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ats.�so-oo2o Ci ofZe h rtuAs Fire <br /> � . p y Fax-813-780-0021 <br /> , ' � Permit APPlic�tion � <br /> Date Received <br /> , - � PhOne COntad for Permit <br /> - � � ___._._ ��� 9�4z 1943 <br /> ��:. - _ .. <br /> _ �,._.... _ --- <br /> Owner's Name �_�.:.a��,. r.,._: : <br /> ........ . .. <br /> 2T��wo - cQ m�uo,� n-,e,� o�r�N��� � 7PP ��l <br /> Owner'sAddress 3(��Q �E�L}/ �� Z'/��y�HIC`s r� 2Y��/� <br /> G K/ %J •�� M <br /> Fee Simple TitleDoldar Nery�e . . , . . . . � � � �_'1 <br /> ;itlehdder Phone Number <br /> Fee Simple Tillehoider Addr�Bsa <br /> .::+� .�.:::�;.. <br /> ,_ <br /> i <br /> 3�'��O �N ,� ��:�.;�� � �_ �._-.:_.., <br /> JobAddress ,�/ � � ���s /� ����� � <br /> �� Lot# <br /> 5ub Division <br /> _ .. _ _ - Parcel* <br /> ,..; �.,��-,,�.a�-�+-�,•:- —�:.�zw�e..�-'..��-��y�- <br /> ._m., w .*.r_z':- w'3�--�'a_:ii�ttl�i^x- -- � I <br /> ., �,�,^t,�a,+f•�-?a TM"^>'w__... ? <br /> B�o-Ma¢ard VYaaee SOorap�-ANNUAL � }�dous MBtEtel(Tier II w RQ Fadtiry)ANNUAL - <br /> ❑ Comm Exhaust ICl6chen Hood/puct Q Hood&�Astion <br /> ❑ Controlled Bum <br /> Q LPMalural Csasdr�IletiOn <br /> � Emer98ncy Gena�atar<30 kw � LPH�apirai Gas-AMNU,AI.Sale <br /> Emer9ern�Genera6Dr s 30� <br /> � Fire''toFeC6on Mair►tenaexe.�, . � P�Ces Of Asaentby,ANNUAL <br /> � �� Q ��s�, <br /> Sprinkier X' p � +� � � Spa�r$ <br /> Fue Nerm � 4 ❑ j'—'} �� <br /> L�_1 ��kier Syskm Instafiations /) <br /> Hood Geaning � � � � i �U <br /> �+�p�P�s.(Sprinkkr 9Ys� <br /> Hood Suppresaicn ❑ a Q � Q 7orch RoofinptTar Kattle ..1(I�/ <br /> � Fire Alarm Ins�118Don � �.� <br /> Q MhsEe T1re SODrage ANNIUAL <br /> Fire Pumps <br /> Fire Wbrks <br /> Fiammabl6 AppliCation-A�ry�NJAt, <br /> Fuei rar,ks , Valuation of Project <br /> ❑ �r <br /> �. �W ��:: <br /> ConVactw � <br /> �,.�, _ <br /> • •±�tt.u;,.�:�- <br /> Signature �y .�-� � <br /> Aoaress i R�ed Y i.N;� Fee Current Y/N <br /> t�ECTRiciaw — '�c:enses Q ` .� ia <br /> Signature Co[rp9qy. <br /> Address � Y/N . Fee Current Y/N <br /> �'!UMBER ��'�# � <br /> ,�gnature • Cpmp�tY <br /> Address � 1'Z N Fee Current Y/N <br /> r��FCHANtCAI ��� 1 - <br /> ��ynature �. <br /> Address �� ��N Fee Curtent Y/N <br /> GiHER ���� ' � <br /> `,yr,a!u�g L r�..��,. <br /> ,�w.��� <br /> Addeess �9�ermd Y/N Fee Curr�t Y/N <br /> �-uect�ons . !iClns9# <br /> . , ._.... Y�a--s.t-- -- <br /> Fill Out appliCation Complete,yy, <br /> Owner 8 COntractor gip�barJt af appfieeyp�.�tOr,�PY of signed eo�trset wittt owner <br /> If over 52500,a Notice pf Comm�����I walc Over�Sppp � <br /> Supplyr M�o(2)s�s of dr�wj�gg yyy�.��� ) . <br /> Alfow 10.i4 days for revier�,e�r�d�e. ' <br /> Paroel#-obtained frprrt Aroperty T�ac Fbtiae(httpJlappreiser.Pascogov.com) <br />