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s�3a8o-oo20 , City of Zephyrhiils Fire Fax-s�3asaoo2� <br /> Permit Appfiption <br /> �ate Received /D�/ '�1S /l7tL. Phone Contact for Pertnk �f�3 � �� 3 U <br /> iwners Nama T o�,er$�N,,,� �� � � <br /> aM,ers ada�s �h O Q�b�t'q' d 1=C. 3358—7 <br /> ee Simple Tttleholdor Name T�ieholde�Phone N�mbe� �� � I I <br /> es Simple Tideholder Address <br /> L_,__� <br /> ob Add►ess aJ�'�'� C, � <br /> Lot# <br /> �b���, ��# bz.-z --Z1- 1 <br /> aBIO-Hazatd W3ste Storage-ANNUAL � Fumigabon Tertt <br /> a �°mrr'E�chaust Kitche"H°°dJauct � Hazardous AAate�ial(Tier II or RQ Fac�ity}ANNUAl. <br /> � Controt{ed Bum � Hood tr�stallation <br /> � Emergency Generatw<30 kw � LP/Natura�Gas-Instaltation �` C <br /> � � v <br /> / � <br /> Emergancy Ger�rator>30 kw lPMatural Gaa-ANNUAL Sale �Q�/' L <br /> � F►e t'rotectlon Maintenance-ANNUAL Q Places of Assembly-qNNUqL �7 <br /> (� e A r <br /> ❑� ��� ❑ ���r,,'�„ ��,�',� <br /> 5prinkler D O O Recreational Bum � i,� <br /> Fire Alarm � O ❑ ❑ � � Sparklers ��� <br /> Mood Gea�ing � ❑ ❑ p � � <br /> Sprinkier System tnstaNatlons <br /> kood Suppression � � ❑ O �� ❑ <br /> � Sta�dpipes{Sprinkler 5ys) <br /> Fire Alatm Instaltation � Tor�ch RocfingffarKetqe <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL 1-- � <br /> 1 /�S.�7 O Yaluation of Project <br /> ,-�el Tanks�� , — <br /> � � Other. <br /> � <br /> :ontractor ' - ' <br /> ComPe�Y <br /> �ignature Reglstered Y/N Fee Current Y/N <br /> ��� Q � License# r�, S' <br /> LECTRICIAN � �� <br /> �9�ure I Re9istered Y/N Fee Currant Y/N <br /> Address <br /> License# <br />'LUMBER <br /> �9�� C°mPe�Y <br /> Registe"ed Y/N F�Cunsnt Y!N <br /> Address <br /> License# <br /> 1ECHANIC <br />�gnature <br /> Company <br /> Registared Y/N Fee Ciararrt Y/N <br /> Address <br /> License# <br />�THER <br /> ignature C�Pe�Y <br /> Reg�stered Y/N Fee curnerrt Y/N <br /> Address <br /> License# <br />�►ectfons: <br /> Fill out applkatlon completely. <br /> Owner&Contractor sign back of applk:aUon,notarized(pr.copy of signed contract wtth pwner) <br /> tf over$250d,a Notice of Commencement ta r�aqulred(Mechanicai worlc over g5ppp� <br /> SuPWY two(2)sets aFdrawings with applicable docurtrerrtation <br /> Allow 10-14 days for review after submlttal date. ParGel#-obtained frcm Property Tax NoHce(http:pappraiser.�s�gov.com) <br />