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813=I80 City of ZephyrhiUs Fire FaX-at�-�ao-oo2� <br /> Permit Application <br /> )ate Received '�V� �� t�',� / Phone Contact for Permit � � c <br /> �,3a.��z.�:..�:w'3����b:x...«x.1..._,......_,...�-« •�.-s�"is�C��' .�SX�_ <br /> )wner's Name L „(„�L � •%7(/'� Owners Phone Number �� � . �S <br /> )wner's Address / . V • �V'\ � �J(� / � �7 � �C- k3 I -�o / / <br /> ee Simple Titleholder Name Titleholder Phone Number �� � <br /> ee Simple Titleholder Address <br /> - x . =- 'r<csE�� r�� �.«,w„�,�:. <br /> �: - s �_ . <br /> ob Address Gl/L-�L/ v �TT/V.UTT �/ ��S ��G�J�� .3""�'" • Lot# �� <br /> �ub Division Parcel # <br /> a Bio-Hazarrl Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material �er II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Instalfation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installa6on <br /> � Emergency Generetor> 3D kw a LP/Natural Gas-ANNUAL Sale �(�� � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �` <br /> �y emi �n er �' <br /> Sprinkler � O ❑ ❑� a Recreational Bum <br /> Fire Alarm � O ❑ ❑ � � Sparklers <br /> Hood Cleaning �1 ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑� � Standpipes (5prinkler 5ys) <br /> � Fire Atarm Installation � Torch Roofing(far Kettle <br /> � Fi�e Pumps � �Naste Tire Storage ANNUAL <br /> a Fire Warks <br /> a Flammable Application- ANNUAL r � Valuation of Project <br /> � Fuel Tanks <br /> � Other: <br /> �ontractor Company <br /> 5ignature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee CuRent Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee CuRent Y/ N <br /> Address <br /> License # <br /> Directions: <br /> Fili out application complelely <br /> Owner & Contractor sign 6ack of application, notarized (Or, 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 applicabie documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.�om) <br />