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10/26/2010 10:58 7275310596 COMMERCIAL FIRE <br /> '4t- 1(6 PAGE 04 <br /> WIZ-160-0020 City ofZephyrhiilsFire F ax- al3-780 -0021 <br /> Permit Application <br /> Date Received ITOI • • •Phone Contect•for Permit c, F l 4. _ <br /> Owner's Name If'- lo (ta13- t fl \ .�C squat.. till 1 C. 1 w Owner's Phone Number l b I S , I (t a 1, l 'Ig <br /> Owner's Address 15$O 1 ��.QT cJq (xu. ..e. Willi' F I 6.x <br /> Fee Simple Titleholder Name I I Titleholder. Phone Number I I 1 1 <br /> Fee Simple titleholder Address I <br /> Job Address �� B6bt Maxic -" 6ql 'e ht-h i I �S % 7 T Q t .. I; <br /> Sub Division I n <br /> Pael # ) <br /> D Bio- Hazard Waste Storage - .ANNUAL Q Fumigation Tent <br /> Q Comm Exhaust Kitchen Mood /Duct = Hazardous Material (Tier II or RO Facility) ANNUAL. <br /> I I Controlled Bum = Hood Installation <br /> • El Emergency Generator c 30 kw LP/Natumt Gas - installation <br /> 1 Emergency Generator> 30 kw n LP/Natural Gas-ANNUAL Sale <br /> Frq Protection Maintenance - ANNUAL Places of Assembly - ANNUAL, n � <br /> ® b.11 L:Ir , . ,M <br /> � L 1 <br /> Sprinkler D D D MN a Recreational Bum <br /> Fre Alarm (0 b 1,4 I _ I Sparkler J I ( f / � <br /> Hood Cleaning b 0 D I I = SprinklerSystem Installations // (1) ,, i '1,4 <br /> Hood Suppression = p o ❑ L I Q Standpipes (Sprinkler Sys) <br /> 0 Fire Alarm Installation = Torch Rooflng/Tar.Kettle <br /> Fire spa D Waste Tire Storage ANNUAL <br /> Fie Work <br /> Flammable Application- ANNUAL ) ) Valuation of Project <br /> Fuel Tanks <br /> Contractor j j J/ pany . Registered Y / N Fee current Y / N a�Scl(� <br /> Address <br /> r _ License # <br /> ELECTRICIAN` Company t <br /> Signat J Registered f •Y / N 1 Fee Current I Y/ N J 1 <br /> Addretm I I License # I <br /> PLUMBER Company I <br /> ____I Signature Registered Y/ N Fee Current I Y / N J <br /> Address I License # I <br /> MECHANICAL1 Company I <br /> Signature . I J I Registered Y / N 1 Fee Current 1 Y / N <br /> Address I ' <br /> OTHER License # ( I <br /> Signature Com I <br /> Registered Y / Foe Current I Y f N j <br /> Address License# <br /> Directions: <br /> F11I out application completely_ <br /> Owner & Contractor aim beck of application. noterIzed (Dr. copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply'w (2) sets of drawings with epDCoable documentation <br /> Allow 10-14 days for review after submittal dsle. Parcel # - obtained from Property Tau Notice (htipJ/apprel .peseogov.eom) <br /> • <br />