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813 -780 -0020 City of Zephyrhills Fire. /0(if-30 Fax- 813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit I I <br /> l,. I <br /> Owners Name I ANDERSON PRESSURE CLEANTNG I Owner's Phone Number IRl 3 I I RR I S?nR I <br /> Owners Address I 5104 MURRAY HILL DR, TAMPA, FT,. 33615 -4734 <br /> Fee Simple Titleholder Name I Titleholder Phone Number I I I <br /> Fee Simple Titleholder Address I <br /> Job Address GOLDEN CORRAL 6855 GALL BLVD..ZEPHYRHILLS.FL.33542 -2576 Lot# <br /> Sub Division I I Parcel # I <br /> -7 -M =� .. <br /> _.?5. - =..?;?: S%�.� _. &- .�-^,. �a�..rr + ^,: ��,ss+mx "- ,4 €'Rc:a �x',.4 ,'r+..e«.� .:;': �c�a"'3S' ".fry. ..i�"�°�'z:Sc"?3 ..� ,v°..�,..,,: - - <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> ® Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum I-1 Hood Installation <br /> n Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas- ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> man semi) Gj1l1 other <br /> Sprinkler El ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ED ❑ ❑ ❑ 1 1 n Sparklers <br /> Hood Cleaning ® ❑ ❑ ❑ I l n Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> F Other: <br /> ,,..,: ,s:�.':. °ic <:a.,' ke -'.. ' ::�.s....c ter, :a:1 ..a?':✓�:;•' ,. :x -..: str' -:;� I <br /> Contractor Company I <br /> Signature Registered Y/ N I Fee Current I Y / N j <br /> Address <br /> ( License # I I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N j Fee Current I Y/ N J <br /> Address I <br /> 1 License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N J Fee Current I Y/ N <br /> Address I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I I License # I I <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N I <br /> Address License # <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 l /appraiser.pascogov.com) <br />