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s�s�eo-oozo City ofZePhyrh�ills'Fir�:� Fax-s�3aao-ooz� <br /> �/ :��? Permit ApPlication <br /> Date Re�eived .l .: - � , :Plicrie ,Co�rrtacf for Pertnft � ' <br /> C1�nmer's Name , - '�vC�t� ,�lq! . � - -. �• E�eda Phone Nnmber <br /> -- T <br /> Owne�'s Address 3� ��� � • - - • - <br /> Fee. Simple Titlehold�r Nante Titlahtiltlen Rhone:Number �� ;� �� <br /> Fee Simple?IUeholder•Add�ess ' " - <br /> Job Address a �"'� �,. ' � <br /> Lot # <br /> Sub Rivision • ParCel # <br /> , 0 BlaFfazA Waste Stot�ge -1kNNUAL <br /> � FuYntgaticn �ent�� <br /> � Gom►n Exkis�uat Kltchen Wo,od/puct �� Nazardous Matei�al (Tlar II or RQ��eillty) ANNIIlk! <br /> � Controlled Bum a Hood In�tallation <br /> Emergeitey.Ganeratar < 90 kw � 1.P/t�laturaF Gas-Instapatfon <br /> � •Emergehcy �enetater> 3U kw , � LWJNetyral.Gas-AMNUAL Sale <br /> � Flre I�rotection 1ulalnteaance - ANN�r�1L • �. plecds:of Asse�bly-ANNUAL. � <br /> �y em ��,: r .. <br /> - '5prinkl�r � "C! ❑ D : ., .� RecreaUonai Bum � / �' <br /> ° Ffro Rlarm / � t � <br /> ❑ q O " • - SRarklbrs <br /> Hood Cleaning O O. ❑ Sprinkler�ystam:an�tallations � <br /> Hood Supp�sslon �. p � ❑ � Standpipes (Sprinkl�r8�e,$) <br /> Flre NarFn IhstaNation � Torch Rooflng/Tar Kettle <br /> Fire Pumps . . '� W�sta'flte-5torage:AN1�lUAL <br /> Fire Works • . <br /> Flamrriable ApplicaUon- ANNUAL � <br /> - Valuation of�Proje�t <br /> Fuei Tenks ' • <br /> o �,e�: <br /> Contractor Company � _ <br /> Signature " Registered Fe CUrreAt �' / {V <br /> AddPess a � �, ` <br /> 7 ' , Licens� # <br /> ELECTRICIA •. ��� <br /> Signatu�e Reg"istered /��: Fee Curtent ��: Y/•N <br /> Address • License # <br /> PLUMBER Company <br /> Signature Registerod Y/ N Fee Current Y/-N. <br /> Address <br /> License # <br /> MECHANICAL Company <br /> Signature � Registered Y/ N Fee Curront Y/ N <br /> Address License # <br /> OTHER • � Company <br /> Signature � Regtstered Y/ N Fee Currefit Y/ N <br /> Addrees � ' <br /> License #� <br /> Diroctlons: . <br /> Fill out applicetlon completely. - <br /> Ovmar 8 Contractor s(gn back of applieatlon; notarized (Or, cqpy of gigned co�t[act with owner) <br /> If over 52�00, a Notica of CommencemenY Is roquired,(Mechartfcal work over �50Q0) <br /> Supply Mrq (2) sets of drawings with appficable documentadon <br /> Allow 10-14 days for review after submRtal-date. Parcel #- obtain�d from Property Tax:Nodce (httpJlappraiser.pascogov.com) <br /> , . . <br />