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; e�a�so.oa2o <br /> , City oTZephyrhilts Fire• , <br /> PermR Application ��8f3-18D�Op21 <br /> " bate Recelved <br /> � ' Ptane ConfecCtof Permit <br /> • Qwnara Name J�N�.! S l� g �._ <br /> i Otwrtet's Phone Number '3 <br /> : Owne�e Addre�3 6 6 o e (�L(� v�.�(� Z!+.�.�1( 1�-l.. '�� 5 �,E,Z . 4 ZA . �pZ.-Z'i <br /> ! �ee S� . . <br /> � imPle TiUoholder Aiame, <br /> ! 1=ee SimpleThlehplder 1ltlehoider-W�one Nurt�bpr <br /> Wo � � � <br /> Add�'B3S <br /> Job Addreas S�.tv�.� p,.;s ���J� <br /> Sub Divfsbn Cot�C � <br /> Pam,el# <br /> � BIo-Hazard Waste 3tbrape-ANNUqI, � <br /> ❑ FumlyaUon 7ertt <br /> Comm E�pyst Kltchan Hood/putt <br /> � � Hazardous Matertal{Tter II or RQ Faclllry)ANNUAL <br /> Controlled Bum � <br /> �mergency Generator<30 kw Hood InsratlaGon <br /> � ❑ �'+�^Jef�y Co.wralor�9�kw �P/NQturRl Gas-Itut�liation <br /> � (�`j ' � Lp/Natumi Gas-ATttluql,Sale <br /> �1 Fkre Protectlon Mairrtenst�ce-ANNUAI. <br /> ' � a Piace9 of As�emb�y�►NNUAI. <br /> �� em �o� STA2-T <br /> i SPdnkler o O ❑ � <br /> � ❑ RecrCatlanal9u.m �l�,'� �/ <br /> i F��s warn, ❑ o a L..�1 <br /> Sparklers <br /> Hood poaning � ❑ � � ('�-1 a Spr[nkler'System MatallsUons �. 2� �� `� <br /> � � <br /> �'laod Suppresslan ❑' ❑ p � Stand I <br /> � FGe aarm Instaltanan p�(SP�'+nkler Sy$� <br /> F��e Pumpe � 7orch Roofing/TAr Kettle � r l/ ��`' <br /> Fire Vyotks Waste Tfre Storape ANNUAL ; `f' J <br /> Flammab(e Appllcatlon-ANNUAL �—�^- <br /> Fuet 7anks I Valuation of Project <br /> Q Othcr. <br /> , Caumctor <br /> ; Signature � Company �„�Qv • � Y�r„� �-' , <br /> ; ���g � �• Registarsd Fae Currenl /N <br /> '7L�-� t.+o��S u��,q L � . <br /> t- Z� tiaenee# <br /> I ELECTRICIAN � <br /> ' S�9�BIu►e . Company <br /> . Addreaa Regietered � Y�t�t I Fee Curre►�t .Y/N " <br /> PlUM6£R �1°�s°# ", <br /> ' Sigaahxn Company <br /> q�� Ragfst�red Y/fV Fee Curtvrrt Y'/N <br /> MECHANICAL Llcanso# � <br /> ; 31qn2[ure ComppnY <br /> , Adaresa . Reglstered Y/N Fee eurrent Y/N <br /> OTHE�t L�anae Ii� �� <br /> ISlgruturo � Gompany <br /> Addrats �9�tered � � r rv � Fee Curront Y!N � <br /> Dlrsctlona: License� <br /> Fl��appUcHtb�eompie�e�y, <br /> Owner b Ca�tractor slgh back of aPPllCatlon.notarized(pr,tOpy of slBned cantmct wrth owt�r) <br /> � tf avar S2S00,a Noc�ce of Commencement la requtred.(Mec�.fw�icai work Pv��56000) <br /> SuPNY�(2)aoia of drpyyings witfi eppllcab{e doc�men�tion <br /> '411rna�a-�4 deyS for review flft6r submiRal date. <br /> � Parcel#-odtalned irom Property 7ax Notice(hrtp;//s <br /> Ppra I s C r.pa scogw-cor�) <br /> I <br />