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31?-7£�-0�-'� C.I�Ofz ephyrhilis FIf�' rax-oio-iov-v��ci <br /> Permit Applica±ion _ _. <br /> Dat= R>ceived Phone Conact for P=rtnit I G��_1 Z( --� 5'� <br /> z ,�:��:..,-w:.r.�r.�.�:'.��.-w.�..w..�_�.:F..... , .. � �s�.���^��.�s�a�� ��E._s �-..��� �.-_ �.:. .. ,�:... <br /> � A <br /> Owner's t�am= 1 1� � i�a� Ql% L�-�G Owner's Phone tJumber $�� �.`7 ��7 <br /> OwnersAddress '1Zs Co1�51�t�v�x.c.� ST1kFC RD f3/a-1.A CY�t'kXD�QA �o�Z1o2 <br /> F=e Simple Titl=holder Name Titlehold=r Phone Number ���� <br /> F>e SimplaTitleholderAddress <br /> �... °�.. � z��ae-r.�a�x�+, . -..' ' - ' ..�`.F?.x�"��"'e,�"'�. -'S?�'�:cs.rru-s�����+.�..�.�,,Kx,_,�,�.�r'..��.�•r�: -.*;:-r;-x;.•��g�^;�:_ys <br /> Job Address ��j �i �o 1�2L l�1..�1 z,L�p►�'Y/ P'�. Lot # �� <br /> Sub Division 1'�( 171G Ge (.LS Paroel � �• "• Z 1• CYj 10 • D D!� • 600 <br /> :� <br /> .o-�s <br /> � Bio-Hazard Waste Storege -ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitch=n HoodlDuct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controiled Bum Q Hood instaliation <br /> � �mergency Generator < 30 kw a LPINatural Gas-Installation <br /> � Ememency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance -ANNUAL a Places of Assembly-ANNUAL � f ` <br /> tr y emi Qn ar r�! � �� V <br /> �i i� i <br /> Sprinkier � � ❑ 0 � � Recreationai Bum � <br /> Fire Alarm � � ❑ ❑ � � Sparkl=rs <br /> Hood Cleaning � ❑ ❑ ❑� a Sprinkler System fnstallations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Aiarm Instaflation � Torch RoofinglTar Kettls <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> FlammableApplication-ANNUAL Zs,�p ValuationofProject <br /> Fuel Tanks <br /> Q Other: <br /> ConVactor Company <br /> Signature Regist�red Y/ N Fee Current Y/ 1v <br /> Address Licertse # <br /> ELECTRICIAN Company <br /> Signature Ragistered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTH�R S(�21L�( T- CompanY Q_pl�(.}l•l `r)/Z.� �/2t ►.I�CLlQI,g ,f/1G <br /> Signature Registered / N Fea Current �/ N <br /> Address 1 • n0 S License � ( ��( �j zC�bp � � <br /> . . — <br /> � . ...._ . _ ....,:4.�=.R - -� ,-•-� �-- - .._ __ "-___.°. _._:_�.._ �,_. - ._......v.�..._..e.�.�. � ��.,��,. <br /> Directior,s: � <br /> Fill out application completely. <br /> Ovmer & Con:rector sign back of aaplication, no;arfzed (Or, co�y of signed contract with owner) <br /> lf ovar 52500, a Notice of Comm>ncement 3s required {Mechanicat work over 5�000) <br /> Suopiy two (2) sets of drawings with appficabls documen;afion <br /> Allow 10-14 days for review aftsr submi;tal date. Paroel r- obtained from Property Tax No;ice (http:/Iap�aiser.pascogov.com) <br />