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913 - 780-0020 City of Zephyrhiils'Fire L`j Fax - 813 - 790-0021
<br /> i I
<br /> Permit Application ( I
<br /> Date Received 1 1 Phone Contact for Penns 1 •• 7 -
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<br /> 27-687 1 28C
<br /> I
<br /> Owners Name 'Alliance Church of Zophyerhills I Conte Phone Number 1813 -782 -8865 11 I
<br /> Owner's Address 16251 Fort King Rd. Zephyrhills, Florida 33542 • I
<br /> Fee Simple Titleholder Name (Alliance Church of Zephyrhills 1 Titleholder Phone Number 1813- 782 -8865 1 1 I
<br /> Fee Simple Titleholder Adores., 16251 Fort King Rd. Zephyrhills, Florida 33542 I
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<br /> Job Address 16251 Fort Kin >Rd. Zephyrhills, Florida 33542 Lot# l I
<br /> Sub Division I Parser a 03- 20- 21 -Q010- 09500-0000 I
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<br /> 0 Bio-Hazard Waste Storage - ANNUAL Fumigation Tent
<br /> 0 Comm Exhaust Kitchen Hood/Duct u Hazardous Material (Tier 11 or RO Facility) ANNUAL.
<br /> 0 Controlled Burn 0 Mood Instadadon
<br /> Q Emergency Generator < 30 kw = LP/Natural Gas - Installation
<br /> I I Emergency Generator 3. 30 kw f LP/Natural Gas - ANNUAL Sale
<br /> 0 Fire Protection Maintenance- ANNUAL I Places of Assembly- ANNUAL
<br /> Sprinkler Lj O 0 0 0 Recreadonal Bum
<br /> tiro Alarm El O O O n SparMon:
<br /> Hood Cleaning © O O X 1 Sprinkler System Installations
<br /> Hood Suppression D ❑ ❑ f7 a Standpipes (Sprinkler Sys)
<br /> Fire Alenn Installation = Torch Roofing/Tar Kettle
<br /> 0 Fire Pumps Q Warts Tin: Storage ANNUAL
<br /> R Are Works
<br /> Flammable Appllcallon- ANNUAL 3501 Valuation of Project
<br /> I_I Fuel Tanks
<br /> 0 Other: 1 • I
<br /> + :r?4nmx wi ¢:A•;! I1 r% larill "it4tF.IIMIATZTAJ'JfirS :IR:•` 71101 .1$17 d:.RR^er4". :.... ` ,,..,,-, • '.4... n . 'c• w. ^a .... - A,,, .. :a.... : 1 ........... ...x >: ,:tir.?7C.^."r.v.r
<br /> contractor `Kevin Hoch Company Fire Systems Inc, I
<br /> Signature Registered Y/ N J Fee Current I Y / N I
<br /> Address IP.O.Box 48741 St. Petersburg, Florida 33743-8741 1 License I I
<br /> ELECTRICIAN • Company I
<br /> sic...hue Registered Y / N J Fee C "rent I Y/ N I
<br /> Address I I License* 1
<br /> PLUMBER I Company I
<br /> Signature Registered Y / N j Fee Current I Y / N I
<br /> Address J 1 License* I
<br /> MECHANICAL Company I
<br /> Signature Registered Y/ N J Fee Current I Y / N I 1
<br /> Address I 1 # I
<br /> OTHER Company I
<br /> Signature Reoistered ( Y/ N 1 Pea t:urrant I Y/ N I
<br /> Address I I License*
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<br /> DIrecdon3: .. ...
<br /> All out application completely,
<br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner)
<br /> If over 52500. a Notice of Commencement is required (Mechanical work over S5000)
<br /> Cuddly two (2) sew of drawings with applicable documentation
<br /> Aflow 10.14 days for review after submittal date. Parcel* - obtained from Property Tax Nodce (http: //appraiser.paseogov.eom)
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