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813-78o-002o City of ZephyrhUs 'Fir; Fax- 813 -780 -0021 <br /> Permit Application <br /> Date Received - P Contact for P rnit <br /> ; n ° 7! srm�ecaF- yc °�.'r_q= . ,.,..,--- •.-- ._..:.. ..,..a <br /> ORS CO e 1 <br /> - - „=.�„e.: .s ��- r ° "_- .....„- <br /> Owner's Name S TMPL,FXCRTNNELL Owners Phone Number 813 6 2 6 5482 <br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610 <br /> • <br /> Fee Simple Titleholder Name ) • - } Titleholder Phone Number <br /> Fee SimpleTitleholderAddress I . <br /> Job Address (L./(J D C 6 tp, Z Pj�� It To1I J \CIf (' ll Lot# <br /> Sub Division Parcel # <br /> - .. ^. t...,.n_+s - n 7 .-, = .,.- . r.�.sti ." ,-- - u� x -,,, — -- <br /> . I - Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I • Controlled Bum 1 I Hood Installation <br /> I . Emergenc < 30 kw I 1 LP /Natural Gas - Installation �p <br /> Li Emergency Generator > 30 kw ( I LP /Natural Gas - ANNUAL Sale . t )( <br /> • <br /> . I I • Fire Protection Maintenance - ANNUAL ' I 1 Places of / <br /> rv iltarly1 'Semi! Other <br /> • Sprinkler, ❑ ❑ 1 1 Recreational Bum 1 <br /> Fire Alarm I 1 ❑ ❑ ❑- 1 • . 1 1 1 Sparklers . <br /> • - Hood Cleaning 1 1 ❑ ❑ ❑ 1 1 I 1 Sprinkler' System Installations <br /> Hood Su ression 1 ❑ ❑ _❑ 1 I I 1 Standpipes (Sprinkler Sys) <br /> 1::".-: I ` Fire Alarm Installation I f ` Torch Roofing/Tar Kettle <br /> I ; I Fire Pumps • • Waste Tire Storage ANNUAL " - - , -_ - • _. _ <br /> _ - <br /> I `I' - Fire Works • 1' ' ' <br /> VII' Flamrnable Application- ANNUAL <br /> / f . : 1 Valuation of Project . • <br /> Fuel Tanks <br /> I I Other - 1 `' • ■. ! ✓ <br /> Contractor . 4111F Or Company ( 1' r'� .� <br /> Signature Registered Y / N Fee Current Y /N j <br /> • Address 1 <br /> • . , 1 . . License # I <br /> - <br /> ELECTRICIAN <br /> • Company , : = • - •.-. . . ... . " , <br /> Signature -'..-.0,", ( Registered Y / N I ...Fee. Current I . :' Y / N. (. <br /> Address I 2. • . . ` I <br /> 1 License # , , <br /> PLUMBER f Company a <br /> Signature L.. I I Registered Y11\11 Fee Current I Y / N- I: <br /> Address I I License* • I • _ I <br /> MECHANICAL • I Company <br /> Signature 1 1 Registered Y/ N J Fee Current I Y/ NI j <br /> . Address I - <br /> I,_ ( License # I I <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current I Y / N j <br /> Address License # <br /> • zmustagispzigsza <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 (httpi /appraiser.pascogov.corn) <br />