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<br />.. <br /> <br />Pennit Application <br /> <br />~eceived <br />.M\;! <br /> <br />J...._... . I <br />~\"''> <br />4-& ~ Gc...\\ ~\\)c:P <br />I <br />I <br /> <br />r's Name <br /> <br />ts Address <br /> <br />iimple Titleholder Name <br />ijmple iItIehoIder Address <br /> <br />I <br />I <br /> <br />- <br /> <br />.ddress <br /> <br />-$ B09:3 <br />~~ctfurPennit ~~ ... ~. __ ~, '" ""! <br />I Owner's Phone Number r ~ 131 I '"1~b 111 ~~\ I <br />7~~~~"'\\\~ \ ~ ! <br />I ~PhoneNurOOer I II II I <br />I <br />'~I <br />I <br /> <br />Lot # <br /> <br />I <br /> <br />Parcel # <br /> <br />)jyjslon <br /> <br />_!ill. ~.;;.; <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />o <br />o <br />o <br />o <br />Emergency Generator > 30 kw 0 <br />FIl'8 Protection MaintenanCe - ANNUAL 0 <br />~I~emll~~' <br />Sprinkler D 0 0 0 D <br />Are Alarm D 0 0 0 D <br />~~ 0 oc=J D <br />Do ooc=JD <br />o <br />D <br /> <br />~ <br /> <br />Blo-Hazard Waste Storage -ANNUAL <br /> <br />Comm Exhaust Kitchen HoodIDuct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />tractor <br />I8ture <br /> <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />FlanvnabIe AppIGtion- ANNUAL <br /> <br />Fuel T~ <br /> <br />Address <br />CTRICIANj <br />lature I <br />Address I <br />IMBER I <br />18ture <br />Address I <br /> <br />~::11 <br /> <br />Address I <br /> <br />~I <br />Address i <br /> <br />ilCtions: <br /> <br />Fumigation Tent <br />Hazardous Material (TIer II or RQ Facility) ANNUAL <br />Hood Installation <br />LPlNatural Gas-lnstaIlatIon <br />LP/NatlnI Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />SparkIenl <br />Sprinkler System lnstaHations <br />Standpipes (Sprinkler Sys) <br />T on:h RoofingITar Kettle <br />Waste Tne Storage ANNUAL <br /> <br />~ Valuation of Project <br /> <br />Company <br />Registered Y/N I Fee Current I Y/N <br />Ucense # <br />- <br />Company <br />Registered Y/N I Fee Current I Y1N <br />Ucense # <br />Company <br />RegIstered Y/N I Fee Current I Y/N <br />Ucense # <br />Company <br />Registered Y/N I Fee Current l Y/N <br />Ucense # I <br />Company I <br />Registered Y/N Fee Current I Y IN I <br />LicenSe # 1 J <br /> - - <br /> <br />All 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 CommetlC8ment Is requirecl.(MechanIcaI wortt over $5000) <br />Supply two (2) sets of drawings with applicable documel dation <br />Allow 10-14 days for review after SUbmIttal date. Pan:el # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />