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eis-�so-oo2o City of Zephyrhiils Fire Fax-873-780-002� <br /> ` • Permit Application <br /> oate Receiveu — Ptwne Contaa tor Permit ��'i 9y Q �9 q 3 <br /> � �.��� - �,,-.:_:�-.� ��,.:_<-��-�,�.�-�---�__. _..... ..__.__ ... _.... <br /> �=::�n�_��:�,::...���=- _ _ t <br /> Owrtzrs Name �ff�Qni��� ��CIL rnfll�l4�i��Z" Owner'g phone NumbEr P�3 0 0 ����i <br /> Owner'sAddreSs �6 /�OZ� �/�Qf� �,ri ��j�/�Q/y�/��r � 335�F�. � <br /> Fe=S�mcie Titleholder Name Tideholder Phone Number �� �� � <br /> �ea srrple ritteno�aer Aadress <br /> . .y�.:x�;_. • 1 <br /> ,. <br /> .. .. . - —�— ' ...�_,w_._.._..y_... <br /> p � ,�.-�r_::H„ 1;:.��. �:.,. .. <br /> Jc�A�dress Q o��� K d/G � "l�l�,S � 3 35�2-- Lot# � <br /> Su�uivision ��� <br /> ,,, _-_:.��_.�,,,.,-- <br /> :::��. ...._�.�.:'��,- ���.: . .;..r�a:: - .. <br /> -'--��sao�t�._ --� :: �:c.�i:e�,c:..��- �-.�:::_.:-.. <br /> ❑ , �iii*' . . . . . .'2�-"�+;'1 "^_. ..._._ .. . <br /> Sio-Hazard Waste Storage-ANNUAL � H�p���t(1`�er II or RQ FaciGty)ANNUAL <br /> � Comm Exhaust KRchen iiped/puct Fbod Instailati0n <br /> � Conffolled Bum � � LPlNeturel G33-Instaliation <br /> � Emergency Generator<30 kw a �p/Natural Ges.ANNUAI Sale <br /> � Emergency Genetatpr>30 kyv � PlaCes of Asgertlbly,ANNUAL <br /> � Fire ProLection MaiMenance-qNNUAI a ��a!8um <br /> Sprinkler �� ��� a S��rs <br /> Fire Alartn � ❑ Q �Q Q � g���cys69m instalfations �� <br /> tiood Cleanin9 � O ❑ D � Stsndpipes(Sprinkler Sys) <br /> Hooc SuPPression � :❑ ❑ O � Torch RoofiaglTar Kettle <br /> � Fire Alartn Installation � INt►ste 71re,,cLp�ge ANNUAI. <br /> QFire Pumps <br /> � Fire VYbrks <br /> � Flammable Appliption•ANN(Jq� <br /> � Valuation of Project <br /> Fuel Tanks <br /> ❑ Other. <br /> .,_ _w. � <br /> �.,� �, <br /> Cc,�Gactor � �.x _.. -' <br /> . ��e'_.—.-._._�_-.:�.:., .. <br /> S:�pnature ��►Y � ( �• <br /> Re9isterod Y/N Fe�Current Y 1 I�t <br /> Adaress 35 31 V+ �}b� a, <br /> i.ieenae# F �1! <br /> r:_cCTRICIAN <br /> ;�r,na:ure COmPafly <br /> atl•�reSs <br /> Re9�stered Y/N Fee Current y/� <br /> _u��aER <br /> u��* -1 <br /> Siynature COR1P8ny <br /> Re9is�red Y/N Fee Current Y/N <br /> AdCress <br /> r.�ECHANICAL ��# � <br /> S�gr,atu�a Company <br /> Atldress <br /> Registered Y./N Fee Cunant Y/N <br /> OTHrR <br /> License� ��— <br /> S,grature �mP�Y <br /> Address �'�� Y r� Fee Current Y/N <br /> :::y. .�: _ <br /> ��;�.. ... �: :_ _ uce�se� <br /> ,.LJonS ��-' -`�-� .�-.._...vaoc-_.ry.a;.a .. <br /> +oe.s'�_,.�: . ::::.�... ... <br /> tin out a - - 9�'�-'z'"��"',. <br /> PW�Cition corTWlotNy. �_ . <br /> Owner 8 Contractor <br /> S+9n b3ck of aPP���atlOn.�otarized{Or,copy of signed contract wim owner) . <br /> !f over 52500,a Notice of Comn�neempyt�����M������er 55000) <br /> SuPA�Y Nro(2)Sets Of drawiflgS wflh 8pP1'�bl@"dOpJrtfP.tlydtlOtl <br /> Auow t a1a days ior raview arter submitqJ date. <br /> RarGel#-obtained from Prop�rtyr Tax Notice(htip_!/appraiser.pascogov.com) <br />