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813780 -0020 City ofZephyrhills - Fire. Fax- 813 -780 -0021 <br /> /� t Permit Application Phone Received �u e CO Permit <br /> y <br /> .__. �� ::,�•- — .3 - _ v.... --' <br /> Contact for P erm <br /> Owner's Name STMPT,FXGRTNNELL Owner's Phone Number 813 1 626 5 4 8 2 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name - ' Titleholder Phone Number <br /> Fee SimpleTrtfeholderAddress I • <br /> pnn � <br /> Job Address S . g.:6 `Dctv3ri vot �� . Zeehirk1�IS TL 3 -±5 Lot# <br /> Sub Division Parcel # <br /> mow. <br /> te = . ..� . ; a== : .;s - - -z- �..... --tt v�.m - :— . =5,,:: %--, ' P - -- —' ,a - s: �- - a'c -,,,,,,a,e r ..s.. <br /> 1 • I :. <br /> Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> Comm Exhaust Hood /Duct I �l/� <br /> S Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> I. Controlled Bum (7 1/ IJ 1* / , I Hood Installation / i •) <br /> Emergency < 30 kw 7 I LP /Natural Gas - Installation / 0 il 6 V <br /> E Generator > 30 kw I • LP /Natural Gas - ANNUAL Safe i <br /> I`. ( mergency <br /> 4 <br /> I " I' Fire Protection Maintenance - AnNUAL I Places of Assembly-ANNUAL <br /> IQ trly 'Semi IAni Other <br /> Sprinkler, ��f I I ❑ ❑. l ( Recreational Bum <br /> Fire Alarm I 1 ❑ ❑ ❑• 1 ' 1 1 I . Sparklers <br /> Hood Cleaning 1 ! El ❑ ❑ I I l I Sprinkler' System Installations <br /> Hood Suppression. I l CI ❑ ❑ ) I ._ I ( Standpipes (Sprinkler Sys);. <br /> t t <br /> I I Fire Alarm Installation L Torch Roofing/Tar Kettle • <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> I Fire Works ,, <br /> I. Flammable Application- ANNUAL <br /> / Valuation of Project . <br /> Fuel Tanks • <br /> I I Other . . <br /> • <br /> F' ? <br /> Contractor � _ Company iKr.nv.t, t.( <br /> Signature Registered Y / N 1 Fee Current I• Y /'N _I ' <br /> Address I .. I License # ..I • L <br /> ELECTRICIAN , Company . . . , > , <br /> Signature :"f' - Registered Y 1 N I Fee Current I , / N'. I i . <br /> Address 1 I License # . . <br /> PLUMBER :. Company ' <br /> Signature Registered Y1 N ' Fee Current I Y / N <br /> Address I . . • I License # • I <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current I Y/ N <br /> Address I; . : -. I License # I <br /> OTHER • Company - <br /> Signature Registered L Y/ N I Fee Current I Y/ Ni I <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 Notice (httpJ /appraiser.pascogov.com) <br />