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813-780•d020{C'7�,)( � ���u,.��� L,t�1'�-'�City of Zephyrh�ils Fire Fex-8t3asaao2�
<br /> `' Permit Applicatlon
<br /> ! ��Dete Recl�ived hone C
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<br /> P ontad for Permit
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<br /> Owner8 Neme � O►vners Phone Number �� � ��
<br /> Owner's Address l �
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<br /> Fee Simp�s TlQeholder Name 7iUehoider Phone Number � �
<br /> Fee Simpte TiUeholder Address
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<br /> Job Address ' Y �J � lot# �
<br /> Sub Divisfon Parcel#
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<br /> Q Blo-iiezaM Waste Storage-AMNUAL � FumigaGon Tent
<br /> � Comm Exhaust IGtchan HoodlOucE a Hazardous Material(Tier II or RQ Facilfiy)AMNUAL
<br /> Controlled Buns a Hood Instaltatlon
<br /> � Emergency Generator<30 kw � LP/Natural Ges-IrtstellaUon
<br /> � EmergencyGenerator>30 fc�v � � LP/Naturel Gas-ANNUAL Sale �
<br /> � Fire Proteclion Maintanance-ANN� �� � Places of Assembly-ANNUAL � �f, �
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<br /> Spr(nkler ❑ O ❑ � � Recreaiional9urn
<br /> fire Alarm �, ❑ ❑ Sgarkters
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<br /> Hood Cleanfng � d O O � � Sprinkler System Instakations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Spdnkler Sys)
<br /> � Fire Alarm Instalietlon Q Torch Eioofingl7ar Kettle
<br /> Fire Pumps Q Waste 7ire Storage ANNUAt
<br /> Fire WoAcs
<br /> Flemmebte ApplEcaHon-ANtJUAL
<br /> Valuation of Project
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<br /> Fuei Tanks
<br /> � o otne�:
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<br /> ConUactor � Company
<br /> signature � ReStsterea 1 N Fee current Y/N
<br /> �d�� ��icense# �
<br /> ELEC7RICIAN � Company
<br /> Stgnature Registered Y/N Fee Cument Y/N
<br /> �d�sg Ucense#
<br /> PLUMBER Company
<br /> Stgnafure Registered Y/N Fee Current Y/N
<br /> Addrass Ucense#
<br /> MECHANICAL Company
<br /> Signature Repfstered Y/N Fee Curcent Y/N
<br /> Address License#
<br /> OTHER Company
<br /> stgnature Registered Y/N Pea c�rrern Y/N
<br /> Address L[cense#
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<br /> Diroctions: ---- - - - . ` . .-°
<br /> FIII out applicaUon completely.
<br /> Owner 8�ConVactor eign badc of applicadon,notartzed(Or,oopy of sig�d contract with owner)
<br /> if over$2500,a lVoUce ot Commencement is requked(Mechanlcal wadc over 55000j
<br /> Suppiy two(2)sets of draw�p6 with appticabie docur�entatlon
<br /> Altaw i0-14 days for review after submittai date. Pa�cel#-obtatned irom Property Tax Notice(hUp:/lappiaiser.pasoogov.00m)
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