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4(14- <br /> 813 City ofZephyrhats'Flt[e = Fex- e1e- 7$o -oozi -it <br /> . Permit Application . _._ <br /> Date Received – p' - Phone Contact far Permit E.' cil : 0 I 3 1 <br /> Owner's Name i p ., b . i - 7' es Jay • J Owner's Phone Number 1 13 1 L F?3 11 ///-5 <br /> Owner's Address 1 7 9 6 7 &x(/ Pivot I <br /> Fee Simple TtUeholder Name J ] "Titleholder Phone Number , <br /> Fee Simple Titleholder Address 1 I <br /> Job Address I J Lot# 1 1 <br /> Sub Division } J Parcel # ) I <br /> D Bio- Hazard Waste Storage - ANNUAL 1 FumlgatiorrTent <br /> 0 • Comm Exhaust Kitchen Hood/Duct D Hazardous Material (Tier I I or RQ Facility) ANNUAL <br /> D Controlled Bum ED Hood Installation <br /> D Emergency Generator a 30 kw n LP/Natural Gas - Installation <br /> D Emergency Generator> 30 kw n LPiNaturai Gas - ANNUAL Sale <br /> D Fire Protection Maintenance - ANNUAL D Pieces of Assembly- ANNUAL <br /> eml ®timer <br /> Sprindier D � ❑ ❑ 1 D Recreational Bum <br /> Fire Alamo ❑ ❑ ❑ I i 0 Sparklers <br /> Hood Gleaning ❑ ❑ ❑ 1L'IRJi ED Sprinkler' System Installations <br /> Hood Suppression ❑ ❑ ❑ I 1 D Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation D Torch RooflngtTar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application ANNUAL J 1 Valuation of Project <br /> Fuel Tanks <br /> n rather:. 1 i <br /> \ company ire A—) a Td <br /> J <br /> Si ` IJ .' Registered Y/N Fell Conant Y/N <br /> Address 1 I License #.. 1 I <br /> ELECTRICIAN Company <br /> Signature Registered Y/N I Fee Current I Y/N I <br /> Address I I License # I <br /> PLUMBER I Company <br /> Signature ! Registered Y/N I Fee Current I Y/N 1 <br /> Address I 1 License* I <br /> MECHANICAL Company I <br /> Signature , Y / N I Fee Current I YIN 1 <br /> Address I - License # ,. _ <br /> OTHER Company 1 <br /> Signature [ Registered Y/ N 1 Fee Current I Y/ N I <br /> • <br /> Andreas •--- License # <br /> Directions: ' <br /> FM out application completely. <br /> Owner & Contractor sign back of application, notarized (Or. copy of signed contract with owner) <br /> M over $2500. a Notice cf Commencement is rewired (Mechanical work over6000) <br /> Supply two (2) eats of drawings with applicable documentation <br /> Mow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (htip F)appraiser pascogov.com) <br />