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a�3aaa-oo2o City af Zephyrhiils Fire Faac-ais-�so-oo2a <br /> � . , Permit Application <br /> Date Received � � Phone Confact for Permit 352 544 1100 <br /> :=--_��-_._.___...._.- ._ --- -_-_---.._._T�=.w.._- �-'Y--'- ►-_,..'-;,_-�..�._ "'_ <br /> Owner's Name S&L Properties Zephyrhills,LLC � Owner's Phane Number 608 W� 742 2893 � <br /> Owner's Address 2651 Kirking Court,Portage,WI 5390i <br /> Fee Simple Titleholder Name Pasco County School District Titleholder Phone Number �� � � <br /> Fee Simple Titieholder Address <br /> --�._.,_____.—�__�..- --- ---__,-.___ --- -------�--- ----------_ -___.�--- --� <br /> �JobAddress 6386 GaII Blvd {Culver's Restaurant} � /bt��nl BhjLpr,ni� PErtar,r�19j�5 �ot# �� <br /> Sub Division p�j��# 42-26-21-000000 7Q00 040 <br /> �..- --- --__.;-- _ ' =..��._...-..----�:...__�:.V_�..:_.� -_.._=.---��:=- - -_- -- _..___ -- -- -�- � <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Ki#ohen Haod/Duct � Hazardous Materiai{Tier tl or R4 Facitity)ANNUA� <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � �P/Naturai Gas-installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Profectian Nfaintenance-ANNUAL � Places of Assembiy-ARiN1JAt <br /> try emi �n t er <br /> Sprinkter � ❑ ❑ ❑ � E2ecreational Burn `�j1'(�' <br /> ..�� ,�.-r <br /> Fire Alarm � ❑ O ❑ � � Sparklers q <br /> KoQd Cleaning � ❑ ❑ ❑ � � Sprinkte�Sysfem Instatlatians <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm 3nstallation Q Torch Roofrngii'ar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Ftammable AppIiC�Bon-ANNUAL ��JV�-� Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address �icense# <br /> EL.ECTRICIAN Company <br /> Signature Registered Y 1 N Fee Gurrent Y J RI <br /> Address License# <br /> P�UMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company JAX HVAC, (C1C. <br /> Signafure Registered Y N Fee Current J N . <br /> Address 1529 S 3c'd St., Jackso ' e Beach, FL 32250 �icense# CMC1250544 <br /> O7HER Company <br /> Signature Registersd Y 1 N Fee Gurrent Y(N <br /> Address License# <br /> ----__-------_....—_ .__. _----_____._.__,_-------------- <br /> Directions: - ---------- --------_._..�__ _._.___.._�__ <br /> Fill out application completely <br /> Owner 8 Gontractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> tf over$2500,a Notice of Commencement is required{Mechanical work over$500f1} <br /> 5uppiy two(2}sets of drawings with appiicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtai�ed from Property Tax Notice(http://appraiser.pascogov.com) <br />