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<br />14 ! <br /> <br />_'ii'WE[, Ir>::4 F':\~ <br /> <br />ZEPHYRH I L,:;:; B' J : WI ["lG <br /> <br />Fe~ Simple TitlGhQIder N;irne <br /> <br />FeeSlmple ~ltlehoIder Address. <br />llII T - r r l~ <br /> <br />Job Add~ L <br /> <br />rW~'~v\:'~' ~' <br /> <br />813-780-0020 <br /> <br />, Date Received <br /> <br />CNmer'5 N;lme <br /> <br />Owner's Addr~5 <br /> <br />, S~b Division <br /> <br />o <br />CJ <br />o <br />D <br />o <br />D <br /> <br />o <br />D <br />,0 <br />D <br />o <br />D <br /> <br /> <br />Addrell5 <br /> <br />ELECTRICIAN <br />Signature <br /> <br />Addre8s 1_ <br /> <br />pl.UMaER 'I <br />Signature ' <br /> <br />J owner's Phone Number <br />0<i",~'\lS .~L 2>"S'l~ <br /> <br />, Tltieholder Phone Nl.rnber [ <br /> <br />City ofZephyrhll1s Fire <br />Permit Applic!ltion <br /> <br />5-J-D'O <br /> <br />~\d~~$ <br />III belt LaU5)~ <br />L <br />,r A- .. <br />:il =_ ~lr II <br /> <br />1< I), ~I: ':,-- <br /> <br />C: _ j' ,'1 <br />......Jt..... <br /> <br />'1 <br /> <br />-<< 161JJ <br /> <br />Fax-8~3-780-0021 <br /> <br />Ptlornl contaot for Permit <br /> <br />(;) 6'l), <br />1'1-*7 bd. -] [~~~ <br /> <br /> <br /> <br />- <br />II <br /> <br /> <br />8\3 ' <br /> <br />I! <br />...: <br /> <br />: ' <br /> <br />i-I <br />J LDt# I <br /> <br />\vtH~II~{) t"KVIVlr'KUt'~~~ IN< ,,,vI Ie;) r=: <br /> <br />~~ ,I~ - <br /> r <br /> ' I Parcel' <br /> <br />Elp..~ Was~ Storage ~ ANNUAL <br />, Comm Ext.aust Kltohen Hood/Duct <br />controlla':! Bum' <br />, EmergenC7f Generator < 30 kw <br />Em~rgelcy i3en<<atol ;> 30 ~:w, <br />Fir'" ProlecUon Maintenance ~ ANNUAl. <br />Spr1nkler 0 <br />FIre,Alarm. 'D <br />Hood Cl.an/Suppr~lQl': D <br />,FlrQ Alarm'lnstaGation <br />Fire pumps <br />Are Works <br />FhilmmabJe App"e:atlon- ANNUAL <br />Fuel Tan4 <br />other: <br /> <br /> <br />-.J <br /> <br />,~, ' Company <br />~ Registered <br />Adcll'EtSS r J Uc9li$6 # <br /> <br />~~~=11 J~::;:~ <br /> <br />Acldresa [" I UcenS6 # <br /> <br />OiHSR I ' " - , ,] Company <br />Signature ~ . _ Rsgistcrcd <br /> <br />~~:s~ss '"._o..~_:~-...~ .,.._~,:~_.,_ .._ .,_ .-- v~ n~~~ge If r L <br /> <br />RlI o\lll!lpplleajJon complvtlllly. ' . ' , <br />Owner & contrst:tOt, sign baol<. of applloatior.,notaMed (Or. ::oPY Qf' sIgned con~ct WIth owner) <br />:t over $2500, e NotiC$ of Commencement is roql.lif1iill:l (Ml'ehanlcai WQri< over $5000) <br />5I.tpply two (2) sets of dn:Min516 with applicable docurnentElion <br />......ow 10-14 d8y5 for r","iJitw etter subtn!ttal date. ' <br /> <br />D. <br />o <br />D <br />o <br />o <br />o <br />o <br />o <br />D <br />D <br />, t <br /> <br /> <br />Fumlgatlon Tent <br />~OU9 Matellal,(Tler 1\ or RQ Faoilit)') ANNUAl. <br /> <br />Hoodlnstallatign <br />l.P/N<iliJml.Oss-lnsiallation <br />LP/NatUra! Ga&-ANNUA!.. Sale <br />F'13= of Nl15elTlbly-ANNUAL <br />Reaeational Bu'n <br /> <br />5paflderS <br />slri1klar System InstlIllatlofl$ <br />standplpe.S (Sprinkle/' Sys) <br />Torch Roollng <br />Waite Tire .Stprage ANNUAL , <br /> <br />.\ Valuation Qf Project <br /> <br />Company <br />Registered <br /> <br />Ucanse fI. <br /> <br />Company <br />Registered, <br /> <br />\ ~4 f=t..c.."TIl~ I <br /> <br />.. <br /> <br />I ""3~4'i ~ <br /> <br />I <br /> <br />Y I N,] , <br />1 <br /> <br />Y IN I <br />I <br /> <br />Licenlle # <br /> <br />[~ I N J ~Fee Current <br />I <br /> <br />'~ Y I N I Fee current l <br />T <br /> <br />,F .y I N r Fes Current <br />I <br /> <br />I Y/N 1 <br /> <br />Y / N I <br />1 <br /> <br />:1 I <br /> <br />Y INl <br />""] <br /> <br />, -l <br />F$e Curreni <br /> <br />J I ~uL...:..... <br /> <br />"'l~ .,... <br />