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, ; <br /> 813-780-0020 City of Zephyrhills Fire Fax-813-7$p-0021 li <br /> Permi#Appiication �� <br /> 813-?8d-002Q Fax-813-780-0021 � <br /> Date Received �0��26/ZO'I6 1 �� Phone Gontactfor Permit� $"I3 T 247 T 4777 I <br /> Owner's Name Z0 h r Il LLC �wner's Phone Number � �� � <br /> Owner's Address 14524 N. Rome Ave Tam a FL 33613-2029 <br /> Fee Simple Titleholder Name Titleho(der Phone Number �i� [� �� <br /> Fee Simple Titleholder Address <br /> �� . ��..��.. ,__.�..s,._z...� �.� ,�._:.._�...� <br /> .Job Address �5935 Gall�Blvd�, Zephyrhills, FL 33542 �oc# �� <br /> t <br /> Sub Division Parcel# 10-26-21-0020-00000-0050 <br /> �.�..�u..�._:.:.. _..__.__ - �.�..�,. _..�.__. — ._..���. ,� <br /> ; � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier Il or RQ Facility)ANNUAL <br /> � � Controlled Bum Q Hood installation <br /> � Emergency Generator�30 kw � LPlNatural Gas-lnstallation <br /> . � Emergency Generator>30 kw � LP/Natura(Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembfy-ANNUAL / <br /> �y em� � t er �t� <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Burn � � <br /> Fire Alarm � Q ❑ ❑ � � Sparklers ��� <br /> � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations � <br /> Hood Suppression � ❑ C1 Q � � Standpipes(Sprinkter Sys} ��(�j <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettte � <br /> Q Fire Purnps � Waste Tire Starage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUA� $4,�50 , Va(ua#ion of Project <br /> aFuel Tanks <br /> Q t}ther: <br /> �a.y°.._._..�.�, �,�- <br /> Gontractor Company <br /> Signature Registered Y/1� Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature ( Registeeed Y/N Fee Current �'/N <br /> Address License# <br /> PLUiv18ER Campany <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Regisfered Y 1 N Fee Current Y 1 N <br /> Address License# <br /> OTHER Company Cox Fi1'8 ProteCtion, (nc. <br /> Signature p�Q�1 Registered Y/N Fee Current Y/N <br /> Address 7910 Profassional P(ace,Tam a, FL 33637 �icense# EC13004651 <br /> �'-".-,-T.�.e.. — ..�,.,.,..:.x,.�...,�.�...�..�.,..,.._.�,..._,�.._.. - ,�..._ - :....un..._..m....._...._....._.�..,�._.�....�...�....�_�� .._..,...J...,�.�.,�.Y..�. - -��,:'� <br /> Directions: <br /> Fil[out application completely. <br /> Owner&Contractor sign back of applicatian,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$500Q) <br /> Supply fwa(2}sets of drawings with appticable documenta#ion <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pescogov.com) <br />