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ai�-�eaoo2o City of Zephyrhilis Fire Fax-e�3a8°'°°2� <br /> Permit Application <br /> Dete Rfloeived ' - Phone Cont�t for Permit � r_� �� <br /> Owners Name QI dt�'� Ownera Phone Number � � <br /> Owners Address q�r 1� Ze /`� • ` �L <br /> Fee Simple TitlehWder Name Titleholder Phone Number � � �� <br /> Fee Simple Titlehdder Addtess <br /> Job Address 1 C� I �I� �� � �� '� " Lot# C� <br /> Sub Division Pa�el# <br /> o Bio-Hazard Waste Storage-ANNUAL � Fumigation Terrt <br /> Q Comm E�diaust Kitcrien Hood/DuCt a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Q Cor►trWlCd Bum a Hood Instedlation <br /> oEmergency Generatpr<30 kw Q LPMatur�Gas-Installatlon <br /> n Emergenc�,Generator>30 kw � LPMahuet Gas-ANNUAL Saie <br /> �� Fire ProteClion Maintenance-ANNUAI � � Placea o(Assembly-ANNUAL <br /> � �_�'.J� <br /> Sprinkler � ❑ 0 ❑ � Rea�eati0nal Bum ,//1� � <br /> Fire Alertn � ❑ � � � 5��� �/ r _ <br /> Hood Cleaning � � ❑ O � Sprinkbr Sysiem Installations <br /> Hood Suppression � ❑ ❑ ❑ � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Instatlation � Tach RoofingfTar Ketde <br /> Fire Pumps � Waste Tire Storage APpdUAL <br /> Fire Works <br /> Flammable AppficaGOn-N�IUAL ��� Valuation of Project <br /> Fuei Tanks <br /> Q Other: <br /> cawaaa �"'c'a"y <br /> 5��� Registered Y!N Fee Cument Y/N <br /> Address LiCense# <br /> ELECTRlCIAN C��y � « <br /> Signature � a Re9iistered Y/N Fee Current Y/N <br /> Address ��# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Address LiCense# <br /> MECHANICAL COm��Y <br /> Signawre Registered Y/N Fee Curtent Y/N <br /> Address LicenSe# <br /> OTHER Company <br /> signature RegisEered Y/N Fee CurreM Y/N <br /> Address License# <br /> Direc�fOns: <br /> FII out application cornpietelY. <br /> Owner 8 C�b�ctor sign back of application,nosarized(Or.copy of signed conVact with owne� <br /> tF over$2500.e Notice of COmmenCement is required(MeCheniCai wotic over S500U) <br /> Supply two(�sets of drawings with applicable documentaUo� <br /> Allow 10-14 days tor review after wbmitt�date. Parcel#-obtained from Property Tax Notic�(hQpJ/appraiser.pascogov.Can) <br />