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a�saso-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 800� 868 9151 <br /> . r�. Y . . �. ��.k�....�..�...,�,,.��:::�,.t,..,��-�,..�..��.��,�:����, ,. .. <br /> Owner's Name K-Mart#3761 Owner's Phone Number 813 �82 1957 <br /> Owner's Address 7422 Gall Boulevard,Zephyrhills,FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> «s.:e�+'x�::.�.+a;e �,.a=+�� <br /> Job Address 7422 Gall Boulevard � <br /> Lot# <br /> Sub Division Parcel# <br /> �.�-..dre:�c: . <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Bum a LP/NaWral Gas-Installation <br /> Emergency Generator<30 kw LP/Natural Gas-ANNUAL Sale n 2 <br /> � Emergency Generator>30 kw � Places of Assembly-ANNUAL � , �'V <br /> � Q �,�, <br /> Fire Protection Maintenance-ANNUAL Recreational Bum <br /> � emi � r <br /> Sprinkler � ❑ ❑ ❑ � � Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm � ❑ ❑ ❑ � � Sprinkler System InstallaUons <br /> Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> Hood Suppression � ❑ ❑ ❑ � Torch Roofinglfar Kettle <br /> � Fire Alarm Installation Q Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> Fire Works —5���-���"S <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> TM:aMxr..�.ti�.a;.4�,s,:� bs'�t�.,z���C+.au.R:<�:ai�'6.k .:�:.^r , <br /> COIIVBC�Of <br /> 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 <br /> License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Vendor Company NT Fireworks <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 6255 SE 78th treet,Ocala, FL 34474 �icense# <br /> Directions:r-v , , f _ . , , > - -� _. _ _. . _ .. .,., . .. .�, a. , <br /> Fill out application completely. � <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) ��j�eA,L�..�� "" <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) �� <br /> �p� �v <br /> Supply two(2)sets of drawings with applicable documentation „�b ,� <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br /> -Site plan at store-placement dictated by Fire Marshals office <br /> -State Sparkler Licence attached <br /> -Product List attached <br />