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013 0020 Fu* Fi e- 813 -78o -oat! -it: _ '- <br /> Permit me ReGeived - 11111111111111111111 ,-- Phorie - : c 1111111111111 <br /> dNVV S anises <br /> ds Phase Number <br /> szter's Name [Sad ernes Addnass , -' (LS u 6 a: _∎k 9 ) \vc-i 7,o OW Nt...% x - 1 1 1 <br /> se Name 1 , - f sholderPhoneNumber 1 I ) <br /> se Simpielleshokier Address 1 1 <br /> obi 1 � Pon* # <br /> tub Divisi* on co- <br /> n irolitizied welds Stagage -ANNUAL [] Frrrigetlan Tent <br /> ED Daum Exhaust Kitchen HoodiDurt Hazardous ous Materiel {Tier N ar RD Facility) ANNUAL <br /> En Controlled Burn o mad Instailtdion <br /> Emeagency Generator < 30 kw LP/Nitra1 Csee -tr <br /> Emergency Gersaator> 30 kw ! ^ t N1 UAL ate <br /> Fke Protection Maidens= _ ANNUAL - n - Pieces of Assembly-MI 1AL <br /> ® ®-® loaner 1 <br /> Fine Sprinkler -p 0 a1 1 Reasational Bum <br /> Hood Clearing v 1 Naiades-System Instalialions <br /> Hood Suppmesion M0 0 0 1 ) <br /> Fire Alarm trIStellatiCM R Tanis Rooting/Ter Kegs <br /> Fire Pub Waste Tire Storage ANNUAL <br /> UAL <br /> Fin:Works Appliamon-AtasiAL ) 1 Valuation of Project <br /> Fuel <br /> Team ` <br /> Cankac0or it - - Registered f Y / N , Fee Currant 1 Y / N <br /> Address 1111111f7f <br /> _ Registeed 1 Y/ N I Fee Carrara j YIN f <br /> Address �' ( License # 1 <br /> Signature et �` I wed 1 Y/ N I Fee cursor 1 Y/ N I <br /> I <br /> Add) t license# 1 company <br /> I ,md 1 Y/ N ( Fee Currant 1 Y/ N 1 <br /> S� ! - Lkaalse# 1 <br /> address 1 <br /> OTHER I Reed Y/ N Fee arrant Y/ N <br /> Sgptakere 1 Registered <br /> # <br /> Addmse <br /> C>kec6anx Re out application compbtely. <br /> Owner & Conkardor sign back of appecation. noladzed (Or, cow of signed conned with ° <br /> it over $2 00, a Nodal of Commencement is reaafrad.gneciu scat work over ) <br /> Supply two (Z} eels of drawkgs with appikabie documentation ' <br /> Parcel �E - obtained from property Tax Notice ( p gw mcn) <br /> Abw 10-14 days for review add sn>b date <br />