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City of Zephyrhills Fire Fax-813-780-0021 <br /> 813-780-0020 <br /> Permit Application <br /> Phone contact for Permit F-6180 <br /> Date Received <br /> Owner's Name Publix#1245 Owner's Phone Number 813 DE 1957 <br /> Owners Address 7838 Gall Boulevard,Zephyrhills, FL 33541 <br /> Fee Simple'Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> 7-- <br /> 5�7 <br /> Job Address 7838 Gall Boulevard Lot# <br /> C� <br /> Sub Division Parcel# <br /> Hazardous Material(Tier 11 or RQ Facility)ANNUAL <br /> Blo-Hazard Waste Storage-ANNUAL <br /> Comm Exhaust Kitchen Hood/Duct Hood Installation <br /> Controlled Burn Q LP/Natural Gas-Installatiop <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 Pe—mli F9 MtTeW7 <br /> Sprinkler F-1 0 0 0 F-1 Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm F-1 0 0 0 7 Sprinkler System Installations <br /> Hood Cleaning 0 11 0 El = F-1 Standpipes(Sprinkler Sys) 17 <br /> Hood Suppression F 1 0 0 0 F-1 Torch Roofing/Tar Kettle- <br /> F-1 Fire Alarm Installation Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> Fire Works -SPARKLERS <br /> F-1 Flammable Application-ANNUAL r Valuation of Project <br /> F-1 Fuel Tanks <br /> Other: <br /> Contractor Company <br /> Signature F Registered Y/N Fee Current -=/N <br /> Address License# 71 <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/_N_ Fee Current �IN <br /> Address E_ License <br /> MECHANICAL Company T_Y/N I <br /> Signature Registered Y/N Fee Current <br /> Address License <br /> Vendor Company ITNT Fireworks <br /> Signature Registered I Y/N Fee Current I Y/N <br /> Address [6255 SE 78th Street,Ocala, FL 34474 License <br /> Directions: Fill outapplication 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 /> -Site plan at store-placement dictated by Fire Marshals office <br /> -State Sparkler Licence attached <br /> -Product List attached <br />