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81>>-7&0-002.� Ciry of Zephyrhilis Fire Fax-813-78�-OQ2'1 <br /> Permif Application <br /> �te Received Pho'nB�bntaC't f+sr Pert�iii ; 7 � ` <br /> r+t�ecmws*,�++n�cw?wn.a�M*t�.°&m�.+�. ' . ..... . ... �ag;� . ... , . nra�m;�A�fn%wt.�A:'.r�xvtonawu.ruarrx.m'vWUr ... G-� ., �.,� .� . <br /> vner's Name 1d , � OwneYs Phone Numtrer C;�� � . V'� <br /> vner's Address r 2 �+'L'�.. �i�'_J , �`" � 3 � <br /> �e Simpie Titleholder hlame C) 0 /�-�� l�j�- Titleholder Phone-Number ;� �� � <br /> �e S�mple Tittehalder Address <br /> ��;au�. - <br /> ib Address r 1'� C..-� U'/1-'t✓L. 1�j L�J�1� ��`C� / � / � Lof# <br /> �b Division Parce!# <br /> i� . <br /> , <br /> � Bio-Hazard W�ste Storage-ANWUAL o Fumiggtion TeY9t • <br /> � Comm Exhaust Kitchen Hood/Duci � Wazardous Ivla'teN�l(tler H ar FEt�`Facility}�4W�IU34L <br /> � Controlied Bum � Hood instei(ation <br /> � 4�rergenc,-�anqrat�r c 3p k�•, � LP/Natural G3as=lnstallatian <br /> a Emergency Genergtor�30 kw � LP/Natwral Gas/kN�11J{�L Saie ` ���� <br /> Q Fire Protection MainYenance-/4NNUAL � Places of Asser�iF�ly�AWNUAL ` � � <br /> �< � � t sr ,/� 1 <br /> Spriniiler � Cl ❑ Cl � � RecreStfonel9um <br /> Fire Alarm � ❑ D ❑ � � Sp�rkiers <br /> >(/ Hood Cleaning �i ❑ C7 a � Sprinkler System InstaNations <br /> l- <br /> Wood Suppression ❑ ❑ [7 � � gtendpipes(Sprirtkl�r Sys) <br /> � Fire Alartn installation � 7orCh i�aoflng/Tar K�ttfe <br /> � Fire Pumps � Waste tire 5torage ItiF11�UAL <br /> � Fire Works <br /> oFlammable AppiicatiornANNUAL � Vaivation of Project <br /> Fuel Tanks <br /> Q Other. <br /> ���;�.�rn�� __ . _. _ . <br /> Contractor ,�� Compariy <br /> _ , � <br /> Signature ._...,...�..�..__ <br /> ' Reg(stered 1�/ Fee Current Y/ <br /> , .., <br /> Address License# <br /> ELECTRICIAN Compeny <br /> 5lgnature Registered Y/1�1 Fee Current Y/N <br /> Address <br /> License# <br /> PLUMoER I Company <br /> Signature � Regfstered �'/I;�I Fee Current Y/Fd <br /> Address L'rcense# <br /> MECWANICAL Compeny <br /> Signature Registered Y./W Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address -•° <br /> �.��.,vcstNV�.m,aaw:.;ra exn..,,.,,�,. ,. ..:�.rs;.. � ,... � �' <br /> Lf ense# <br /> . �arrne.,. ,.. �.<.�. �*.a»� ,wr __, . ,t ir^ �.a�°, m_�,�a?..-. r., 7:: 'e;�',�,tY?�.K±,.,�'Bl'N..#i, i,��u4+'�'ia <br /> Dfrections. � ., ,,.4�!&�, .,�w-�rcr�r��e��. <br /> Fi{I out application completely. <br /> Owner&Contractor sign back of apptication,notarized(Or,copy oT s;gnetl con!racc vv�th owner) <br /> If over�2500,a Notice of Commencement is required(Mechanical wo�lc over$5000) <br /> Supply two(2)sets of drawings with applicab�e aocumentaiion <br /> Aliow�0-14 days for review after submittal date. Pa*csl#-obtained from Property Tax Notice(h:tp:/lappralser.pascogov.com) <br />