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. _ i <br /> �813-7so-oozo City ofZep yrhitlsFir�- Fax-s�saso-oo2� <br /> , ' Permit A p(ication __ <br /> Date Received -- -Phone Corrtactfor Permit <br /> _�Y._..�.,:,�. _. . ...:,:�,��:�-.�:�.�:-_:..—�.._-_ ._- ,:i. _ : . .- � .. - - - - - .�_7..��-.�..,,�:�,�.,_.,.� ..: <br /> Owner's Name AIVDERSON PRESSITRE Owners Phone Number •Rl � � � <br /> OwnersAddress. SI.O�F MURRAY HILL D r <br /> Fee Simple TiUehoide�Name T�lelioider Fhone Number � l�J � <br /> Fee Simple'f'iUeholderAddress � ' <br /> �.�i.°�..s�m;w�.s�r..>.�-�'..sa:._ `"��"-,�_h'_"�.-.....�a�^-�r,�F�'•�','f�i�:'=.-��'�k�=?�^_-.a�"�.�,..'Y�''S''r�-`�.�:��ti`�;iz.�'���.�"''a'?::aur•. ...•,=ws"�"�'c.",b*s.i��.:�._ns;_._.:.—`�-" - ° _ - - - -_- - <br /> _ _ sc,-�:,.-'w'%';.�"�-�E:a;:-z�'��'-r <br /> Job Address GOLDEN CORR.AL 6HSS GALL BLVD. ��1?,�LT S 3 — . •Lot# � <br /> Sub Division Parcel# <br /> :-;--�.,'=x.�... ...._. .. - - :��° -- -�;s.��,,:���- _ �r =-€.�;.:.:=>r,-���;_::�.:�.�-.� ��.--��x::�.r.�M=�._:r.�:�e.:: <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent - <br /> � Comm.Exhaust FGtchen Hood/Duct � Hazardous Matedal(Tier II orRQ Facility)ANNUAL <br /> � Contrnlled Bum � Hood installation <br /> �, - Emergency Generator<30 kw � LPMatural Gas-installa6on <br /> � Emergency Generator>30 kw � LPMatural Gas-ANNUAL Sale <br /> - � Fre Protection Mairrtenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi � er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fre Alartn � ❑ ❑ ❑ � � Spatklers. r�� v - <br /> � �� <br /> Hood Cieaning � ❑ ❑ ❑ � � SprinklerSystem Installations <br /> Nood Suppression � ❑ ❑ ❑ � Standpipes(5prinkier Sys) <br /> � Fre Alartn Instaliation � Torch RoofinglTar Kettle <br /> � Fre Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works � <br /> � ,Flamma6leApplication-ANNUAL , Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> r,���'a`°:.:�"�a°A�"`_��;'�='�'�"�§=T°" �°_sxVry.�-r.--=--,--.,--_'^'t'�..-„�:�:,�'�.-r�y;��z�-�_��Lt'�':>�..•�;�-.rt<-'�"�.�- <br /> Contractor Company <br /> Signature Registered Y!N Fee Curtent Y%IV <br /> Address license# <br /> ELECTRtCtAN Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address � License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N _ <br /> Address � - � License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER ' Company - <br /> Signature Registered Y/N Fee Current Y/N <br /> Address � License# • <br /> . .....__.. .._ ,;..- -=-�..- . . �„-..,- . ��-. _,- z.y=='-^�-'�" -` - - - -- - - - - _.,�..:..._,-�s..-,....7---:._�ez <br /> Directions: � <br /> FII out appiica4on completely. � <br /> Owner&Contractor sign back of appiiccation,notarized(Or,copy of sig ed contract with owner) <br /> , ,tf over$2500,a Notice of Commencemetrt is required.(Mechanical wo over$5000) <br /> Supply two(2)sets of drawings with applicabie documentafion � <br /> Allow 10-14 days for review after submittal date. Parcel -obtained from Property Tax Notice(httpJ/appraiser.pascogov.com) <br /> . � <br />