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� <br /> �s13a8o-oa2o City of ZephyrhiUsFire• � � 3�j�.� <br /> Fax-81�780-0021 <br /> Permit Applicafion <br /> Date Received � - - <br /> :--:=�"'x:<.�:� :,�,_.�,:_---�.,�-,�,. Phone Corrtact for Pertnit <br /> u��-. �r�>> _.. ,��g�.,>.: <br /> Ownets Name ANDERSON P Owne�'s Phone Number . <br /> � � � <br /> Owner's Address S j�!{ �Y <br /> Fee Simple Titleholder Name Titletiolder Phone Number C] � �� <br /> Fee Simpie Trtleholder Address �--�� <br /> "`:�;'�'�- _ <br /> Job Address GOLDEDT CORR.AL 6855 GALL BLVD. — Lot# �� <br /> 5ub Division <br /> -_ .,., ��r _ Pamel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent ���� <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Matgial(fier II or RQ Facility)ANNUAL <br /> � Corrtrolled Bum � Hood Installation <br /> � Emer9ency Ger�ator<30 kw � LPMaturai Gas-installation <br /> � Emerge�cy Generator>30 kw � lP/Natura!Gas-ANNUAL Sale <br /> � Fre Protection Mairttenance-ANNUAL � Places of Assembly ANNUAL <br /> � m� � r <br /> Sprinkier � ❑ ❑ ❑ � � ���onal Bum <br /> Fre Alartn � p ❑ ❑ � � Spariders <br /> Flood Cleaning � ❑ ❑ p �� � Sprinkler System Installations <br /> Hood SuPPression � ❑ ❑ ❑ C� � ��P�A���nkler SYs) <br /> � Rre Alartn installation � Tor�h Roofing/Tar Kettle <br /> F��P�ps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Appticatio�-ANNUAL <br /> Valua6on of Project <br /> Fue!Tanks <br /> � �}1@f: <br /> Contractor . <br /> Signature ���Y <br /> Re9ister� Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRlCIAN - <br /> Signature <br /> Company <br /> Resistered Y/N Fee current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> 5ignature <br /> Company <br /> - Registered Y/N Fae Cumsnt Y/N <br /> Address <br /> � u�# <br /> MECHANICAL <br /> Company <br /> Signature Registered Y/N Fee cumerrt Y/N <br /> Address <br /> License# <br /> OTHER <br /> Signature <br /> Company <br /> Regiscered Y/N Pee currern Y/N <br /> Address <br /> License# <br /> Directions: ' <br /> Fil(out application completely. <br /> Owner&Corrtractor sign back of aPd��lion.notarized(Or,coPY��9�ed contract with owner) <br /> If over$2500.a Notice of Commencement is required(Mechanical worfc over$5000) <br /> SuPP�Y two(2)sets of drawir�s with applicabie documerdation <br /> Allow 10-14 days fpr review after submittal date. Par�ei#-obtained frpm Proper(y Tax Notice Jla <br /> (http ppraiser.pascogov.com) <br />