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<br /> . Ci'ry ofZephyrhilfs�Fir.�� Fax-a13-7ao-ao21
<br /> Pzrmii App(ica�ion
<br /> Date FZeceived . _ '
<br /> �,�.,.�,.. .�_�,�R,� - ���� -� Phone Confact for Permit �
<br /> z"'°--'�-°�-�, ,.,{ �"�� �- = -�.� �-�.� �.,- . _
<br /> Owners Name
<br /> owners Phone Number g� 3 6 2 6 5 4 8 2
<br /> Owne�sAddress 4701 Oak Fair Blvd T�MPA FL 33610
<br /> Fe� Simple ,Tiffeholder I�ame • - Tfleholdar Phone M1lumber �� �� C
<br /> Fee SirrtpfeTitlehofderFiddress
<br /> r=y.� ,=..
<br /> 7 �
<br /> _ - _ _ ��
<br /> Job Address 5 f� �", �1 , h( 5c.j2 �� 'S �i.{ ve ry.w.¢� Lbt # C
<br /> Sub Divisia� Parcel �#
<br /> . � - � �..._.�:-:�.��
<br /> Bio-Hazard Waste Storage -ANt�tUAL � Fumigation Tent
<br /> � Comm Exhaust'Kitchen Ffood/Duct � Hazardous Maferfal (Tier If or RQ Facifify) AhlM1(UAL
<br /> � Controlled Bum � Hood (nsfalfa4ion
<br /> ,� Emergency Generator <30 kw � LP/t�latural Gas-Insfaflation
<br /> . . �,_ �EmergencyGenerator> 30�kw � LP/t�fafural Gas-ANf�lUALSa[e
<br /> , •- � Fire Protecfian Maintenance - ANhlUAL ' � Places of Assembiy AHt�lUAL
<br /> - � ---� emi nT ' er
<br /> . , .r' ` Sprinkter, . _ � p ❑ - � Recreafional 8um
<br /> � � � -, Fire Alarm � Q ❑ ❑' � � Sparkfers . �
<br /> � � �� � Hood Cleaning � p p � � � L I j � ��
<br /> Sprinkfer Sysfem Insta(ta6ons � � �/
<br /> - -- - �- - ' • . _ Hood $uppression - - � q ❑ ❑ � � •� �
<br /> , _ _ "; _;; .�i . -: °-� � . _ Standpipes (Sprinkler Sys)
<br /> .. _ ,;._. •. . -- � .. - _ . _ _ :. , ,
<br /> : ._ ....,. .. -...
<br /> "`' Fre Alarm nsfallafion - ' ' '
<br /> _.....
<br /> .....:. ...... :...�• . . _ .. __ _ , .. ,
<br /> ..__.._....__..__�..,. ._, . . . • - - - - - - - -
<br /> ..--.._.,-. � . ,. .__..._: �' ?o'r�f� Rbofing%Tar'Keffl'e= �'_ -. - . _ ._ _.. , .
<br /> . .._...__._. ._____ . ^__........._..._,=••--
<br /> . . .__._ �- - • - _ ._.;_ ....... ,
<br /> .... ..
<br /> ." '' � Fire Pumps � •-.. _ ,... _ ._ , _._.--..- -- - -
<br /> ` `N.` �� -. Waste Tire 5torage A[�[KUAL - �
<br /> Fre Works �
<br /> . r;i, �• ,- Ffamrimab[eApp[ica6on-ANt�lUAL , . � Valuation of Project
<br /> ' ,^ �' Fue( - F`snks ' - - • . , _ , .
<br /> �. , � 0 .Ofher. . . ,
<br /> r� -
<br /> Confractor •
<br /> Compahy f �y�'�- ��,� ��
<br /> Signature ' Registered I Y� N I Fee Current Y/ N
<br /> Add�es§
<br /> ' �•.7: ' - -' License # .
<br /> ELECTRICfAN ".: ` ._ _ _ ' - • -
<br /> . . , , . _ . . . ., - - . - , Company . : - ; , . .
<br /> Signafure . , _.. - � " . • � Re istered < Y /�N �' � ' . -
<br /> 9� ., Fea,Gurrent> Y / N �
<br /> Address - • -
<br /> License # ' • , ,
<br /> -PLUMBER . _ • , � , Company • `��
<br /> Signafure ' . " - . '; -� .
<br /> Reg;stered Y( Iv � Fee CurrenP �' /. �('� ,I
<br /> Address .
<br /> License # '
<br /> MECH�4NfCAL
<br /> Company
<br /> Signaferre Registered Y/(� Fee Current Y/ I�j
<br /> Address . .,, -
<br /> License #
<br /> OTHER �
<br /> • Company
<br /> Signature Registered �' /(�( Fae Current Y/[�f
<br /> Address
<br /> License #
<br /> Direc6ons: ' -
<br /> � . FF[f out appiication comp(efely_ �
<br /> _____ _ Owner 8� Corttracforsigrt 6ack of appticatiort, nofadzed (Or, copy of sign=d contrac( with owtter)
<br /> If over $Z500, a rlofice of Commencement is required_(fvF_chanieal work over $5000j .
<br /> ,_ _ .- Suppty two (2) sefs of dr�wings wifh applicabfe documenfa8on • -
<br /> _ _. - _ Alfo�nr 10-14 days for review ar�er submifta[ dafe_ Parcet t# - obtair�ed fmm prnperf�r Tax (�ofice (hifpJ/appraiser.pascogov.com}
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