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°'"°"�`R"" Gtty of Zephyrhilts Fire Fax-8137840021 <br /> � i j <br /> ' � P2rntit Application 1 <br /> Date Received �rJ.� ! Phone Cor+tac3 fior Fermit � � � �� � (D <br /> t <br /> Owner's Name 4rme�s Phone Mumber � � � <br /> C 'sAddress . G (3�� � ���� L ['�{,fr7 � <br /> J C, <br /> Fee Simpie TiHehoicier t�laine -{F��������� �� � � <br /> Fee Simpie TdleMolder A�3dress <br /> .3ob Address �Cf,3 � J�, (�Ot{' �]� ''��}`�(2-�-{�J� F� 33-�{Z � Loi# �� <br /> Sub Division / �T Z� A Parcet�X � � <br /> o8io-Hazard Waste 5tarage-�1�IllAL � }-1�y��a��atertal(f ier II ot F;Q Fac1'Ryj ANNUAL <br /> � Comm Exhaust Kdthen}�oodlDud � Fio�od 5nstailztl'son <br /> � Cordrotled Sum � LP/IVatura!Gas-Instailation "��, <br /> � Erraergency Generator<30 Icvv � LP/�Vatural GasANNUAL Sale � <br /> � Emergency Generaior>30 kw � Places o#Assembly-ANNU,4L � �� ��1 <br /> � � �1 � ° <br /> Fire Protection Nlairrtenance-pN1�t�� � � Recreational$um /���/� <br /> ❑�--� ' n � c� ,�.. <br /> SprinMer ❑ ❑ ❑ Sparklers J �Q�� <br /> Fire Alarm ❑ ❑ ❑ p � � Sprinkler System installations <br /> Hood Ckeaning O ❑ p ❑ �� � Standpipes(Spnnkler Sys) <br /> tfaad Suppression � ❑ CI ❑ �� � Torch Roofing/Tar Ke�tle � rJn 5 <br /> / � u( <br /> Fire fUarm instaTlation � Vllaste Tire Storage ANNUAL / � � <br /> � f A <br /> Fire Pumps � <br /> � Fve Worics <br /> � �lammabte A�tica#ion..pfdNUpL ���5�' . �e� �/aluation of Project <br /> � � �uelTanks <br /> � Other �i�p � � ' �lyli i9YJ/'If,��. <br /> Contractor ---- Com1m+�' �_ 1 <br /> Signature _ Registererl ����ee Current N <br /> Address '.2PY7� 3tst� �0� ta 5T►��Gid'SJ�C PL ?✓3)J.(s License#� � <br /> ELECTRIGAN �o��ny ( <br /> Sigrnature Ragisiered Y J N Fee Current Y/N <br /> Address � °---� <br /> Licerrse# � <br /> PLUMBER �o�� <br /> Signafure f�egis�red �'1 N F'ee Currc.mt Y/N <br /> Addrer,s � � <br /> License# <br /> MECNAPIICAL <br /> Signature ���� <br /> Reg+stE� Y 1 N f ee Cvrrent Y/N <br /> Address � � <br /> L�ense�t <br /> OTHER ����Y <br /> Signature Registered Y 1 N f=ee Curreni Y/N <br /> Address � � <br /> License# <br /> Directions. <br /> Fi11 ovi appfication comple#e�r <br /> U�vner 8 Coidractor sign bacic ot appficaifon,notarized(Qf,�opy of s{gned conirad wRh otimerj <br /> Ifi over$2500,a Notice of Corrimencem2ni is required{i�7e�ani�al worlc over$SDQOj <br /> Supply Mro(2)sets of drawinc�s w�h a�pficable documenfatitm <br /> , Afbw 10-14 days Par review after submi#tal date Parcel�_abtairsed from Property Tax t�io5ce(htf�J/appraiser.pascagov.com) <br />