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<br />/] 4 ii <br /> <br />'7/HIt'T"'. <br />_ ,'- !I;.,.!." <br /> <br />c: : ~ 4 P;,! <br /> <br />ZEPEYRH I LS BJ I 1.1) I ["IG <br /> <br />/ 0'-+> 813.-78(]-0020 <br />'tl l.\/O--\ . ' <br /> <br />\ \ '\~tT R!CeiV~ ._,I, ~.I.: li:~:'....~~~L"Jr""- <br /> <br />SV". OWner6 Name [Mark Morrison <br /> <br />Owner5 Addrellll <br /> <br />~AX IJ0. S:S--782-J021 <br /> <br />(.", < <br /> <br />Clt<j ofZephyrhllls Fire <br />,Permit AppUcmion <br /> <br />Phone contact for Permit <br />.~w <br /> <br />Fax-813-780-0021 <br /> <br />l352 _.....L[-~ JJ:2~_5 _ <br />I 813 1'1 788 'I f0896 <br /> <br />owner's Phone NlJmber <br /> <br />II I" <br /> l!l <br /> , <br />Lot # I <br /> <br />~~Ol~R~a~n go~rt, Z~phyrhil~~j ~L~33540 <br /> <br />Tltietlolder Phone Hl.rnber '[ <br /> <br />Fe~ Simple TitIGh9Ider N4lme <br /> <br />FeeSlmJlIe TjtIeI10Ider Address <br />,1lWO\'" I Iv llt <br /> <br />L~ <br />, [; <br />.~ ~t..~ I!lI!f i <br /> <br />IlIJ <br /> <br />~j llh.1 <br /> <br />Job Add/lililS <br /> <br />, S'Jb Division <br /> <br />t.looov IT '1 <br />D <br />LI <br />D <br />D <br />o <br />D <br /> <br />o <br />D <br />.0 <br />o <br />D <br />D <br /> <br />~ <br /> <br />IN <br /> <br />~I JIll I <br /> <br />5222 20th Street, Zephyrhills, FL 33542 <br /> <br />r <br /> <br />: I <br /> <br />f'arcel , <br /> <br />'I"" " " ;; <br />, \VtlIAII'tI:.U t-KVM,t"KUt'f::J'\I.T I~ NVI ll.it;) <br />_I L 'II '<il'lJI 'AI : _, 'UlTTI7 <br /> <br />In ., 1_ 1 '~. wil<-U <br />ElJo..~ Waste Sto,aga M ANNUAl.. <br /> <br />Comm Extlaust Kltchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />, E;m.rgeoaf Generator < 30 kw <br /> <br />, Em~l'gilI1C;' Generator ;> 3U ~;\"I, <br /> <br />Fir~ Proteoiion M~lntenance ~ ANNUAL <br /> <br />,0 <br />D <br />D <br /> <br />Sprinkler <br />FIre,A1arm ' <br />Hood Cl..nlSupprelKllQl'i <br />,Fln;l Alarm'lnstalation <br />FIre Pumps <br />Fire Works <br />Flammable App"~1I0n- ANN IiAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />. _ r <br /> <br />lJiM I <br />m FJrnigEltiQn Tent <br />o HaZal'dous Matertal.(ner II or RQ Facility) ANNUAl. <br />D - -Hood Instdatign <br />D l.P/Natullll G8~nsl8llalion <br />'0 LP/NatlJraI G8li-ANNUAL Sale <br />o P1ac~ of Assembly-ANNUAL <br />D R.E1aeatiClnal Bun <br />D 5parlders <br />o <br />o <br />o <br />D <br />I <br /> <br />Spri'lkler System Inatalla\1ons <br />standplpe$ (Sprinkl~ Sys) <br />Torch ROl)lIng <br />Wa&le Tire ,S~rage ANNUAL <br /> <br />, I <br /> <br />Valuation of Project <br /> <br />* <br /> <br />ConinJ,,1cr <br />Signature <br /> <br />Addrells <br /> <br /> <br />I. <br />~ <br />,~ <br />J <br />J <br />I <br />I <br /> <br />~ee~~~$S !"-",.~".~~~,.. 'I' ..,~,..~-~:-_~. ~_.~ ..... '" n; "",J ~ I I r;r <br /> <br />FIll QlJt ..pp1loatlon completl!l)'. . ' , ' <br />Owner & COntrBI.:tor sign baok of applicatior..rlOta~ild (Or. oopy gf' $lgned contract WlttI owner) <br />if over S2500, ill NoliC$ of C,ornmencement is rlllll.4inld {M...e"'anlca! WtlJi,: o\ler $5000) <br />S\.lppJy two {2} sets of dIliVfl"~6 with owllcable dacwnenintion <br />.....1""" 1 0-14 ~ for r""tow ~"r "ubtn!ttal date. ' <br /> <br />ELECTRICIAN, <br />Signature ' <br /> <br />Addree8 I <br /> <br />PL.UMBER _I <br />Signature - <br /> <br />Address I <br /> <br />MECHANICALf <br />Sign61U1ll '. I <br />MdrflSS I <br /> <br />otHER I' <br />Signature . <br /> <br />~ ' <br /> <br />Company <br />RegIstered <br /> <br />Ucense '# <br /> <br /> <br />_ Company <br />Registered <br /> <br />Fee Current <br /> <br />I <br />Y/N~) . <br />I <br /> <br />Y IN I <br />I <br /> <br />Ucemle #. <br /> <br />Company <br />Registered <br /> <br />Weanse # <br /> <br />Y / N fFee current -\ <br /> <br />ComperlY <br />, R~lstered <br /> <br />,'- ' <br />.y I N r Fee Current <br /> <br />Y INI <br />:J <br /> <br />UcenS6 # <br /> <br />COmpany <br />Registered <br /> <br />~ <br />F$e Curreni I <br /> <br />"'N <br /> <br />Y/N <br /> <br /> <br />I nf~L:-- <br /> <br />'17 <br /> <br />llllr--1",--1 <br />