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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Perm it $�3 63� 0303 <br /> Owner's Name Zephyrhilis Plaza LLC Owner's Phone N umber C� � � <br /> Owner's Address 236 Commercial Way, Spring Hill FL 34606-1995 <br /> Fee Simple Titleholder Name TiUeholder Phone N umber C� � � <br /> Fee Simple Titleholder Address <br /> JobAddress 7425 Gall Blvd., Zephyrhills FL 33541-4311 (BEALLS STORE 30) �ot# � <br /> Sub Division ephyrhills Commons Parce�# 34-25-21-0160-00000-0010 <br /> � Bio-Hazard Waste S torage-ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/D uct � Hazardous Material(Tier II or RQ Fac;ility)ANNUAL <br /> � Controlled Burn Hood Installation ,, <br /> � Emergency Generator<30 kw � LP/Natural Gas-Install ation /''�� �� <br /> u Emergency Generator>30 kw � �.Fi�va[urai:;.,a-ANHi1i,L Sa�e � `'� ✓ <br /> �X Fire Protection M aintenance-ANNUAL � Places of Assembly-ANNUAL •.,,�_,,,,�..-�/ <br /> ❑ ry emi �n er ❑ <br /> Sprinkler X ❑ ❑ 251 Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ p ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/T ar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Appl ication-ANNUAL �j0 -1 Valuation of Project <br /> Fuel Tanks <br /> Q Other• <br /> Contractor Company ayne U Ofl'18 IC If@ pnn @fS, f1C. <br /> Signature Registered �'(/N 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 �(/I� <br /> Address <br /> License# <br /> PLUMBER <br /> Company <br /> Signature Registared Y/N Fee Current Y/N <br /> Address � �� �� License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Com pany <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Directions: <br /> Fill out applic ation com pletely <br /> Owner&Contractor sign back o f application,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 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com ) <br />