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8�3aso•oo2o City af ZephyrhiNs Fire > Fax-al�-7so-oo2� �
<br /> Permit Appi9ca#ion
<br /> ate Received� �� � Phane Contact for Permit ���
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<br /> �wners IVame x f{��'._ �cj .s � �Gl.j � C�I� fZ �4 Owner's Phon�TJumber e�t� 7�� '?
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<br /> ee Simpte Titlehoider Name Titleholder Phone Numbet �� � ��
<br /> ee Simple Titleholder Address '
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<br /> �b Address � Lot# C�
<br /> ub Division Parcel#
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<br /> :°� � Bio-Hazard W aste Storage-ANNUAL � Fumigation Tent
<br /> � Gomm F�rhaust Kitchen Hood/Duct � Hazardous Materiai{Tier)1 or RQ Facitity}ANNUAL
<br /> r o Controlled Bum _ � Hood tnstalletion _
<br /> � Emergency G�enerator<30 kw ,� LPINatural Gas-Instatiation
<br /> oEmergency Generator>30 kw � LP/Naturai Gas-ANMUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-AtdNUAt '
<br /> ,, Chr y em� � er p
<br /> Sprinkter � ❑ ❑ O � � Recrearionai Bum `?.
<br /> Fire Aiarm � ❑ ❑ � � � Sparklers
<br /> Hood Cieaning � � ❑ , ❑ ❑ � � SpnnklerSystem instailations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes{Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch Roofing/Tar Kettie ' �
<br /> �� Fire Pumps Q Waste Tire Storage AtdNiJAL ,
<br /> � �lammable Application-ANNUAL �-- , Valuation of Froject
<br /> � Fuel Tanks �
<br /> Q Other:
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<br /> :ontraotor - Company
<br /> �ignature J���2��..���� Registered Y/N Fee Current Y/N
<br /> Address Liosnse#
<br /> :LECTRICIAN ' Company
<br /> �ignature Registered -Y i[�) fee Curreni Y/N
<br /> Address License#
<br /> 'LUMBER Company '
<br /> tignaiure�` Registered Y I 1d Fes Gurrent Y/R)
<br /> Address License#
<br /> AECHANICAL Company
<br /> iignature • Registered Y/1!1 Fee Current Y I�1
<br /> Address � � Lioense#
<br /> �
<br /> }THEF2 . Company '
<br /> iignature Registered Y J N Fee Current Y/N
<br /> Address License# I
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<br /> )irections:
<br /> Fill put application completely.
<br /> OJmer&Contraotor sign back of applicatipn,nofarized{Or,capy a#signed contract with awner}
<br /> " it over$250d,a Natice o!Commencement is required{fUlechanical wor4c over$5000)
<br /> � Supply two.(2)sets of drewings with appliaable documentation ' �
<br /> Allow 10-14 days for review after submittal date. Parcei#-obtained from Property Tax Flotice(httpJJappraiser.pascogov.com}
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