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Ob�J <br /> 813-780-0020 City ofZephyrhills'Fire <br /> l Fax-813-780-0021 <br /> Permit Application <br /> Date Received F. __ x -.� ,. n ctfor .. _..,. - ._.r..�.,.._ _,2.1 ., a. ,...._ <br /> - Phone Contact for Perms <br /> Owner's Name S TMPT,FXGRTNNET,L Owners Phone Number 813 ,, p 626 5 4 8 2 <br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610/ f L_ /ksv1-i ZeT tyrh IpS <br /> Fee Simple Titleholder Name - Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> -rn^�7'�z -. E . r ..,, - X,"" AIx xs ,:;�`� . _` • � - �ic�...� .Ew� �...3`� - '.��:.e' �.=''�4,..-x��'s:..,._ ....- �:..7� v ". <br /> Job Address -3; Tav -fix (4. !teef by h (( F 3 t Lot# <br /> Parce <br /> Sub Division ���� <br /> �,<_"�, :,Y.�� -� s— . - ,�.. �,.. °' = -cam <br /> I ' I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> I I Controlled Bum I Hood Installation <br /> I I Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> I .. 1 Emergency Generator> 30 kw 1 LP /Natural Gas - ANNUAL Sale <br /> 1 . I', Fire Protection Maintenance - ANNUAL I Places of Assembly-ANNUAL <br /> IQtrlyl'SemuI !Anl1 Uther <br /> Sprinkler. —� � �I1 ❑ ❑ ❑. I I Recreational Burn <br /> , Fire Alarm I 1. I ❑ ❑ "U 1 ' 1 I 1 Sparklers <br /> Hood Cleaning 1 0 ❑ ❑ 1 1 1 1 Sprinkler' System Installations <br /> Hood Suppression 1 ❑ ❑ ❑ I 1 1 I Standpipes (Sprinkler Sys) <br /> f I_ Fire Alarm Installation , r <br /> _ ...... .. .L .. I Torch Rbofing/TarKettle • <br /> Fire Pumps I - Waste Tire Storage ANNUAL <br /> Fire Works <br /> I . <br /> Flammable Application- ANNUAL 1 I Valuation of Project <br /> I' Fuel Tanks <br /> • ( Other: I <br /> Contractor ' Company 3 ( Yr'`'? ie• Kp.. -.'`t t( <br /> Signature Registered _ Y/ N 1 Fee Current L Y/ N <br /> / Address I. License # 1 . <br /> ELECTRICIAN <br /> Company > <br /> Signature - Registered Y / N 1 Fee Current I :Y / N 1, <br /> Address I I License # I <br /> Company . <br /> PLUMBER <br /> Signature Registered Y / N - 1 Fee Current 1 Y / N' 1 <br /> Address I I License # , I ' 1 <br /> MECHANICAL Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N j <br /> Address I, I License # I - OTHER Company - - <br /> Signature Registered Y/ N I Fee Current 1 Y / N <br /> Address License # <br /> icense <br /> - .-- ,.^� s�,�.�_ � ..,�. :._ .�,�,.. _.,. .,,.�.< . r =.w�.��:.._:�.�- ��:. =,.. :_sic - ate .�.y..: z-: x.. - ,� -- ..,,,.� .. .�,c,• <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 (http: / /appraiser.pascogov.com) <br />