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; 813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> � � Permit Application <br /> Date Received � Phone Contact for Permit 800 868 9151 <br /> , -__._, �. _._. .__�.-�-.___�._.,..�».wc----.-�_�._� <br /> , <br /> _..�..�..,,...:. -•�,,.,••-_,m•--�.-,•.•-._,� .. _�, :., e_. . <br /> Owners Name Rural King#0101 owners Phone Number 813 779 0200 <br /> Owners Address 7422 Gall Blvd,Zephyrhills, Florida 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple TitleholderAddress - <br /> � <br /> Job Address 7422 Gall Blvd Lot# � <br /> Sub Division Parcel# <br /> �"�'...'.�""_.,". �. .�.v..,. m <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Bum � LP/Natural Gas-Installation � <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale <br /> , � Emergency Generator>30 kw � Places of Assembly-ANNUAL <br /> � Fire Protection Maintenance-ANNUAL � Recreational Burn <br /> r y emi �n er <br /> Sprinkler � ❑ ❑ ❑ 8 X� Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Cieaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) �i� / �/�� 1�// <br /> �_ � � �T_ <br /> Hood Suppression � ❑ ❑ ❑ � � Torch Roofing/Tar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> � � Fire Pumps <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> r�'°'��~-v-- x . - _�.�~'..~�__..�._....�.�_...�_ �.,...,._��.�._......_�ti�-�'_�.��..�._v:...��. ._._..___.__..._.__�._.,_..__....._........WI <br /> contractor Company TNT Fireworks <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 6255 SE 78th Street, Ocala, FL 34474 License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ��."`•_".�"""" "_."_'��.�� <br /> Directions: <br /> Fill out application 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$5000) I <br /> Suppiy two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) , <br /> -Site plan at store-placement dictated by Fire Marshals office � <br />