Laserfiche WebLink
. - � <br /> 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> ' ' Permit Application <br /> Date Received – '– O Phone Contact for Permit 800 m 868 9151 y <br /> Owners Name PUblix#1245 Owners Phone Number 813 782 1957 <br /> ownersAddress 7838 Gall Boulevard,Zephyrhills, FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> ��.'._..s�"."_ - – <br /> Job Address� 7838 Gall Boulevard Lot# � <br /> Sub Division Parcel# <br /> t�...-'-,`..'•'."•„- ------ .------�--•.,--_-...,-- -�<-w- - „r ----�-----�-�-^�r <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Burn � LP/Natural Gas-Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generdtor>30 kw � Places of Assembly-ANNUAL <br /> � Fire Protection Maintenance-ANNUAL � Recreational Burn <br /> r y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � X❑ Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Cleaning � O ❑ ❑ � � Standpipes(Sprinkler Sys) j �y'/ /// <br /> Hood Suppression � ❑ ❑ ❑ � � Torch Roofing/Tar Kettle <br /> � < < � �v <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> � Fire Works SPARKLERS <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> f'� .......,...�.»,.. .,.__........_.._._.._....�_�.._..-......am.v,.......�...._.�_..v....,..s..........�..r..wa_.�..._... ' ....._.. '.7"""" �_....w ...r...._�.. .._._.................�.....�� <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Vendor Company TNT Fireworks <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 6255 SE 78th Street,Oc a, FL 34474 �icense# <br /> �.'._-'_--_.. �___._ _ � -------�-----�--, <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br /> -Site plan at store-placement dictated by Fire Marshals office <br /> -State Sparkler Licence attached <br /> -Product List attached <br />