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s•� 30- �o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received 1/30/2012 Pnone Contact for Permit 813 313 1637 <br /> Owner's Name Zephyrhills Police Station Owner's Phone Number C 813 780 0041 <br /> Owner's Address 6907 Dairy Rd ,Zephyrhills, FL 33542 <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> JobAddress 6118 8th Street ZEPHYRHILLS FL 33542 � �oc# � <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Matenal(Tier II or RQ F acility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw a LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> try emi �n t er <br /> Sprinkler ❑ ❑ � � � Recreational Bum (L <br /> Fire Alarm ❑ ❑ � � � Sparklers � <br /> Z � �r � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> XD Other� (1)Annual backflow inspection &(1)Annual Wet sprinkler inspection <br /> concractor � � +.-�n ��� Company SimplexGrinnell <br /> Signature �.�^�� �1.%� <br /> Registered Y/N Fee Current Y/N <br /> Address 4701 Oak Fair Blvd., Tampa, FL. 33610 �icense# <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 Company <br /> Signature Registered Y/N Fee Current Y/N <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 /> Aliow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />