Laserfiche WebLink
"R �ai3aso-oo20 ` 1 `�� � � CityofZephyrhiilsFir�• Fax-e�saso-ao2� <br /> . � � PeRnit Application <br /> Date Received �� ���K .. Phone Contact for Pertnit <br /> �..�r.w,,..E�a ....�g.>.:��: <br /> Owners Name ANDERSON P Oumets Phone Number � �� �� <br /> Owner's Address 510LF M[J�Y <br /> Fee Simple TiUeholder Name TrHetiolder Phone Ntxrtber �� �� � <br /> Fee Simpie?irieholderAddress <br /> �a�:�,- �: <br /> Job Address GOLDEN CORRAL 6855 GALL BLVD. Z� — Lot# �C� <br /> �l <br /> Sub Division ��e�# <br /> � � Bio-Hazard Waste Storage-ANNUAI � Fumigation Tent <br /> � Comm 6chaust Kitchen liood/puct a FlazaRious(Naterisl(Tier tl or RQ Facility)ANNUAL <br /> � ConUofled Bum � Hood lnstaqation <br /> aEmerge�cy Generator<30 kw � LP/Natural 6as-Installa8on <br /> � Emergency Generator>30 kw � LPMaturai Gas-ANNUAL Sale <br /> � Fira Protection Mairrte�ance-ANNUAL � Places of Assembly ANNUAL � <br /> ❑[� � � � . <br /> Sprinkier ❑ ❑ ❑ � a Recreationai Bum <br /> ❑ c� c� y���� <br /> Fre Alartn ❑ ❑ ❑ Sparklers <br /> Hood Cleaning �\dj ❑ ❑ C� � Sprinklsr System Installa ns�. � <br /> Hood Suppressio� � ,� ❑ ❑ � � StarulPiPes tSPrsnkler Sys) `�5 <br /> � Fre Alartn Installation � Tor�h Roofinglfar Kettle �J � , � 3�/ <br /> Fre Pum s � �� � <br /> P � Waste Tire Storage ANNUAL � _ <br /> Rre works �) /� <br /> Flammable qpplic�tio�-ANNUAL v � � � <br /> Valuation of <br /> Fuel Tanks <br /> Q Other. � <br /> Cor�tr-actor Co��Y . <br /> Signature Registered Y/N Fee Ce�rrent Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> sigrrature Registered Y/N Fee Cument Y/N <br /> ��� License# <br /> PLUMBER ���y <br /> S'9"ature _ Registered Y/N Fee cumsnt Y/N <br /> Address . <br /> License# <br /> MECHANICAL �m�rn <br /> Signature Registered Y/N Fee CurreM Y/N <br /> Addtess License# <br /> OTHER <br /> Company <br /> Signaa,re Reyistered Y!N Fee currern Y/N <br /> Addrass <br /> License# <br /> DirecUons: - <br /> Fill out application completely. <br /> Owner&Corrtractnr sign back of ePP�ication,notarized{Or.cnpy of signed contract with owner) <br /> H wer$2500,a Notice of Commencement is raquired.(Mechanicai worlc over$5000) <br /> supp�y two(2)sets or drawings wia,app{ioable documerrtation <br /> Allow 10.'14 days for re�riew after submittal date. Parcel#-obtained ftom Properly Tax Notice(hUpJ/appraiser.pascogov.com) <br />