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813-780 -0020 City of Zephyrhills Fire f v Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received IMESligill Phone Contact for Permit 800 868 9151 <br /> Owner's Name I Sweetbay #1752 I Owner's Phone Number I 813 I I 780 I I 1046 <br /> Owner's Address 1 7325 Gall Blvd, Zephyrhills, FL 33541 <br /> Fee Simple Titleholder Name I I Titleholder Phone Number 1 1 1 1 1 <br /> Fee Simple Titleholder Address I <br /> Job Address I 732 Gall Blvd ( Lot # <br /> Sub Division 1 I Parcel # I <br /> 0 Bio-Hazard Waste Storage - ANNUAL n Hazardous Material (Tier I1 or RQ Facility) ANNUAL <br /> 0 Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> 0 Controlled Burn n LP /Natural Gas - Installation <br /> 0 Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> 0 Emergency Generator> 30 kw 0 Places of Assembly- ANNUAL <br /> 0 Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> r y emi OA [ ' yly � <br /> Sprinkler ❑ ❑ ❑ ❑ is Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm 0 ❑ ❑ ❑ 1 1 El Sprinkler System Installations <br /> l` r <br /> Hood Cleaning ❑ ❑ ❑ ❑ I 1 10 Standpipes (Sprinkler Sys) <br /> Hood Suppression 0 ❑ ❑ ❑ 1 1 n Torch Roofing/Tar Kettle <br /> 0 Fire Alarm Installation a Waste Tire Storage ANNUAL „ L <br /> o il ',� <br /> Fire Pumps J1 4 <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> 0 Fuel Tanks <br /> Q Other: I , <br /> Contractor <br /> Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I <br /> I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N I <br /> Address I I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address ( I License # <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I I License # <br /> Ci ii <br /> I <br /> Vendor Company TNT Fireworks <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address 6255 SE 78th Street, Ocala, FL 34474 License # <br /> Directions: � ' i <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 /> - Site plan at store - placement dictated by Fire Marshals office <br /> - State Sparkler Licence attached <br /> - Product List attached <br />