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<br /> 813-780-0020 City of Zephyrhills FirE_<„, 1 ( Fa-x-813-780-0021
<br /> Permit Application
<br /> Date Received :•- Phone Contact for Permit j. l
<br /> Owner's Name S 1-MPT,F,XGRTNNFLTiri Owner's Phone Number 813 1 626 115482
<br /> Owner's Mdress 4701. Oak Fair Blvd TAMPA FL 33610
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<br /> Fee Simple:Titleholder Name - ' Titleholder Phone Number - .
<br /> Fee SimpleTitteholder Address 1
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<br /> Job Address / 54.) -- Do.‘r\I 2 --1 2--P,P■ ct- S.73 146t4-4, ba6 Lb t#
<br /> Sub Division Parcel #
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<br /> Bio-Hazard Waste Storage - ANNUAL I Fumigation Tent
<br /> Comm Exhaust Kitchen Hood/Duct 1 Hazardous al flier If or RQ Faciiity) ANNUAL •
<br /> . • Controlled Bum I Hood Installation
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<br /> Emergency Generator < 30 kw 1 i LP/Natural Gas ,-Installation
<br /> . ..., . ••„. . Ernergency Generator > 30 kw LP/Natural Gas-ANNUAL Sale
<br /> .:'-•:: - . ' ' Fire Protection Maintenance - ANNUAL . . 1 Places of Assembly-ANNUAL .
<br /> Ruin MEI lAn1 I Other
<br /> rig f , •
<br /> .., ; ,„. • . , 1 . , , Sprinkler , I: 0 0 ' 1 I Recreational Bum
<br /> : i. ; :i.: - . - - -,..- •-.., • .. Fire Alarm , • , 1 0 0 la • • I , 1 1 Sparklers
<br /> HoOd Cleaning - Li 0 01'1 I I Sprinkler System InstallatiohJ
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<br /> : . :, - • • . HOod.Suppression - 1 1 0 0 p 1 Standpipes (Sprinkler Sys) . - . •
<br /> --- " ' - ' ":• -.--: 4 -i. •::::' -. -, :i , .•
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<br /> - - ...• - •... ••••'`..i 1 i r---1 . , - - Fire Alarm Installation - ' : ' - • 1 ---- i Torch Roafihg7Tar Kgt - 7 : -- . - - , - .. - - • .
<br /> ,.... _ • ..,......, '
<br /> Fire Pumps . '-. • I _ Waste Tire Storage ANNUAL -
<br /> Fire Works • , , . ,.
<br /> . • • . .
<br /> I. ::., Minn Application- ANNUAL 1 : .
<br /> 1 Valuation of Project
<br /> ' A.:. I •••• ' • Fuel Tanks ' . - •
<br /> ' ' : 1"-• I Other: .1 . . •
<br /> _ ____ -,'''''.... ,.. - ' .....- .. LW---,..,-.1..."1.T..44474-4MSFMM.Sar.V. ,,..'.- ---- . v• nr.Wira
<br /> Contradtor - ,' /
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<br /> . - ' Company - (1-7 i-ex
<br /> Signature . Registered _ Y / N Fee Current ' Y / N I •
<br /> Address t .:,..,,,:::,...;2: i ..,.„ . . .-, - .: I License # . .. • . . - . 1 , .
<br /> ELECTRICIAN ••;l:l::::?. ;"••••'".':•; •-? ; - • - '.::_: . y..! y.... ... ' ' , • ..i ". :•• 1 ' i . - ' :.- ' ., Company . . •- ..-. ." ..:,•-i..,'• -'• -,;,- ,.•.. • .: l...,. ..... -; • . , . , ', ,
<br /> • Signature - ' '• L.:.." 4'.., • . ,1 . ' ' ,, ... . ; ' .', . . ', -, .. . . : - RegiStered -. -- Y / N. 1 :: ep-currqilt,. 1...-...:Y / N.. 1 ...,..
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<br /> Address 1 . • . - 1 License #
<br /> .PLUMBER , Company
<br /> Signature . Registered Y / N '1 Fee Ciirrent 1 Y / N t: ' •
<br /> Address -. - .
<br /> 1 License # . - . . I
<br /> MECHANICAL • Company -
<br /> Signature . . - Registered Y 1N Fee Current 1 Y / N 1
<br /> Address I.,., :, .. . - -
<br /> 1 License #
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<br /> OTHER • Company • . .
<br /> Signature . - Registered Y / N J Fee Current YiN_
<br /> Address License 4
<br /> Dfrections: • _
<br /> . Fitt out application completely. .
<br /> • Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
<br /> s ... - . -.....: ...- . .. If over $2500, a Notice of Commencement is required .(Mechanical work over $5000) .
<br /> 7, -.. . - Supply two (2) sets of drawings with applicable documentation -. -
<br /> . .
<br /> „:?...--,.:••.:- - Allow 10-14 days for review after submittal date. Parcel :le- obtaided ft Property Tax Notice (Fitp://appraiser.pascogov.com)
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