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813-780-0020 City of Zephyrhills Fire a021 <br /> Permit Application <br /> Date Received -v�t Phone ontact for ermit 813 867 <br /> Owners Name South Pasco Health Care Properties,Inc. Owner's Phone Number 407 975 3000 <br /> Owner's Address 485 Keller Rd.,Suite 250, Maitland 33542 <br /> Fee Simple Titleholder Name N/A Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 38250 A Avenue, Zephyrhills, 33542 Lot# L� <br /> Sub Division Parcel# 14-26-21.-0010-01300-0010 <br /> - - - (OBTAINED FROM PROPERTY TAX NOTICE <br /> Bio-Hazard Waste Storage=ANNUAL F7 Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct FI Hazardous Material(Ter II or RQ Facility)ANNUAL <br /> Controlled Bum F-1 Hood Installation <br /> Emergency Generator<30 kw a LP/Natural Gas-Installatior <br /> Emergency Generator 30 kw LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> Qtd FS—E-11 An Other <br /> Sprinkler ❑ ❑ ❑ 7 Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning El ❑, ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> aFire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> 0 Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address. License# <br /> ELECTRICIAN Company VdWr Constructors,LLC <br /> Signature o Zp Registered [YIN Fee Current Y/N <br /> Address 220 W 7th Ave. Suite 210 Tama FL 33602 License# EC13006590 <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 I Y/N Fee Current Y/N <br /> Address License# <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.com) <br />