Laserfiche WebLink
<br />04/03/2008 <br /> <br />Dille Recel~'eCl <br /> <br />Ownli!l's Name <br /> <br />Ownet$ AQorese <br /> <br />17:02 <br /> <br />3525809052 <br />f 11l s <br /> <br />Permit Application <br /> <br />"ee Simple Titleholder Name <br /> <br />Sub OIVl&lOn <br /> <br />(', <br />, <br />. ), <br /> <br />HOOD TECHS <br /> <br />1 \J.(' <br /> <br />Owners Phone Number <br /> <br />..'. I ') ..., .--'. <br />....,"' l, (,. I ,.;~ <br /> <br />- <br />.'-7. , <br />. .;.o~. I~\"tr \, . . · <br />....-.. t.,.. ,r \... <br />-~ <br /> <br />D Blo-Hazard Waste SlOr3ge - ANNUAL <br />D Comm F.xha\l3t Kitchen HOO(llOoCl <br />D Con'rolled Bum <br />D Emergency Generator <: 30 kw <br />Q./ Emergency Generator> 30 kw <br />~ Fire Protection Maintenance. ANNUAL <br />Sprinkler D <br />o <br />jKJ <br /> <br />! <br />1--'. :-:..<:'<\"1 ',). .~~. <~ .:.~ {\1 .. ~ " ~'. <br />['"'\, C:c~' '-.t {~ (~' li ,( ,-;;~" <br />I .\ \(Y'Yt -1(~("(/<~" I <br />f=lles,mpleTllleMoerAddress r W('C::" (~: r{~li r",('=' <br />.<00 Add_ '()\(), 5, l10 --,u S+ <br />.:~f <br /> <br />..... . <br />,.eonU'aClor 'I <br />. .S!9nalure... ,.. , <br /> <br />Address L <br /> <br />ELECTRICIAN I <br />SlgnSlvre . <br /> <br />AOCIre.s.s L <br /> <br />PLUMBER <br />Signature <br /> <br />IIddres$ I <br /> <br />MecHANlcALI <br />Signature . <br /> <br />Ad(lress I <br /> <br />OTHeR <br />Slgnalure <br /> <br />AClClre~m L <br /> <br />Olrectlons: <br /> <br />o <br />D <br />D <br />o <br />o <br />D <br /> <br />FirEl Alarm <br />~SUPPI'l!l$slOn <br />Fire Alarm 1nst.!lll8tion <br /> <br />" ( . <br />, '.,. I <br />'- \. l..~)... I .' '- <br /> <br />_,I'~~jt"1 <br /> <br />,- <br />T'/:-.. <br /> <br />.';;S i-1 '-I I ~ <br /> <br />(-. <br />.~ L <br />f <br /> <br />,,;,,':;..;rLj~ <br />... -"___..........J ..&.t:.I <br /> <br />Fire Pumps <br /> <br />Fire WorKs <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br />Other: <br /> <br />(.... <br /> <br />.' ./"'2.::;::"-' ~ <br /> <br />Parcel # <br /> <br />D <br />o <br />D <br />D <br />o <br />D <br />D <br />o <br />o <br />D <br />D <br />D <br /> <br />FumigatioI11l':r')1 <br /> <br />LOl #. <br /> <br />(08' AINI::U I-ROM PRul"'t:H I Y IAA NOTICE) <br /> <br />Hl;lzarlious Material (Tier II (ll" R:C' FS(:illly) ANNUAL <br />Hood Installation <br /> <br />LPINalura' Gas-Installation <br />IJ"/NaIUf'lil1 G~ANNUAL Slllp' <br />P~CP.S of A6liembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />$f):!lrklers <br /> <br />t\ t 4-\ Oe, <br />~ <br />~.s,~8 <br />e-d <br />~~ <br /> <br />Sprinkler SystsrTI In&iallations <br />Slllndpipes (Sprinkler Sysl <br />Torch Roofing <br />\I\I!I~te TiI'P Storage ANNUAL <br /> <br /> <br />q~S <br />C ..Orlf E? 3 0 1<- <br />rUV' D(/a-I;~g <br /> <br />Valuation of oject <br /> <br /> <br />~- yd~'J J ~:~l~~~}~{i~/:N.J <br />! I <br /> <br />I Y / N <br />I <br /> <br />I Y IN <br />I <br /> <br />I Y I N <br />I <br /> <br />~Y/N <br />I <br /> <br />L(.. <br /> <br />) t! f' ,r.r.,d"'"i (0.. ~ ,- v /) r <br /> <br />C'- r-ll<:. ,h.~(n.:~ <br /> <br />I <br />] <br />I <br />] <br />I <br />I <br />I <br />I <br /> <br />Company <br />Regi:ste:red <br /> <br />U~n~ # <br /> <br />(mpany <br />RegisterE!C! <br /> <br />UCr~nBe _ <br /> <br />Compan~ <br />RegistElf'e<l <br /> <br />License '1/ <br /> <br />Company <br />Registerec <br /> <br />License 1: <br /> <br />Company <br />Registereo <br /> <br />L iCP,nse 'IJ <br /> <br />Fee CUITi!f1t <br /> <br />Y/N <br /> <br />Fee CUITMt <br /> <br />Y I N I <br />J <br /> <br />F~ Current <br /> <br />Y/N <br /> <br />~r'LJ <br />] <br /> <br />Fee ClIn'llrlt <br /> <br />f'1II out application oomple1Bly <br />Owner a. C"n\1'$C\Qr 91gn Clack 01 appUo;Ittnn. nOl;orlzoxl (C)r, r..opl' r:>' 51gn~cl oonl....'" w,,~ nlNT1sr) <br />If over 52500. " Natie~ of Commencement is r&Quired (Mech;;orrical wor1( over !<~OOl)) <br />Supply two (2) ~ of drawings wl1Il applicable docvmentaltOn <br />Allow 10-14 oays ror revle.v lifter submittal date. <br />