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<br /> e�s-�so-o�2o Ciry of Zep yrhills Fire Fax-813-780-p021
<br /> 4 �. • Permit plication
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<br /> Date Received �' .. . � z .. ._ r '-----W—"� ____.._�v._ _ �. ...,.._�.k.��.
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<br /> Owner's Name Lt,`C S� �-�""� Qwners Phone Number �� 3�� ��
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<br /> Ovmar`s Address
<br /> Fss 5lmpls Titlehotdsr Name Titleholder Phone Number �� � �
<br /> Fee Simple i"i#leholder Address _ . _
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<br /> Su€�D�v�siorr Parcei# ��'�—��—C�Oi G—C�al�0—'� �O
<br /> . _. . o F ,9io-Fiazard Waske`Storage-ANNUAL .. . . .� .,� Fumigation WTent�w M _ . �w.^. _. �.,,_.._�,.°..°. , .....-.-.-.
<br /> Q Comm�xhaust Kitchen HoodlDuct Q F{azarcious tv�aieriai(Tier(t ar RGt Faoliity}ANNUAL
<br />') � Controtled Bum � Mood Instailation
<br />� a Emergency Generator�30 kw o LPlNaturat Gas-instaltation
<br /> � Emergency Generator>80 kw � LPlNatural Gas-ANNUAL.Sale � ��• Q �
<br /> QFire Protection Meintenance-ANNUAI �Placas of AssemEaly-ANNUAL � � _ � {,4_
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<br /> Sprinkler O ❑ Cl � Recreationai Burn .i_� 1
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<br /> Fire ftlarm O ❑ C7 � Sparklets � 1 J
<br /> H o o d G l e a n i n g � ❑ � 0 ❑ �Pf����er 5ysfem installations
<br /> Hood Suppressian ❑ ❑ p � Standpipes(Sprinkler Sys)
<br /> ❑ ('� 7"orch Raafingtfar Kerite ��� �- �� _`'�
<br /> o Fire Alarm installatian L_�
<br /> � Fire Pumps � Waste Tire 5tor,�age ANNUAL
<br /> � Fire Worits
<br /> � Flammable Application-ANNUAI. ���� Valuation of Praject
<br /> � Fue!Tanks
<br /> QOther. ' �,u �._ �.,,_:._�._,.�._.�_.�..�
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<br /> Contractor . ��{� � � ��t Company
<br /> 5ignature I�l 7 Registered Y/N Fee Curreni Y/N
<br /> Address License.#
<br /> ELEC7R(CtAN Compeny
<br /> Signature Registered Y l N Fee Gurrent Y/N
<br /> Address Liaense#
<br /> PLUMBER Company
<br /> Signaiure Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MECFtANtCAI Company
<br /> Signature Registered Y/t�l Fae GuRent Y 1 RI
<br /> Address License#
<br /> OTHER Coinpany
<br /> Stgnature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Fil1 out appltcafian conipteteEy.
<br /> Owner 8�Cont�acior sign back of applicatfan,notarized(Or,copy of sign d contrect with owner)
<br /> if over$25(l0,a Notice of Gosrimencemerit is required tMechanlcal vrork over$5000�
<br /> Suppiy two(2)sets af drawings with.appiicabie documentattan
<br /> Allow 10-14 days for review after submittal date. Parcel -pbtained from Property Tax Notice(htCp:!lappraiseF.pascogov.aam). I� �
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