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8'k3-'T`.•0-0020 Clh/OfZ@ph�hfllS'�If9; Fax-813-780-0021 i- <br /> Permit Appiication _ _�. <br /> Date Received � -- Phorie Cartact for Pertnit <br /> Owner's Name <br /> � Owners PFane Number ��� [ �� �c Z <br /> ONmers Address g �^'. , • � <br /> Fee Simple Titleholder Name ��� N ��� ���� <br /> Fee SimpleTitleho�de� Add�ess <br /> Job Address Lot # C� <br /> Sub Division �� # <br /> Q Bio-tiazand Waste Storage - ANNUAL � Fu�ation Terrt <br /> � Comm F�F�ust Ki6d�en i-�� � Hazardous Material �er II or RQ Facil'rty) ANNUAL <br /> � CoMrolied Bum � t'i°°d Installapon <br /> � Emetgency Generator < 30 kw � LPlNaturai Gas-Insfaliation <br /> a Emenger�,y G�or> 30 kw � lP/Wahaal Gas-ANNUAL Sale � <br /> � Rre Protection Mairdenance - ANNUAL � Places of AssemblY-ANNUAL r <br /> ��� f <br /> Sprinkfer � ❑ ❑ ❑ � � ���� Bum <br /> Fre Alartn O Q ❑ C� � SParid�s J h�.� I <br /> Hood Cleaning O �, ❑�� a SP►���� SYstem Installatior�s ]j � O � <br /> O' <br /> Hood Supp�sion O � ❑ L_� � StendWPes �5�nider SYs) <br /> � Rre Alartn Instaliation a Tor�h Roo�nglfar KeUle �, _ <br /> Fire Punps a Waste Tire Storage ANNUAL <br /> Fire works <br /> � ��� ��,,,� Vaivation af Project <br /> Fuel Tanks <br /> er. <br /> Contracroor ` - COR <br /> S �� Rey�erea Y i N � c�e�c Y/ N <br /> nddress �icense # <br /> ELECTRIC CO ��y <br /> signaa,re Regiscered Y/ N Fee ciarene Y/ N <br /> Address Lice�ae # <br /> PLUMBER CO � <br /> Stgrrewre tiegistered Y/ N Fee cunent Y/ N <br /> Address License # <br /> MECHANiCAL �Y <br /> Sig ��� Reglstered Y/ N Fee Cument Y/ N <br /> Address �� # <br /> on��t c°'"�"y <br /> slynaa,re Registered Y/ N Fee Currem Y/ N <br /> Address License # <br /> Directions: <br /> Fill aut appikation cor�le�ely. <br /> Owner 8 Corttractor sign bacic o# applicatlon. �ed (Or. coPY oF signed co�tract with ovvner) <br /> t� over 52500. a Notice af C,ommer�mer►t is required.(Mecfiar�cal work over 55000) <br /> Supply two (2) sets � drawirgs wifh appScable documar�tion <br /> Allow 10-14 days ior review after submittal date. Parcei #- obtained irom P�vperly Tax Notice (MtPl/aPWaise�•Pasco9ov.com) <br />