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313- 780 -0020 <br /> City ofZephyrNIIs Fire <br /> I 7 ran -o i ..) ov - vac i <br /> Permit Application / _ ` <br /> Date Received y <br /> Phone Contact for �c <br /> ac Permit . 3$ <br /> (rZl � <br /> Owner's Name frTiM)I\ifle%J 2 Th7t C,(C <br /> I O I ------ <br /> wner's Phone Number <br /> Owner's Address I iz; 6pri ?ft ifpcx,u-{y% srA-rt: i Cyr* 1p cg, in oO4 Liov- <br /> Fee Simple Titleholder Name j <br /> 1 Titleholder Phone Number 1 1 1 I --- <br /> Fee Simple Titleholder Address I <br /> ::£WVY- y , ,4. .. La^ %.trit ,:', ... , if4iV_4 . AV.Z1." <br /> F1.yp .0 4 . r , e , e.�L`M , e , :w': . "Vet�4.T.t�_ R,.!;k. .II <br /> Job Address li3t►� Co Rc.� : r <br /> ...—....L....—" ° <br /> ZCO c t lot. • I Lot# <br /> Sub Division 1 M OF 7 ihr/f—i.h LLS i <br /> Parcel # <br /> .e aw � el • 60 )0 • oes� ' X00 f7 <br /> Bio -Hazard Waste Storage - ANNUAL I I <br /> 1 Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I I Controlled Bum I I Hood Installation <br /> I 1 Emergency Generator < 30 kw I I <br /> 1 1 LP /Natural Gas - Installation <br /> ►1 <br /> I _`7I Emergency Generator 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> F4 Fire Protection Maintenance - ANNUAL I I <br /> Places of Assembly - ANNUAL <br /> Utrly Semi all lUther 1 <br /> Sprinkler 2/ ❑ ❑ 11 I <br /> Recreational Bum <br /> Fire Alarm ( I ❑ ❑ ❑ I I I I <br /> Sparklers <br /> cep t <br /> Hood Cleaning 1 1 ❑ ❑ ❑ l I { I Sprinkler 4 <br /> nkler System Installations A�� � / �� / <br /> Hood Suppression i I ❑ ❑ ❑ I / <br /> I I I Standpipes (Sprinkler Sys) /] Oct <br /> � <br /> ri <br /> Fire Alarm Installation I I Torch Roofing/Tar Kettle G (% <br /> M1 <br /> Fire Pumps I I Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> Fuel Tanks'•oa 1 Valuation of Project <br /> 1 Other: I <br /> Contractor T� � <br /> Signature �� Company Qoa� f-i 5pt2►n� 1 <br /> .. - - • Istered I Y / N . 1 Fee Current 1 Y / N <br /> Address —�� <br /> License # 14 B Low t i cAS I <br /> ELECTRICIAN <br /> Signature I Company <br /> Registered I Y / N 1 Fee Current I Y / Ni 1 <br /> Address I I I <br /> PLUMBER License # I <br /> Signature I Company <br /> Registered I Y/ N I Fee Current 1 Y/ N I <br /> • <br /> Address I 1 <br /> License # I <br /> MECHANICALI <br /> Signature , I Company <br /> Registered Y/ N I Fee Current 1 Y/ N <br /> Address I <br /> 1 License # <br /> OTHER <br /> Signature 1 Company <br /> Address <br /> Registered Y / N - I Fee Current I Y/ N 1 <br /> . ..� License # <br /> Directions: - >.:--a.,.s te:... zW <br /> z <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (0r, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement Is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice htt //a <br /> ( p: pp^3iser.pascogov.com) <br /> • <br />