Laserfiche WebLink
: i• <br /> � r 813-780�0020 Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 800 868 _ 9151 <br /> r�. _._1_._.,._____ ...v.�d_ - —._.� ...._.,._.__._. - - -- _____._� <br /> Owner's Name Wal-Mart#706 Owner's Phone Number 813 782 1957 <br /> Owner's Address 7631 Gall Blvd,Zephyrhills, FL 33541 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> r� �. - - �------°-, <br /> JobAddress 7631 Gall Blvd �ot# � <br /> Sub Division Parcel# <br /> r-`-- --.-_____, - _____._�.. . ____.� <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/Naturai Gas-Installation � n �� <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale � / � <br /> � Emergency Generator>30 kw � Places of Assembly-ANNUAL <br /> � � Fire Protection Maintenance-ANNUAL � Recreational Burn <br /> tr y emi � er <br /> Sprinkler � ❑ ❑ ❑ � Sparklers Inside Retail Sales of State Approved Sparklers <br /> Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br />' Hood Suppression � ❑ ❑ ❑ � � Torch RoofinglTar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> � Fire Pumps � <br /> XX Fire Works-SpARKLERS /� c� 7� <br /> � Flammable Application-ANNUAL �(.> W t Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> e-�, �.� _ .... __�.�_______. __ ��_�_._.=..� <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 Lice�se# <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 �icense# <br /> __.__._.. _ _.�_��_______..__.._._. .�____......,�..._._..,..�.__.��..,,._.�..�.__�_,._..�..�_�_.__.��__ _._.__._.__._._.._.. -°�-�.��� <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 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 />