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a i3-�8o-002o City of Zephyrhilla Fire Far.-8i3-780-OU21 <br /> Permit Application <br /> Date Received ' � ,p �z Phone Contact for Permit � Gj"�'J (J7� <br /> Owner's Name �! �LL % ' � Owner's Phone Number � � � <br /> Owner's Address � � � Gf?' <br /> Fee Simple Titlehoider Name Titleholder Phone Number �� � � <br /> Fee Simple Titleholder Address <br /> Job Address Lot# � <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � F�re°rot�ctior Alaird�nancc-ANNUAL C FiacES ofi Assembiy-APJNUAL <br /> try emi �n t er � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Burn �l�y ( <br /> Fire Alarm �❑ ❑ $ � � Sparklers � � \f/ <br /> Hood Cleaning � � ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> 0 Other� <br /> Contractor � Company / �i�?�j� <br /> Signature Registered Y/ Fee Current Y!N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature �_ ___ Registared 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 <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Direchons <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappraiser.pascogov com) <br />