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a;�-7aa-�c�o City af Zephyfiills�Fire� Fax-813=/80-OD21 <br /> Permlt Application <br /> )ate Raceived � Phone Contactfor Permit � <br /> :�;s��s�� o���s+��aarr.�sox�. +� �....�.�.,..��ri.w..��.�.w...�..�,,.�..,..,� _.,_,_ <br /> 3wne�'s Name � , � Owne1''s Phone Num6e� � � � ,;�., <br /> �wna�s Addross Z �� � " � � <br /> =ee 5imple Titleholder Name ?itlaholder Phone Number � �� � <br /> =ee Simple Titleholder Address <br /> � �i3e{.ak�'1'�:��X`:.�;�'t <br /> „ �.Ot# � <br /> Jab Address �_ �� <br /> Sub Division �1 � Parcel# /�'�<p ,a10� 'vv/C� -r)��StJU 'l�t.)C� <br /> �r�a�a�x���u�}r:::.rr�a,��� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumipailon Tant <br /> � Comm Exhaust Klichen NvodlDuct Q Hazardous Matedal(Tier II or RQ Pacifliy)ANHUAL <br /> � Cantrolted 8um a Haod Instailatlon <br /> oErrcr7ancy Gsneratar<3C kw � LPINatural Gas-Installativn <br /> Emergency Generator>30 kw � LP/Platural Gas-ANNUAL 5ale <br /> Fire ProtecUon Mairttenance-ANNUAL � Plaoea of Assembly-ANNUAL <br /> �y �ert A�n'� er <br /> 5prinkler � 0 ❑ !� � � Racreatlonal Bum �/ <br /> Fire Alarm O ❑ }�] �� � SParklers ��1 <br /> Hood Cleaning � ❑ C3 ❑ � � Sprinkler System InstallaUons <br /> Hood Suppresslan � p p p � a 5tandpipes(5prinkler Sys) <br /> � Flre Alarm Instailstlon a Torcfi.RootinglTar KetUe <br /> Fire Pumps Q Wsate'f'ire Stvrags ANNUAL <br /> Fire Works ' <br /> FlammableApplicatlon-ANNUAL ��—� Valuation of Project <br /> Fuei Tanks <br /> Q Other: <br /> �:��� <br /> Contraotor :' �T <br /> Comparry ' s '�. L .E:. 'S itL' t� <br /> 5lgnature • Registered Y N f Fee CuRent �___�� <br /> Address l � � �- �'• ' License# J i�, ►i3 <br /> ELECTRtCiAN Campany <br /> 5lgnature Regfsiered Y 1 N Fee Current Y 1 N � <br /> Address License# <br /> PUfMBER Company <br /> Signature RegistBrEd Y 1 I� Fee Gurtent Y/N <br /> Address Llaensa# <br /> MEC1-1i4N1CAL Company <br /> Signaiure Registered Y!N Fae Current Y/N <br /> Addrass license# <br /> OTHER Company <br /> Signature Registered Y/� Fee Current Y 1 N �— <br /> Address License# <br /> :� s��- �., �..�.... v�sn� �_�- <br /> DlrecUons: ����a � •�-�-� '""'��°�Y��tcvlt��'�: <br /> Fill vut application completely. <br /> Owner 8�Contractor sign bacic of applicaUon,notarized(Or,capy ai slgned contract with owner) <br /> If aver 32500,a NOtica of Commencemant fs requlred(Meehanica!work over 55000) <br /> Suppiy two(2)sets of drawings with epplicable documentatlon <br /> Allow 10-14 days tar revlew after submittef date. parcek#-abtained from Praperty 7ax NoUce(http:l/appraiser.pascogov.00m} <br />