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a13-�eo-oo2o City of Zephyrhilis Fire F�-et�-�eaoo2� <br /> � . PeRnit Application <br /> �ate Received . J�—.���}� [3 �-l"ZC'7 b2 t-[ <br /> Phone Contact for Permit <br /> Mmers Name � �1 �� � <br /> Ovmers Phone Number �3 J �g g� 0 <br /> h�vners Address ��D�S A�2 Po,ot' 2a Z- H���� �� '� ��'j 4--�. <br /> ee Simple Titleholder Name Tftleholder Phone Number � � �� <br /> ee Simple TiUeholder Address <br /> , _ � , ..;,;,.. ,.. <br /> �b Address �ArM� � �,0 v� �L/ , <br /> Lot# � <br /> �b Oivision Peroel# <br /> , , ,..> , , : .. <br /> � 610-Hazard Waste Storaga-ANNUAL � Fumigation 7ent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Matarial(Tier II or RQ Facillty}ANNUAL <br /> QControlled Bum � Hood InstaUation <br /> � Emergency Generator�30 icw Q LP1Natural Gas-Installation <br /> � Emergency Generator>30 kw n LP1Natural Ges-ANNUAL Sale <br /> oFire Protection Ma(ntenance-qNNt1AL � Places of Assembly-ANNUAL <br /> ❑��i]yr emi �n er ❑ �O � �jT l�CL� <br /> Sprinkler O ❑ � Recreational Bum <br /> Fire Afarm � ❑ p � ��`�-- <br /> C� � Sparklers <br /> Hood Cleaning � O O ��� o Sprinkler System Installations � / t � I 1 � <br /> Hood Suppression � ❑ p E7 �� a Standpiyes(Sprinkier S ys) <br /> OFire Alarm Installation � Torch Roofing(far KecUe ' LI <br /> � Fire Pumps � Waste Tlre Slorage ANNUA� �( ��� �i <br /> � Fire Works � i / <br /> � Flammable Application-ANNUAL <br /> aValuation of Project <br /> Fuel Tanks <br /> � Other. <br /> ,. :; � �. <br /> :ontractor � �mparn _ _ . <br /> �igna[ure <br /> Registered Y/N Fee Currertt Y/N <br /> Address L �O p ps�.e � <br /> License# <br /> iECTRICIAN � Company � <br /> ignature � Registered I Y 1 N I Fee Cutreht Y!N <br /> Address <br /> Licensa# <br /> tUMBER <br /> ignature <br /> Company <br /> Registered Y/N Fes Curcent Y/N <br /> Address <br /> License# <br /> 1ECHANICAL <br /> ignature <br /> Company � <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> �THER <br /> ignature <br /> Company � <br /> Registered Y/N Fee CuRent Y/N <br /> Address <br /> License# <br /> �irections <br /> Fill out appiicatlon completely. <br /> Owner�Contractor sign back oi applicatiort,notarized(Or,copy of signed contraci with owner) <br /> If over$250D,a Nofice oE CommenCement fs required(Mechanical work over 55000) <br /> Supply two(Q)sets of drawings w(th appiicable documentaBon <br /> Allow 10-14 days tor review after submittal dafe. Parcel#-obtained from Property Tax Notice(http;l/appraiser.pascogov.com) <br />