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313 -0020 City of ZephyrhiltsTira; Fax -313- 780 -0021 <br /> Permit Application <br /> Date Received <br /> Phone Contact for Permit <br /> Owner's Name. S TivIPT,FX(zRTNNFJ,T, Owner's Phone Number 813 626 15 4 8 2 <br /> Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name - ; Titleholder Phone Number f <br /> Fee SimpleTitteholder Address . <br /> 5.. t � ,..�.- �":�= / _- x a..__ � r .- ....- _ -&� " i - �� 'r'._ 9.ii - ...:..�ti. ,. —.. «.y _.r � � �_s�.... �" <br /> Job Address "i lS 1ct(t 9tVA, • 2-€,P q 461iS L 33541 � 1�lii i 'I'S GO( Lot# 1 <br /> Sub Division Parcel # <br /> • Bio- Hazard Waste Storage - ANNUAL pi Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous grial (Tier If or RQ Facility) ANNUAL • <br /> I .. . Controlled Bum 1 Hood Installation <br /> I ? Emergency Generator < 30 kw ! LP /Natural Gas <br /> E Generator > 30-kw LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL I I Places of Assembly-ANNUAL .. <br /> Lip !Semit (Anti ether <br /> Sprinkler, NI • ' ❑ ❑, r Recreational Burn <br /> Fire Alarm I ❑ ❑ ❑- I1 : 1 ' Sparklers <br /> - Hood Cleaning 0 ❑ LI I I I Sprinkler System Installations <br /> . _._ . Hood Suppression. - . ) I ❑ . 0 _ .. I I .. ,. " I ..Standpipes (SprinklerSys) • <br /> Fire Alarm Installation p. " Torch Roofiig/Tai' Kettle <br /> Fire Pumps • • • 1 ----- 1 Waste Tire Storage ANNUAL <br /> ::1'.. I Fire Works • • <br /> I I <br /> Flammable Application- ANNUAL Valuation of Project <br /> ` Fuel Tanks <br /> I I Other: I • <br /> Contractor Company C - i {�lin, •ti 1( <br /> Signature Registered Y / N • Fee Current I• Y / N I • <br /> Address I I: License f I - <br /> ELECT . Company <br /> Signature Registered Y 1 N " ` I : Fee Current I Y/ N .. I r <br /> Address I" .. I License # " . - 1 . . <br /> •PLUMBER - . - - Company " .. <br /> Signature Registered Y./ N' I Fee I Y /. N; I: <br /> • Address I I License # I 1 <br /> MECHANICAL • Company <br /> Signature . Registered Y / N Fee Current Y / N <br /> . Address I; 1 License # I <br /> OTHER • Company • . . <br /> Signature - Registered Y / N Fee Current I Y / N _ .I <br /> Address <br /> License <br /> Directions: r"r <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 aver submittal date. Parcel #- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />