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___ _ -- ZLPHYRHILLS BUILDING _ . 11 33iF _ �I' q30 5 : -- . 1 <br /> 813- 786-0020 City of Zephyrhihs Fire Fax -a :780.0021 <br /> Permit lApplication - <br /> Data Received IMMIIIIIII _ i Phone Contact for Fermit <br /> ,ww,cx,r«.• •.+icy'",.""'S.'SCt°v'�^' ,.u. °.a ^,. ,an . ,;;.+SSOx -,:... M, n .. ... _. a., <br /> N i <br /> Owner's Name C G \\ \ \I 1 - C ` i� '.Owner's.PhoneNumber <br /> \ 1 �� <br /> Owner's Address t - `• <br /> Pee Simple Titleholder Name • 1 'Titleholder Phone Number : i • <br /> Fee Slrnple Titleholder AddreSS . <br /> —. ,- �..._._ . • Job•Address. \Q (' ` ` cl ` Loth <br /> Sub Division Parcel # • :.!J Zcp," 7 ' C O � p&30 -0 .'.' <br /> iUiitAINtU f-uUM K'1tUNtttlY 1 ( YC.fi!(;} <br /> n 3iv Hazard Waste Storage ANNUAL n Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct . • . C Hazardous Material (Tier 11 or R4 Facill ANNUAL <br /> f I Controlled Burn • n Hood Installation <br /> — • Emergency Generator < 30-kw • 1 I LP /Natural Gas - Installation <br /> L 1 Emergency Generator> 30 kw - • I • 1 LP /Natural Gas - ANNUAL Sale. . <br /> Fire Protection Maintenance - ANNUAL 1 Places of Assembly - ANNUAL • <br /> Sprinkler - - n ..RecreatIonal Bum <br /> Fire Alarm 1 f SparKlers <br /> Hood Clean /Suppression = Sprinkler System Installations , <br /> Fire Alarm Installation • • • n Standpipes (Sprinkler Sys) • <br /> I Fire Pumps j F 1 - Torch Roofing • <br /> Fire Works ' n Waste Tire Storage ANNUAL <br /> Flammable Application- ANNUAL <br /> E Fuel Tanks . • J 1 Valuation of Project <br /> Q Other: . <br /> Contractor • • • Company <br /> Signature Registered . Y! N i Fee Current 1 Y / N ' <br /> Address • 1 - License # 1 <br /> ELECTRICIAN . Company 1 <br /> Signature . Registered . Y / N • Fee Current Y / N <br /> Address l License # , <br /> PLUMBER Company. <br /> Signature • 1 1. R Y 1 N. ! Fee Current • Y . 1 N <br /> Address 7 1 • License # • <br /> MECHANICAL . i I Company J <br /> signature Registered .Y i N Fee Current 1 Y/ N 1 <br /> Address l <br /> ■ 1 License # <br /> oTHER — . Company Ca y N I BWrial \T/ <br /> .;gnature 1111W11116. � ! Registered , N Fee Current I r / p <br /> Address �.! le l WPM License .r <br /> ' , 1 - _Z : nklege <br /> •.evr.• !�+..,v.aw...�rxaa. — ...Sf#: a. •- -: .:..'u.r..a:, sH .. -.::r ,zmmn. �._.I ...... 1. .. i <br /> '..)irections: <br /> iii out application completer'. <br /> Owner Contractor sign cacti or application, notarized (Or. cony of signed contract with owner) <br /> if over - 2500, a iVatice of Commencement is requireci (Mecnan;oai work aver 5000) <br /> Supply 7WC, (2) sets or drawings ../rth applicable documentation <br /> , -flow 10 - days for review after submiitai date. I <br /> 1 <br /> 1 <br />