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813:780 -0020 City of ZephyrhiUsFir# Fax-813-780-002' <br /> Permit Application <br /> Date Received Phone Contact for Permit _ <br /> • Owners Name 1 S Tt�RT,F3 C;R TNN 1 Owner's Phone Number 1 813 1 626 1 .r 4 8 2 <br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610 . . <br /> Fee Simple Titleholder Name 1 ' 'Titleholder Phone Number i <br /> Fee SimploTitteholder Address 1 . . <br /> g?. �'''` . 7�. , ��h ►„� �� 35�'� : <br /> Job Address fi ate— Lot* <br /> Sub Division I 1 Parcel # I <br /> . fl Blo- Hezard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm E4 aust•Kitchen Hood/Duct n Hazardous Material (Tier if or RQ Facility) ANNUAL - <br /> n ., Controlled Bum n Hood Installation • <br /> FJnorgency nera <br /> Getor < 30 kw n LP/Natural Gas - Installation <br /> •: •Emergency Generator. 301 w n . LP /Natural Gas - ANNUAL Salo <br /> Fire Protection Maintenance - ANNUAL • Places ofAssembly- ANNUAL . <br /> + Lim em, 1i utner n <br /> Sprinkler, Ei 0 .0 0. f • n Recreational Bum <br /> '. Fire Alarm . . V O 0 0e L , n Sparklers , • , <br /> ' Hood n 0 ' 'ID ❑ I LJ SprinklerSystem Installations • <br /> ., : HMI Suppression. n O � • . d 1 o S tand i <br /> _ _ ... p pes ( Sprnkler Sys)_. <br /> � • . ® • Fr Alarm Iristaltation ... • : <br /> • . .. , ' - Toreti Rdo t ttldr _::•• -::•• _ <br /> •.. _ .. . . • • • <br /> . Ea <br /> Waste Tire Storage ANNUAL • <br /> A.; • :.. • • Fire Works • . . <br /> •ry Flammable Application- ANNUAL ( ,, Valuation of Project , <br /> . .. • iii I , Fuel t <br /> [2. ' Other. <br /> Contractor Signature Company / N • • C C ny �t>'"�Frvw' e <br /> g Registered Fee Current I • /N I <br /> Address • I' , . • . I: - Ucense # I_ <br /> ELECTRICIAN " "';•'. • ., • .. • Company . - . ,.. • a: ); , ... . , . <br /> Signature • • ' <br /> _r - •!...: • , re <br /> Registed , .5 :: Curr95rt, .., . :Y / . T , <br /> Address I . .. I License # l <br /> .PLUMBER • , : Company Signature - • Registered ¥/N j Fee Current'• I Y /. N;% f : ' - <br /> Addros$ I • <br /> I License # • • • I <br /> MECHANICAL _ Company - <br /> Signature f Registered , Y/ N 1 Fee Current I Y / N j <br /> . Address :,,, 1 License # I <br /> _ <br /> OTHER _ , - Company • <br /> Signature Registered Y / N 1 Fee Current 1 Y / N, .I <br /> Address Ucense # <br /> mom <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.(Mechantcal work over $5000) . <br /> Supply two (2) sets of drawings with applicable documentation ., - <br /> . .. Mori 10-14 days for review after submittal date_ Parcel #r:- obtainod from Property Tax Notice (httpJ /appral er pescogov.corn) <br /> . <br /> c • <br /> TOO �j • <br /> %H,d fO ST OTOZ /17Z /C0 <br />