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_ . <br /> W 1. 6)3 E3 <br /> .. • <br /> 813-7804020 CRY of ZePhYrtgRa FilgitIrz:. F=413-780-0021 <br /> Pertnit Application - <br /> Dots ReesIved -l----: • r ' - Phone — & - naict . for Permit <br /> Owner's Name - 11271:11;1"40111,111111A.17M; Dallies Phone Numbrir 1 1 1 - I <br /> Owner's Address 11P-1.41/1re — _ ZAT.Z.4frAIP.ME .416-4.v4161alliglir- -atel f. <br /> Fee Simple Titleholder Name Titleholder Phone Number 1 I <br /> Fee SImplefilleholdsr Address <br /> . <br /> Job Address 1 Lot ft <br /> Sub Division I Parcel 0 <br /> ' & <br /> El Bio-Hezerd Waste Storage - ANNUAL J Fumigation Tent • <br /> ED Comm Exiseust Kitchen Hood/Duct ED Hazardous Wade! (Tier II or Ft0 Fecility) ANNUAL <br /> 0 Controlled Bum ED Hood instalation <br /> Ernergway Generator < 30 kw <br /> ji <br /> Emergency Generator ). 30 kw <br /> Firation Makeenance -ANNUAL <br /> EEO ES PEI LLA:a• Ei LP/Nitural Gas-insieliation <br /> LPINsturat Gas4NNUAL Saki <br /> e Probation <br /> El Places of Assembly-ANNUAL <br /> Sprinkler 0 0 0 Recreational Burn <br /> Fire Alma 0 0 0 Sparklers <br /> Hood Cleaning 0 0 0 Sprinkler Spam habitations . <br /> • . • <br /> Hood Sappington 0 d ir 0 Standpipes (Sprinkler Bye) . <br /> • <br /> Fire Norm kistaation - Ei Torch Rooting/Tar Katie , <br /> _ <br /> -- <br /> Fire POWs , — " -. <br /> Fire Works <br /> • Famish', Application- ANNUAL . <br /> 1 1 Vtduadon of Project <br /> Fuel Tanks <br /> 11111 61 - • <br /> AMP NIMAINIANIIIMIIIIIN <br /> Cant/odor =741141111 . • conitany P7izi:V71 ,ZY LifAr"ArlIVA - -041 10 4 <br /> Sidman IIEFAMPIINIMIIIIMPrea . _ Regkilm• itikilv Iraall <br /> Addrms VI ;fe,' 1 z 74Per , I VV.411111111111k:X3147142A111111 . wenn* ize <br /> ELE - Company <br /> Signature R•gistered Y/N Fee Gwent Iliffialli - <br /> Address I & <br /> . ‘, ., License # 1 <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current I Y / N <br /> Address 1 Ucense # 1 <br /> , .. <br /> mEcHANiel Compam/ I <br /> Signate Reprieved Y / N ‘ I RIB cum* I, Y / N <br /> Address 1 License I/ <br /> OTHER <br /> I • . Compeny <br /> Signature Ftegisiered I Y / N . 1 Fee Current 1 Y / N I <br /> Address I License 0 1 , <br /> Direcams: - . ' <br /> Omar # Oorrirecior leill0.010M4 .' -4 0 *Pod obltmoi %Net oallad <br /> if over 12300. a Notice ,, , , work oar 85000) <br /> Swart., Masts of . - ) • <br /> AIIcw 10-14 days for ilflasublfraal data. • t- 4 Parcel ft - obtained from Property Tax Notice (litadlappnalser.pascogov.com) <br />