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313J60 -0020 City of Zep ,yrihills -Fire; Fax- 313 -730 -0021 <br /> Permit Application <br /> Date Received <br /> I Pho ne Contact for Permit <br /> Owners Name 1 S TMPT,FXGR TNNFT,T, Owner's Phone Number 1 81 8 I I 626 1 5 4 8 2 <br /> Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610 • Fee Simple - f itleholdar Name I - Titleholder Phone Number f <br /> Fee Simple Titleholder Address <br /> z — <br /> Job Address U ��Q J. 2 / je 1 _ .�. 'w, c <br /> N Len ►4( did,. �`Jnl(,, at( P4(�- Lot# <br /> Sub Division <br /> Parcel # <br /> Bio- Hazard Waste Storage - A UAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct r ---- i Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> I • Controlled Bum I I Hood Installation <br /> . I. - Emergency Generator < 30 kw LP /Natural Gas - installation <br /> ; -. Emergency Generator >30 -kw I I LP /Natural Gas - ANNUAL Safe <br /> I _ Fire Protection Maintenance - ANNUAL • I I Places of Assembly -ANNU . <br /> IUtrly('Semi' lAnl Uther �/ <br /> Sprinkler, ® ❑ ❑ , . I ` <br /> Recreational Bum <br /> .1 ! <br /> Fire Al arm , I I ❑ ❑ ❑• [ I ( Sparklers • 1� <br /> • Hood Cleaning I I p ❑ ❑` <br /> I I I I Sprinkler System Installatioh <br /> Haod Suppression ❑ ❑ 0 <br /> I , I S es (Sprink '. <br /> I : ` h _ Fire Alarm Installation • tan <br /> dpip le r Sys) <br /> -. - _. - .. "• ...: � I - Torch Rooting/Tar Kettle _ �� <br /> I Fire Pumps <br /> _ Waste Tire Storage ANNUAL <br /> - I Fire Works <br /> I Ffammable Application- ANNUAL . <br /> :I Valuation f Project <br /> Fuel T <br /> I Other I WQ.k 'ec I! ✓ -f - P-,GLk -Fe J • - - - e6 Pe -L 4' jvvl <br /> Contractor <br /> Company '��'.< ."'_`""' " ",_y - �� ' �`� <br /> -- CY7 l.SrY`-e. e ( <br /> Signature J F - \ 1 <br /> l I Registered Y / N Fee .Current Y / N • <br /> • Address I <br /> : ., - .. License # <br /> ELECTRICIAN ,_, Company . <br /> Signature - Registered Y / N: •F Current <br /> f I <br /> Address I - .: 1 License # I' ! <br /> PLUMBER Company `� <br /> Signature ' Registered Y N F <br /> g / 1 Fee Current I y / N.. <br /> Address I I <br /> I License # • I ' 1 <br /> I <br /> MECHANICAL I Company I <br /> Signature I 1 Registered Y/ N Fee Current N <br /> Y <br /> Address I '; . <br /> 1 License # I I <br /> OTHER I Company <br /> Signature Registered j Y / N ] Fee Current I Y / N_ J <br /> Address <br /> ter_ �, <br /> License <br /> Directionsk __wa 1 <br /> _ Rif out application completely. <br /> - <br /> Owner & Contractocsign 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 /> . <br /> :- .-- ---.. - - _ Ago* 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http: /!appraiser- oascogov.com) <br />