Laserfiche WebLink
-�i � <br /> s�s-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received 0113112017 � Ptrone Contact for Permit 813 R 9$0 � 32$2 <br /> Owner's Name � ����y Road Heal#h Gare P(operties(nc. Owner's Phone Number �� �� � <br /> Owner's Address 485 N. Keller Road,Suite 250, Maitland, FL 32751-?535 <br /> Fee Simple Titleholder Name Titleholder Phone Number l� �� �� <br /> Fee Simpie Titleholder Address <br /> r--•--_,.-�•----• ,.--.,.~.....°.,--_.,.^'-'�.""`,_•',t <br /> .�ob Address 7350 Dai Road 2e h rhills F�33540-'!354 Lot# � <br /> Sub Division Parcel# 35-25-21-0010-0$500-0020 <br /> �—`--�.–�-.�'� ---� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Camm Exhaust Kitchen HoodlDuct � Hazardous Material{Tier tI ar RQ Facility}ANNUAL � <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generatar<30 kw � �P1Naturat Gas-Insta[2ation <br /> ; <br /> a Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale , <br /> � Fire Protecfion Nlainfenance-ANNUAL � Ptaces of Assembly-ANNUAL <br /> tr y emi � t er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers ���(, �� ' <br /> Hood Cieaning � Q ❑ ❑ � X❑ Sprinkier System instailations , <br /> Hood Suppressian � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> QFire Alarm Instailation � Torch RaofngtTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL �",�(o�l+����� <br /> ��;�. , Valuation of Project <br /> QFue!Tanks <br /> Q Other; Change existing sprinkler heads from pendent to semi-recessed pendent and add 1 head. � <br /> Contractor Company ' <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company � <br /> Signature � Registered Y/(� Fee Current Y/N <br /> I <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y!N <br /> � <br /> Address License# ' <br /> MECHANIGAL Gampany <br /> Signature Registered Y/�I Fee Current Y/N <br /> Rddress License# i <br /> OTHER � � company Cox Fire Protection, Inc. j <br /> Signature ���� � � , �}1 Registered N Fee Gurrent Y 1 N <br /> Address 7910 Professional Place,Tam a, FL 33637 �icense# 016982-0001-1985 <br /> �`_.'"".�. .�...._ __�___.__�� -- ..----------� <br /> Directions , � <br /> Fill out appiicatian 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$5044} <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submitta!date. Parcei#-obtained from Property Tax Notice(http:!lappraiser.pascogov.com} <br />