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, <br /> s���aaao2o City of Zephyrt�ills Fire Fax-813-780-0021 <br /> Permit Appiication <br /> ate Received � ` 1 �-(�/1 'Phone Contact for Permit 3 5 2 7 3 2 5 3 2 6 <br /> ��`1 I� 5 l <br /> wners Name BRINKER FLORIDA INC C/O MARVIN F POER & CO pNr�ers Phone Number � � � <br /> w„ers nddress PO BOX 8 0 2 2 0 6 DALLAS TX 7 5 3 8 0-2 2 0 6 <br /> 3e Simple Titleholder Name NA TiUeholder Phone Number � � � <br /> 3e Simple Titleholder Address <br /> �bAddress 7643 GALL BLVD ZEPHYRHILLS Lot# � <br /> �bDivision ZEPHYRHILLS SUPERCENTER-A paroel# 34-25-21-0110-00000-0040 <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigatlon Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Instellation <br /> QEmergency Generator<30 kw � LP/Naturai Gas-Installation <br /> � Emergency Generator>30 kw a LP/Natural Gas,A�UAL Salo � �� ^ 2 <br /> � Fire Protection MaiMenance-ANNUAL � Places of Assemb -ANNUAL t � J <br /> � emi � er � <br /> Sprinkler � ❑ ❑ O � � Reereational Bum <br /> Fire Narm � ❑ ❑ ❑ � � Spa►klers <br /> Hood Cleaning � O ❑ ❑ � � Sprinkler System InstallaUons <br /> Hood Suppresslon � ❑ �1 ❑ � � Standpipes(SprinWer Sys) <br /> � Fire Alartn Installation � Toroh Roofing/Tar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fue1 Tanks <br /> Q Other. <br /> �ntractor Company AMERICAN FIRE & SAFETY SUPPLY <br /> gnature Regietered Y/N Fee Current Y/N <br /> Address 953 NE OSCEOLA AVE OCALA FL 34470 �icense# 06461500021985 <br /> .ECTRICtAN �JA Comp8�y <br /> gnature � Registered Y/N Fse CurreM Y/N <br /> Addross U��# <br /> _UMBER NA �m��y -� <br /> ��t� Registerad Y!N Fee currern Y/N <br /> Address License# <br /> =CHANICA NA �n,pa�y --� <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER NA Company <br /> �nature Registered Y!N Fea Current Y/N <br /> Address License# <br /> rections: <br /> Fill out application completely, <br /> Owner&Contractor sign back of appfication,notarized(Or,copy of signed contract with ovmer) <br /> H over$2500,a Notice of Commencement is required(Mechanical woric over$5000) <br /> Supply two(2)sets of drawings with applicable documenfation <br /> Allow 10.14 days for review after submittsl date. Parcel#-obtained from Property Tax Notice(httpJlappraiser.pascogov.com) <br /> s <br />