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<br />Oct 01 07 04:08p PGM Holdings 813-650-8993 <br />S~r/27/200rITHU 07: 52 AM ZEPHYRHILLS BUILDI~ FAX tlo, 613-760-D021 <br /> <br />813-7BO-OO20 Ci1y of zephyrhnls 'Flre <br />Pennit AppJc:ation <br /> <br />I I~ <br />~ick.( d o--hcs <br />OMetsAddnlss ., lQ74 -, n ath Lo...k.Q Qe. <br />I <br />Fee Sllmpl!! T""""der AddRIBC I <br /> <br />IlQ1~ <br />I <br /> <br />Fee Simple TiUBtlcIder Name <br /> <br /> <br />I <br />~I <br />I \..iGense . I <br /> <br />I =~J Y/N <br />I Lbr.e. I <br />I =nv.~ r Y/N <br />:i -. i <br />I =[ Y/N <br />W L Ucen&e' ,: <br />I"IJ aut ........lbl~. . <br />Own8r. ConIractor iVlIlla of appIic:etiun, nolari2ed (Or, copy of &Igned alntI8Ct with owner) . <br />If over f25OO, a Not_ of CoImII_ament is required (M8cIlaIical WOItc: over t6000) <br />SUpply two (2) .. of cbNngs will applc8ble doCUll1el...... <br />Allow 1o-14d8ys1OrnMe'wafter '''mIlIaI d8te. <br /> <br />CIte Received <br />. 11"'&11 <br /> <br />0Ml8t'8 N8IIIIe <br /> <br />Job Addnt5S <br /> <br />SUb DMalcn <br /> <br />D <br />o <br />o <br />o <br />D <br />D <br /> <br />Conlrador <br />$(gnaUe <br /> <br />Adctess . <br /> <br />ELECTRICIAN <br />SlsnaVe <br />~I <br /> <br />~= l <br /> <br />Add~ll ~ <br />MECHANlCi <br />~tuf1i! <br />Acldresa I <br /> <br />:1 <br />AddtMll I <br />~: <br /> <br />p.2 <br />P. ODI <br />Fax-813-780-0021 <br /> <br />~J <br /> <br />Pmne CclrDalb Pennit I s:l-,:; ~. <br />I Owner'e PIlone Numller.r I , r I f <br />, <br />I <br />I <br />t U)1#.1 I <br />r (V~ '~-:f~\SO' b~oO' (j/J, <br />:: ,~I r. _ tlr~n I"", _' JY:I :::. <br /> <br />o FUIIIplIon Tent <br />o Huardous.... <br />D ~ IltStlil8llon <br />g-LP/lIIatIRI G_lnSUllJallor\ <br />o LPINIIll.ra Gae-ANNUAL SM <br />D Pla~ t6 Ass8I'llbly-lallNJAL <br />o RelRetionll Bum <br />D <br />D <br />o <br />o Torah RooIng <br />o Waate Tire Storage <br /> <br />I TiMokfer Phone Nlxnber I . <br /> <br />r L <br /> <br />II <br /> <br />(\o{-+h lLLt~ DL.- <br />I Parcel ~ <br /> <br />1 ; <br />Bio-HIJ7a'd W~ Sklrage . ANNUAL <br /> <br />Comm Ext1aat I<IIeh8n HoDcrIDUCI <br />Conwolled !kI'n <br />I!II'IeIg8IICy Gen&rator < 30 Ic.w <br />ElI18I'gIIrICy Generator:> 90 kw <br />Fire PIOt<<Bon MIlIn1eMnce - ANNUAL <br /> <br />" <br />..[ a;.Y' <br />)J '" .vJ <br />IL9- ../1 ,j.iJ <br />e( (Y') . ;.,,l/ <br />rJO.y ell {15r <br /> <br />o <br />Fire AAtrm D <br />Hoot! Clean/SuprnesJan 0 <br />Fire AIarrn ,....1aIan <br /> <br />Splllllcler . <br /> <br />SparkJCI3 <br />SpdnkIer Syatem Insl!lldons <br /> <br />S1anc!pipee (Sprfnldw Sys) <br /> <br />81<<. <br /> <br />~c0 <br /> <br />Fir. Pumps <br />FInt Wcrlc:t <br />Flammable AppllcaIon- ANNUAl. <br />Fuel Tanks <br /> <br />z S~ ~ r-l{Y'\ 'O/2-/en <br />, ~ \?>D <br /> <br />~ <br />R9llloo"Bd <br />Urzne.' <br /> <br /> <br />YJN lFeeClmlnt ( Y/N ( <br />] <br /> <br />1 <br /> <br />I <br /> <br />, Fee CUrrent . r Y / N j <br />- I <br /> <br />Fee Cutrent l <br /> <br />YJN'l <br />f <br /> <br />Y I N ,~ <br />L <br /> <br />-.J <br /> <br />F.. Co.mlnr 1 <br /> <br />I , <br /> <br />.._.._...."~._- ,... <br />