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613-760.0020 City of ZephythMs Fire Fax.S13 784-11G21 <br /> Permit Application ; <br /> Data Received _ _ gone contactrar Permit 581_ 93x 9 !. <br /> r�.:,.,u,�-�.:�;•.�. -- - - ---:a _.__.�_�;.»'%.._._.. _ .�:..-��;.Lr�:.-_.t_ :'��;.^ -::.etc �.a<� _�� ._ .ar—�—�--� _�,—_.--_� <br /> Owner's Noma KSFZEPHYR COMMONS LP4 oNmeretafwnsNnmber <br /> Owners Address 40 CLEMATIS ST STE 201,WEST PALM BEACH, FL 33401-5322 <br /> Fee simple Titiehoider Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> ,= i <br /> Job Address 7838 GALL BLVD ZEPHYRHILLS, FL 33541 Lct.# <br /> Sub Division parcel# 5-2541-0130-00000-0140 <br /> r Bio-Hazard Wads Storage-ANNUAL � Fumlgadon Tard <br /> k <br /> Comm Exhaust K)tchsn HoodtDuct Hazardous Material(Tier It or RQ Faulty)ANNUAL <br /> Controlled Sum Hood Installation <br /> Emergency Generator<30 kw LPiNatutai Gas-kfstailatter <br /> REmergency Generator>3D kw LPINatu ak -ANNUAL Sub <br /> Fire Protectlon Matntenanoa- NUAL� I Places of Assembly-ANNUAL <br /> 9 1 er <br /> sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fre Alarm n ❑ 0 ❑ Sparklere <br /> Hood Cleaning (��j O ❑ ❑ Sprinkler System installations <br /> Hood Suppression 0 ❑ p Rmste <br /> Stadptpas(Sprinkler Sys) <br /> Fire Alarm Instaliatlon Torch RoofingfUr Kettle <br /> E3 Fire Pumps Tire Sin.ANNUAL <br /> ® Flammable Application-ANNUAL Valuation of PfiO)EC{ <br /> Fuel Tanks <br /> L..� er. _ <br /> Corrtraclar Company PIPER FIRE PRCTECTi <br /> signature Repisterad YIN Fee Current <br /> Address Lis t AY 19N CLEARWATE [wnse# 145152366011999 <br /> ELECTRIC" company I <br /> Signature Registered I Y/N,-1 Fetes Current Y I N �A <br /> Address Licensed ' <br /> PLUMBER Company <br /> Signature Registered �_ _r_/MTF'ee Cruieni r Y l id <br /> Address] License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current <br /> Address Uoenee 8 <br /> OTHER Company <br /> ftnatws Ragiewed ' N . Fea Garrard -MY/N <br /> Address License e. <br /> Diredons: <br /> FBI out application completely. <br /> Owner&Contractor sign back of application,notarized(Or.copy of signed oombod with owner) <br /> If over WOO.a Notice at Commencement is required(h%clhanical work mmr$S=) <br /> Supply two(2)sate of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Penal#-obtained from Property Tau Notice(httpdrappralser.pascogoy.canr) <br />