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E���80-002o City of Zephyrhills Fire Fax-813-780-0021 <br /> � Permit Application <br /> Date Received 0 9�2 5�2 013 Phone Coniact for Permit 813�rt 6 9 0 19 3 2 <br /> �..:.Kx�.�:_.�x,a.,-.��:.��..�.,m........�_. - -L���,:�=.��,�tv.�.,:-y,x..:...._.�.,,,- - .., <, <br /> _ ' _ .. __. _:t{✓'�?E4�c-.?qVpyn++s�',�l'A'+N.YA2U+'Y ...wv � wr:f e.s.�Me.r: � ..��. <br /> Owner's Name KMART-3 7 61 Owner's Phone Number 81 3 7 8 3 8181 <br /> Owner'sAddress 7422 Gall Boulevard Zephyrhills, Florida 33541 <br /> Fee Simple Titlehoider Name Titleholder Phone Number �� <br /> Fee Simple Titleholder Address <br /> ,��' '-*1N'3;s,tt�?;: ��"'z _ �^.§�f:.�+S1P��xcs�tr�+..+s.. �a�mr . .�, <br /> JobAddress 7422 Gall Boulevard Zephyrhills, Florida 33541 �o�� � <br /> Sub Division Parcel# <br /> ��z�p'� . - - !r'�'"�+ar�_�'�..�ffic.-�_�::'rg#§��-,�'�:,,'y".X"-iei..':iXS:5's3'x4iiL'§3d+'�b's:a3:aF�E5.3.�1Aiattl+a'ds�tat eNd^a.�r Qwf�tiic,:a3�:;F,�s�=-..� - <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> � Comm Exhausl Kitchen Hood/Duct � Hazardous Matorial(Tier II or RQ Facility)ANNUAL <br /> Conirolled Bum � Hood Installatlon <br /> � Emergancy Generator<30 kw � LPlNatural Gas-Instailetion <br /> � Emergency Generalor>30 kw � LPlNalural Gas-ANNUAL Sale <br /> � Fire Prolection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> tr y em � t er <br /> Sprinkter � ❑ O L�{ � � Recreational Burn <br /> Fire Alarm � ❑ O [� �� � Sparklers � <br /> Hood Cleaning � ❑ O ❑ � � Sprinkier System Installations ������l/ <br /> Hood Suppression � ❑ ❑ O � � Standpipes(Sprinkler Sys} <br /> � Fire Alarm Instailation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Warks <br /> � Flammahle Application-ANNUAL Valuation of Project <br /> Fuei Tanks <br /> � Other: <br /> [Ei:J"S':;:'<tu'i=-a.,��.3F4'i,�.};..:�.#� -'3ir��F:-:"'.3^n.,_u._wY'±"',9ll;:k�3.Z�t�a."?:�:�'F`z:s:?�'<z4V�.yu,..�:�:.'�'.:��?"<`1"e''..u�a:�.�;�_.�-_ '..�.�,=��_�:�5.'�.R"Tai"° o:�`":s'g€:Y'.+�4:�*'3s��'.'F�:_'4'. <br /> �3 Y�-�T.:;c <br /> Contrector - Company �Grunau Com an <br /> Signature � Registared 1�'/N Fee Curfent Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee CurrenT Y/N <br /> Address License# <br /> PLUMBER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company � <br /> Signature Registered Y/N Fee Curreni Y/N <br /> Address � <br /> License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current Y!N <br /> Address License# -� <br /> 4:4'ST;.H�l4'/14�:^�Si'[�.r....t_.x�r...a�r.o.....e . _u.. ..t�......,.c-�...�_�..x ir,�.,_ . > .: .._ _._� ..... :.e.st__"..v. �:#;Laa�rn:"'i.s.5� a, . . � <br /> r �- . , >.... .. �.... ... <br /> Directions: - - -- � . __. ,_:��.a��.._<_-�.�.u,�G�?-._�.�__._:. <br /> Fill out application completely <br /> Owner&Contractor sign back of apphcatfon,notarized(Or,copy of signed contract with ownerj <br /> if over$2500,a Notice of Commencement is required{Mechanical work over$5000j <br /> Supply two(2)seis of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:l/appraiser.pascogov.com) <br />