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613-760a20• City of Zephyrhills Fire FaXA13.780-0021 <br /> Permit Application <br /> Dale Received PbonsC rdwAforPermit `,S1 3 ail . _a591 <br /> Owner's Name, Ch3clt-,f.11=A; InC: Owna'sPhor►e-Number <br /> 502 753 6624 <br /> �. � <br /> Owners Address 52.0'0 .Buff ington Road•, Atlanta, GA. 3 034'9 <br /> Fee Sknpla1106holdertVam•- F._Z., r Commons Outparcel LP lmhclderPhoneNumber 954 557 6869 <br /> Fie simple r0hoklerAddrese. . Suitd One,- Maw am, ntario <br /> Job Address7490 Gall Boulevard Main Permit # BNC-000526-2 2 <br /> Lot# <br /> Subdivision Ztrphyr, Commons Pam.#_ 35-25-21-,0130-00000-0110 <br /> ter• ._.. :,.�.,.-� - - <br /> Lj <br /> 6104azard'Waste Storage-ANNUAL a FUmigatbn Tenn <br /> a Comm Exhaust Kitchen HoodMuct a Hazardous Material(Tier Itor:RQ Facft)ANNUAL <br /> 0 Controlled Bum Hood Instay®don t <br /> Emefgency Generator<30 kw LPIWaWrel Ges-Instaliatior <br /> 'Emergency Generator;-30 kw LP/Natuml Gvs-ANNUAL.Sa1e, <br /> Fir•Protection Maintenance-ANNUAL Places of Assembly-ANNUAL a <br /> em ,®_ r <br /> Sprinkler O 13 ❑ Recreational gum- <br /> FireAlarm ❑ ❑ ❑ Spwklvrs%: <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ O Standpipes(SprIhIder.Sys) <br /> Torch <br /> Keft <br /> Fi�Aumps telletion Waste Ttre-Storagre.ANNUAL <br /> 8 Flamm"Appikeptlon--ANNUAL Valueftwof.Projeot ,^ 0 <br /> ,,,fuel Tanks <br /> i <br /> Convector Company <br /> Signore Registered I YIN Fee Cum u t Y/N <br /> Address- . ucmw*. <br /> ELECTRICIAN Company <br /> Signature RegkiteredI Y/N Fee current <br /> Address. ucwm# <br /> PLUMBER Company <br /> Signature Registered I Y/K Ne,Currem Y I N <br /> Adclrsu;j License 40 <br /> MECHANIC L Company <br /> abnat" Z Regis>red I .Y/N I F«Conant Y/N <br /> Address 7 7 27. Lberlss�!' <br /> OTHER Z <br /> --- __ Company. <br /> Slgnahnm — -- Registered N FeeCrarerrt I YIN' <br /> Addreu.. Ucense# . <br /> Diredbna: <br /> Fig out'applic ation 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(Mechankml work over t5000) <br /> Supply two(2)sole of drawings with epplWable documentation <br /> Allow 10-14 days for review after submittal date: Parcel*=obtained fram,Propacty Tax:Notice(Mtp:/lappraiser peecogov oom) <br /> i <br /> s <br />