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81.3-780-0020 C4 of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 800 1 868 9151 <br /> Owners Name Wal-Mart#706 Owner's Phone Number <br /> Owner's Address 7631 Gall Blvd,Zephyrhills, FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address [7631 Gall Blvd Lot# <br /> Sub Division Parcel# <br /> Bio-Hazard Waste Storage-ANNUAL Hazardous Material(Tier 11 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 /> P Mry F e—m Ji F 7n M Fe—r 7 <br /> Sprinkler F� 0 El 0 FX Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm 7 0 0 11 F-1 Sprinkler System Installations <br /> Hood Cleaning F-1 0 El 0 7 Standpipes(Sprinkler Sys) <br /> Hood Suppression F] 0 0 0 F Torch Roofingrrar Kettle <br /> F-1 Fire Alarm Installation Waste Tire Storage ANNUAL <br /> F7 Fire Pumps <br /> Fix Fire Works-SPARKLERS <br /> F-1 Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current [_=/N <br /> Address License# <br /> ELECTRICIANI Company <br /> Signature Registered Y/N Fee Current L_L/NJ <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current =/N <br /> Address License# F_ <br /> MECHANICAL Company I <br /> Signature Registered Y/N Fee Current N <br /> Address License# <br /> Vendor Company ITNT Fireworks <br /> Signature Registered I Y/N Fee Current L�/N <br /> Address 16255 SE 78th Street, Ocala, FL 34474 License F_ <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) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(hftp://appraiser.pascogov.com) <br /> -Site plan at store-placement dictated by Fire Marshals office <br /> -State Sparkler Licence attached <br /> -Product List attached <br />