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13 =r80 -0020 City of Zephyrhills "Fire; Fax- 813 -780 -0021
<br /> Permit Application
<br /> Date Received = :- Phone Contact for Permit l
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<br /> Owner's Name S TMPT,FXGRTNNELL Owners Phone Number . 813 626 1 5 4 8 2
<br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610 •
<br /> Fee Simple Titleholder Name ' Titleholder Phone Number
<br /> Fee SimpleTitleholderAddress I .
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<br /> Job Address !` 2 j' COUn 'r 1 ?—e 54 , , J' , `l % D 1e-- V i'e.t ' r2 g 7if Lot#
<br /> Sub Division Parcel #
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<br /> . 1 • I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent
<br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier If or RQ Facility) ANNUAL •
<br /> I • Controlled Bum I Hood Installation
<br /> I , Emergency Generator < 30 kw LP /Natural Gas - Installation
<br /> 1:;::. -Emergency Generator > 30 .kw 1 LP /Natural Gas - ANNUAL Sale
<br /> 1 I Fire Protection Maintenance : ANNUAL - • 1 Places of Assembly-ANNUAL .. IMI UM1 16erni + 1Anl( tither
<br /> Sprinkler, ID ❑ V- ! I Recreational Bum .
<br /> Fire Alarm . 1 1 ❑ ❑ ❑• 1. , (, I Sparklers • • •
<br /> Ho Cleaning l ❑ • ❑ ❑ I I 1 " I Sprinkler System Installations •
<br /> _ _. .. Hood.Suppression - - .I 1 ❑ ❑ ❑ f I .. I . Standpipes (Sprinkler Sys) .
<br /> Fire Alarm installation -- - ( Torch Roofing7Tar Kettle
<br /> I I ; Fire Pum • 1 Ti
<br /> I Waste Tire Storage ANNUAL -
<br /> p
<br /> Fire Works
<br /> I' ':.I. Flaminable Application- ANNUAL ` - Valuation of Project
<br /> - Tank.
<br /> I ' Fuel Tanks
<br /> [ Other. ► - d r W • • . ow o by 5 • ,. A.
<br /> dassEssmansistaxisemagessessum
<br /> Contractor Company ( I'"? Z�F 't 1( •
<br /> Si Registered Y / N J Fee Current 1• Y / N . 1 .
<br /> •
<br /> Address ��_.++: License #
<br /> ELECTRICIAN m `r ;r Com ., ,
<br /> Signature . '`x Registered Y /. 1 ,, Current J : Y / N ; ,:1 r
<br /> Address ` I License # 1 . .. • • ;.1
<br /> • PLUMB .._ Company
<br /> Signature Registered Y/ N 1 Fee Current. 1 Y 1. N • F.
<br /> Address 1 I License it . ' •
<br /> MECHANICAL • Company -
<br /> Signature . . Registered Y / N 1 Fee Current 1 Y / N _1
<br /> . Address I., .. I License #. I
<br /> OTHER Company . . .
<br /> Signature Registered Y/ N Fee Current 1 Y/ N_ J
<br /> Address License #
<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 (httpi/appraiser.pascogov.com)
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