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s��-�ao-oozo City of Zephyrhil{s Fire ��o.�
<br />' Permit Application �-"'��� `"
<br />� Date Received _r�✓<</ l O�C�/S"r� Phone Contact far Permit � /�
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<br /> Uwne�s Name �� �' t�J'�, dwners Phane Number' �,y 3 C�p-JJ I..�Zj���1J
<br /> Owne�s Address Q � �' ` � � �f
<br /> Fee Simple Titleholder Name Titleholder Phone Number [� � �
<br /> Fee Simple Titleholder Address
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<br /> Job Address -.:.._°':����1- j f�'=- `/� �=' '=�J �"`�s- i�-�ja-= - �ot# M C�
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<br /> Sub Division Parcei#
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<br /> Bio-H rd-Wastefitorege-M.A�AI o Fumigation Tent
<br /> Comm Exh tist Kitchen iioodlduc � iiazardous Material(Tier II or R4 Facitity)ANNUAL
<br /> on ro led Bum � Hood Installation fntf��j �
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<br /> � Emergency Generator<34 kw Q LP/Natura�Gas-Instailation
<br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale ' �
<br /> � Fire ProfecGon Maintenance-ANNUAL Q Ptaces of Assembly-ANNUAL
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<br /> SpnnkEer ��Q � �� � }2ecreatianai Bum � � �;�"�"i,
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<br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers ��!�-
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<br /> Hoad Cleaning � ❑ C1 0 �� � Sprinkler System Instalaatians � � {}�jp� ;�
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<br /> Hood Suppression � ❑ ❑ ❑ � � 5tandpipes(Sprinkler Sys) �,;.,1� .���="
<br /> � FEre Alarm insta!lation � Torch Roofingti'ar Kettie Y"�/��
<br /> � Fire Pumps Q Waste Tir�e Storage ANNUAL �`~���l/ �
<br /> � F(ammable Apptication-ANNUAL r � Vaivation af Project
<br /> � � Fuel Tanks
<br /> [� {)ther. t.I � !.a '� � J O c:�
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<br /> Contractar Campany .-� � .`� t�ts �' .1�'1L
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address f� 7 t�l�f� a14c.� �a� 4 t�icense# — � � ,— �
<br /> ELECTRICIAN Company .
<br /> 3ignature Registered Y/N Fes Current Y/N
<br /> Address License#
<br /> ��i1MBER Company
<br /> 3ignature Registered Y/N Fee Curre�t Y/N
<br /> Address License#
<br /> NECHANICAL Gomgany
<br /> 3ignature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> �THER Campany
<br /> , iignature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> 7irections: " A. ., . ' ` '`'.`���' .
<br /> i FiI!out applicaGon completeiy.
<br /> Owner&Contractor sign back of appiication,notarized(Or,copy of signed contract with owner)
<br /> }f aver$2540,a iVotice of Commencement is required{Mechanical work over$500d)
<br /> Supply two(2}sets of drawings with appiicabie documentation
<br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com)
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