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81s- 780 -0020 City of Zephyrhills Fire ? Fax -813- 780 -0021 Permit Application 41 (0 o Date Received I Phone Contact for Permit 1813 1 1630 I 10303 I Owner's Name ephyrhills Plaza LLC I Owner's Phone N umber I 1 1 I I Owner's Address 5236 Commercial Way, Springhill FL 34606 Fee Simple Titleholder Name Titleholder Phone N umber I Fee Simple Titleholder Address Job Address Beall's Store # 30 7425 Gall Blvd., Zephyrhills FL 33541 -4311 Lot # 11 Sub Division Zephyrhills Commons Parcel # 134-25-21-0160-00000-0010 I Bio- Hazard Waste Storage - ANNUAL h Fumigation Tent E Comm Exhaust Kitchen Hood /D uct n Hazardous Material (Tier II or RQ Facility) ANNUAL nI Controlled Burn Ii Hood Installation I — I Emergency Generator < 30 kw I LP /Natural Gas - Installation El Emergency Generator > 30 kw I] LP /Natural Gas - ANNUAL Sale © Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL ry 'Semi' GLII MEM Sprinkler © ❑ ❑ l I I Recreationai Burn Fire Alarm 0 ❑ ❑ ❑ 1 1 17 Sparklers Hood Cleaning I] ❑ ❑ ❑ 1 1 I Sprinkler System Installations Hood Suppression 0 ❑ ❑ ❑ I I 7 Standpipes (Sprinkler Sys) 7 Fire Alarm Installation I Torch Roofing/T ar Kettle a Fire Pumps n Waste Tire Storage ANNUAL I - I Fire Works ri M Flammable Application- ANNUAL 50 I Valuation of Project Fuel Tanks n Other: I Contractor Company 1.41 _ 1 ■ 1. m ..MPcric � ,• .4 , , 1).„X„., Signature ( Registered X N Fee Current X / N Address 13226 Cherry Palm Drive, Tampa FL 33619 I License # I/ I ELECTRICIAN Company Signature Registered Y / N I Fee Current I Y/ N I Address I I License # I PLUMBER Company Signature Registered Y/ N J Fee Current I Y/ N I Address I I I I Li�ens a is MECHANICAL Company Signature Registered Y / N I Fee Current 1 Y/ N I Address 1 I License # I OTHER Company I Signature Registered Y / N I Fee Current 1 Y/ N I Address I I License # Directions: Fill out applic ation completely. Owner & Contractor sign back o f application, notarized (Or, copy of signed contract with ow ner) If over $2500, a Notice of C ommencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com )