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813-780-0020 . / City of ZephyrhiliS Fire. Fax -313- 780 -0021 <br /> Permit Application <br /> Date Received ,T� _ / -�.� h_ i_ � . <br /> ,.,:�_. am -c -,. M - roy.._, -.�- --_ .. s .= -`^ - Phone Contact x . s <br /> ontact for Perm <br /> Owner's Name STMPTIRXGRTNNELL Owners Phone Number 813 626 5 4 8 2 <br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610 . <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> c` r.— ../"3- ;L°�3R� --,. ss ` v -. ."? - �:i t\ -,..p s-. -- -iS -:- - ---.=._ ''�.. '-- ' .: -r' *...I. '` v .�- : --.- <br /> Job Address v 9 D $ 2 0 i\- lie `h\' '1 it\ 5 L, 33 5 `I - Lot # <br /> Sub Division Parcel # <br /> V . - . - Y - .: - .1 u ,: .. `;� .- .r ...5., 6 -. , , -- -" - .. - erg °_:u -.-s.,:. - . - *:...1.' ss -fir a.<s = ..3.: ; � .kts:V,� <br /> I Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct j / I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> . I Controlled Bum Z �2 I 1 Hood Installation <br /> Emergency < 30 kw / - r LP /Natural Gas- Installation `- `. <br /> L I <br /> Emergency Generator 30 kw ' 1 I LP /Natural Gas - ANNUALS 4 /1? <br /> I Fire Protection Maintenance - ANNUAL ' • I I Places of Assembly -ANNU L <br /> I(` 1SemiI lAnl I Other <br /> Sprinkler, u ❑ ❑. - J 1 Recreational Bum <br /> Fire Alarm 1 1 ❑ ❑ ❑• I. . I J 1 ' Sparklers <br /> ' Hood Cleaning 1 0 ❑ ❑ I 1 1 1 Sprinkler' System lnstallationS <br /> .; Hood Suppression I I 0 0 0 J I_ I I Standpipes (Sprinkler Sys) - - <br /> I I : Fire Alarm Installation 1 1 Torch Roofing/Ter Kettle <br /> ,_ I Fire Pumps • • I ( Waste Tire Storage ANNUAL <br /> I I . Fire Works • , ,:' <br /> Flammable Application- ANNUAL. Valuation of Project • <br /> I <br /> F uel Tanks <br /> - I I • Other . " • <br /> Contractor Company 3 �Y �` Ks.,-e, +-'-e. �-( <br /> �. <br /> Signature Registered Y / N Fee Current 1' Y / N I <br /> License # I ', • . <br /> ELECTRICIAN ' Company . : = . - <br /> Signature Registered Y/ N, I ..Fee Current I;: ¥ / N :: I i <br /> Address I I License # I 1 <br /> PLUMBER . Company <br /> Signature Registered Y / N '1 Fee Current I Y / N. 1: <br /> Address I . . • I License # . ' I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current Y/ N <br /> . Address I. ;.., I License # <br /> OTHER Company . <br /> Signature Registered Y / N Fee Current Y / N j <br /> Address License #- <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 /> - Supply two (2) sets of drawings with applicable documentation - <br /> Allow 10 -14 days for review after submittal date - Parcel #- obtained from Property Tax Noti aise ovcor <br /> Notice ( http: / /apprr.pascog.n) <br />