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, Per�rtit Applicaiion <br /> Dete Recelven Phone Cantect/or Psrmlt <br /> ���� �+�w�essr��=��a:;��v:3:t�°....-=r1-.;...,—,-:,��:�+�s��em^�sb <br /> a n �y a. <br /> ` � �� �..'--s.'Lf.S..l.! <br /> Owne�s Name Owner's Phana Number <br /> o�,sr6 addreee � rJ �t.{�'����e �jC� l� Z <br /> �ae Slmpte 7lltehofdar Name Tf Oaholder Phona Number C� C� � <br /> Fae 8lmple'RtlaholderAddress . <br /> - -- -auseYpr���uaM� s.t_ �-��_- + F• �+��Y33ri�s3r,ca�tiif.t?nara.7€=�;:!ii�:?i:��5i.;i.i�G.i311�'r'.-�!�� :::r 7o•,:iyal�.-- i sa;. a tr <br /> ._.....�o._....�.,. pE�'.'�__3�:�f,_51a..tk�k:.��z_.f_�f �� i 'P <br /> Job Acfdresa � �' (,.�,�� " vd, � � � � <br /> � lot# <br /> 3ub Oivialon Parcel# <br /> -a�ffiag�e�u:,r�.s.�•�,s� -— �c�""=�':�ifU-''wt''.'.t£!�t v ,i�a�—a3s,TiI6a°F!�,-'ar�s__.�c+c'�ic,'"`�� <br /> ._•:uc *tf�•.—�-..m:3�i:.tYrav� •astvl�dl <br /> Q 810-HazeM Wsste Storaga=AMfJUAL ' � FumiqaUan Tent <br /> � Comm Exhauat Kltchen Ftood/Duct � Hezerdous Maiedal(Tler II or RQ Fadllty)ANNUAL <br /> � Controlled Bum � Nood lnstallatlon <br /> � Emergency Oeneretor<30 kvi � LPINatural Ges-fnalellatlon <br /> � Emergency Cianerator>36 kv� � LPINaturei Gas-ANNi1AL Sate / , <br /> � Ffra Protectfan HSafn[enance-AkNUAL � Q Places of Assambly-ANNUAL. 11� / 3!"I �� <br /> . � em � sr � '�!'1 <br /> 3prfnklar �9., O D RecreaUonel6urn <br /> Flre Atarm ❑ O D � Spailcier6 <br /> - • Hood Cieen(np � ❑ ❑ ❑ � Spdnkier System InsfallaHons <br /> . Hood Suppresafon � ❑ ❑ O � � Standpipes(Sprinkler SysJ <br /> " a Flre Aiarm InatellaUan � Torct�Roo8ng/Ter Kedte <br /> Fire Pumpa Q Waste Tire Storage AhINUAL <br /> Flre Waks <br /> Flemmebl8 Applicalfon-ANNUAL � Valuatlon of Project <br /> Fuel Tanks <br /> � Other: <br /> ..�.�.,.,-�-"-'.�'�—,�.a:.�r�,3tA�;':uF�:e.:_e�,'�=..r,a — - a�a <br /> ConUactor /!�����` 1�41'`-1' CompanY . c� <br /> Signature � y�,� � . <br /> Repistered Y/N Fee Curcent Y/N • <br /> ��88 � Llcense# i� <br /> ELSC7RICVW Compsny <br /> Slgne{ure � Registered Y/N Fee Curcent Y/N <br /> Addresa Lfcenee# � --� <br /> PLUMBER Company <br /> Signature Regisfared Y/N Fee Curreni Y I 1� <br /> Address L{oense# � _� <br /> MECHANICAL � , � Company <br /> 8lpnetura Raglstered Y/�1 Fee Current Y/I�1 <br /> Addrees � License# <br /> QTHER � Company ' . <br /> $Igneture Replatsred Y/N Fee Cunent Y/N <br /> Addteea Ucense# ' <br /> {.3�(9C�0I16: - . 5 �i'�. �4ezr- - _ talY�1{Y�.s=f2i�.Yew! <br /> FIO out appllceUon complately. <br /> Ownel&Canttactar elpn bedt of eppflcallon,noterized(dr,copy af eipned coniract with pwnar} <br /> If oVer 32500,a NaUce of Commencement is requ(red(Mechanlcal work ovar*�5000) ' <br /> Suppiy lwo(2j seta oE drawlnps wilh appticabla documentatlon <br /> ' Ailow 90-i4 deya tor reviev�aftat submittal dela. Parcel#-obteined lrom Properiy Tex Notica(http://appralaer.pascogov,corn) <br />