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813-780.0020 City of ZephyrhUls Fx413. 780 -0021 <br /> Permit Application • - <br /> Date Received - -77- ' - Phone Contact for Permit <br /> Owners Nams .. - S„Mare. /► ` r�'�� Owners Plane Number . I 1 1 1 1 1 <br /> / �. -4 <br /> Owners Address / l s ir a I IF _ ` __ <br /> Fee Skeels T1llalaldsr Narne Titleholder Phone Number <br /> Fee Simpls1ltlslaldsrAddress I I <br /> Job Address 386 ,c Ato" ' - # <br /> Sub Division Parcel # <br /> x <br /> 0 Bto.H.zand Waste Storage - ANNUAL a Fumigation Tent • <br /> El Game Exhaust Kitchen Mood/Duet a Hazardous Mshrlal (Tier II or RO Facility) .1 -- <br /> D Conte Bum Q Hood kn elation <br /> a Deviancy Generator < 30 kw 0 LP t rat Gas -kn taYtlon 9! 9 <br /> jii Emergency Generator> 30 kw LP/Natural Gas - NUAL : . <br /> Rre Protection MakMsnenos - ANNUAL ® ®® Q Places of • • ' AL <br /> �prrer <br /> Spdnidsr 0 0 0 P ssUonel Burn <br /> Fire Alarm 0 0 0 Spatters <br /> Hood Cleaning o o 0 I Sprknlder Sykora irtialorrs - • <br /> Hood Spppree.bn 0 X 0 I • I Standpipe. (Sprkdd.r Sys) • <br /> Fire Mum n - _ Torch Rooting/Tar Kettle ' <br /> Fire Pumps — - - Waste Tire Storage ANNUAL <br /> Fire Works . <br /> Fie enable Applealon- ANNUAL ) ) valuation of Project <br /> Fuel Tank <br /> 0 • <br /> NM <br /> t; «tractor <br /> SIgnati • IrAirtraillek Campary /:1:�:CJl:���-7,j�'JL�►J <br /> Rellisbred ire12•1102=1111h7EA <br /> Address Ill �3I�7arg=_AP/ /A4d�. liaLban.s# VZ le.L7 '..1.1.7:0 I ; <br /> Gigesakell Pr �� / L ' 1 � '' �' ~ Registered Y / N Fee Current Y / N <br /> Adder I - I License* I I <br /> PLUMBER I I I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License I I <br /> ME <br /> S I Registered I Y/ N 1 Fee Current I Y/ N 1 I <br /> Address I I License # I I <br /> OTHER 1 I <br /> Signature R.gielsred I ¥/ N • 1 Fee Current I Y / N <br /> Address I 1 Lhar s# I I <br /> Directions: • <br /> FM out application oanpkWy. <br /> Owner & Conlracior sign beck of application. notarked (Or, copy of signed contract wph owner) <br /> M over 12500. a Hoke of Commencement k required (1Aechanieal work over $5000) <br /> Supply two (2). sets of drawkngs with applicable documentation . <br /> ANow 10-14 days for review after submittal date. Parcel 0 - obtained from Property Tax Notice (htlp Happralser pescogov.00m) <br /> • <br />