PERMIT APPLICATION

The following information must be provided in order to obtain a permit from the City of Peoria Fire Prevention Division.

Date:  ___________________

Company/Owner Name:  ______________________________________________________

Company/Owner Address:  ____________________________________________________

City/State/Zip Code:  ____________________________ Phone:  ______________________

Renewable Permits: 
[   ]	Paint Booths new $ 150.00 (Renewable Fee = $50.00)

[   ]	Hazardous Material, Use, Storage, Handling  (Renewable Fee = $150.00)
           Install/Change tanks or piping - $360.  Additional Tank - $50 ea.  Modification - $100 ea.

[   ] 	Underground Fuel Storage Tanks; Storage, Use, Handling, Dispensing  
     Install Fee - $360.00  (Renewable Fee = $250.00 per Site)

[   ]	Aboveground Fuel Storage Tanks; Storage, Use, Handling, Dispensing 
     Install Fee - $360.00  (Renewable Fee = $250.00 per Site)

[   ]	Liquefied Petroleum Gas (LPG) Storage, Use, Handling, Dispensing  
     Install fee - $360.00  (Renewable Fee = $50.00)

Other Permits:

[ ]   Aerosol Products			[ ]   Blasting Operations			[ ]   Compressed Gas Systems
[ ]   Aircraft Refueling			[ ]   Fireworks Display			[ ]   Flammable/Combustible Tank Removal
[ ]   Auto Wrecking Yards			[ ]   High Piled Storage			[ ]   Hazardous Materials
[ ]   Assembly, Open Flames			[ ]   Spray Painting Booth			[ ]   LPG Installation >125 Gallons
[ ]   Cellulose Nitrate Film			[ ]   Dispensing Flammable Liquids		[ ]   Bowling Pin or Alley Refinishing
[ ]   LPG Exchange Station			[ ]   Repair Garages			[ ]   Open Burning
[ ]   Places of Assembly			[ ]   Tire Storage

[   ]	Type Permit Requested:  ________________________________________________________           
 (Submit  8 1/2 by 11 inch sketch of site and contact Fire Prevention for additional                            requirements and appropriate fee.)

Mail application and check payable to The City of Peoria:
Peoria Fire Prevention
8401 W. Monroe Street
Peoria, AZ 85345-6560
(623) 773-7279