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- -- j}�j . vvl <br /> 813- 784-0020 City ofZephyrhids Fire I " 1 <br /> Permit Application Fax-813-780-0021 <br /> • Date Received <br /> Phone Conteetlor Pound <br /> Owners Name 4R:T LA.'4 tJ of Z p44 `I rte} t U .... ^ <br /> I Owrier's Phone Number 13 lini .113S q ') <br /> Owner's Addres3 3W tto • 1-1- ` j -) 1-'1 D2 S-- 1"-t ✓j,; .1I�S, L 3%g �ko . <br /> Fee S" j .. . <br /> Simple Tltlotroldsr Name. L--- f <br /> Fee Simple lbeholder Address Titleholder. Phone Number <br /> pp <br /> Job Addl <br /> ddress f S44% r_ f D0_JcL <br /> F <br /> 1 Las • <br /> Sub Division • <br /> t--t parcel # I • I 1 B ird Waste Storage - ANNUAL <br /> El <br /> Fumigation lent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material <br /> 0 Controlled Bur„ 1 i (Tier 0 or RQ Facility) ANNUAL <br /> Emergency Generator < 30 kw = Hood Installation <br /> LP /Natural Gas - Installation <br /> Emergency Generator a 90 kw • <br /> LP/Natural Gas - ANNUAL gale <br /> Fin Protection Maintenance - ANNUAL Places, of l Assembly-ANNUAL Gas - b 4- • <br /> • SPri <br /> 0 I's;IF7 ISemll ® '!USprinkler � D <br /> � � � t7,acreatlona! Bum `j , 1 / 2 v N <br /> Fire Alarm ❑ ❑ .1 1 <br /> Sparklers <br /> Hood G n owning ❑ kr t I 1 S prinkler System kratallsUons • <br /> H <br /> • <br /> ood Suppression El p: ❑ • o I • 1 Q Standpi <br /> El pes P Pas (Spdnkter Sys) <br /> F <br /> • <br /> ire Alarm installation <br /> Torch Roofing/Tar Kettle' <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Fire work! <br /> Flammable Application- ANNUAL t <br /> Fuel Tanks f - I Valuation of Project <br /> Q Other. I • . . . <br /> • <br /> ff <br /> • Sig la c ie r ,. .. , .. • .._ / _. . Company Tn.. A .. �.. .. C . <...! • <br /> I Registered <br /> Address J 11117431 Fee Current MEI <br /> 3 7 J , _ At (- tr L. License # J I <br /> ELECTRICIAN <br /> Signature 1— l3 -- 4 2 0— b Z Z 1 4.4. 3$. Company <br /> Registered Y/ N j Fee Current J Y / N I <br /> Address I <br /> PLUMBER <br /> 1 License N 1 • . <br /> • S Company <br /> ignals, <br /> Address I <br /> Registered Y/ N Fee Current J Y N I <br /> MECHANICAL License Sr ( 1 <br /> Signature f Company 1 <br /> Registered Y/ N I Fee Current J Y/ N I <br /> Address I <br /> OTHER 1 License M I I. <br /> Signature I I Company I <br /> 1 1 Registered Y/ N I Fee Current ( Y J N <br /> Dh•ctlons: —_ .. ,.... T ,_.._.,, License # <br /> FNl out application eompletety. <br /> Owner <br /> If over °( <br /> & Con back of application, notarized (Or, copy of signed contract with owner) <br /> Commencement is required .(Mechanical work over $6000) <br /> Supply two (2) seta of drawings with applicable documentation <br /> • <br /> Allow 10 days for review after submittal date. <br /> Parcel # - obtained from Property Tax Notice (htlp; / /appratser.pascogovcom) <br />