • <br /> ( C'. • t et <br /> e k tG1 Sprinkler O ❑ 0 Recreational Bum <br /> rl '12- Fire Alarm ., ❑ 0 ❑ l • 1 'Sparklers <br /> 3) (K J(D Hood Cleaning I1, ^ a 0 0 l Spr$nklerSystem installations • <br /> 5 - l p M Hood Supptesslon / A O 4 0 • E Standplpee (Sprinkler Sye) , <br /> y Fire Alarm Installation Torch Roo1iing/Ter Kettle <br /> • <br /> Fire Pumps Waste Tire Storage ANNUAL • <br /> • <br /> Fire Work; <br /> I t Flammable Application- ANNUAL , Valuation of project <br /> L Fuel Tanks <br /> r-7 <br /> {� J Other <br /> 'c rr acutr Company ..... : <br /> • <br /> Si pr,rltare Registered Y / N I Fee Current Y / N <br /> f,:. • �P0 .gDX - 737r 2 r � Y- 1 f� �3 VW lic en se.* ..r . 1 - <br /> .Ltr14:1CfArl( .. ' Company <br /> Sigewiv L _ Registered Y / N 1 Fee Current L Y / — N - 1 <br /> Address C I License #• 1 • 1 <br /> PLUMBER • • • Company V <br /> • ._:,gna'ilfd l Registered Fee Current 1 Y / N <br /> Address [ License # <br /> ` LCHANICAL Company ��. <br /> Signature J Registered Y / N TFee Current I r/ N j <br /> AdCross ��1 License # <br /> C1THF R Company <br /> ;incturc, � Registered - ,I . Lit N Fee Current 1 Y N 1 <br /> Adare55 "(I" # I <br /> Fill out application completely. <br /> Owner & Contractor sign back of application. notarized (Or, copy of signed contract with owner) <br /> If over 32s00, a Notice of Commencement le requlred.(Mechenlcai work over $6000) • <br /> Supply two (2) sets of drawings with applicable documentation . <br /> Allow 10 -14 days for review after submittal date. Parcel 0- obtained from Property Tax Notice (http: / /appralser.pascogov.com) <br /> • <br /> Hood <br /> Svc. <br /> P.O. 8 z 2 • F13 . <br /> P: 813-932-9100 F: $13-1133419118 . • • <br /> gate a t . <br />