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Date Raceived ° PFwne Ca�rtxtfor Psmdt <br /> Owners Name —�O�j� �..Qf'�Lt�.�� Ow�er's Ptwne Nhanber �� L�.iLi1_J L�iLJ <br /> � F i� � /� <br /> VYri1Q�AY4�.�J i r Q� /� � � <br /> �4 � <br /> r-�e s�m�-nnenoa�n� ��N�„� C� � U <br /> Fee Simplelltl�dder P�ddress <br /> Job Addrass � <br /> Lot# <br /> Sub Division Par�el� <br /> � Bio-�iazard Wa�sta Storage-ANNUAL � F�a�n T�t <br /> Q Camm E�d��st�EcF�en Hood/DuU � F�dous Material(Tier 11 or RQ Fadi[ty)ANNUAL <br /> � Controlled Bum � Hood Irotaitatlon <br /> Q �9�Y Genetator<30 kw � LP/Nahual Gas-Installation <br /> a ErtrergencY Generator>30 kw � LP/Nahiral Ges-ANMU/LL.Sale <br /> � Fire PmtecBon Mairrier�-ANNUAL � Places of A�Iy�ANIVIlA(. ' �� � --._ <br /> � �.� I l <br /> Sp�,� D o 0 0 � � ��B�, <br /> ��� - o 0 0 � <br /> ❑ 0 � �� <br /> �� � � o 00 os��,,� <br /> raoa S�res�oR � � o Q star,aa�r�(�a�+nwer sr�� <br /> F'ire Alartn ir►s�ilaUon � Tor�h Roofing/Tar Kettle <br /> F�e Pwnps � Waste Tire Stnrage ANNUAL <br /> Fina Works <br /> Fl���"��O""�u� �--� Valuation of Project <br /> Fuel Tardcs <br /> er. <br /> Co�racoor t � �, <br /> S�� ' Reg�ed Y/N Fee c�arent Y/N <br /> � . Lit�se# �— � <br /> ELECTRICIA C�mP�Y <br /> S�"a�° � Res�tered Y/N F�Ctmant Y/N <br /> Address License# <br /> PLUNBER ��Y <br /> S�"°�° Reg�te� Y/N Fee Cianent Y/N <br /> Address Ucense# �–�-- <br /> MECHAPII <br /> Comparry <br /> s�'�"° Registerod Y/N �ee Ctmern Y/N <br /> Address Lk�ae# <br /> OTHER ��y <br /> s�"�11° Rsgfsterad Y/N r-ee Current Y/N <br /> � Lic�nee# <br /> Direc�s: <br /> F!N ait app�ion�mpletely_ <br /> Owner$Co�Urac�or slgn b�ic aF a�licaUon,notarized(Or coPY��9�1�wlth ovme�) <br /> if rnrer S?500.a f�ics d Cons�msnt is�e4uir�d.(Msdwnical work wer Sr M) <br /> �P�Y iwo(2)sefs of drawirgs wfth aPP�icabb doqntrerrtatlon <br /> AIIav 10-14 days iw�sview after stil�tniKal datB. Par�ei#-obfained trom Propetty Tax Notice(MfpJ/appraisar,pascogcv,com) <br />