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813-780-0020 (;Ih/OT LBphyrI1111S FIPA Fax-813-780-0021 <br /> Pertnit Applicatlon <br /> nate Received � w,one corNact fo►Pem,k �� �� 7340 <br /> owne�'$Ne� Chatterbox Cafe Owners Phons Number 813 13 6777 <br /> Owners Addroas 5014 Gall Blvd <br /> Fae Simple Titleholder Name Titleholder Phone Number C� � �� <br /> Fse Simple Titleholder Address <br /> Job Address 33542 �ot# C] <br /> Sub Division pa�el# <br /> � 610-Hazard Waete Storage-ANNUAL Q FumlgaUon T�t <br /> � Comm E�chaust Kitchen Hood/Duct a Hazardous Meterial(7ier II or RQ Facility)ANNUAL <br /> Q Controlled Bum � Hood lnstaltation <br /> � Emergency Ganerator<30 kw a LP/Naiural Gas-Installa6on ( j�� � <br /> Q Emergancy Generator>30 kw Q LPlNatural Gas-ANNUAL Sale � 1 �� <br /> � Fire Pratecdon Maintenance-ANNUAL � Pla�s of Aasembiy-ANNUAL � <br /> �� � �� <br /> Sprinkier ❑ ❑ O � Recreational Bum <br /> Fire Alartn � ❑ C] O � Sparklers <br /> Hood Cleaning � ❑ p d � � Sprinkler System Installaeons <br /> Hood 5uppresaion X ❑ E4 D Standpipes(Sprirtkler Sys) <br /> QFire Aiartn InstallaBon a Torch RooflnglTar KetUe <br /> Fre Pumps � Waste Tiro St�age ANNUAL <br /> Fire Works <br /> Flammable Appiicatlon-ANNUAL �--, Valuation of Project <br /> Fuei Tanks <br /> Q Other. <br /> Conhactor ��y <br /> Si9nature tzegbtered Y 1 N Fee Current Y/N <br /> ��esg License# <br /> ELECTRICUW �p��y <br /> Signaw►e ( Registered Y/N Fee Curtsnt Y/N <br /> Address License# <br /> PLUMBER �mpa�y <br /> signahxe Regtstered Y/N Fee Current Y/N <br /> Address License# <br /> MECFIANICA ��y <br /> slynature ttegisterod Y/N Fea current Y/N <br /> Address License# <br /> OTHER �ompany Securit Fire E i ment LLC <br /> siynature Repist�ed Y/N Fse Cu�ent Y/N <br /> Address 1 S 3 3 0 Lawrence Rd License# <br /> Dlrectlons: " . .. ,. , , , <br /> FHI out application campletely. <br /> Owner 8 Contractor sign back of applicatlon,notauized(Or.copy of signed contract with ovmer) <br /> If over 52500,a Notice of Commencement is required(Mech�nical work over 55000) <br /> Supply Mro(2)sets of drawings with appUcable documerrtation <br /> Allow 10-14 days for revlew efter submittal date. Parcel#-obtained from Prope►ty Tax Notice(httpJ/appreiser.pascogov.com) <br />