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a�sa$aoozo City ofZephyrhilis"Fir�e?•"�.'=. Fax-8�3-780-0021 <br /> �' Permit Application <br /> Date Received � Phone Contact•for Pertnit � <br /> Owner's Name � Owners Phone Number � � <br /> Owner's Address � � � <br /> Fee Simple'fitleholder Name Titleholder Phone Number � �� � <br /> Fee Simple Z'itleholder 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 Bum � Hood Installatlon <br /> aEmergency Generator<30 kw � LP/Natural Gas-InstallaUon <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL 5ale / � <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � � ��C� � <br /> C.L�y emi �n er <br /> 5prinkler ro � ❑ ❑ � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> fiood Cleaning � ❑ O D � � 5prinkler8ystem Installations <br /> Hood Suppression � ❑ � ❑ � � Standpipes(5prinkler 5ys) <br /> � Fire Alartn Installation , � Torch Roofingrfar Kettle <br /> Fire Pumps � Waste Tire Storege ANNUAL <br /> Fire WoHcs , <br /> Flammable Applicahon-ANNUAL Valuation of Project <br /> Fuef Tanks <br /> � Q Other: <br /> Contrector Company Q , n..! <br /> Signature Registered /N Fee urrent Y/ <br /> Address License# <br /> ��- - <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Add2ss , License# <br /> PLUMBER Company <br /> 5lgnature 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 /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contraet with owner) <br /> If over$2500,a Notice of Commencement is required.(Mechanical work over$5DD0) <br /> Supply iwo(2)sets of drawings with applicable documentation <br /> Allow 10-'14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />