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a�3-�ao-oo2o City of Zephyrhills Fire Fax-S13-780-0021 <br /> Permit Application <br /> Date Received ± -Z— Phone Contact for Permit s��� 868 9151 <br /> Owner's Name K-Mart#3761 Owner's Phone Number 8��f �82 1957 <br /> owner�s address 7422 Gall Bou�evard,Zephyrhilis, FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � �� <br /> Fee Simple Titleholder Address <br /> , , . . , ,. <br /> Job Address 7422 Gall Boulevard Lot# � <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct Hood Installation <br /> � Controlled Burn � LP/Natural Gas-Installation "I � <br /> � Emergency Generator<30 kw � LPlNaturai Gas-ANNUAL Sale �� t <br /> � Emergency Generator>30 kw � Places of Assembly-ANNUAL X� ` <br /> � � I <br /> Fire Protection Maintenance-ANNUAL Recreational Burn <br /> �y emi �n er <br /> Sprinkler � ❑ o ❑ � X❑ 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 a� Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> 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 Company TNT Fireworks <br /> Signature Registered Y/N Fee Current Y J N <br /> Address 6255 SE 78th Street, Ocala, FL 34474 �icense# <br /> Directions <br /> Fill out application completely <br /> Owner&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 submittal date Parcel#-obtained from Property 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 />