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813 - -0020 <br /> City of Zephyrhills Fire f O Z(- Fax -813- 780 -0021 <br /> Permit Application <br /> Phone Contact for Permit 1 1 I,_I <br /> Date Received .r d� � _. �z x; ,.. s 4 < a,Y m_ ., . Contact ,r .rrit <br /> Owners Name 1 The Magnuson Hotel I Owner's Phone Number l 813 11783 119 9 2 6 <br /> Owners Address 1 5734 Gall Rd Zephyrhills F1 33542 I <br /> Fee Simple Titleholder Name <br /> I same I Titleholder Phone Number I I I I Fee Simple Titleholder Address I <br /> s ,; . - A:x a ,'>7'r 14,0 1 '"4? ?'rt. :"? , .. ,, t? F?,??.•' ?t "'^ . x e. . s , R 'i?*i .1.fi ; 4.0 <br /> F .. <br /> �i��� <br /> Job Address I 5-7-8-5'Gall B1 vd Zephyrhills Fl 33542 I Lot# <br /> Sub Division 1 I Parcel # <br /> . .':'. :? . .......v.. key:,kaZga*` 4" :I,1 « "q,:ax..'svgaX-YV1 . «s4w:::.V.!k MM., '. (4f£,s <br /> „,,,- ,. -r',_ „ , , ''i”' . "M«w". �.$`3eJHi`t Nk. :a.50.?..:Al .Wrat 7i.;, iykri'8 <br /> Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> a Emergency Generator < 30 kw n LP /Natural Gas - Installation • <br /> in Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> ® Fire Protection Maintenance - ANNUAL in Places of Assembly- ANNUAL <br /> ❑ ry prim � It� I <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarrn <br /> © ❑ ❑ X I 1 n Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ 1 1 n Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works I I <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> El Other: I <br /> .Q4V CI- r.'_ s £`..`..;, " a.0 'Sig :€..,:a kk' aa,`a,4 .v,,.x` u'' >�¢,�," "uiaz:0k;.0 a<. giMWL5$s..,x„ .. R. ,:,.74Mig;._::m"tolt..,.::;� » "C. ....::`'#te..',U:VK �._,n,r..Ats... .c <br /> Contractor Company Russell Electrical Const LLd <br /> Signature (-- Registered Y/ N I Fee Current I Y/ N <br /> Address 141224 Boat Landing Rd Umatilla F1 1 License# ( 0002542 I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # 1 <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y / N <br /> Address I 1 License # ( ( <br /> MECHANICAL Company ( <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I 1 License # <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N 1 <br /> License # <br /> Address ( <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 $5000) <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: / /appraiser.pascogov.com) <br />