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813 =780 -0020 City of ZepihyrhillsFire, Fax -313- 730 -0021 <br /> Permit Application <br /> Date Received <br /> Phones Contact for Permit <br /> Owners name S TMPLF,XGR TNNET,L Owners Phone Number 813 626 5 4 8 2 <br /> Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple "Titleholder Name I - i Titleholder Phone Number <br /> Fee Simple Titleholder Address i . <br /> Fc -..-ry ."°Tq ,1_ .._-1- ._r�r -= -; x -q. f- .� :__:STAIM.:4 M _.,- aLTEAS�, 5�' � :,4�"�"•i..,_.yVM. WIt.�z <_..s_,,;.M ._a_4fe.M - �^_'"� <br /> Job Address 5335 `35 % 34 -re- 335-(2. Z-ePr% (II I S b t Lot i <br /> Sub Division Parcel # <br /> ,ar m <br /> Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> I . • Controlled Bum I Hood Installation <br /> I Emergency Generator < 30 kw n LP /Natural Gas - installation f r <br /> . i -;.: . Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> I. Fire Protection Maintenance - ANNUAL • • T1 Places of Assembly- ANNUAL .. 1 <br /> i 4 Qtrlyf !Semi' lAnl Other <br /> • Sprinkler. ❑ CI Recreational Bum ( L i . <br /> Fire Alarm n ❑ ❑ ❑" I • , l f Sparklers f <br /> Hood Cleaning 1 D 1=1 0 1 1 Sprinkler System Installations <br /> : Hood Suppression n ❑ ❑ ❑ j I i I Standpipes (Sprinkler Sys);.. <br /> I Fire Alarrn Installation Torch Roofin /Tar Kettle - • • i <br /> f •: I Fire Pumps . • I • • I _ Waste The Storage ANNUAL <br /> `I Fire Works <br /> m . , I I. Flamable Application- ANNUAL ! I Valuation of Project <br /> I Fuel T <br /> .:. I' I ..Other: I . <br /> j - . , � ' � -s, 'S .:w:'? ;:g�'.'Ax— �^sr,; .. , IT .+:'"5_: =`, ._,nL._...< "�€=— �:ss�:ign <br /> Contractor / Company 3 ei-714 K t <br /> Signature ds Registered Y / N S f Fee Current l Y /"N _I • <br /> Address i .' ' se # <br /> -• . Lice - i <br /> ELECTRICIAN :, <br /> Company . <br /> Signature Registered . Y / N 1 Fee Current 1..:-. Y/ N J <br /> Address I I License # I , <br /> .PLUMBER Company <br /> Signature Registered Y1 Ni I Fee Current I Y / N I - <br /> 1 <br /> Address I - I <br /> i License # . • <br /> MECHANICAL • <br /> Company <br /> Signature Registered Y/ N I Fee Current Y / N j <br /> Address I • .;_, i License # I i <br /> OTHER Company • - . <br /> Signature Registered Y / N I Fee Current i Y/ N J <br /> Address i Licensees <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 /> - Allow 10 -14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />