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. Fax-813 78f3-002i <br /> City of Zephyfiills'Firs� • <br /> ��;,-r se-oo2o permit Application <br /> Phorre C ar P� �„��;� <br /> �ar�e�s�ae � `�•��� ��'�� <br /> � �� <br /> aate Received ,_ - �� � �_�_SZLi_J � <br /> :�BL�:m�k"a�re�'�.'�''""""''' <br /> � � pwna�'s Phone Number <br /> hrmers Name t7 n �� <br /> 5 3� r v►� �; e �� �-� � ��. .�5� � � <br /> )wners Add�ass � <br /> �r �, •. Titfeholder Phone Number <br /> �ee SimpleTitleholder Name <br /> tH51��a;y2�� <br /> =ee Simplelitleholder Address <br /> �� � �, 1 �of# <br /> 1ob Address � � ���_�� � �) IGjV��� <br /> � Z e *�+ Parcel# �b ��D f �� " ��'�l} 'C) c�CJ� <br /> .:�YxLA�.��l�T�3�3� <br /> Sub Division <br /> � � Fumigatlon Tent <br /> Sio-Hazard Wasta 5lasage-AN AL � <br /> � Comm F�chaust Kltcha�F{codl�tw� Haza►dcus Material�Tier li or RQ FaciIHY)ANIJUAL <br /> aControllod 8um a Hood Installation <br /> � � 4PfNaWret Gas-installaflon <br /> Emarpency Generalc?r:3R kw � <br /> Emergancy Genetator>30 kw tPlPlattua!Gas-APiNUAL 5eie <br /> Flre Protection Meirrtena�ee-ANNUAL <br /> o places of Assembly-AHNUAL <br /> ❑� m� � er � ��//) <br /> 5prinkler C] a 0 RscreaHonal Bum , { � <br /> ❑ O Sparkiars � <br /> ����, � �1 ❑ ����'� <br /> Hood Cleening � O O � � a Sp�nkler System installatlons <br /> Hood Suppressfon � ❑ � O �� S��P�p°S�Spnnkler Sys) <br /> a �-�-� Torcfi RooflnglCar KetUe <br /> FVre Alarm Installatlon � <br /> WastsThe Storage ANNUAL <br /> Fire Pumps <br /> �ire Wo�cs �� Valuatian of Project <br /> �lammabie Appllcation-ANNUAL <br /> Fuai Tanks <br /> � Other: �. . ' <br /> __ , �--�.��:,m,..,�.,w.,�.,� <br /> Comparry `, _.,�m�..m- _ .�er '.��-, <br /> ConUaotor � , � ��y�erod Y N Fee Curcent N <br /> Signature <br /> Address i � �Ice�e# U t3 +� <br /> ELECTRtCIAN Company <br /> Registsred Y!N Fea CuRent Y I N <br /> 5lgnature <br /> Ucense# <br /> Address — <br /> PLUMBER � _` -..._-"'.,�...._..,....t.,,_,_�� CompanY <br /> Regtstered Y!N Fee CuRent LY/N <br /> 5ignature <br /> Liaense# <br /> Address --�"" <br /> MECktAN1CAL Company --- <br /> �g��e� Y�N pee Current Y/N <br /> Signature � <br /> License# <br /> Address <br /> OTHER Comp�ny <br /> Rogiatered Y!N Fee Cw�rent Y 1!V <br /> 5tgnature <br /> Liconse# �,�„�,� <br /> Address """`�"°"-y <br /> OirecUons: <br /> Fill aut applieation campletely. <br /> Ownar 8 Contractor sign back of applicaUori.notarized(Or,copy ofi slgnad oonUa�t with°�°T� <br /> if over 52500,a Natiae of Commence�t la raqulced(Machaniea!work aver 35000) � <br /> Supply two(Z)sets of drawin90`�iU+ePPfi�dacumentatlon <br /> Allaw 10-14 days for review aRer submltlal date. Parcel#-obtafned fi'orn Property Tax Notice(fittp�llappraiser.pasoogov,cam) <br /> , <br />