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, wsi3aso-oo2o CityofZephyrhiils"Fir�• Fax-eis-�sa-oo2� <br /> Permit Application - <br /> Date Received � Phone Contact for Pertnit Y�,-_�-.� <br /> ° : .- - -�;:_�;.:,xiY;,:�.��._..�_ > .,_ ; ���..�=ss�b��.�,..-~z.� - . ::�:__ .. - <br /> Owners Name ANDERSON P Owner's Phone Number � ( � 5 �Q <br /> Owners Address 51Q�} �RA�' — <br /> Fee Simple Titleholder Name TiHeholder Phone Number �� � <br /> FeaSimpleTitleholderAddress �� ,�,� � � � _ <br /> �,., .m.>.��;;. �; . ,;� __.. . �... <br /> "y���'�".:_.`� .,�...�,.. �°�„'?�x ,�. �+.. ,"°��. ' .: , °'�"`�t-�. :;a�`� <.�:�1�. -'�'gc:S:�,��.::�.c.�t�:. °- ._. ��c: _.: . <br /> ..���: . � . . �° � � <br /> Job Address GOLDEN CORR.AL 6855 GALL BLVD Z��H�� — Lot# <br /> .. <br /> Sub Diviswn � +d,: ��� _ �. � <br /> --...-�.. . ,. . �,�. . > _ �.� :�:� � -_. �..�.,�.:...�k.�.�. , <br /> _._�._...__.- �._.�-�---.�� ��. _ _ ... . <br /> . . ... .. __ .. .. ...:.2��' � '=cP",�?"v.. -�-.x'—"�'s�.�'s. "�" ��a;- ,,,,.,,�.. <br /> . .,�:R^;a;:. -. ,<-.,�..�t . N . .. .� . <br /> �� Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Materia► (Tier 11 or RQ Faciiity) ANNUAL <br /> � Controiled Bum � Hood Installation <br /> � Emergency Ge�erator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor> 30 kw � LP/Natural Gas-ANNUAL Sale ,----�. <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL -�/ <br /> �r�y emi � r <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum n O <br /> �(% <br /> Fire Alarm � � ❑ ❑� � Sparklers I I <br /> Hood Cleaning � ❑ � ❑� � Sprinkler System InstaUations �I' <br /> � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Instaltation � Torch Roofing�iar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> -, .�-s� - � , F..��-=-� ���u�,- � _. <br /> Contractor Company <br /> Signature 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 /> 5ignature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ rl Fee Current Y/ N <br /> Address License # <br /> «?'� o. - ::aa��_r.a,�..�ax*� a,�c�sxa..,y:s��� - � �aa:.�:>i�e�.` . ..,.�<...n. ' «�._:-.'--. -..a-;.> - "�z��..�.� <br /> Directions: <br /> Fill out application compfetely. <br /> Owner 8 Contractor sign back of appiication, 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 applicable documentation <br /> Allow 10-14 days for review after submittal date. Paroel #- obtained from Properry Tax Notice (httpJ/appreiser.pascogov.com) <br />