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�,_. <br /> a�3-�ao-oo2o City of Zephyrhiils Fire Fax-813-780-0021 <br /> Permit App�ication <br /> Date Received Phone Contact for Permit 800 868 9151 <br /> , .,»�e.._....,, ..__�.. �, .,...�. <br /> � .���«x�„�,. <br /> ����.,��a:�,,�., <br /> Owner's Name Sweetbay#1752 Owner's Phone Number $�3 780 1046 <br /> owner's Address 7325 Gall Blvd,Zephyrhills, FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number C� C� �, I <br /> Fee Simple Titleholder Address —� J <br /> ,.Ft�r-;t�,»••� ... .. .��'aat�.: te>?�- <br /> Job Address 7325 Galt Blvd �� <br /> Lot# <br /> Sub Division <br /> Parcel# <br /> . ;.,�.e;karca..�:ww,fa��v.rr,-,,r�.9c�-�at,mr.,�;�:�4:x°��r�.e�a^.�bF�.3�:a�,:�'�a�:d���7�tc�:,:� � <br /> �� i <br /> Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Faciliry)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Ducc � Hood Installation <br /> � CoMrolled Bum � LP/Natural Gas-Installation <br /> � Emergency Generator<30 kw � LP/Naturaf Gas-ANNUAL Sale <br /> � Emergency Generator>30 kw � Places of Assembly-ANNUAL (�f�3 <br /> � Fire Protection Maintenance-ANNUAL a Recreational Burn �� <br /> ❑� emi �n r <br /> Sprinkler ❑ ❑ ❑ � X� sparkiers Inside Retail Sales of State Approved Sparklers <br /> Fire Alartn � ❑ ❑ ❑ C� � Sprinkler System Installations <br /> Hood Cleaning � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys) <br /> Hood Suppression � ❑ p ❑ � � Toroh RoofinglTar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> Fire Works — S�a r�lf.--S <br /> Flammable Application-ANNUAL <br /> Valuation of Projed <br /> Fuel Tanks <br /> Q Other: <br /> �`�! .�:Y3'a,x. .i..�;.v�:'-�..,c.{:CC[Y.:.tRks�+ti�$s:'.c, h �n.�.�q`' <br /> �� '' ^�w: <br /> C011tf8CtOf <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Vendor <br /> Signature Company NT Fireworlcs <br /> Registered Y/N Fee Current Y/N <br /> Address 6255 SE 78th reet,Ocala,FL 34474 <br /> a-=�+°^��^��^,� .. . , License# <br /> Directions: . . �, �.�:ux�a�.y:,•.; �.>�l,�.,. � �< ra>�;�w <br /> Fill out applicaUon completely. <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed conVact with owner) J n,P yi,�.`}�.i�,Q� <br /> If over$2500,a Notice of Commencement is requfred(Mechanical work over$5000) r'� �"�y; <br /> Su p p t y t w o(2)s e t s o f d r a w i n g s w i t h a p p lica b te documentation y[ /p�,r`� �� <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Pro ���U��J � <br /> perty 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 />