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8�3a8o-oo20 • City af Zephyrhliis Fire Fax-813-78Q•OD2i
<br /> Permit Apnlication
<br /> Date Received ° ' Phona Contact for Permlt ��jC'���� �
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<br /> Owners Name � L Owne►'s Phone Number � � �T�
<br /> ow„ers Add�gs
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<br /> Fee Sfmpta Tidehofder iVame TiUeholder Phona Number � � �
<br /> Fee Simple Tltleholder Address
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<br /> dob Address Lot#
<br /> Sub Division Parcel#
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<br /> � BiaHazard Waste Storage-ANNUAI. � Fumigallon Tent
<br /> a Comrse 6chaust Kitchen HoodlDuct � Hazardous Matedal(Tisr I(or R�Facifity)ANNUAL
<br /> � Controlled Bum � Hood InstallaUon
<br /> QEmergeneyr Ganeraior<30 kw Q LP1Natursl Gas-fnstallatEon
<br /> � Emergancy Generator>30 ktv a LP/Natural Gas-AtJNUAL 3ale ����J Vi
<br /> � Fire Prolectlon Maintenance-AMtJUAI. � Ptaces of Assembiy-AIJNUAL � f ��
<br /> � em [ nF�T er
<br /> Spdnkler Cl ❑ � � Recreaflonai Bum .
<br /> Fire Alarm � ❑ ❑ � � ❑ Sparlclers
<br /> Hood Cleaning � d O O � � Sprinkler System Installalions
<br /> Hood 5upprasslon � O C7 0 � � Siendpipes(Spdnkler Sys)
<br /> a Fire Alarm InstaltaUon � Torch RooftnglTar Keltle
<br /> � fire f'umps a Waste Tire Siorage ANNUAL
<br /> Bf,�eWo�a
<br /> Flammabta ApplicaUon-ANNUAL �--� Valuation of Project
<br /> ' � Fuel Tanks
<br /> � Other: t _
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<br /> Contractor /! � p/ � �,� . Company
<br /> SignaWre (,� , ����-�K��" i2egistered Y/N Pee Current Y/N
<br /> Address �� �l. � � ( License#
<br /> ELECTRICfAN Company
<br /> Signalure RegisEered Y/N Fee Current Y/N
<br /> Address Ucense#
<br /> PLUMBER Company
<br /> Signatura Registered Y/N Fee CuRenl Y/N
<br /> Addreas Eicense�
<br /> MECHANICAL Company
<br /> Sfgnalure Registered Y/IV Fee Current Y/N
<br /> Address License#
<br /> �THER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address Licensa#
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<br /> DlrecBons:
<br /> �ill out appfica0on compietely.
<br /> Owner&Contractor sfgn back of applicaUon,notarized(Or,oopy of signed conUact�vilh owner)
<br /> If over$2500,a NoUce of Commencement is required(Mechanical work over 55000)
<br /> Supply two(2)sels of draw(ngs wiih applicabte documenta6on
<br /> Ailow 1D-9 A days for review after submittal date. Paroel#-obtalned from Property Tax NoUce(http_//appraiser.pasoogov.com)
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