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sis-�eo-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contactfor Permit 813 630 0303 <br /> Owner's Name Lowes Home Center Inc Owner's Phone N umber � � � <br /> Owner's Address O Box 1000,# 1854 Attn Tax Dept 1 ETA, Mooresville, NC 28115-1000 <br /> Fee Simple TiUeholder Name Titleholder Phone N umber C� � � <br /> Fee Sim ple Titleholder Address <br /> JobAddress 7921 Gall Blvd , Zephyrhills, FL 33541 �ot# C� <br /> Sub Division ephyrhills Colony Company Parcel# 34-25-21-0010-00100-0010 <br /> � Bio-Hazard Waste S torage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/D uct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Install ation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale /// <br /> � Fire Protection M aintenance- ANNUAL � Places of As sembly-ANNUAL �� <br /> ry emi �n er �� <br /> Sprinkler �X ❑ ❑ � � � Recreational Burn � <br /> l <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> HoodCleaning � ❑ ❑ ❑ � � SprinklerSystem Installations <br /> HoodSuppression � ❑ ❑ ❑ � � Standpipes(SprinklerSys) n ���1 �m <br /> � Fire Alarm Installation � Torch Roofing/T ar Kettle ���-L i�2� <br /> � Fire Pumps � Waste Tire Storage ANNUAL �j <br /> � Fire Works <br /> ❑ Flammable Appl ication-ANNUAL rjQ , Valuation of Project <br /> � Fuel Tanks <br /> 0 Other <br /> Contractor �" / , Company ayne U OI'T18 IC IP2 pnn @fS, I1C. <br /> Signature N/' Registered �/�I Fee Current �/N <br /> Address 226 Cher Palm Drive, Tam a FL 33619 License# 0 9 8 4 6 6 0 0 012 0 0 8 <br /> ELECTRICIAN Company <br /> Signature Registered Y/I� Fee Current Y/N <br /> Address License# <br /> PLUMBER Company �- <br /> Signature Registered Y/N Fee Current �(/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y!N Fee Current �(/N <br /> Address License# <br /> OTHER Company � <br /> Signature Registered Y!N Fee Current Y/�I <br /> Address License# <br /> Di recti on s. <br /> Fill out applic ation com pletely <br /> Owner&Contractor sign back o f appl ication,notarized(Or,copy of signed contract with ow ner) <br /> If over$2500,a Notice of C ommencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-t4 days for review aiiei submitta!datc. ?ar_e!�-�bfained from Prooertv Tax Notice(http://appraiser.pascogov com ) <br />