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<br />2008-_~Jan'0909,;43 AM OunnWell Facilities Services 919.661-11900/' <br />. ,DEC/JJ6/201?,"fHU D4:22 PM ZEPHYl'JIILLS BUILDING FAX No, 1113"78D-D021 <br /> <br />6/7 <br /> <br />, , <br /> <br />City of Zephyr-hills 1:Olre <br />,Permit Applica:1ian . <br />. " <br />f'Mn!l,OCli'l:tliot for pennlt <br />'I -.Jillllll""~11I <br />J OWIl~~: Pilone 'Num~ <br /> <br />It 1.38 0 <br />~1S.780.oD21 <br /> <br />p, 003 <br /> <br />813--1!!O..II020 <br /> <br />~~_t U'~7J.j~ <br />1~1-?1Il7ti~ "P515 <br />, " <br /> <br />= ~ec~~~i1_.~.["'C'''_ _ iii ,-~t..,..,.. <br />,'CCb1.h~' ~ . <br />I 76~3 'i:Q'}',. "~'lJ~ <br /> <br />OWner's Namli <br /> <br />I' <br />I . <br />, <br /> <br />Owr\e~ Add['l)S:; , <br /> <br />FM Simple "Ilenl;lld~~ ~rna' '. " " <br /> <br />Fee SImple TlIIt!llloh:l,r Addt_ " 'I ' <br />Qt'.- - -~!riI_""" fl I <br /> <br />J~bAd~~S'" [7{o~~' (:olLJ5Jvd <br />I ,',', ' ," <br /> <br />.-'--.. . <br /> <br />I l1t1eholoer PhOne Numbel: ,I <br /> <br />1__"'. '. <br /> <br />! ,1,1 <br /> <br />n <br /> <br />v--'"'~ml"iihl1r TI - . [J: ,,--- <br /> <br />':~:=--=:=" ~.:' ..' ~ I L~t: "[, <br />'~1: ~',!~2.;.,,;':1'''''' '"': ",Jr~, :. ,"^ "U'"'" ~ <br />, l' <br />, 0 r'\J~cInT'l\t . " i <br />, D Haz:aRltll.I:J Ml!lterllll (TIer II or ~~ FacDliy> ANN~AI. " <br />. D Hood llffillllaliDn , <br />o 'LPJNIIItur.~J ~s-Instan~tion <br />D I.pJNflhlntl ca"AN~UAL Sale' <br />o ~ 1)laceG ~i' ~.s5embly.,AN~UAL <br />D Recrea:UcrnalBllm, . . <br />: 0 SpaIillers <br />, ',: CJ s~n~~lr S~1Stem InilBllatlonl <br />, . ' , D S1anc!plpaiJ (Sprinkler Sye) <br />Cl Toroh f\'O::I!Ing <br />, , D Was16 "rim SlDrsge ANN~ <br /> <br />Sub Division , <br /> <br />1lIt!'t1l <br /> <br />.1L:"'UlU~- ... .! !1r# .~ 'W-~ <br />r-, Blo-Hazam Waste Storage - ANNUAL. <br />~mm E!~~i:h~~ Hci~dlO~ot ., " <br />C::J Cgntl'OlICld Bum . <br />[=:1 <br />[=1 <br />~] <br /> <br />. ~mergency GenerlltD~ < 30 kw <br />, , ' <br />Emttglnoy Gtn~rBtor)> 30 ~ " <br />FIre Froteclion' Maln,tenam:e - ANNUAl. <br /> <br />,I <br />. t <br />f <br /> <br />'. <br /> <br />~prlnl<ler " 0 <br /> <br />~'Fl" 'D" <br />'" '-':dC: SUPP~~ 0 ' <br />rm InstaliaUon " ' <br />'FIre PLlJT1PS ' ','. <br /> <br />I <br />, <br />I, <br />, . ' <br />'I. <br /> <br />" <br /> <br />[---I <br />, ..-... <br /> <br />[:J <br />C:J Fire Works <br />r"J Flllmmeble Appll~t1on. ~NIJAl.. <br />" . ,[~J Fue[Ta,nks . , <br />r-J other: I ' , <br />SD3l~U v~~~~ ~ I!I j - ~~~~~~1-cfix1;rw.;f! <br />=: j~~~,~it;.b..... 'I:.~..~~, <br />, Addres",!~:-"~-~ ~t\(~l1f1l;~rntl"""j . u-.~ 'Ii <br /> <br />~LI;C1RIClAN ,,' , ,"', I , , , . ' , CC,InP'nl' 1: : <br />Signature' L_ . , ' , .' , .. ' " , Regi5U't'lJd Y I N I Fee CUJRint <br /> <br />Addl'8lfi [---- . , 'j' ' Llce~5f>~.! I . ,. <br />I . .....~_ " <br /> <br />FI.U~BE~ '/--:: I" , Company "'I ,,;,' .: ~' <br />Sign:llture . ::::~-.-: ' 'Re,glsblrncl'l Y IN " . ... ou~ <br />. ~dd~Sl\~'I::::: II.. --::' ~ i .. ~ <br />'MEC~ICA , Company,.,'.:.. , '; <br />. Siprmur. "'0 ' ,ReglttOl'~~ 1 . V 1 N : . Feo """'I"' <br />A~dresr;. L., :- I' Ucenlll rJ . : <br /> <br />~~:~ ' C- ~~ 1 ~:=:~ I Y' N Fee curr~nt <br /> <br />,...... <br />~i;;~~~. ..-~--. ,~.., 1" ~J <br />re 11$:., . <br />, 1'111 out i1Pplica/lcn compIertaly.. '.. '. ", , , , , <br />"Volner & oomreCllor Ilsn _ok.of applloallon, -notarlzetl (Or, copy or 51~ conlr.:.G!: with owner) <br />1'( .;IV<< $2600, a,Notice of Commencement is l"8qund (Mechanical work 0\1." 5SL'OO) <br />Supply two (2) sets of dlllwll'lSl.wth applicable documentallon <br />Allow 10-14 d8)'8 farreviswaftsrsubml1i2l dam. <br /> <br />{ I <br />I <br />, <br /> <br />. I <br /> <br />C""''' <br />, ' . <br />, , <br />. -~..:~..: <br /> <br />I .' <br /> <br />, I. " '. <br /> <br />1 . Valuatior of, P;.oj~ct . <br /> <br />'j <br /> <br />'~; J <br />IN, <br />f . '. - -, ' <br />" . <br /> <br />~, I:=: <br /> <br />. " <br /> <br />l. Y IN I <br />J <br /> <br />:::: :. <br /> <br />I <br /> <br />" <br /> <br />Y/N I <br />I. <br /> <br />lh <br /> <br />1~~- <br /> <br />I <br />II!IllJl'.r.1' <br /> <br />,! <br />