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<br />Date Received <br /> <br />1~200R <br /> <br />I Dairy Queen <br />Owner Address <br /> <br />Fee Simple Title Holder I <br />37930 Medical Arts Court <br /> <br />Owner Name <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Contact Phone Nbr <br /> <br />Owner Phone <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br />352-424-0906 <br /> <br />R13 <br /> <br />I I 7RO I I 2R26 <br /> <br />I Titleholder Phone Nbr <br /> <br />II II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Lot Nbr. <br /> <br />Subdivision <br /> <br />I ,.... G.tl BI.., '_"I., R <br /> <br />L-TI <br /> <br />,9130 1YlE1/I<:.IR ART' <br />I Parcel ID <br /> <br />Company <br /> <br />Registered <br /> <br />license <br />Company <br /> <br />Registered <br /> <br />license <br /> <br />Company <br /> <br />Registered <br /> <br />license <br /> <br />Company <br /> <br />Registered <br /> <br />license <br /> <br />Directions: <br />Fill out application completely. Company <br />Owner & Contractor sign back of application, notorize ( Or signed <br />Copy of contract with owner) Registered <br />If over $2500.00, a Notice of Commencement is required <br />Mechanical work of ( $5000.00 ) requires a Notice of Commencent <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10 -14 days for review after submittal date. <br /> <br />118330 Lawrence Rd. Dade City, FI <br /> <br />B Bio-Hazard Waste Storage - ANNUAL 0 <br /> Fumigation Tent <br /> Comm Exhaust Kitchen Hood - Duct 0 <br />0 Hazardous Material (Tier II or RQ Facility) Annual <br />Controlled Burn 0 <br />0 Hood Installation <br />Emergency Generator <30 KW <br />0 0 LP - Natural Gas Installation <br />Emergency Generator> 30KW <br />D Fire Protection Maintenance - Annual 0 LP - Natural Gas Annual Sale <br /> Sprinkler 0 0 Places of Assembly - Annual <br /> Fire Alarm 0 <br /> Hood Clean - Suppression [k1 E] Recreational Burn <br />0 Fire alarm Installation Sparklers <br />0 Fire Pums E] Sprinkler System Installations Value of Project <br />0 Fire Works Standpipes ( Sprinkler System) $1 1 <br />0 Flammable Application - Annual E] Torch Roofing <br />0 Fuel Tanks Waste Tire Storage Annual <br />0 Other: I <br /> <br />Contractor Sign <br /> <br />Address <br /> <br />Electrician Sign. <br /> <br />Address <br /> <br />Plumber Sign <br /> <br />Address <br /> <br />Mechanical <br /> <br />Address <br /> <br />Other Sign <br />Address <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />I <br /> <br />Security Fire Equipment, LLC <br />Y N I Fee Current <br />502552000220004 <br />