Laserfiche WebLink
� <br /> • ' alsaeo-oozo , City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Pertnit 800 Y 868 ^ 9151 <br /> � _._.. ._._. m..� <br /> Owner's Name K-Mart#3761 Owner's Phone Number 813 782 1957 <br /> Owners Address 7422 Gall Boulevard,Zephyrhills, FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titieholder Address <br /> ' - - ----� <br /> JobAddress 7422 Gall Boulevard � Lot# � <br /> Sub Division Parcel# <br /> E'�." -�..,._....v.__._.� ___.__ - - �__._ e - _..._"""",""'^^^--"^�� <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 � LPlNatural Gas-Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generator>30 kw � Places of Assembly-ANNUAL � �� 7�Y <br /> i'T <br /> � Fire Protection Maintenance-ANNUAL � Recreational Bum <br /> tr y emi �n t er <br /> Sprinkler � ❑ ❑ ❑ 8 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 /> � Fire Works SPARKLERS � <br /> � FlammableApplication-ANNUAL )`�� ° Valuation of Project <br />� � ��.s, <br /> Fuel Tanks <br /> Q Other: <br /> �-�----� ...� _ �v--�--°� -- ,----�----------, <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 License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Vendor Company TNT Fireworks <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 6255 SE 78th Street, Ocala, FL 34474 License# <br /> r-.-- ......_....___�_ ..._. .__.,.� -____�. ._.... _ ---, <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 />