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<br />*1eD~ <br /> <br />.~:::::-=b~\r~~~~~~8~~ <br />L~lp.5l\tz SQ.. ~Lr- 2 ...e..-(>~~'~?~ \-L <br />I I j <br />:: :::::: ~::::::: :::" [- I ""holdee PM"' "umho, - <br /> <br />:"''3>:~~~m.~3'a'~~~Z~~~~'"1~~~"}i~~~~'''-'''''~ <br /> <br />813-r8[J..>0020. <br /> <br />Owner's Address <br /> <br />.Job ll.ddres5 <br /> <br />I I <br />I \ <br />o <br />o <br />o <br />~ <br /> <br />[] <br />o <br />o <br />o <br />D <br />D <br /> <br />City of Zephyr hills Fire <br />Permit Ap:lHcetion <br /> <br />Pax-Cl1::F/oO.U021 <br /> <br />U II <br />.,_._.~..,v,^ ""~.t-...~~~"""~" <br /> <br />II--1x.z J I ({2-it-- <br /> <br />I t <br /> <br />r <br />I <br />I <br /> <br />BiD-Hazard Waste Storage -- ANNUAL <br /> <br />CDmm Exhaust Kltchen HoodlDuct <br /> <br />Controlted Bum <br /> <br />Emergency Generator < 30 h~' <br />Emergency Generator;;> 30 kw <br />Fire Protection l'Aaintenance -- ANNUAL <br />Sprinkler 0 <br />Fire Alarm \ \ <br />Hood Clean/Suppression ~ <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />, <br />i <br />.~ Lot# <br /> <br />Sub Divislon l Parce\# lJt-;i/~:!;'(~:8~l~ )~Qt41&:; 0010 <br /> <br />':-..:;;....._,:,l"a,,~~~tfli~~~i;a!Eii""'~~~~~~~~~~ <br /> <br />D Fum~93n~n Tefl! <br />D Hazc"lnicus Material (Ler n or RQ Facility) ANNUAL <br />D Hood Installation <br />n Lrr;.;Nahjm~ GaE-:nstaHaticn <br />"'---' <br />D LPlNatural Gas-ANNUAL Sale <br />o Places of Assembly-ANNUAL <br />o Re.::realio!12\ Bl:IT1 <br />D Sparklers <br />o Sprinkler System Installations <br />o Standpipes (Spr:nk!er Sys) <br />o Torch Rooting <br />! I Waste Tire Storage ANNUAL <br /> <br />Other: <br /> <br />Valuation of Project <br /> <br />Contractor <br />Signature ; <br />,t\ddress <br /> <br /> <br />~,;-... <br /> <br />ELECTRiCIAN <br />Signature I <br /> <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />! <br />I <br />I <br />~~v.,e,~~ ?~~~ <br /> <br />\ <br /> <br />I <br />I <br />\ <br /> <br />Address I <br /> <br />MECHANICALI <br />Sigr!.ature . 1 <br /> <br />Address I <br /> <br />OTHER .l' <br />Signature <br /> <br />~~dre.~:j ~, <br />Directions: <br /> <br />Ccmpany <br />Registered <br /> <br />Fee Current <br /> <br />YiN <br /> <br />Y/N <br /> <br />License #. <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y1N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Come any <br />Registered <br /> <br />r Y/N <br />I <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />License # <br /> <br />Compan:: I <br />Registered [ Y i N I Fee Current <br /> <br />Ucsnse # <br /> <br />Y/N <br /> <br />Comf:,any . <br />Registered l Y! N I fee Current <br /> <br />~+'_~..-"''''~='-''-"_''''-'~'''_'''''''''____'_''__ ,__~",__ I ;_Ltcense#,_'~ <br />R ~;;.co;;; ___lb;3~~- _'l~._ _f~'__'_""'K''"'':oS'-:''';'~ "",-,,",,,,,..'!;~.G!~"~' :::'l!j-... <:.~c-.~. ....,.""".-..,O::-:::.1"~~......;.tJ.l.......,..:1>..""'"".. <br /> <br />Y iN I <br />. I_ <br />., -,~--~""""""~-~..~ <br /> <br />~;';'." <~~'.''''f-,-',,"",''' <br /> <br />Fill out application completely. <br />C!wner & Contractor. sign back of application,notarlzed (Or, copy of sig"'oo contra:;t with O\mer) <br />:T over $2500, a Notice of Commencement is required (Mechanics! won.''''' $500O'i <br />Supply two (2) se~s of dra\,f,ngs witI-] applicable documentation ' <br />AHc\'\' 1 D-14 days for r~Jl/le\'" after subrnitt'a[ date. <br />