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<br />Date Reoeived <br /> <br />ITl--'-9 ---0'4 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />~ 1 vrfb <br /> I I <br />RB II 715 II 9621 I <br /> II II <br /> <br />Contact Phone Nbr <br /> <br />Parsons Ice Cream <br /> <br />Owner Phone <br /> <br />Owner Name <br /> <br />Owner Address <br /> <br />5009 GALL BLVD, <br /> <br />Fee Simple Title Holder <br /> <br />I Titleholder Phone Nbr <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address 15009 Gall Blvd <br />Subdivision <br />n Bio-Hazard Waste Storage - ANNUAL <br />D Comm Exhaust Kitchen Hood - Duct <br />D Controlled Bum <br />D Emergency Generator <30 KW <br />D Emergency Generator> 30KW <br />~ Fire Protection Maintenance - Annual <br />D <br />D <br />Hood Clean - Suppression D <br />F ire alarm Installation <br /> <br />Sprinkler <br />Fire Alarm <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fire Pums <br />Fire Works <br />Flammable Application un Annual <br />Fuel Tanks <br /> <br />Lot Nbr. <br /> <br />Parcel ill <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier 11 or RQ Facility) Annual <br />Hood Installation <br />LP un Natural Gas Installation <br /> <br />LP un Natural Gas Annual Sale <br /> <br />Places of Assembly - Annual <br /> <br />B <br />B <br />B <br /> <br />Recreational Bum <br />Sparklers <br />Sprinkler System Installations <br />Standpipes ( Sprinkler System) <br />Torch Roofmg <br />Waste Tire Storage Annual <br /> <br />Value of Project <br /> <br />$1 I <br /> <br />Other: I <br /> <br />Contractor Sign I Company <br />Address I Registered y N I Fee Current I <br />Electrician Sign. License <br /> Company <br />Address I I Fee Current I <br /> Registered y N <br />Plumber Sign License <br />Address I Company <br />Mechanical I Registered y N I Fee Current I <br />Address L"c/3'~ License <br />Other Sign Company <br />Address I 18330 Lawrence Rd, Dade City, FI Registered y N 1 Fee Current I I <br /> License <br />Directions: <br />Fill out application completely. Company Security Fire Equipment, LLC <br />Owner & Contractor sign back of application, notorize ( Or signed ~-I I Fee Current I Y6 oS <br />Copy of contract with owner) (j) N <br />If over $2500,00, a Notice of Commencement is required <br />Mechanical work of ( $5000,00 ) requires a Notice of Commencent 502552000220004 <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10 .- 14 days for review after submittal date, <br />