Laserfiche WebLink
Permft Applicai(on ���•—� <br /> Date Recelved + Phone Coniacl for Parmll ��_/y��,���,,��� <br /> �+�r���g"='f°��_s*as.....�' �-Yt:3'y..�t,�T.r:�..c=_:=„�,��.��:��r�_.�,�-�wt►fe�xt+c a=�ir:-�v�x'°'aw..� - <br /> L1at1W�Pfl��i� �"�`�—r� �� <br /> Ownera Name <br /> > Owners Phone Number � <br /> Owners Address 1`` �. � cS <br /> Fee&fmple Tlitehofder Name Titleholder Phone Number C� � � <br /> Fse 8lmple TlUahoiderAddress _ _,s,,, <br /> `�'�,�„��.m.�.�l`h�lu-JZ1a4-�t3�#Fi1 R �L" Y�- LSZt13F.c'�Y.� usn�.�z�i.:.s��- 'S,� 1�4`c�t -N'�1� <br /> 'ai� 's.�.� ri iY *-d i .7.,1.>i:t.�� =it��'4,.c...+'i." y'^ .=star`-'sl��� <br /> • � � , � �4/ � �t� <br /> JOb Add(BB$ <br /> Sub Divlsion Parcel# _ - <br /> —TeZ;�K"�1a�=-,_._�>;r�.r::.Y�eka�ta'�`...,-_r �s-e�s�a��ra�' •'� <br /> � BIo-Hazerd Waste Storage'-ANNIIAL . � Fumtpatlon 7ent � <br /> � Comm Exhaust Klfc#ten FtoocilDuct � Hazardous MaEerlal(Tler!i or RQ FaclSlty)ANNl1AL <br /> a Controlled Burn � Nood lnstelletion <br /> � Emergency Oenerator<30!cw � LP/Nalural Qas-lnatalletlon <br /> aEmergency(3enerator>30 kvi � �-P/Natural Oas-ANNUAI.Safe . <br /> � Flre Protectlon Mainienence-ANNUAL � Places otAssembly-AtJNUAL <br /> e� 8f 3�� �— <br /> � o � <br /> Spdnkler � CJ D Et � Recreational Bum � ( <br /> Ft�e Alerm � C1 � �- � Sparicle�s , <br /> . Nood Cleaning � ❑ � � � Sprinkler System InataOatlane <br /> yood 8uppreaslon � ❑ C1 ❑ � ❑ Slendpipea(Spdnkter Syaj <br /> ' � fire Alem3 Installatlon a Torch Rooflng/far Kettle <br /> Flte P�mpe a Wasle 71ra Storage MINUAL <br /> Flre Works <br /> �tammabte Appllcailon-ANNUAL ���, ValuBtiOrt of Pl'oJeCt <br /> Fuef Tanke <br /> � Other: � <br /> -;r.-�x,::,+��c�... t��t <br /> -- .�'�t�z.e?i-m.r'3:��s�Y3[�..�'�' <br /> L� Company , � � � . <br /> contraclor „ „�i . , <br /> Slgneture (lX V Registerad Y/N Fee Current Y/N <br /> Address license f1 � I <br /> ELEGTR[CIAN Compeny � <br /> Slgna(ura ' Reglsterad Y/(� Fae Curcant Y/N <br /> Addreas License#t <br /> PLUMBER Company <br /> SlgneEure �eg�s►ered Y I N Fee Current Y/N <br /> Addrese ucenge�l � <br /> MECHANICAL Company _ <br /> Slgnature Repletered Y/N Fea Currant Y!N <br /> ��88 Llcense# , <br /> OTHER � Company <br /> Repiatered Y 11d Fee Current Y/N <br /> 6lgnature . <br /> Ltcense# n�....���y��a <br /> Addresa �w,ra..�,s �__�+' ---- <br /> Ilt�l� <br /> D1recHona: ' <br /> FIII out appllcstton compleie3y. ' , <br /> Owner 8�Contrector algn back oE appffceUon,nofarized(Or,cepy ot signed conUact with owner) , <br /> I(over;2600,a Notice ot Commencement Is required(Mechanical�vork over$5000) <br /> . Supply iwo(2}sete of drewinga wtth appllcabie documentaUon <br /> • Allow 10-14 daya for revlaw after auhmlttel dale. Percel#-obtalned from Proparty Tax Nouce(htip:llappralaer.pascogov.com) <br />