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813-780.0020 City of Zephyfiilis Fire Fax 813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 727 5811 9339 <br /> ice:,--�:�.._.: ._... �....m....._...----^•s-.�.�_..-� --- -Owner's Name SF ZEPHYR COMMONS LP Owner's Phone Number <br /> owners Address 4-00 CLEMATIS ST_STE 201, WEST PALM BEACH, FL 33401-5322 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 7838 GALL BLVD, ZEPHYRHILLS, FL 33541 Lot# <br /> Sub Division r Parcel# 35-25-21-0130-00000-0140 <br /> Bio-Hazard Waste Storage-ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Burn Hood Installation <br /> Emergency Generators 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 /> ® emi n or <br /> Sprinkler � ❑ ❑ ❑ ® Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch n arRft <br /> Fire Pumps to Tire Storage ANN L <br /> RFlammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> ec - <br /> Contractor Company PIPER FIRE PROTECTION <br /> Signature H Registered T Y 1 N fee Current . Y/�— <br /> Address"13075 US IG WAY 19N CLEARWATER, License# 45152300011999 _ <br /> ELECTRICIAN <br /> Company <br /> Signature Registered Y/N Fee Current -Y/N <br /> Address - License# <br /> PLUMBER Company -. <br /> Signature Registered Y I N Fee Current Y/N <br /> Address — - - License# <br /> MECHANICAL Company Signature Registered �_ Y/N Fee Current _ Y N J'- <br /> Address License# <br /> OTHER - Company <br /> Signature Registered `•- Y/N Fee Current <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$50001, <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:ilappraiser.pascogovoom) <br />