Laserfiche WebLink
DBCi10/ 2 007 / / MON 1I:44 AY Z FHYRHILLS BUILDING FAX No 8.8 - :C_ n - G <br /> 813780 -0020 City of Zephyrhilis'Fire - * 90 Fax.ti13.780 -0021 ilt=1 <br /> Permit Application. :. FIp <br /> Date Received - - Phone °antpet fer Permit <br /> Owner's Name WV" IC ,,,PMMi • rt/AFB ,f3' Owner's Phone Number . <br /> Owners Address , t/ E 1; - 2 ' , 4,/t / 1 13-72.77.- <br /> 5 r • <br /> Fee SimpleTltleholderName TitiaholderFrionaNumber I - L__1 t-----J <br /> Fee Simple Tluehclder •Address <br /> Job Address 3 �5 z-G E 2e k 4 711 . �f . 1 1 Lot # <br /> Sub Division Pafpel <br /> 0 Bio- Hazard Mate storage - ANNUAL n Fumigation Tent <br /> R Comm Exhaust Kitchen Hoodl <br /> El Hazardous Material (Tier 11 or RQ FacJtty) ANNUAL <br /> Controlled Bum Hood Inetallatton <br /> Ej Emergency Generators 30 kw II LP /Natural Gas - Installation n / `�, eV/ ci <br /> n Emergency Generator 30 kw LIB /Natura1 Gas - ANNUAL Sale L- <br /> Li Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL / / / G <br /> It7friyl semi • fa r <br /> Sprinkler © ❑ ❑ d 1111.1 El RscreaConal Burn <br /> Fire Alarm ❑ ❑ ❑ . n Spenders <br /> Hood Cleaning 1i( ❑ ❑ Sprinkler System Installations <br /> Hood Suppression d 0 ❑ I Standpipes (Sprinkler Sys) <br /> • Fire Aiartn Installation B Torch Root igfTar Kettle <br /> Iire Pumpe Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL •C7— I Valuation of Project <br /> E Fuel Tanks <br /> Other: <br /> Contractor <br /> SIgnatuns 1 �.� •� f . . •, • Y / N I Fee Current [ Y / N <br /> Address (. 7 O fns - 1 OW 4 rS SZEIMINIE .... L'cetfse.# . -' I --- <br /> eLBCTRICIA CA it < „In 0\10 1 f T— 3 'S <br /> . &C c1 ;Company y -J <br /> Signature L - - - Registered Y / N I Fee Current I Y / N I <br /> Address I I License # - I <br /> PLUMBER Compeny _ . <br /> SIgnetu fe Registered Fee Current Y / N <br /> Address � _ License# L .----- - 7 <br /> MECHANICAL - - Company <br /> Signature Registered Y/ N 1 Fee Current F Y / N I <br /> Address —_ —^ -. ! License # 7 I <br /> OTHER C Company J <br /> Signature Registered MUM Fee Current MC <br /> Address . License* <br /> bireotlona: <br /> FYI out application Corlrpietraiy- <br /> Owner a Contractor sign back of application, notarized (Or, copy of signed cantract with owner) <br /> II awl' 32800, a Notice of Commencement Is requIred.(Mechnnicat work over 35000) <br /> Supply two (2) seta of drawings with applicable documentation <br /> Allow 10 days far review after submittal data. Paroel # - obtained from Property Tax Notice (httpJ /appraiaer.pascoguv.oam) <br /> —rile- ? €ESSuee c iv, a c . <br /> 17C Gga/.. / .w.ti i/-4 -, L <br /> Gcf /<t /.f.wn, W/. 3 3 kc �7 <br /> 'vLe <br /> W 4 scv - - - - <br />