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s�a-�so-oo2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received 1j— �� � Phone Contact for Permft r 352� 5 7 7340 <br /> Owner's Name Blackstones Restaurant owners Pnone Number 813 82 1623 <br /> owner's Address 38361 CR 54E <br /> Fee Simple Titlehoider Name Titletalder Ptrone Number � � �� <br /> Fee Simple Titleholder Address <br /> Job Address Lot# � <br /> Sub Division ���# <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> o Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Trer I{or RQ Facility)ANNUAL <br /> � Controlled Bum a Hood installation <br /> � Emergency Generator<3p kw � LP/Nahxal Gas-Instai{aUon <br /> � Emergency Generator>30 kw � LPMatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL o Places of Assembly/1NNUAt � <br /> �y m� �n r � <br /> Sprinkier � ❑ O D � Recreational Bum /� <br /> Fire Alarm � ❑ ❑ � � � Sperkiers �r <br /> Hood Cleaning � ❑ ❑ � � � SprinklerSystem fnstallations /� <br /> Hood Suppression a ❑ ❑ ❑ New � Standpipes(Sprinkler Sys) ��`� c��f'�'`1�� <br /> � T/ <br /> � Fire Alarm instatiation � Torch Roofinglfar Kettle �t. <br /> Fre Pumps o Waste Tire 5torage ANNUAL � <br /> Fire Works <br /> Flammable Application-ANNUAL 17 0 0.0 0 -, Valuation of Project <br /> Fuel Tanks <br /> [� Other. <br /> Contractor ��^Y <br /> g�9��� Registered Y!N Fee Current Y/N <br /> Address License# <br /> ELECTRICfAN Company <br /> Signature � Registered Y/N Fee Current Y!N <br /> qdd�� Licertse# <br /> PLUMBER Company <br /> Signature Registered Y 1 N Fee Cunent Y/N <br /> Address License# <br /> MECHANICA ��►�Pa�Y <br /> Signature Registered Y/N Fee Curtent Y I N <br /> Address License# <br /> OTHER Company Securit Fire E ui ment LLC <br /> Signature ��� Registered Y/N Fee Curtent Y/N <br /> Address 18330 Lawrence Rd License# <br /> Directions <br /> Fill out appiication compietety. <br /> Owner 8 Corrtractor sign badc af application,notarized(Or,copy of signed corrtract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over 35000) <br /> Supply Mro(2)sets of drewings with applicable documentation <br /> Atlow 10.14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(hMpJ/appraiser.pascogov.com) <br />