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'013-780-0020 City ofZephyrhillsFire: Fax - 813 -780 -0021
<br /> Permit Application
<br /> Date Received Phone Contact for Permit
<br /> Owner's Name S TMPT,FXGR TNNET,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 . . . -
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<br /> Job Address Sq Qa �L e2 )5 1, 1 _S easF- Vlfq��l e. YV a f'G1� Lot#
<br /> Sub Division Parcel #
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<br /> Bio- Hazard Waste Storage - ANNUAL ) Fumigation Tent
<br /> Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier If or RQ Facility) ANNUAL •
<br /> I. I • Controlled Bum I Hood installation
<br /> I ` Emergency Generator < 30 kw i LP /Natural Gas - Installation
<br /> •Emergency Generator > 30 -kw LP /Natural Gas - ANNUAL Sale
<br /> Fire Protection Maintenance - ANNUAL .. , . • I Places of Assembly-ANNUAL ..
<br /> 'Carly! ISemillAril ' ' Uther
<br /> Sprinkler, i 1 ❑ •. ❑ ❑. I I Recreational Bum
<br /> Fire Alarm • ' - iI ❑ ❑ L - -1 1 Sparklers _ •
<br /> • • Hood Cleaning • I I ❑ ❑ ❑ I I ” Sprinkler" System Installations
<br /> Hood Suppression: - . 1 ❑ O . - -O .
<br /> t Standpipes ( Spnnkler Sy
<br /> I I' • Fire Alarm Installation , •'. -.. -- - - -- I Torch Rooffng/Tar Kettle s)
<br /> I r I Fire Pumps I • • .Waste Tire Storage ANNUAL - .
<br /> • I Fire Works , . • - -
<br /> Y ,':.I• Flammable Application- ANNUAL .I Valuati of Project
<br /> cr Fuel Tanks
<br /> : ' L .... �. .Other: .) •
<br /> Contractor / Company �f� E F c, ' 1(
<br /> -7
<br /> Signature f 3 `' Registered Y / N I Fee Current I' Y / N - I •
<br /> Address i : .. License # -
<br /> r • ELECT . ` .: • • • • Company r -3.: a - , •
<br /> Signature L - . , • _ • Registered Y [Nit I ;,,Fee• Current 1-..-- . • Y / N I r • Address I I License # I ..
<br /> PLUMBER . Company ;� r
<br /> Signature Registered Y / N j Fee Current, I Y / N' I. •
<br /> Address I i License # , - • _
<br /> MECHANICAL • Company -
<br /> Signature _ Registered Y / N I Fee Current I Y / N I
<br /> . Address
<br /> I- ;., i License* I
<br /> OTHER Company . .
<br /> Signature I • Registered Y/ N 1 Fee Current I Y / N, J
<br /> •
<br /> Address License # _ I J
<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_(Mechanieai work over $5000) . -
<br /> - • Supply two (2) sets of drawings with applicable documentation ' -
<br /> A1fow 10-14 days for review after submittal date. Panel #- obtained from Property Tax Notice (httpf /appraiser.pascogov.com)
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