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/ • ; '12/02/20'16 �6:03 #965 P.002/003
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<br /> 813-780-0020 City of Zephyrhills Fire Fax-8�3aao-0ozl
<br /> , ' Permit Application
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<br /> late Received ' � � Phone Contacl for Permit
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<br /> Mmers Name LIVINGFOODS OASIS LLC 'Owner's Phone Number � � C�
<br /> rvne�s Address �2431 DUCK LAKE CANAL ROAD DADE CITY FL 33525
<br /> �ee Simple TiUeholder Name TiUeholder phone lVumber � � L�.�
<br /> °ee Simple 7iUeholder Address �
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<br /> ebAddress 38201 10TH AVENUE ZEPHYRHILLS FL 33542 V Lot# 13,14 8�15
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<br /> �ub Division TOWN OF ZEPHYRHILLS PB 1 PG 54 BLOCK 65 parcel# 11-26-21-0010-06500-0130(CARD:001 OF 001) �
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent i.
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<br /> Comm Exhaust Kitchen Hood/Duct Q Hazardous Material(Tier 11 or RQ Faciiily)ANNUAL 4
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<br /> Controiled Bum Q Hood Installation €
<br /> • � Emergency Generator<30 kw Q LP/Natural Gas-Instaliatiort �� �('�`� �1�{� r
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<br /> a', Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � ��Q,iS W �
<br /> � Fire Protection Maintenance-ANNUAL � Piaces af Assembly-ANNUAE. C�� � �
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<br /> ^ Sprinkler � � ❑ � ,� � Recreafional Bum n �� �
<br /> , \ Fire Alartn � ❑ O � � � Sparklers P ��1`I f �..
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<br /> Hood Cleaning � a ❑ ❑ � � Sprinkler System Installalions 3
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<br /> Hood Su ression � ❑ ❑ O � � Stand i es(Sprinkfer S s �
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<br /> � � Fire Alarm Instaflation � Torch RooTing/Tar Kettle �
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<br /> � Fire Pumps � Waste Tire Storage ANNUAL °'
<br /> � Flammable Application-ANNUAL $2450.00 ValuaGon of Project �
<br /> � Fuel Tanks � '
<br /> � Other: INSTALL FIRE SUPPRESSION SYS E �
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<br /> :ontractor �----- Company DO c:
<br /> �ignature -'�� Re9istered Y/N Fee Cu nt Y/N �
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<br /> Address License# ''�
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<br /> :LECTRICIAN Company a�
<br /> �ignature Registered Y/N Fee Current 1�/1� �� �
<br /> Address � License# �
<br /> 'LUMBER � Company �
<br /> �ignature Regisiered Y/N Fee Cuirant Y/N �`
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<br /> Address � License# F
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<br /> fECHANtCAL Company �r`
<br /> ignature Registered Y/1� Fee Current Y/N �:
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<br /> Address � License# �
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<br /> �THER � Company �
<br /> ignature Registered Y/(�I Fee Current Y/Id
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<br /> Address � License# �"`
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<br /> �irections: }I T.. ,.. �
<br /> FillOutappticationcompietely. � f; �I
<br /> Ow�er&Contracfor sign baCk of applica8on,notarized(Or,copy of signed corttract with owner) � �,
<br /> ff over$2500,a NoUce of Commencement is required(Mechanicat work over$5000) x:
<br /> Supply two(2)sets of drev+ings wfth applicable documentation � �
<br /> Allow 10-14 days(or review after submiqal date. Parcel#-obtained from Property Tax Notice(httpJlappraiser.pascogov.com) � �
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