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04- 26 -'10 16:19 FROM- Alliance Fire Safety 9414833321 /,C�/ T -692 P002/003 F -080 <br /> 813 - 780 -0020 City of Zephyrhills Fire ) /0 / r' Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received ( I Phone Contact for Permit I 941 I 485 1155y402x33 <br /> Owner's Name ( K -MART #3761 1 Owner's Phone Number i(,f /p 3 FO P <br /> Owner's Address ( 7422 GALL BLVD ZEPHYRHILLS, FL 33541 <br /> Fee Simple Titleholder Name l Titleholder Phone Number I I <br /> Fee Simple Titleholder Address I <br /> Job Address 7422 GALL BLVD Lot # I <br /> Sub Division L Parcel 11 34 25 0000 - 00300 - 000 <br /> El Bio- Hazard Waste Storage - ANNUAL I I Hazardous Material (Tier Il or RQ Facility) ANNUAL <br /> n Comm Exhaust Kitchen Hood /Duct I Hood Installation <br /> I —I Controlled Burn I I LP /Natural Gas - Installation <br /> I I Emergency Generator < 30 kw 1 1 LP /Natural Gas- ANNUAL Sale <br /> I I Emergency Generator > 30 kw L - <br /> FTC-1 Places of Assembly-ANNUAL <br /> J Fire m <br /> e Protection Maintenance - ANNUAL I 1 Recreational Hu <br /> pail 'Semi ILLI ter <br /> Sprinkler El CJ El U (l Sparklers <br /> Fire Alarm 0 L.] El f7 I 1 1 Sprinkler System Installations <br /> Hood Cleaning C ❑ U O I 1 Ii Standpipes (Sprinkler Sys) <br /> Hood Suppression Fl I fa 0 1)1 I I 0 Torch Roofing /Tar Kettle <br /> pi Fire Alarm Installation I , Waste Tire Storage ANNUAL <br /> n Fire Pumps <br /> I -1 Fire Works <br /> Ii Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> El Fuel Tanks <br /> Q Other: I I <br /> Contractor Company I <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I I License # ( I <br /> ELECTRICIAN Company I <br /> Signature — — Registered Y / N -I fee Current L - Y 1 N I <br /> Address I - - -- 1 License it --___I <br /> PLUMBER Company J <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address ( License# ( I <br /> MECHANICAL Company <br /> Signature — -- -- -- -- -- —� ) -- - -I Registered Y / N _ - I Fee Curren I Y / Ni <br /> Address ( / License # ( I <br /> OTHER �, . , r° Company ALLIANCE FIRE & SAFETY I <br /> Signature /l , ,(4. - ,L< a 2' ;/°? Registered Y / N [ Fee Current I Y / N I <br /> Address 1 500 BASE AVE E VENICE, FL 34285 I License .# 1 48254100012004 <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 - days for review after submittal date. Parcel # - obtained from Property Tax Notice (http:/ /appraiser- pascogov.com) <br />