Laserfiche WebLink
r- <br /> �o ir�criori s�vEv - �vee ►� oo� I0: Da� o <br /> Last Surveyed: <br /> lJ� I►�I(: (00 ►d07 O85(,UZE pre-printed informatim.) <br /> District:�/l FDZ: gp Plat/C,: Ai E_ � <br /> Street No: /qoq Suite/etc: <br /> Street Name: (�j�pq�f w�y /-�V�t1lLL <br /> Occupancy Name: (j,po�Id war �ycte <br /> Pnone �t:�g�o2599 <br /> PREVIOUS BUSINE55 (if any) <br /> Mail To Name: r-, <br /> Mail ro Business: �A �v <br /> Street/P0: <br /> Suite/etc: <br /> City, 5T, ZIP: EiJe.R�cua, 4glo I <br /> Person Contac[ed: L ��1,� ce_�� <br /> � -- <br /> Buildln� Owner/AGENT: <br /> � : �e��v hi A R v.e,� <br /> Street/P0: <br /> City, 57, ZIP: <br /> CONTACTEO regarding the Clean Air Act? v (y,/ N or n/a) <br /> / <br /> Fixed Prop Use:S'Sy- m � �, a <br /> Type Construct:s-u2 m � � m <br /> Bldg OcCup Type: r3.'1, ' m ` � <br /> �}/Stories: t - a � S N <br /> Number cf Apts: o m� � ° ; <br /> Elevator: N � � � - <br /> Sprinklers:�✓ Arrxial Test Oete / / a a <br /> Standpipes: u �� ��ti� �": -�trol Valve Ou � � <br /> Y��take OK? Oischarge OK? � � <br /> Private Hydrant: pi -- — <br /> Alarm System: �v Ann��al 7e�;t / / � <br /> Hood System: N Semi-annua;Test % / n <br /> Other P:otection: � — '— — o � <br /> Knox Box: N � <br /> EFD Per�nits Required: N m <br /> List EFO Permits Issued:N' N � <br /> e ' <br /> Hazardous Materials: M Flammable Liquids: N <br /> Pestic des: Stocage: <br /> Radioactive: Handling; <br /> LPG: Spraying: <br /> Nit/Oxide: Underg,ound 7ank: <br /> Chlorine: <br /> Ammonia: <br /> Other: <br /> �• •r SUZVEYOR'S TRAINING ND._ O ��] <br /> aa� <br />