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813 -780 -0020 City of Zephyrhills Fire 'Fax- 813 -780 -0021
<br /> Permit Application
<br /> Date Received Phone Contact for Permit 727- 6 67 - 12 851
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<br /> Ownarn Nd,n6 (Alliance Church ofZephyerhille 1 owners Phone Number I813_7R9.RRR5 1 1 I
<br /> Owners Address 16251 Fort King Rd. Zephyrhills, Florida 33542 I
<br /> Fee Simple Titleholder Name 'Alliance Church of Zephyrhills I 'Titleholder Phone Number 1813=782 -886 1 I
<br /> Fee Simple Titleholder Address 16251 Fort King Rd. Zephyrhills, Florida 33542 I
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<br /> Job Address 16251 Fort King Rd. Zephyrhills, Florida 33542 1 Lot # I
<br /> Sub Division ' I Parcel # 03- 2621 001 0950 0.0000 I
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<br /> I I !to-Hazard Waste Storage - ANNUAL n Fumigation Tent
<br /> 17 Comm Exhaust Kitchen Hood/Duct I I Hazardous Material (Tier 11 or RQ Facility) ANNUAL
<br /> Controlled Bum n Hood Installation
<br /> 0 Emergency Generator < 30 Kw LI LP /Natural Gas - Installation
<br /> n Emergency Generator 30 kw n LP / Natural Gas - ANNUAL Sale
<br /> El Fins Protection Maintenance - ANNUAL = Places of Assembly-ANNUAL
<br /> Wp iwri (y j rther
<br /> Sprinkler 0 0 0 n Recreational Bum
<br /> i• ire Alarm E 0 0 0 I 1 n Spin Mere
<br /> Mood Cleaning 0 0 O ❑ I 1 El [1 Sprinkler System Installations
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<br /> Hood Suppression 0 X I:1 (
<br /> 1 Standpipes (Sprinkler Sys)
<br /> n Fire Alarm Installation a Torch Roofing/Ter Kettle
<br /> El Fire Pumps ICJ Weeto Tiro Storage ANNUAL
<br /> Fre Works
<br /> a Flammable Application. ANNUAL ' 1751 Valuation of Project
<br /> a Fuel Tanks
<br /> Ej Other: I I
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<br /> Contractor ^ Kevin Hoch Company 'Fire Systems Inc. ��»
<br /> Signature Registered Y/ N Fee Current I Y / N I •
<br /> Address IP.O.Box 48741 St. Petersburg, Florida 33743 -8741 I License# I I
<br /> ELECTRICIAN I Company I
<br /> . .signature ( Registered Y/ N J reel Current I Y/ N I
<br /> Address I 1 License* I
<br /> PLUMBER Company I
<br /> Signature Registered Y/ N J Fee Current I Y / N I
<br /> Address I I License* I
<br /> MECHANICAL Company I
<br /> Signature Registered' Y/ N J Fee Current I Y/ N I
<br /> AOOrGSS I I License# I I
<br /> OTHER Company
<br /> Strohm* Registered Y N _I Fes Current I V/ N J
<br /> Address 1 1I( sear
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<br /> Directions:
<br /> Fill out appllcatIon completely.
<br /> Owner & Contactor 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 55000)
<br /> Supply two Cz) sets of °raw fngs wnh apPllbab)e oocumenlason
<br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http / /appreieer,pascogovrcom)
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