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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Recewed Phone Contact for Permit 800 868 9151 <br /> Owners Name K-Mart#3761 Owner's Phone Number 813 782 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 /> Job Address �422 Gall Boulevard � <br /> Lot# <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen HoodlDuct � Hood Installation <br /> � Controlled Burn � LPlNatural Gas-Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale � i�/ � / <br /> Emergency Generator>30 kw � Places of Assembly-ANNUAL � <br /> � Fire Protection Maintenance-ANNUAL � Recreational Burn <br /> ❑ r y emi � er <br /> Sprinkler ❑ ❑ ❑ B � Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> Hood Suppression � ❑ ❑ ❑ � � Torch Roofing/Tar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> XX Fire Works-SPARKLERS <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other <br /> Contractor 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 <br /> 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 <br /> Company TNT Fireworks <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 6255 SE 78th Street, Ocal , FL 34474 �icense# <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittai date Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov com) <br /> -Site plan at store-placement dictated by Fire Marshals o�ce <br /> -State Sparkler Licence attached <br /> -Product List attached <br />