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813 City ofZephyrt�illsFir�- Fax-e�s-�eaoo2� :� <br /> Pemmiitt Ap�ication - _.-. <br /> DateRec�ived �- _ �. - Pt,orieGoMacttorPennit -�� � � <br /> �roe .� , <br /> Owners Name Owrler's Ptlone N�anber � 7�� 74�. <br /> o�rs,�aa� 3 i �.Q � 1 �-- <br /> Fee Simple T�lehoider Name TitleFwlder PFwne Number �� �� � <br /> Fea SanpleTitlehdder Addreas <br /> Job Address � # � <br /> Sub Division Par�ei # <br /> � Bio-Hazatd Waste 30or'age - ANNUAL � Fumigation Tent <br /> Q ��� ��p� � f{�aidous Material (T�er II w RQ Facility) ANNUAL <br /> � Controlled Bten � Hood InstaUation <br /> Q Et►�ergency Gene�ator < 30 kw a LPMattxal Gas.Insfallation <br /> � Err�argen�y Ger�a�o�> 30 kw � LP/NaUaal GasANNUAL Sale <br /> -- o Fhe Protection Mair�enance - ANNUAL � Places of Assembly-ANNUAL '-!" <br /> ��� � SpriNder � ❑ ❑ O � Reueadonei Bum <br /> �re,��, ❑ o 0 0 0 o S� �[ � 3 <br /> �� � . o o 5���,� -� � <br /> � o 0 <br /> r�oa s�o�, �� o � Q Q s�ar� csa� Sv�> <br /> � Fire Alartn 1� � Tor�h RoofirglTar Kettle <br /> Fre Pumps � WasUe Tma SbOra9e ANNUAL <br /> Fme Works <br /> Flanr►,�te a�ucauon- �ua� Valuation of Projact <br /> Fuel Tanks <br /> her. <br /> Contracbor . �Y <br /> g; Regis�ed Y/ N Fee cunent Y/ N <br /> Address Lice�se # <br /> ELECTRIC ��Y <br /> Signad,re Reyistered Y/ N Fee Curtent Y/ N <br /> Addtass Lice�e # <br /> PLUMBEft CornpanY <br /> s;ynat�e Re�ed Y/ N Fee Cument Y/ N <br /> Address License # <br /> MECHANI Cort�any <br /> gign��e Regi�ered Y/ N Fes Cur�arrt Y/ N <br /> Address Lioense # <br /> OTHER Compeny <br /> sigr�ue Reg�ered Y/ N Fee c�rent Y/ N <br /> Add�s License # <br /> DireCtlons: <br /> RII a�t appUaa�lon carlple6My. <br /> Owner 8 Corrtrac6or s19n back of applicaHon, notarizsd (Q , copy of signed c�ntract wfth owner) <br /> If over S250Q. a Notice of Cortsne�oament is t�quired.(M�I wak wer 55000) <br /> Supply Lwo (2) aets of drawings wiftt appiicable do�tion <br /> AAow 10-14 days far rsvisw after subrNttal date. Parael #- obtained from ProPaAY Tax Noiice (MtP��PP�er•P�9o�.can) <br />