|
s��asaoozo q ,��, City of Zephyrhiils Fire�� Fax-sla-7so-oo2�
<br /> � Permit A IE�ation
<br /> N�� . PP
<br /> _.
<br /> Date Received Phane Con2act for Permit �} ���i`�
<br /> ...:'�� ��:�.~-�..� �. �
<br /> Owner"s Name Gall Bouleval'd Land Trust � _ Owners Phone Number C� � �]
<br /> Owner'sAddress 350 Harbor Passage,Clearwater, FL 33767�
<br /> Fee Simpie Titiehoider Name Titiehotder Phone Number �� � ��
<br /> Fee 5imple Titleholder Address
<br /> , ,,;,.. , . , , , „ , ;� , ,,,,, < , .. ,
<br /> JobAddress 030 Gall BLVD,Ze hyrhills, FI �ot# �
<br /> Sub Division � , Parcel# 03-26-21-0010-12800-0000
<br /> , ... . ,. , _ � .,.,�.,�����:��r� . v ,
<br /> � Bio-Hazard Waste Storage-ANNUAL Q Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> oConfroiled 8um � Hood insfa(ia6on
<br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation ,„J,
<br /> � Emergency Generator>30 kw Q �PlNatural Gas-AP1N[!AL Sale �jN�r �� I
<br /> � Fire Protection Maintenance-ANNUAL � Places af Assembly-ANNUAL� r
<br /> r y em� A�n er
<br /> Sprinkier � ❑ ❑ ❑ � RecreaUonai Bum /'���y,�4
<br /> � ��'I�ET-'
<br /> ��
<br /> Fire Alarm � � O ❑ � � Sparkiers !
<br /> Hood Gleaning � ❑ ❑ ❑ � � Sprinkler System Installations � � l,J
<br /> Hood Suppressio� � � ❑ ❑ � � Standpipes{Sprinkier Sys} 1� ���� l��`�
<br /> � `
<br /> Fire Alarm Installation Torch Roofing/Tar Kettle I.iJJ �� �
<br /> Fire Pumps � Waste Tire Storage ANNIIAL ��
<br /> FlammableApplication-ANNUAL Valuation af Pro'ec�� ,
<br /> � � , S� �Q���
<br /> � Fuei Tanks _ ��
<br /> Q Other:
<br /> � ,.... -.,� � a
<br /> , _
<br /> , . ,
<br /> �.
<br /> Gontractor Company ►"��vi,.i�" - -
<br /> Signature Registered Y/N Fee Current /N
<br /> Address License#
<br /> ELEC7RICIAN Company
<br /> Signature Registered Y!t�l Fee Current Y/N
<br /> Address �icense#
<br /> PLUMBER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MECHANICAL Company
<br /> Signature Regisfered Y/N Fee Current Y 1 N
<br /> Address License#
<br /> OTHER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> ,, �.. ..,, _ w.�� ��--� ,, ,,,,,,,. ��,,.,,,.., �,,�
<br /> . . mv,��,h„ . ... , .,,�i,a�,...�r����,.".�i.�r�,�-"��,�„ , . ��.:;..:�W,:;�, „ „ . ..��,...._.""�,us:,,�
<br /> Directions:
<br /> Fili out appiication campleteiy
<br /> Owner&Contractor sign back of applicatian,notarized(Or,copy of signed contract with owner)
<br /> If over$2500,a Notice of Commencement is required(Mechanica!work over$5000)
<br /> Supply#wo{2}sets of drawings with appSiCable documerr#afion
<br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
<br /> �
<br />
|