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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Date Received Permit Application <br /> 09/13/2 17 Phone Contact for Permit <br /> Owners Name Dairy Road Health Care Properties Inc. Owners Phone Number <br /> Owners Address 485 N. Keller Road, Suite 250, Maitland, FL 32751-7535 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 7350 DairV Road, Zephyrhills, FL 33540-1354 Lot# <br /> Sub Division Parcel# <br /> —35-25-21-0010-08500-=020 <br /> Bio-Hazard Waste storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier[I or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installation <br /> F� Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> EDFire Protection Maintenance-ANNUAL o Places of Assembly-ANNUAL <br /> f7rTyl Pe—mIQ Fn-q MFe_r1 <br /> Sprinkler F-1 0 El 0 Recreational Bum T <br /> Fire Alarm ❑ El n H--SWarkl P. <br /> Hood Cleaning F-1 0 11 0 X Sprinkler System InstallationsV <br /> Hood Suppression Sprinkler <br /> lpes ys) <br /> F-1 Fire Alarm Installation F El 0 El <br /> F-1 Fire Pumps Torch Roofingrrar Kettle <br /> F-1 Waste Tire Storage ANNUAL <br /> Fire Works <br /> MFlammable Application-ANNUAL $16,430 Valuation of Project <br /> Fuel Tanks <br /> LF-_1 Other: Add, re lace or relocate 4 <br /> heads. <br /> Contractor Cory <br /> pany <br /> Signature <br /> Registered Y/N Fee Current [_Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N —Fee Current L Y <br /> Address License# <br /> PLUMBER F_ Company <br /> Signature Registered I Y/N j Fee Current L=/N <br /> 'Address L License# Ll <br /> MECHANICAL Company <br /> Signature L Registered Y/N. I _aescwrrent---I Y/N <br /> Address License# <br /> OTHER <br /> Signature Company Fire Protection, Ind. <br /> Registered Y/N <br /> I Fee Current] I Y/N <br /> Address 7910 Professional Place,Tampa,�FL 3�3637 License# 016982-0001-1985 <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(http://appraiser.pascogov.r-om) <br />