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s��-�so-oo2o City of Zephyrhills Fire Fax-a��-�so-oo2� <br /> ' Permit Application <br /> ate Received �� Phone Contect for Pertnit 3 5 2 7 3 2 5 3 2 6 <br /> wners Name UKUMBAK APT IN C/O BRUCE SADLER pwners Phone Number � � � <br /> wner's Address 6 0 0 BEACH DR NE ST PETERSBURG FL 3 3 7 O l <br /> �e Simple TitlehoEder Name Np' TiUeholder Phone Number � � � <br /> 3e Simple Tideholder Addrass <br /> 389c21 CR 54 ��G,� �P � � <br /> �b Address Lot# <br /> .ibDivision Parcel# 02-26-21-0000-03800-0011 <br /> � Bio-Hazard Waste Storage-ANNUAL � FumigaUon TeM <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Bum � Hood Installation <br /> N� a Emergency Generator<30 kw � LP/Natural Gas-InslallaGon <br /> \ a Emeryency Generator>30 kw � LPlNatural Gas-ANNUAL Sala <br />.rl� � Fire Protectbn MaiMenance-ANNUAL � Places of Assembly-ANNUAL <br />' U � emi � er <br /> Sprinkler � ❑ L7 ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ O � � Sperklers <br /> Hood Geaning � O ❑ ❑ � � Sprinkler System InstallaUons <br /> Hood Suppression � Q � ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> Fire Pumps � Waate Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL � Valuation of Project <br /> Fuel Tanks <br /> Q Other. <br /> mtractor Company AMERICAN FIRE & SAFETY SUPPLY <br /> gnature Registered Y/N Fee Cument Y/N <br /> Address 953 NE OSCEOLA AVE STE 100 OCALA FL License# 06461500021985 <br /> .ECTRICIAN NA Company <br /> gnature � Registered Y/N Fee Cument Y/N <br /> Address ����# <br /> _UMBER NA Company <br /> o"e�� Registered Y/N Fee curremt Y/N <br /> Address License# <br /> =CHANIC Company <br /> 3nature NA Registered Y/N Fee Cument Y 1 N <br /> Address Licanse# <br /> fHER NA Comparry <br /> 3nature Regtstered Y/N Fee Currer� Y/N <br /> Address License# <br /> rections: � <br /> Fill out application completely. <br /> Owner 8 CoMractor sign back of applicadon,notarized(Or,copy oi sipned contract with ovmer) <br /> Ef over$2500,a Notice of Commencement is roquirod(Mechanical work over 35000) <br /> Supply two(2)sets of drowings with applicable documentation <br /> Allow 10-14 days tor review afler submirial date. Parcel#-obteined from Property Tax Notice(httpJ/appraiser.pascogov.com) <br /> c <br />