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° � ais-�so-oo2o Gty of Zephyrhilis Fire Fax-a�saao-oaz^
<br /> Permit Appiication
<br /> L�ate Rece:ved �� � G�� ��
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<br /> Phone Conqct for Permit
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<br /> Fee S�mple Titiehoidet Name Trt1eh01der Phone Number �� � �
<br /> f:�S�mpie TRleholtler Atldress
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<br /> Sio-Hazard Waste Storage-ANNUAL � Hazardous Materia!(Tier II or RQ Faciiity�ANNUAL
<br /> � Comm Exhaust Kitchera Hood/Duct � Hood Installati0n
<br /> � Conuolled Bum � LP/Natural Gas-Instaliation
<br /> � Emergency GeneraYor<30 kw � tP/Natu21 Gas-ANNUAL Sale
<br /> � Emergency Generator�30 kw Q PI2Ces of Assembiy-ANNUAI
<br /> aFire Protection Maintenance•ANNUAL � ReCreatlonal Burn
<br /> D� em� n"7 er ❑
<br /> Sprinkler p � � 5��� ��w
<br /> Fire Alarm ❑ p � ❑
<br /> � `� Sprinkler System Instaitations i� •`�(j/,,
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<br /> Hood Cleaning � O p Smndpipes(Sprinkier Sys) �'
<br /> Hooc Suppression � Q ❑ p � � Tprch Roofing/Tar Kettle
<br /> � Fire Alarm Instaliation � iMMaste Tire Storage ANNUAL
<br /> � Fire Pumps _._
<br /> Fire Works
<br /> � Flammabie Application-ANNUAL
<br /> aValuation of Pro�ect
<br /> Fuel Tanks
<br /> � Other:
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<br /> s�gnature C0"�"Y -r 1 Iu�'1'O v�
<br /> Registerod Y/N Fce Cunent Y/N
<br /> Address 35 31 l�e ,},�rt� Rd.
<br /> License� F 00 �!f
<br /> cLtCTRiCiAN
<br /> Company �
<br /> �ignature _�
<br /> Registered Y/N Fee Current Y/N
<br /> A�dress
<br /> License#
<br /> �'L'Jf�SIiER
<br /> SignaturE
<br /> Cr,mpany
<br /> Registered Y/N Fee Current Y/N
<br /> adaress
<br /> �icense# '—1
<br /> h7ECHANiCAL
<br /> S�enatura Company
<br /> Registered Y./N Fee Curcent Y/N
<br /> Address �_�
<br /> L;cense# ��
<br /> OTHER
<br /> SignaSure COmpany
<br /> Registered Y P N Fee Current Y/N
<br /> Address
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<br /> Fill out application completely
<br /> Owner&Contractor Sign back of appliption,notarized(pr,�py of signed contract wim�ner)
<br /> if over 32500,�Notice of Commencement is teqwred(Mechanical work over 55000)
<br /> SuPP�Y�o(2)sets of drawings with appiicable documentation
<br /> Aftow 10-14 days for review after submittal date. Parcel#-obtafned from Prp
<br /> perty Tax Notice(http://appraiser.pascogov.com)
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