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3137,9C:0020 City of Zephyrhills - Fire , ( Ct 11 Fax -3 730 -0021
<br /> Permit Application 4.,
<br /> Date Received , : - r Phone Con, for Permit
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<br /> Owner's Name I S TMPT,FXGR T NNFJ,L Owner's Phone Number 813 626 5 4 8 2
<br /> Owner's Address 4701 Oak Fair Blvd TAMPA FL 33610
<br /> Fee Simple Titleholder Name 1 - ' Titleholder Phone Number
<br /> Fee Simple Titleholder Address .
<br /> Job Address - -i•- � `>Pl 1 7--( hATk•.111i — 7J9 Ta ,i`( T---,- 335 fo Lot
<br /> Sub Division Parcel #
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<br /> • Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent
<br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Ter If or RQ Facility) ANNUAL
<br /> Controlled Bum I Hood installation
<br /> I Emergency . Generator < 30 kw n LP /Natural Gas - Installation
<br /> _ - I Emergency Generator > 30 kw ' I I LP /Natural Gas - ANNUAL Sale
<br /> I. Fire Protection Maintenance - ANNUA • - - I I Places of Assembly ANNUAL
<br /> +Qtrly ISemiI IAnII pa=
<br /> Sprinkler. ❑ ❑ ❑. • I 1 Recreational Bum
<br /> Fire Alarm I VI ❑ ❑ r • , I 1 Sparklers ,
<br /> Hood Cleaning 1 ❑ ❑ ❑ I I I Sprinkler System Installations
<br /> _. . , , Hood - Suppression _ I ❑ ❑ p I7 I I Standpipes (Sprinkler Sys):..
<br /> I I• Fire Alarm Installation 1
<br /> 1 Torch Roofing/Tar Kettle -
<br /> Fire Pumps Waste Tire Storage ANNUAL
<br /> I , .. - I Fire Works , .
<br /> fl I• Flammable Application- ANNUAL f Valuation of Project
<br /> Fuel Tanks
<br /> I..,. ( ..Other: . I
<br /> ,7-ar -
<br /> Contractor / Company 3 CHti . C (�Firn i C(
<br /> Signature Registered Y / N Fee urrent Y/ N I
<br /> • Address I ._ . . , `S
<br /> (: License # I
<br /> ELECTRICIAN
<br /> Signature -' '- , Registered Y / N I ' Fee Current I . r:Y / N
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<br /> Address I , - . .. License # I I
<br /> PLUMBER _ Company <,
<br /> Signature _ Registered Y / N I Fee Current Y / Ili -
<br /> Address I License # • I ' I
<br /> MECHANICAL Company
<br /> Signature - Registered Y / N I Fee Current Y / N 1
<br /> . Address J ... • I License # I
<br /> OTHER - Company . - .
<br /> Signature Registered Y / N I Fee Current Y / N
<br /> Address j (
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<br /> License #
<br /> ae W_ > -:-
<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 4- obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
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