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813780-e020 City of Zephyrhills`Fire. <br /> ft/05 Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received -# _ � -- ;max _ Contact for Permit j N <br /> - Phone it <br /> � �6 2 �,�.,. <br /> j Owners Phone Number 813 626 5482 <br /> Owner's Name STMPLEXCRZNNELL 11/ IciAJ c..\ pfm,✓tk +ryl - <br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610 - <br /> • Titleholder Phone Number <br /> Fee Simple Name L Fee Simple Titleholder Address I - _ _ - _ <br /> _, - . <br /> Job Address <br /> 1?7 K 0- D'a- . Z--(7,9v1 -16/ 1115 L "S35`42- Lot# <br /> Sub Division Parcel # <br /> 1 1 Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> 1 1 Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Burn I Hood Installation <br /> I l Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> 1 1 Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL Places of Assembly ANNUAL .. <br /> _ lutrIyl'Semi' 'Anil ' <br /> Sprinkler. I I ❑ ❑ ❑.. ` f • 1 (- Recreational Burn <br /> - Fire Alarm ❑ ❑ 6 , 1 1 I Sparklers . • <br /> Hood Cleaning 1 1 ❑ ' ❑ ❑ I I 1 I Sprinkler' System InstaUatioris <br /> Hood Suppression. 1 ❑ 0 0 Standpipes (Sprinkler Sys) . <br /> finglTar Ke ettl - <br /> (i Fire Alarm Installation pp r Torch Roo . -.. _ . - <br /> Fire Pumps • • Waste Tire Storage ANNUAL . <br /> 1 ' Fire . <br /> Fire Works UAL <br /> I Valuation f Project <br /> .. _ , � � Flammable Application- ANN / • ... .... -... , , , .. .. . <br /> Fuel Tanks <br /> I Other I <br /> S ... ...,w. i.,.Lti'r L: �.�'.'.s+1tv,+",r'�:� "?a5..:v _'- �"r "d:�'£''"'aG'.xYi's�. _:�"�.r.�k'n- �c3�.:�.•:]� i - _t�'+'..X ,'e•. t;: :^e::. 1� 3':+35 .l,;w'h+._'_ 't-��^ - ,�k'tn ,:;s_k�? �.a�'ei'ti'FLK{'b: <br /> Contractor Company c K1•^iv^"t- t-+( <br /> Signature Yr`'/A � Registered Y/ NI I Fee Current I. Y/ N 1 <br /> Address I . . , . , . ::, - <br /> License # <br /> ELECTRt IA - <br /> Signature :' ' : Registered . i Y / Nt I • Fee Current I Y / N:. I Y <br /> Address 1 , . 1 License # . , . ' 1 <br /> PLUMBER . , Company .. <br /> Signature - ' Registered L Y / NI I Fee Cun I Y / N' <br /> Address' . I License* • I - 1 <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> - Address I, :;.: . .. - ( License # I ( <br /> OTHER - Company . • <br /> Signature - Registered Y / N I Fee Current I Y / N • .I <br /> Address License # I <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 .(Mechanieal 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 (http.J /appraiser.pascogov.com) <br />