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813780_0020 City of Zephyrhiiis Fire, 4 107 50 Fax -313- 780 -0021 <br /> Permit Application <br /> Date Received ,:- <br /> eceiv d _ _ R y _.. <br /> _ _ _ _._-_ Kam: : rF: <br /> Phone Con�acttorPerni <br /> Owner's Name y 8 TMPT,FXGRT. NNFTJL 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 SimpleTitfeholderAddress <br /> _ z, .pr, 111 h r�l5 <br /> Job Address 733 �Ci K= ' Z011\401iIIS 3 1.- eci14-h (' Lot# <br /> Sub Division Parcel # <br /> sfrr- : - x: s,: .a . ::kc: e x .:-. _ w --.. _.. -°.,t. .: -_ ... . `. _ : "aca:.;, ' r ; :.•..,.a_:. _1( .'egge . -A.. :..:.:ac _s <br /> 1 Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> 1 . I Controlled Bum Hood Installation <br /> 1 1 Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> 1" 1 Emergency Generator> 30 -kw I LP /Natural Gas - ANNUAL Sale <br /> 1. - 1' Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> "sal ISemi11AnII Other <br /> Sprinkler, rrA i' ❑ ❑. I ( Recreational Bum <br /> Fire Alarm I ❑ ❑ ❑- [ , I I Sparklers <br /> • Hood Cleaning I 0 • ❑ ❑ 1 I Sprinkler System InstaflationS <br /> Hood Suppression I ❑ ❑ 0 1 I I I Standpipes (Sprinkler Sys); <br /> ['•::.:* 1'r Fire Alarm Installation ofinglTa <br /> Torch Ra r Kettle <br /> 1 • 1 Fire Pumps • 1 I . Waste Tire Storage ANNUAL <br /> ...- I Fire Works . <br /> Flammable Application- ANNUAL 1 .1 Valuation of Project , <br /> I ''' Fuel Tanks <br /> 1 1 Other <br /> : - _ :: Acti,:e,:,a,.'u; _2 we t" gm._` = • ".-- u"' r.W21 _" *^m _.4TECIM ` s' ., ..r: E = .,NAMIM <br /> Contractor Company -• 4 '1 Ks.-ii,-- t <br /> Signature / Registered Y / N Fee Current Y / N <br /> Address I _ :. I- : ... L - . ' I <br /> icense # <br /> ELECTRICIAN - Company ,. - . <br /> Signature _ Registered . Y / N I .Fee Current I . -� / N I :, <br /> Address I 1 License # I <br /> PLUMBER Company <br /> Signature Registered Y / N ' I Fee Current• I Y / N I: • <br /> - Address 1 • 1 License # , • . . 1 <br /> MECHANICAL • Company <br /> Signature - . Registered Y / N Fee Current I Y / N <br /> Address 1., .._. 1 License # I 1 - OTHER • - Company . - <br /> Signature Registered Y / N I Fee Current Y / N - . <br /> Address <br /> . Lic � es ��:_.� � -_,... = ���:� -.. •�<_:�.: , -!�: -.ate. <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: /fappraiser.pascogov.com) <br />