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sis-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 813 621 1357 <br /> owner's Name FLORIDA MEDICAL CLINIC Owner's Phone Number 813 780 8440 <br /> ownersAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540 <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� <br /> Fee Simple Titleholder Address <br /> JobAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540 �ot# Y � <br /> sub oivision CITY OF ZEPHYRHILLS Parce� # 02- -- ' ' <br /> � Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Burn � Hood Installation <br /> a Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LPINatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> r y emi �n er <br /> Sprinkler � � ❑ ❑ � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkier Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � FlammableApplication-ANNUAL $Z 0� Valuation of Project <br /> � Fuel Tanks <br /> Q other <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y! N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company -� <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER �ERRY T BARRO company RO AN FIRE SPRINKLE , INC. <br /> Signature egistered N Fee Current Y N <br /> a,ddress 2 1 N. 7 TH T. TA P �icense # 46 4 20001199 <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 (Mechanica� work over $5000) <br /> Supply two (2) sets of drawings with appticable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:l/appraiser.pascogov.com) <br />