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trom: 08/27I20i� 12:29 #903 P.0011002 <br /> , � St3•I86-002C City ot 2ephyfiills�ire �ax-813-780-Q421 <br /> Permit App(icatian <br /> Date Received � I Phone Contact for Perrnit I`�1 ��2 .µ ll/_j I <br /> t'. . . . . , .�.. !.+" !!J._...^!a+S.», . �... ..... .: „ �. _. ....«_... "''_ ` - r ` 'A='acxti�f.r�-.'.+""1�^.,C .,}...�. <br /> O+mers Nam� �12 0-� a!lo� I J!� J3• 7.t�" �' �~�Q,�a Uwner's Phone Rlumber �� �� �._.� <br /> 4wne�'s Address �g�t7�� ,tJ�h���v�C' I��,Q ' Z/2.. }�, }'1 i ! ' �'"L � � �.. <br /> Fee Simple 7itleholder lJame ( Titieholder�hone hie�mber � � � <br /> Fae 3imple 7�tleholder Address ( <br /> I �UC�('�CT��O j1. .'" .�. „� .• . .:�i,r - :•.;.,.r,.. ..;; .: ;r.. ,.r,: ..__:'+„-.r?...,.-s=:.��:•_.n��=s�.:•.,;:;::�,:•-.,. �..• ;.: ��• _ . - <br /> :' <;i' .:r�C—'.�.'„ ,.f...;�.,- ..y-s»'.?t'�'�as:kF.. <br /> Job Address �tS�A�.� �..Q t"�. ,t�Q G--e- .� .t�..{'�� }1 `J �� ��J'rJ�'� 1�=C: l� tot# ��. <br /> Sub Divlslon I Parcei# <br /> F. . ..� '^ :.•: i � � ��i��. :'�T. . . ..s: �i . ...�%if�'..._i. .�.r.. .. . �.�..:_ � ._c -ti.a:t�-.• • x�, .�. ...'e�}`�.S . i .v.r'i,k,;L'!a.:2"e5-:r.":.T'61+C���N,:..� -'j,y.T,�'�i�i+'.'�u <br /> � ' Bio•Harara Waste Storege-ANNUAL � Fumigation'Ten1 <br /> Q Comm Exhaust Kit�hen Hood/Duct � Hazardou5 Maleriaf(7ler H or RC2 Facfitity)ANNURL <br /> QCorttrolled 6um a iload lnstaNa2ian � <br /> � Emergency Generator<30 kw � LPlNatural Gas-Inst�llalion { � <br /> Q Emergency Gene�star�30 kw Q LPll�itural Gas-ANNUA�$ale ��7 <br /> �,i' <br /> ' Q Fire Prokeotion Maintenance-AhlNUAL � piaces of Assemdly-ANNttAL '� <br /> em� n er � <br /> � �� <br /> sprinkter � p ❑ p � � Recreational Bum <br /> � Pfre Atarm � J ❑ C3 � SpBrkfet9 � <br /> t�ad ciosnin� � ❑ ❑ a � � Sprinkter System tnstallations <br /> Haod Suppress�on � ❑ p G� �� � Standpipes(Sprinkier 5ys} <br /> � Fire Alarm tnstailat�on � T'arch Rootinglfar Keftie <br /> � Fire�'urnps � Waste Tire Storage ATlNt1A1 <br /> FSre 1N9slc& <br /> QFtammable Application-AP1NUAl Vatuativn of Project <br /> l=uel Tanks <br /> � �thef: _ ( <br /> . _ . • . . . ..... . . . ..... .. . . � .,. . _ . , _ _. . .. .. .. . --. ._ . _,._.-�:�.._ _ :,t::.; . ._- . . , <br /> . ,. .. .� >-- • - •--- ., •• ,;...... , .. ... <br /> Contracior I Cpmpany ��' <br /> Signature Registerad Y 1 i� Fee Current Y/I�I <br /> Address � License# <br /> E4ECTRtCiAN I Company <br /> 3ignature Registered Y 1 iV Fee Current Y/N <br /> Address � Ltr,Anse# <br /> Pi.UMBER Company <br /> s��r,ature I Reg�ierea Y/N Fee Cu►rent Y/IV <br /> Address � License# <br /> M�CHAt3IGAt Company ���� <br /> Stgnatura Registered Y l h) �ee Current Y/N <br /> Addrsss � License# <br /> OTtiER Company <br /> S(gnature Registered Y/N Fee Current Y 1 N <br /> Address � Liaense# <br /> �.. .,.., ... . .. .. ..... .. ... .,. _ .. . . . .. _ . - --- : . . .. _. . - ... r r, . . . ... _ . , <br /> Utrecttons; <br /> Fti ouiapgiicailan cflmplete4y. � <br /> C�wner 8�Contractor si n back of a licetion no�rized Or co oi si ried contrack with owner <br /> 9 pp . � , PY S } <br /> if ovE+r$2500,a hioUe9 pf Commencemant is required(Mechanical work over$500D) <br /> Supply Mro{2)sets af drawiogs wiih apgllcabie dacumentatfpn <br /> Allow 7 0-74 days for rev;aw after submltta!d�te. Pamei#-ob2alned trom Froperty Tax Nfotice{httpllsppraissr.pascagav.cam} <br />