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*1/39 <br /> 813 =780 -0020 City ofZephyrhilis Fire: . I l Fax -813 -780 -0021 <br /> Permit Application <br /> Dare Received Phore Contact for Permit <br /> w - rte: _ , �--� . ._ ,.. <br /> Owner`s Name S IMPT,FXCRTNNELL Owner's Phone Number 1 3 1 626 I f 5 48 2 <br /> Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple .Titleholder Name - - ; T itleholder Phone Number <br /> Fee Simple - Titleholder Address . <br /> 7 -e:��M'...ti _. _... pp�� _ .�..� :t -tS:� �... r_ .,�. �a ,. �.`.`� �u�'M: � i '.�... r:.. - U. �.s. _� ,r..... r'Fa_ #" .z:..�..t�' 1'._..s - ,0 e:. 2 .�� s��;as "4 w.� � <br /> Job Address t3 2-5z (\ e. Zi iri, l�iS C` 335�Z 2- ePhIY, tis veil 1dy5 "Lot# Y u_4. <br /> 7 <br /> Sub Division Parcel # <br /> k �;y:.. - ...; ..-..,..-. �::-., �,: y: ?? �- �...-_ �� :.n.�„wur°�'`°A.- :.�:.,.xem"a' _, M. .:�..�.,...__�,_w... .._ .w.. :,N,.�_..,.s,h.�- w - >�,.�% .....s -- ...<,�,.�.. _.t >•�._ :.......� <br /> I. , Bio- Hazard Waste Storage - ANNUAL [ J Fumigation Ten v <br /> Comm Exhaust Kitchen Hood /Duct r Hazardous Material (Tier If or RQ Facility) ANNUAL • <br /> • Controlled Bum 1 Hood Installation <br /> I . ` Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> Emergency Generator > 30-kw I LP /Natural Gas- ANNUALSale <br /> I Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL .. <br /> man f Semi ( !Ant Other <br /> Sprinkler, M CI ❑ V I I Recreational Bum - <br /> Fire Alarm , ❑ v / ❑- I I : r7 Sparklers <br /> Hood Cleaning L ❑ , ❑ 1 " 1 Sprinkler' System Instaifatiohs <br /> _ _. ,. . , _I .. I I � <br /> - HaodSuppression. - .I 1 17 O O Standpipes (Sprinkler Sys). • - 1,:•:, I Fire Alarm lnstallabon - Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL - <br /> I( Fire Works • . <br /> I I• • FlaminabfeApplication- ANNUAL Valuaf n of o a Project . <br /> c;. Fuel Tanks , ... . <br /> I I Other .I ack. Viot4) Prosyv l-sr -1 \I6k 51SI - e,tin • • <br /> Contractor _ Company 3 Ck7' - 44 icFr i-' e_ (-t <br /> Signature l Registered Y/ N • Fee .Current Y/ N I <br /> Addre I r. License # <br /> ELECTRICfAN Company <br /> Signature _ , . . , Registered ? Y 1 N I Fee Current V.,..-::Y / N ,. k-.. • <br /> Address I. ,, ' .. I License # I <br /> I <br /> PLUMBER . . • Company ,..; <br /> Signature ' ' Registered Y / N • <br /> g Fee Current I Y [. Nj' <br /> ' Address I . . . I <br /> License <br /> MECHANICAL Company - <br /> Signature Registered Y / N I Fee Current Y / N <br /> Address I, ; <br /> I License # I I <br /> OTHER • Company • - . <br /> Signature Registered Y/ N I Fee Current I Y/ N <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 /> - - AIloY: 10 -1? days for review aver submittal date. Parcel #- obtained from Propery Tax Notice (http: / /appraiser.pascogov.com) <br /> • <br />