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_ 813-780-0020 City of Zephyrhiils Fire
<br /> Pefmit Application Fax-813-780-002'
<br /> Date Received ��—i�
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<br /> - - _. .. _:. .,... _ Phon ontact
<br /> -_: ..._..._..... ... . :........:�-- e C for Permit �
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<br /> Owner's Name Z/�'C �/?S ��L � /�C � � o
<br /> `� Owner's Ptpne Number b �� �/S Q,S�c i
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<br /> Uvrner;AddresS , ,� �� �p �j�, ��/� �G����it!CL S
<br /> G� .37 5 yC
<br /> �e=S�mn�e Titlehoider Name �--� �
<br /> F��c mp�e T�nehotder Address Trtleholder Phone Number `---- `----J
<br /> � -�-� --�,k,,,� � � �-� t�����.
<br /> ��C�C.�i � ..���._�="-
<br /> Job�ddress �; �, ��� G f`,��n �ICC S •°
<br /> /� �L 3�35�c� �
<br /> Sub Division Lot#
<br /> •. Parcel#
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<br /> Bio-Hazard Waste Srorage-ANNUAL �-�"��-'�°`'-==�--='-=_�----
<br /> � a Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> Comm Exhaust Kitchen Hood/Duct Q
<br /> (-1 Hood Installation
<br /> � Controlted Bum �
<br /> � Emergency GeneraYor<30 kw LP/Natural Gas-Instaliation
<br /> (� a LP/Natural Gas-ANNUAL Sale
<br /> ='mE�Se��y Generator n 3J kw �
<br /> afire Profection Maintenance•ANNUAL P�aCes of Assembly-ANNUAI
<br /> � emi n( a Recreational8urn
<br /> a e� ❑
<br /> Sprinkler � � � ��
<br /> Fire Alarm SPerklers
<br /> ❑ O �y ( n`�
<br /> ❑ � � � Sprinkler System Installations .�J/ v
<br /> Hood Cleaning � � � � ❑ ��t
<br /> � Standpipes(Sprinkler Sys)
<br /> Hood auppression � � � � �
<br /> � Torch Roofinglfar Kettle
<br /> Fire Alarm Installation a
<br /> � Fire Pumps Waste Tire Storage ANNUAL
<br /> Fire Works
<br /> � fiammabfe ADPlication-ANNUAL
<br /> � Fuel Tanks Valuation of Project
<br /> ❑ Other:
<br /> -..- :. . - �==_=. ,. ._..,..
<br /> _....._.��.._:._:=-�:�a-�=�_��>-.....,_-r_.
<br /> conc�actor ..__..._..__-�.�_:_,=x-'.�'�:����.r;.-.��_�;-
<br /> �' �+�z�=<�=
<br /> S;gnature � �a�.- _.. �.�,..:�°�__v,.,...__.__. -
<br /> Company -j- ,�,G� (t.�'�'t•o
<br /> Registered Y/N '�
<br /> Address 3 5 31 K¢y,.�.onQ, Rd. Fee Curcent Y/N
<br /> c�EC7RiCiAN license# EFO000�(�1 t
<br /> s�gnature Company
<br /> adaress � Registered Y/N Fee Current Y/N
<br /> 'r�u nn;3E.H License#
<br /> S�r,nature � Company ��—`�
<br /> aaa�ess � Registered Y/N Fee Current Y/N
<br /> MECHqNi�q� License#
<br /> S,ynature Company
<br /> Adoress Registered Y/N Fee Cunant Y/N
<br /> 07HEF �icense# — ..,
<br /> S�gnature Company
<br /> Address Registered Y/�1 Fee Current
<br /> _,.____-_-_:
<br /> Duections -�... °"_=--- -- -= LiCe ---_._.
<br /> - --__--.. nse#
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<br /> Fdl out aPP��cation compietdy "'- - �.- - ._._.,--- - , . - --
<br /> Owner&ConVactor sign back of apptication,notarized{Or,�py of signed conUact with owner)
<br /> �f over 52500,a Notice ot Commencement is reqwred(Mec,ha�i���n�o�k OVe�$5000)
<br /> Suppry two(2�sets of drawmgs with appiicaWe doc�mentahon
<br /> Auow 10-�4 days for review after submittal date.
<br /> Parcei#-obtained from Property tax Notice(http://appraiser pascogov com)
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