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____.�l� <br /> �.,,�, <br /> s�s-�aa-�o2o City o�Zepnyrhills F9re �ax-a�3aso-oo2s <br /> , P�rmit Applicetion ���j" 'j Qj— Zi��/. <br /> Date Received �— �� Phone Canta for Pertnit 727 365 2232 <br /> Oumer's Name Zephyr Haven Heaith and Rehab ( pwners Phone Number g"13 782 5508 <br /> Owner's Address 38250 A Ave Zephyrhills,FL 33542 � _ <br /> Fee Simple T+tteholder Name � TltSehotde�Phone Number [� [� � <br /> Fee Simple TiUehoider Add255 � <br /> I <br /> .dob Address 38250 A Ave Zephyrhills,FL 33542 " r� <br /> Lot# �^ <br /> Sub Division I Par�el# � <br /> � Bio-Fiazard Waste Storage-ANNUAt � Fumigation Tent <br /> Q Comm Exhaust Kitchen HoodlDuct o f-fazardaus Material{Tier II or RQ Facility)ANNUAL <br /> � Contralled Bum � Hood Ittstalla@on f���,/D p3 <br /> � Emergancy Ganerator a 30 kw � LPlNaturai Gas-Installation -� I�.� 'Z,D <br /> � Emergerzcy Generator>30 kw Q l.Plidatutal�as-ANNUA[.Saie <br /> � Fire Prptection Ma+ntanance-ANNUAL � Places of Assembl -ANNU ,� <br /> Y ��Z� <br /> �y emi �l—�fn r �� � <br /> Sprinkier � ❑ ❑ Cl � � Recrealianal Bum � ,.�/jO� <br /> Fire Alarm � ❑ t� O � � Sparisters � �� �" � ��� <br /> � � <br /> Hood Cleaning � ❑ ❑ C� � a Sprinkler System Inshailations � //��� C _p,� ��(�"' <br /> Haod Su ression � ❑ ❑ ❑ � � r`• �`� <br /> pp � 5tandpipes{Spnnkler Sys} �� f C <br /> � Fire Alarm Installatian • � Torch Roofing(Tar Keitle <br /> � /1�,J(f'� <br /> oFire Pumps o Wasie Tire Storage ANHUAt ������% <br /> � FlammableApplication-ANNUAL $16,291.78 � Valuation af Proj� ,;�^�►� <br /> � Fuei Tanks � �� <br /> � Other: <br /> �- I <br /> Contractor Company Simp(exGrinnel( <br /> Signature Registered Y/N Fee Current Y I N <br /> Address Od niversity Center Drive Tampa,Fl 33612 � License# FPC13-Od00d8 <br /> ELEC7RICIAN Gompany � <br /> S+gr�ature Regtstered Y l 1t) Fae Currant Y/�2 <br /> Address � License# <br /> PLUMBER Company �� <br /> Signature Ftegistered Y/N Fee Current - `(/!� <br /> Address � License# <br /> MEGHANICAL Compatty �� � <br /> 3ignafure Registered Y/N Fee Current Y/N <br /> Address � Licanse# <br /> � <br /> OTHER Company � <br /> Signature Registered Y!N Fee Curnent Y!N <br /> Address � . - Ucense#1 <br /> � Direetlons: � � <br /> ' Fill out 8pplicafion comg(etely. <br /> Owner 8 Contractor sign back of applicaUOn,notarized(Or,copy of signed cantract with owner) <br /> Ii over$2500,a'No6ce pf Commencement is requir+ed{Mechan3cal woric over$50Q0) � <br /> S�pply turo{2}sets flf drawings with applicable daGUmentat3ort i - <br /> Aflow 10-14 days for review aHer submittal date. Parcel#-obtained from Property Tax Mqdce(httpJ/appraiser.pascogov.com) <br /> � <br />