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h .= �002o City of Zephyrhi[Is Fire Fax-a��-�eo-ao2� ,
<br /> Perm9t Application
<br /> Dafe Received ..: .` Phone Contsd fot Permit _ , -, , . . - .
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<br /> Owne�s Name � � Owners Phone tJumber �,� C� �
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<br /> Owners Address
<br /> Fee Sfmple Tidaholder N�ne TiUaholder Phone Number � � ��
<br /> Fee Simpfe TtGeholder Addresa
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<br /> Job Addreas .l��`-J � . � � � • Lot# �
<br /> Sub Divlston G7�Jg..7 P��#
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<br /> � Bio-Hazard Wasos Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhausf Kitchen FbodlDucl � Hazardous Materiat(Tier li or R4 Facitily)ANNUAL
<br /> QCantrolfed Bum � Hood installation
<br /> aEmergency(3eneraWr<30 kw � LP/Malural Gas-InstalfaUon
<br /> � Emerpency Generator>3U kw � LP/IJaturel Gas-ANNUAI 8ete
<br /> � Fire Proiection Meintenence-ANNUAL � Places of Aasembly-ANNUAL
<br /> rTy e�tv r�i et
<br /> Spdnkler � � �7 ❑ � RecreaUonalBum
<br /> Ftre Alarm ❑ � �. � � Sparkters �/5"' -
<br /> Hood Cleaning o � O � � Sprinkler System installa@ons J7X
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<br /> �Gf
<br /> Hood Suppression � d o ❑ � � Sfandpipes(Spdnkler Sys) 1
<br /> � Flre Alarm insiallatlon � Torch RaofingJfar KelOe
<br /> � Flre Pumps � Waste Tire Storage ANNUAL
<br /> Flre Wo�cs
<br /> � Flammeble AppliceHon-ANNUAL Vafuaiion af Project
<br /> Fuef Tanks
<br /> � Other:
<br /> ax',_=�==F,4'btt._... �.:Tb;..,.,.r:...:_.-..._:... :- ._.t:?..._ -•- . - _. ,- - . , :.� .. . , - . - . •- -. . -. .- -., .�.,,.. . .. ..=,£.;-�:F-s=.,_`,i:'�,t3�•.:.,:>...^-2±i::
<br /> ConVactor Company
<br /> Signalure Reglatsred Y/ Fee Curcent Y/N
<br /> Address Y Lfcense#
<br /> ELECTRICIAN ���Y
<br /> Sia��u� Reo�s►ered Y/iJ Fea Current Y/N
<br /> qd�$ L(cense�F
<br /> PLUMBER Company
<br /> Sfgnature Raglatered Y/N Fee Current Y 1 N
<br /> Addreas Licenae* '
<br /> MECHANICAL Company
<br /> Slgnsture Registered Y/N Fee Current Y/N
<br /> qddresa License#
<br /> OTHER Company �
<br /> Signeture Repistered Y/NI Fee Curcent • Y 1 N
<br /> Addreas Uoense#
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<br /> DIfCCtIO�S:
<br /> FiN out app11ca8on completely.
<br /> Uvner 8�ConMacbr slpn back of appllcation,notarFzed(Or,capy ot slpned contract wlth o�vner)
<br /> !f ovar$2600,a Notice of Commencemant is requfred(Mecl�nical vrork over$5400)
<br /> Supply hvo(�sets of drewinps with appliceble documantation
<br /> Allow 10-14 days for re�iew a$er submittai date. Parcel#-obleined from Property Tax NoUoe(htip://appraiser.pascc�gov.com)
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