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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � � '+0 Phone Contact for Permit 813 867 4370 <br /> Owner's Name Dairy Road Health Care Properties,Inc. Owner's Phone Number 407 975 3000 <br /> Owner's Address 485 Keller Rd., Suite 250 <br /> Fee Simple Titleholder Name NIA Titleholder Phone Number . <br /> Fee Simple Titleholder Address <br /> Job Address 7350 Diary Road, Zephyrhills, 33540 Lot# <br /> Sub Division Parcel# 35-25-21-0010-08500-0020 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> Bic-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Burn Hood Installation <br /> X I Emergency Generator<30 kw 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- Semi Anl Other <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> FI Flammable Application-ANNUAL 5y Valuation of Project <br /> Fuel Tanks <br /> 0 Other: <br /> Contractor Company <br /> Signature F Registered Y/N Fee Current I Y/N <br /> Address License# <br /> ELECTRICIAN Company voltA r Constructors,LLC <br /> Signature }' ��_J�L) Registered I Y N Fee Current Y/N <br /> Address 1 220 W 7th Ave., Suite 210. Tama FL 33602 License# FEC13006590 <br /> PLUMBER Company <br /> Signature F Registered Y/N Fee Current Y/N <br /> Address I License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered 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 S2500,a Notice of Commencement is required(Mechanical work over$5000' <br /> Supply two(2)sets of drawings with applicable documentation <br /> AIIow.10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />