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ai�-�eo-oozo City ofZephyrhilisFr�.:;r.�_::.. <br /> Permit �c-s�s-7so-oo2� <br /> _ Application <br /> Date Received � <br /> . � Pt�nne C�far Pemdt <br /> Owners Name I,t) �b� � �S-�"(,� .2 S Owners Phone Wm�ber F5� �j �$ � 1 r <br /> Owner's Address ��p� `_ �1'1 J 11') 1�.Qr1 U..Q,. " r1 r' i'� F 2.- 3�4'o'Z <br /> Fee Simpie'7itletalder Neme Titleholder Phone Number � �� � <br /> Fee Simple'Tideholde�Address <br /> 1 ocG 'r�t • }, 'l �35y� �V i Slee� H i.�� <br /> deb Ad rrss �O�f0 i�Q �; � <br /> 5ub Dlvision Parcel# <br /> QBio-Hazard Waste 5torage-•ANNUAL D Ftmtigaiion T�t <br /> � Comm Fxheust}Qtchen Hood/puo{ . � Flazetdnu,Materi��(7jer II or RQ FacAity)ANNUAL <br /> Q Controlled Bum - � Hood lru�datlmt <br /> � Em�gencY Generator<3D kw - a LPlN�dRal Gas-It� <br /> � Emerger�cY Gene�stor>30 kw Q LP/Napuai Gas-ANNUAL Saie <br /> � Fite PratsCflon t�irrtenanCe-ANNUAL - � -Piacas of Assembly-,AtJNUAI <br /> SPriNder r � <br /> �� �L�l� ���e�„n �'�3v <br /> Flre Alartn � p ❑ O � •g��� <br /> Hood Ctea�ing � � 0 ❑ SprinMar�ystem i�tallations <br /> Hood SaPP�esslon � D ❑ O . Star�PiPes(SPrinkler Sys) <br /> � Fire Alarm Installa8on Tor�h RaoBnglTar Kattle <br /> Fire Pumps � Was6e Tirs Storaga AMNUAL <br /> Fire Wmks <br /> Flammable App�ic�cn-qNNUqL c--- <br /> Fuel Tanks <br /> 1 ~� Vatuafion of Proje�t <br /> �] Other. <br /> cormactor � <br /> 5ig�ture ����,�/ � Regisbered Y/N Fee c:urtent Y/N <br /> Address . -• <br /> 13cense# <br /> F1EC1'ftIC1A • –' -•- • - - <br /> Signatune ���Y <br /> �'�°d I Y!N i Fee c�,t Y/N <br /> Address <br /> Lk�nse# <br /> PLUMSER ' <br /> Signatiuure � <br /> Address . <br /> �9�ed Y/N• Fee Gment Y/N <br /> 1-iCet�# <br /> MECHANICAL <br /> SiBnattme . _ Compa�ryr ---...— <br /> Re9lstered Y/N Fee Currerrt Y%N '– <br /> Address � - <br /> •License# <br /> OTHER - <br /> Sigr�ature � - �rttPenY <br /> " �9�d ( Y I N ,� Fsa Ctarent Y,td <br /> Address � , <br /> D8'edions: - - L.koeense# <br /> Fili out apPiieation wmpleteiy. ' <br /> Owr�r&Conhacfnr�gn badc of appticaticn.n�rized(Or,copy of si9ned carthaet with owner) - <br /> If over T�500.a bloiicx crf Cortui�enCernentis�ired.(Machat�iCal work a�g5000) <br /> S�PPy�°�2�seta°F deawirgs wAh aPP�}ceble docurr�erdaiian . <br /> Aibw'f 0-14 days for raview afEer submit6al date. Par�xi#-ob�fiom <br /> Property Tax Notice(hitPJ/app�a�er.paseogov.rAm) <br />