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8�3-�eo-oo2o City ofZephyrhiNsFir�� Fa,�-s�3-�8o-op2� E�
<br /> PermftApplic�tion _ _._
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<br /> Dat& Receive�
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<br /> Ptwrie Corrtact for Pertnft ��
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<br /> Owners Name � � Ownei's PhOne Number �� E_ � Q�
<br /> Owners Address $3 � ' ` i� � �
<br /> Fee Simple Trtieholder Narrre Titleholder Phone Nwnber C� ��
<br /> Fee Simple Titleholder Address
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<br /> Job Address Lot # ��
<br /> Sub Division Parcel #
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<br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Terrt
<br /> � Comm Exhaust Kf6chen HoodlDuct � Hazardous Material (t ier 11 or RQ Facilify) ANNUAL
<br /> o Corrtrolled Bum � Hood Iristallation
<br /> o EmergencY Gene�ator < 30 kw Q LPRdatural Gas-Installation
<br /> o Emerr�ency Generator> 30 kw � LP/NaWrat Gas-ANNUAL 3ate
<br /> Q Fire Protectl� Maintenance - ANNUAL � Places of Assemby-ANNUAL � ----
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<br /> Sprinkler � D ❑ O� � Recreational Bum ���
<br /> Eire Aiazm � ❑ ❑ ❑ C� � Sparlders �
<br /> Hood Cleaning x ❑ ❑� � Spritdder System Ir�tallations
<br /> Hood Suppression ❑ ❑ ❑ �� � Standpipes (Sprirdder Sys)
<br /> � Fre Alartn tnstallation � Tor�h Roofing/Tar Kettle
<br /> Fire Pumps � Was6e Tire Storage ANNUAL
<br /> Fire Worics
<br /> Aammaae ,app�ica�- ataNVn� ValuaGon of Project
<br /> Fuel Tanks
<br /> Other. .
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<br /> 5ig"at�e �+v ' �' 'SC� Registered Y! N Fee ciarent Y/ N
<br /> Address '� 7 j license #
<br /> ELECTRICtA ��
<br /> sigiiawrs Registered Y! N Fee CurteM Y/ N
<br /> Address Lk�rree #
<br /> PLUMBER ���
<br /> Slgnature Registered Y/ N r-ee Current Y/ N
<br /> Address Licerue #
<br /> MECHANICAL �
<br /> S'9"at"re Ragisoered Y/ N Fee c.ianerrt Y/ N
<br /> Address u ��� �
<br /> o�� com�m
<br /> Signawre Registered Y/ N Fee Current Y/ N
<br /> Address License #
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<br /> D�rechons: - - - _ - �--r --•- �.,�-�
<br /> Fdl out applicaUon con�pletely.
<br /> Owner & Corrtrsctor sign hack of applkxtion, noteriz� (Or, copy of signed contrad wRh owner)
<br /> ff over $2500, a Notice of Commencement is required.(NiechaNcal work over $5000)
<br /> S�PP�Y two (2) sets of drawings wlth aPPiicabie doc�anerftation
<br /> alow � a�a days For review �ter s�mitmt dace. Pa�e� #- obained frum Prc�erty Tax NWice (httpJ/appraiser.pascogov.com)
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