Laserfiche WebLink
R�saso-oozc c;ity�r cepnyrnms rire rax-tsi.s-iau-uuzi <br /> Permit Application <br /> Date Received � Phone Contact for Permit g�3 , �fa SG 3 g <br /> . ° - - - _, ., <br /> Owner's Name a � � � ' Owner's Phone Number C� � � <br /> Owner's Address ,� �3 5 J��� s Cr/P <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> r -��»�� _ +�-c�.;�s+•:.�,�r�c. ..�-.:sa°�e^�R�� .���_�. � ., .,,: ,�,., ,.�. ��� �-�rrr��s�a���^<��_ , _ . ,a�ra�.°���, <br /> Job Address Lot# � <br /> Sub Division Parcel# <br /> R w .w . .„;�..�..,�,. �. a.-at.'"y�`i# . _ . . _ __=°e.-��°-3P��c..ra�.,,wss,�r..._��-,.�..�,i�v'.++s�*�7-$s+; ___ _ . :2u�nn,- - _ _ ,__��-�.�:�--c�.-�.r,°'fi_'. _ _ -,,,. <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> r y emi �n er � �� � �c', <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Burn � � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �� <br /> Hood Cleaning � ❑ ❑ ❑ � �SprinklerSystem Installations y��t/� � 2� <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) .' J�1 <br /> i� <br /> � Fire Alarm Installation � Toroh Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> aFuel Tanks <br /> Q Other: <br />� .� .�.3�� � .. ,�����;���� . .�#����.-.��;�-r:��:�_-_�A���, . . x- _ .. <br /> -,,, �,m�;-�-.:,�:�. ��.��:� ,��,;.�.�.���� �;,. <br /> Contractor Company 1 � r� i j <br /> Signature �� Registered Y/N Fee Current Y/N <br /> Address (Q ,� � L.,3 �" License# <br /> ELECTRICIAN Company <br /> Signature Registered 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 Curtent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br />� <br /> Directions: <br /> Fill 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 Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:llappraiser.pascogov.com) <br />