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• <br /> 31378o -oozo City of Zephyrhilis`Mi7e <br /> Fax-813-730 -0071 <br /> Permit Application <br /> Phone Contact for Permit J I <br /> Date Received � _ -�-- __- _.�.� �� .� - . - �._. -- <br /> ��'= = -� —�- -- 626 5482 <br /> Owner's Phone Number I 813 H <br /> Owner's Name I STMPT,FXC7RTNNFT - - <br /> owners Address 1 4701. Oak Fair Blvd TAMPA FL 33610 . <br /> Titleholder Phone Number I I • <br /> Fee Simple .Titleholder Name <br /> Fee Simple - Titleholder Address I .,.�.,_ <br /> -"_ - te a r..,,w :. = ' .- yg. = <br /> Job Address <br /> U?i5 fVISLAP Nye. n y e , tgSk. \ QT e( Iregtim'e -4- Let# <br /> I Parcel „ _,. <br /> Sub Division ._ . - ss ..,•:--, � .�...k. -- _...... .c. , s.. <br /> I • I Bia- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I I <br /> Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> • Controlled Bum Hood Installation <br /> Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw <br /> LP /Natural Gas - ANNUAL Sale <br /> I Places of Assembly- ANNUAL . / ,. <br /> I I Fire • Protection Maintenance _ANNUAL <br /> F. 4 I(ttrlyI 'Semi( IAnI <br /> Sprinkler , 0 Other !� 1 ' ❑ , <br /> Recreational Bum LJ <br /> Fire Alarm • , ❑ ❑ ❑ [ 1 ( Sparklers <br /> Hood Cleaning <br /> 0 ❑ ❑ I 1 1 Sprinkler' System Installations <br /> Hood Suppression. I I 0 0 - O . I .. Standpipes (Sprinkler Sys) <br /> _.. orah R <br /> Fi e Afarm InstaUafion <br /> f 'r oofing/Tai Kettle • - •. Waste Tire Storage ANNUAL • <br /> I Fire Pumps • • • <br /> I ( Fire Works ' • , <br /> Flammable Application- ANNUAL ` ton o <br /> 1 Valuation of Project <br /> i I F uel Tanks <br /> I - I Other: Cr i . i „J .i V2 _ �� mo . <br /> Contractor Company /pin\ <br /> • I Registered _ Y / N Fee Current I' Y /N I <br /> - <br /> Signature I f <br /> Address I . <br /> (, License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y 1 N Fee Current I Y/ N .: I • Address I ... License # - '' I <br /> - <br /> .PLUMBER Company <br /> Signature Registered Y / N ' I Fee Current- I Y / N' <br /> • Address 1 - I License # • ' I <br /> MECHANICAL - Company • <br /> Registered Y/ N 1 Fee Current I Y / N I <br /> Signature - <br /> . Address I,-:., - I License# I 1 <br /> - <br /> OTHER Company - <br /> Signature • - Registered L Y / N 1 Fee Current I Y / N <br /> 9 Address I ... _ R �- License <br /> teen <br /> Directions- - - - <br /> _ Fill out application completely- <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with ovaner) <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 after submittal date. Parcel #- obtained fr-m Property Tax Notice (blip: /lappraiser.oascogcv_com) <br /> • <br />