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rrom: 08127/2q1� 12:29 #903 P.041/002 <br /> 813-780•002C CiEy oi Zephyrtsills Fire �ax•Si3-786-0021 <br /> Permit Applicatian <br /> . �''` <br /> bate Received ! . .. .. _ . . .�. . . .. . _ , . ._. . ---Phone Contaci fer Perrnit . . ._����ti,_���`� u jj� ., <br /> Clwrtets Nama L� � 1��/s� ) � � '�`.2 S —y �wner's Phone Numher ��� � L.� <br /> a„�et�5 Avdtess '.,�Sto I 5 �n S ' JP - �`1) �L 5 U c�-- <br /> Fee Srmpte Titlettotder NamO I T(deholder Phone Number � � �.�..._� <br /> FHe Simgle 7itleholder Address � <br /> F y,., :: . „ :+.! . y. .. ..,�* . . �. +.._ '::X u_'::.-'.'.y •ifi.. :.;.:�. - r.Ss.: ::.:. v:.Kti'i:_*::'�+. -'.�::.»'tirs'". =.."y <br /> '�.�✓1...�..--!(i�' / ,anr ";r':':a�a^•:.^s-:-:;.'.t•�J.^•!'.�.kw�, <br /> Jqb Address� �y1 .•�-.�.:� ..��1 � .�:2 �1 �I h'�1� .3.A.�1' Z Y �V o� Lot# �� <br /> 5ub Divlslon I Par�e}# <br /> F::r,. .a . r_.. .. . .,. r ... i _> ..�....--....✓... -_......_. .. ... :.:.. ._ __ "-°. • . �•- .aY_ a n c. � .o,:ii;'=^•'ri�:.o� ..:.r�ay�,'cr.:�a.=•'!a'%`.°:x.Y2u <br /> � 81a-Haz2rd Waste Storage-A13N21A� t� Fumigatipn Teni <br /> � Comm Exhaust Kitchen Hoad/puct � Hazardous Materia!(7ier 1t or RQ Facl7iiy)AHMUA� <br /> � Corstra!!ed Bum � Hoad insieflation � <br /> � Emergency Generator K 80 kw Q LP1Naturai Gas•Inst�Uation +- �� � <br /> Q Emargency Generalor>3D kw � I.P/F�t�tutaE Gas-ANNUAi.8ale ,ii S � <br /> � Fira ProtecUon Maintenance-AFtNUAL � Piaces of Assemhly-ANNt{AL <br /> �y em A"�Tn er <br /> Sprinkler � Ci ❑ ❑ � � Ratre�tiana!&um <br /> Fire Alarm � r3 C7 Ci � � Sparkters � <br /> � <br /> Hoed Cleaning � ❑ ❑ a � � Sprinkler System tnstallat3ans � <br /> Hpad Suppression � ❑ Q GT" � � Standpipes(SpCinklerSys) <br /> � Flre Alarm installatlon � � Torch RoqflnglTar Kettle <br /> �I Q Fine Purnps Q Weste Tire Storage ANNUAL <br /> I � FireWor{c5 �� �,� <br /> � Ftammable Applicatton-ANNUAL � Valuation af Projec# <br /> �� <br /> Qfuet Tanks <br /> Q Other: I <br /> ..,.. ' : ' .. . � "' - .r . . . .. ,.. .. `. _ . -� ' . .. . . . . . . .Y�: . . �:«=Y'.....�.:l�v ... . . -. . • i. <br /> Goniractor Company <br /> Signature I Reglstered Y!(� Fee Current Y!N ��� <br /> Address � License� <br /> EG�C�'RiCiAN � Campany <br /> SlgnaWre , l�eg'sstered Y/N� Fee Current Y/N <br /> Address I Liaense# <br /> _ - <br /> FLg S BE�R Regisienred Y 1 N� Fee Current Y/fV <br /> Addcess � License# <br /> M�CHANICAL � Gnmpany <br /> 5ignature Registerecf Y/N Fee Curront Y)� <br /> Address � License# <br /> OThiER Company <br /> Signature I Registered Y/N Fee Cu►rent Y/Fd� <br /> Address � ��cense# <br /> Oirecftons: ... . .. ... .. .. �. .,. _ . . . . . .. _._ �:.. ., . - _. • - - - �� - -= -� - -- . _ <. . . .- . <br /> Fitt out application completelY� I <br /> GWner&COntr�ctor sign back of application,notarized{Or,copy o£stgned contract with owner) - <br /> ,;over$2500,a Nouce of Commertcement is required(Mechanlcal work over$50Q0) <br /> Sopaty two(2)sets of drawings wilh app!lcabla documentatfan <br /> Allow t 0-14 days for review aker submittal date. PafCe4#-obtalned from Property Tax[Jfltice(htt�Jtappraiser.pascagav.cam} <br />