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DE , /`Ih /2UI '/ /'THU IJ4:'l'2 ?Y. GH1'HY1 HILL bU1L1J1Nh i AL IV). iii - 10U-uuL1 1 r, uuu • <br /> 813 7415)-0020 ` City ofZephyrhilts Fire 1 2 l Pax- 813 -78O -0021 <br /> . <br /> •Per Applicaticn . <br /> na f contact for Permit Date Receives; eag Pil <br /> er o —hi �r— l �. • <br /> Owner's Phone Number <br /> • <br /> Z i 1 1 ,..4.6 - <br /> owners Nam( '7 1 - C ' i ` �._ • <br /> I . • Owner's Addrr, ; I 4(1 • r ' Urt __.__:. • i <br /> Fee Simple Ti' eholder Name <br /> r • Titlehakes Phone Number .I • • 1 1 I I <br /> t <br /> Fee Simple Ti"`eholder Address "7 ---- 7 --- .7 ---7----- • . <br /> mi g � ' Lot # <br /> Job Address i -� <br /> Sub Division .Parcel # _` _ .. . • <br /> • <br /> easenc=seseweisisonermassimemoseientismatiasima <br /> E ' Bio-Hazard Waste Storage - ANNUAL • El Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazairicgle Material (Tier II or RQ FacIllt ANNUAL • <br /> 0 Hood Installation I . <br /> -� Controlled Burn . <br /> E _.J , 'Emergency Generators 30 kw • = ' LP/Nab:raI Gas- Installation . <br /> [_ -] Emergency Generator 30 kw # I LP/Nab-al Gas- ANNUAL Sale • I • <br /> [..-] Fire Protection Maintenance - ANNUAL • F Flame of Assembly- ANNUAL . <br /> Sprinkler = I' ( Recreational Burn . 1 <br /> • Fire Alarm ' Ir Sparkle's • <br /> Hood Clean/SUppression Fe J SPrinkler System Installations <br /> 1. Fire Alarm installation ." • n Standpipe (Sprinkler Sys) . <br /> - -] Fire Pumps • • . • , . • = Torch F:aofing , <br /> ] Fire Works • .. j Waste'rire Storage ANNUAL I <br /> -_ i <br /> C _ <br /> _,J Flammable Application- ANNUAL _ <br /> i ' Valuati of Project <br /> • __� <br /> � II —. <br /> Fuel Tanks --- <br /> J <br /> Other: <br /> C,om Ct <br /> !9e � ,,^ _ <br /> early i n " <br /> Contractor 1 i I <br /> • ,,� <br /> Signature fa .. , 0/iFl Ftegiatea ed Y / N Fee Current I Y / N <br /> Addres r r '' '" - R IM1 / i Licenses # <br /> ! - . <br /> ELEC.I RICIP'V Company . <br /> Signature • Ftegirt' red Y / N ( Fee Currant j Y/ N `) <br /> Addresr •• . , � license: # I J <br /> • <br /> PLUMBER Company • . , :' `' <br /> Signature ' - • • • 'Registered . Y / N I • Fee Current. L. Y / N 1 <br /> • Addres,•, tJCansr ') 1 • <br /> MECHANICh Company <br /> 'Signature__ • Registered • Y / N j Fee Current ( Y / N <br /> Addres __ . Uce1 -l5 ( 1 <br /> OTHER --� company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> nieseafasimeas Address i Licerw +; rf - <br /> CCEflrrm .,. --,... -e r_.:^cers....- r- - -r- �SMA16"1 it i i r a un�ai i <br /> Directions: , <br /> Mil out application completely.. of si contsr3ct with owner) <br /> Owner & Contrador sign back of application, .notarized (Or, copy <br /> If over $2500, a. Notice of commencement is required (Mechanical work over $ 5000) • <br /> • Supply two (z) sets of drawings .with applicable documentation ' <br /> J1ow 10-14 days for review after submittal date. <br />