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, e s=7ap-oozo City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received �—`� Phone Contact for Perrnit 8�10 868 � 9151
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<br /> Owner's Name � Wal-Mart#706 Owner's Phone Number 813 7$2 1957
<br /> Owners Address 7631 Gall Blvd,Zephyrhills, FL 33541
<br /> Fee Simple Tittehol tder Name Titleholder Phone Number �..� [� ��
<br /> Fee Simpte Titleh tder Address
<br /> _ .-,., .,----.�."'""-_�
<br /> _ , � 7631 GaA Blvd ��
<br /> Ja6 Address Lat#
<br /> Sub Division I Parcel#
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<br /> ���BiaHazard Waste Storage-ANNUAL � Hazardous Materiat(Tier II or RQ Facility)ANNUAL
<br /> i� Comm Exhaust Kitchen Hood/Duct � Hood Instatlation
<br /> � Gontrotled Bum � LP/Natural Gas-tnstallation ����
<br /> � Emergency Generator<30 kw � LP/Naturat Gas-ANNUAL Sale �� �y�
<br /> S'
<br /> � Emergency Generator>30 kw Q Piaces of Assembly-ANNUAL 1�}����
<br /> � Fire Protection Maintenance-ANNUAL � Recreafionat Burn ��A��
<br /> fr y emi � er /�� �'f 4
<br /> Sprinkler � ❑ ❑ 0 8 X� Sparklers lnside Retail Sales of a�Q���Sparklers
<br /> i �D �,
<br /> Fire Alarm � ❑ C7 ❑ � � Sprinkler System InstaAations ��`
<br /> Nood Gieaning � ❑ ❑ ❑ � � Standp'spes{Sprinkler Sys} Gy^"�'�
<br /> ( Hood Suppcession � ❑ ❑ ❑ � � Torch RaofinglTar Kett2e �,. ��
<br /> ,{ Fire Alarm instaitation � Wasfe Tire Storage ANNUAL ��
<br /> � Fire Pumps �
<br /> � Fire Works-SpARKLERS
<br /> � Flammable Application-AMNUAL �~� Valuation af Project
<br /> � Fue!Tanks
<br /> ,I Other:
<br /> �.�...-_.M, .,�..�,.�-.,.,,�. �-.,...---_- ..�..._...�...-�,,,�.. ,...�.,._A-�.;:-----..---9,
<br /> - - �
<br /> :ontractor I Company
<br /> iignature l) Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> :LECTRICIAN � Cpmpany
<br /> cignature � Registered Y/N Fee Current Y/N
<br /> Address i License#
<br /> �LUMBER � Company
<br /> �ignature i Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> IECHANICAL � Company
<br /> ignature ( Registered Y/N Fee Current Y/N
<br /> Address �� License#
<br /> �
<br /> endor �) company TNT Firewarks i
<br /> ignature Registered Y/.N Fee Curzent Y/N
<br /> Address 62'55 SE 7$th Street, Ocala, FL 34474 �icense#
<br /> ,�-_�r , .. . . . _ .. . ., . ._ ..-..�-r„-�-. �,
<br /> irections: ,�
<br /> Fill�� ut application completely.
<br /> Owt�er&Contractor sign back of appiication,nofarized(dr,copy of signed contract with owner)
<br /> If oyer$250Q,a Notice of Commencement is required{Mechanicai work ovet$5000}
<br /> Supply two(2)sets of drawings with applicable documentation
<br /> Atlo�✓10-14 days ior review after submitta(date. Parcet#-obtained from Property Tax Notice(http:/lappraiser.pascogov.com)
<br /> -Site !an at store-placement dictated by Fire Marshals office
<br /> -State Sparkler Licence attached
<br /> -Prod ct List attached
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