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� <br /> � <br /> F �13-780-0020 _ City of�Zephyrhills Fire Fax-813-780-0021 <br /> Per it Application <br /> Date Received �Z � Phone Contact for Permit 800 � 868 � 9151 � <br /> c=�e��-•.��-°— �_n.__ �._._....�_..._.__ - - .°� _ _, �... .._.�._... <br /> Owners Name Wal-Maft#706 Owner's Phone Number 813 782 1957 <br /> Owner's Address 7631 Gall Blvd,Zephyrhills, FL 33541 I <br /> Fee Simple Titleholder Name Titlehoider Phone Number � � � <br /> Fee Simple Titleholder Address � <br /> f�..._ � - - m�-� <br /> Job Address 7631 Gall Bivd �ot# � <br />' Sub Division Parcel# <br /> C=y.-J.._.....�._...,_.__ ._....,��._.._ -..._.._......_...�._.. _.,.__._, ....�.....� ',.s . _,.....��....._._. ��..�., <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Bum � LP/Natural Gas-Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generator>30 kw � Places of Assembly-ANNUAL �/�$D(p <br /> � Fire Protection Maintenance-ANNUAL � Recreational Burn � <br /> tr y emi � t er <br /> Sprinkler � ❑ ❑ ❑ � 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 Pum <br /> XX ire Works-SPARKLERS <br /> Flamma - NUAL Valuation of Project <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 I Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address � License# <br /> MECHANICAL I 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 /> �:._ ---- _Y___ — u._..._.. _ - _ - _ _ <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of igned contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical�ork over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Pa Icel#-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 /> � <br /> I <br />