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�13 q g� - �����1 <br /> 813-780-0020 City of Zephyrhills Fire Fax-813-7$p-0021 <br /> Pe"rmit Application <br /> 813-780-d020 �i.�C�780-0021 ,"7 <br /> Date Fteceived � '�1 ;�',C?,r,�'��� Phone Contact for Permit $9 3 �'? -�4=7�'7 <br /> �—`_-'�_...-7`�""' - _._._...._._._. - _....._...... __._�_. �.___^___...._......,.v_.__��._._.._�.._.........._..�. ._....,.__.�..._..:...�� - — - - a.,-.__.a <br /> Owner's Name Adventist Health SystemlSunbelt DBA:FL Hospital Ze hyrhiNs Owner's Phone Number 813 803 4424 <br /> Owner's Address 14055 Riveredge Drive,Suite 250,Tampa,FL. 33637 <br /> Fee Simple Tit(efioider t3ame S� Tit(eho(der Phone Number ��-� � �� <br /> Fee Simple Tikleholder Address SAA <br /> i j <br /> �'.�,..__._ �T .»..�.,.. ' _"_�"`"_.,`t <br /> Job Address� 7�50 Gall Blvd.,Zephyrhi!!s,FL 33541 Lot# �� <br /> ' I . <br /> Sub pivision i Parcel# 35-25-21-0010-10500-0000 <br /> _� __...�..,. . <br /> , . _ . - .V...._ .._..._........ :. .. .. . .� -- <br /> _._..__�._�,.._....__.� ..w..__._ _.__ :� <br /> � � Bio-Haxard Waste Storage-ANNUAL � Fumigation Tent ,� <br /> � �omm Euhaust Kitchen Hood/Duct � Naza�do�s Material(.7ier I!or RQ Facility)ANNUAL <br /> � Contro(led Bum o Hood Installatian <br /> QEmergency Generalor<30 kw � LPlNaturaf 6as-fnsta!lation � � � <br /> � Emergency Generator>30 kw � LPlNaturai Gas-ANNUAL Sale � <br /> Q Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �,�!t, � <br /> � tr y em� ��n t er {{'i' <br /> , Sprinkler � ❑ ❑ ❑ B � Recreatlonal Burn <br /> � Fire Alarm, � ❑ ❑ ❑ �� Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � Sprinkler System Installations <br /> Hood Suppression � O ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm installation � Torch RoofingCfar Kettle <br /> � Fire Pumps � Waste 7ire Storage ANNUAL <br /> � Fire Warks <br /> � Flammable Application-ANNUAL � $114,379 �, Va(uatian of Praject <br /> � Fuel Tanks <br /> Q Ofher: Add/re(ocate fire s rinkler heads. Reiocafe one fire hose valve. <br /> f---�-� __.. .._..__- — � --.-, <br /> Gantractor Gompany <br /> Signature ' Registered Y/f� Fea Current Y/N <br /> ' Address � 1` �icense# <br /> ELECTRICIAN j . % Company <br /> Signature � ; , Registered Y 1�4 Fee Current Y 1 RI <br /> Address � License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address } License# <br /> MECHANICAL � Company <br /> Signature I Registered Y/� Fee Current Y/N <br /> Address � License# <br /> OTHER ' // /f� company Cox Fire Protection, lnc. <br /> � Signature ��iy(��Q�./ C-% . (.% � �"f" Registered Y/N Fee Current Y/N <br /> � Address j 7910 Professional Place,Tam a,F� 33837 �icense# 016982-0001-1985 <br /> ,---�------� _.., - ....�.... - - - - - � - -- - �---� <br /> . . _„. _ � . � __.v ._ . ., ._. ._..._.......... ....._ . .__..,.._. <br /> __._,_.� __ _... . .. . . <br /> Directions: � � �. ' � , .- • , ' _ � .. <br /> Fitl out application completeiy. ; • , ,„ ,-�- , <br /> _ . __Owner&Contractor sign back of applicatlon,notarized(Or,copy of signed contract with owner) ' . . ' <br /> tf over$2500,a Notice of Gommencement is requfred(Mechanica!work over$5400} � ; � ` _ ' <br /> Supply two(2}se#s of drawings with appliceble dacumentation = _ � ' -�� , <br /> - Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br /> I � . <br /> ( I <br />