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a813 � - �O f 2 ao -ca2o City of Zephyrhills'Fire � Fex- 813- 780-0e21
<br /> Permit Application
<br /> Date Received � :, �_v._. :,...._.. ,.__ ,_ --- z ..,.. ..�_
<br /> Phone ContactforPermt
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<br /> Owner's Name S TMPT,FXGR TNNFT,T, 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 ' Titleholder Phone Number
<br /> Fee Simple Titleholder Address 1
<br /> Job Address 1‘41)e S a', Z- O& K-e ,( S75 I LaU (e MI IL) 9 , 33 _I 2- Lot 4
<br /> Sub Division Parcel #
<br /> m i awL .,�i.mr41.-;f-: :. e_-izi : ie, mm:4'.:. - `w: ti w.,•..� t i. ... .,>4-vz...• -,„,- ...._.R.. , ._ .. "-}t EveL..: - ,�,,, .:.' r � .w.- '5...: -„'k 7_,. :t.,,,, .... :'=.._.a .A.L
<br /> - I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
<br /> I Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier I1 or RQ Facility) ANNUAL
<br /> Controlled Burn I Hood Installation
<br /> 1 Emergency,Generator < 30 kw I LP /Natural Gas - Installation
<br /> i I Emergency Generator > 30 kw I LP/Natural Gas - ANNUAL Safe
<br /> I • I' Fire Protection Maintenance - ANN AL 1 1 Places of Assembly - ANNUAL . •
<br /> _ Mg Item( Mil MU
<br /> Sprinkler, n ❑ ❑ in I Recreational Bum
<br /> Fire Alarm ❑ ❑ 6 1 I , I I Sparklers
<br /> Hood Cleaning 0 ❑ ❑ 1 I - Sprinkler System Installations
<br /> Hood Suppression 1 0 t) P 1 1 1 I Standpipes (Sprinkler Sys);.
<br /> Fire Alarm ion Installat ` I 1 - Torch Roofing/Tar Kettle
<br /> Fire Pumps Waste Tire Storage ANNUAL
<br /> 1 1 Fire Works • .
<br /> 1 ,'' 1. Flammable Application- ANNUAL 1 Valuation of Project ,
<br /> Fuel Tanks
<br /> 1 1 Other 1
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<br /> Contractor � Company > ( 1.'" Ks.,,,,, e(
<br /> Signature Registered Y / N Fee Current 1• Y / N J
<br /> Address 1 ,:L. , • � .: . ' ... 1; 1 : .
<br /> License #
<br /> ELECTRICIAN Company .
<br /> Signature Registered , Y / N I Fee Curren 1 ° Y / N ,, •
<br /> Address 1 , .. . . .. 1 License # 1 I
<br /> PLUMBER ompany.. .
<br /> Signature Registered Y 1 N 1 Fee Current' 1 Y/14 -
<br /> Address 1 • . . 1 License # • 1 ' 1
<br /> MECHANICAL - Company
<br /> Signature . Registered Y / N 1 Fee Current Y / N j
<br /> . Address 1, 1 License # 1
<br /> OTHER - • Company -
<br /> Signature Registered Y/ N Fee Current Y / N 1
<br /> Address License # 1 1
<br /> Directions: -
<br /> Filf 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: / /appraiser.pascogov.cnm)
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