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<br /> s�s- so-oo2o City af Zephyrhil(s Fire �ax-s�s-7saaa2�
<br /> fPermit•Application '
<br /> Qa2e Reee;ved, �—�� ' Pfione Contact far Permit �f � .7�`�4 •, � �' �
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<br /> Owner's Name ir� / LGJri L�fi L tl LJ< L� �/'f,(�(.S?f� Qwner's Phone Number U/ r�. �.r� �
<br /> Owne�s Address � � �j �� �t'�� �G t- �-"1 J �a3
<br /> Fee Simple Titleholder Name /,�p. � G � C. . Titlehoider Phone Number �� � �
<br /> Fee Simpie Titie 3older Address r r
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<br /> JobAddress 3S.�a 3 a/c%�� t%t�" � � � ��n i�-.$ !"G= � ����o` Lot# ��
<br /> Sub Division � ' Qatcel# "
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<br /> � Bio-Hazard Waste 8torage-APINUAL Q Fumigation Tent
<br /> '� Comm Exhaust Kitcfien Hood/Duct Q JHazardous Matenat{�'ier!1 or RQ Facility)ANNUA� �
<br /> � Controlled Hum ' � Hobd Iristallation
<br /> �� Emergeney Generator<30 kw � LP/Naturai Gas-instaliatian ��
<br /> � Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
<br /> �{ Fire Protec6on Maintenance.-ANNUAL � Places rrf Assembly-ANNUAL ,
<br /> �`r'r`� try emi � t er,,- ,
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<br /> Sprinkier �' ❑ ❑ G3,t;� o �Recreational Bum
<br /> Fire Alarm � ❑ O ❑!}� � Sparklers � `�F�/ ���Y�
<br /> Hood G1eaning � ❑ Cl CI f� � Sprinkler System finstat}a6ons t
<br /> Hood Suppression �� O ❑ � � Q Standpipes(Spiinkler Sys)
<br /> If Fire Alarm insiailation Q Torch Roofing/Tar Kettie �
<br /> ,� Fire Pumps `�' Q Waste T'ire Storage'ANNUAL
<br /> �� Fire Warks ,
<br /> � Flammable Applioation-AIdNUAL �—�r^� Valuation of ProJect
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<br /> , Fuei Tanks
<br /> II Othef: � ,
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<br /> _ Contractor � _` ' Company ` - �
<br /> Signature Regis#ered Y�1 N Fee�Cu�rent Y7 N
<br /> Address � � Cicense# ' - � •
<br /> ECECTRICIAN� Cornpany ,s._� , ' ; .
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<br /> 5ignature ! Registe"r"ed ' ' Y l N Fee Gurrent Y/'N �
<br /> Address ' � License'�f �
<br /> F'LUMBER � � ' Company
<br /> Signature Registeied Y 1 N. Fee current Y 1:N.
<br /> Address � "' - License#
<br /> MECHANiCAt Company
<br /> Signature Registered Y/N Fee Current Y/N �
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<br /> Address License# ` � �
<br /> OTHER Company , :
<br /> Signature � � Registered Y 1 N Fee Current Y I N
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<br /> Address� �O �� -
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<br /> aP. � ,G� C. 3 Ucense# �
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<br /> 'R`��.-21 r'$::Y.:_-�:+ .+4s..^':...:tfim+.n�:i. �.<-���ti�i ._
<br /> directions: ,
<br /> � Fill out application completely. -
<br /> � Owner&Contractor sign back of appiication,notatized(Or,copy of signed contract with ovmer}
<br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
<br /> � Supply two(2)sets of drawings with applicabte documentatio�
<br /> A1tow'f 0-14 days for review after suhmiBal date. Parcel#-obtained from Praperty Tax Natice{http:llappraiser,pascogov.cam}
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