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<br />2008,.J"11409 09:43 AM OunnWell Facilities Services 919-::66T.19 00
<br />.;. Ur,"'!-tJb/.l ,'1 LtiIJ U4: 'IJ. rlll L.r;PliYPJ11L~ HUILUING FA'X-N(I,'H13-7BO-0021
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<br />P, 003
<br />City ofZephymrlls FIre ' F~1~.!BO.(1021 ~1351
<br />. . , ' :permtt Appll:catl~1'l . .
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<br />Fee Simple Tt~'ol(J~r,Narne (',' .." ':] ~hold&rPhoneNumber L ! ,1,1 J- r ':'
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<br />Fee Simple 'l't ehold~ ,Morass " 'I, . ' ~~:~.-;..,; : :
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<br />:ob=~r;na~ N:7\ I_~:. .~~~- . ": 12.'["
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<br />~R_~ AWf l~ !if - n ''!:If' "'111 ~!!!9mlIl til, ~ , _~..;oo .., . i' ,
<br />.LJ Bto-Haurcl Waste ~~rage :~N,NUAL . C] Fl.If!1lsj:r.1lon Tent ' " . I " '
<br />[I Corom ~a~ l<:ltche':l HoodlOuot .. " 'CJ 1-la2alOO1JS Materlal (TIer II or ~~ flBell'> ANNU:'L '.
<br />o Con\l'Olllld Bum . CJ Hoot! Inman.UlIn ,
<br />[J ,'Emergency Seneratm; <; 30 kw CJ 'LPfNfn..ml1 C)ae.lnslall~
<br />o emlllrgency Gen~r2tDr ~ 30 ~ .- [] 1~l'Nlrl\lral Gla8-AN~uAt. S21e '
<br />[J Fire profeclion'Malrltenan.,.. ANNUAl. Cl PJa06<i ~ AssembIY..AN~UAL.
<br />~prtnl<ler D 0 I'\EIcw.$iicmal Bpm, , .
<br />. 'Fire Alenn, . .,.' D ' ' " C], S"'3JIr.lel$ : '
<br />. , Hood Cleanl6uppresslan 0 . ',' t:J S;~nlt1ltl' Sys\BTIlnstB11atlons .) " '
<br />[j 'Fire Alarm Instaliaiion [] ~~I)iM (Sprinkler SYl) : '
<br />D Fire f'umps [] Toml Flgoftng , :
<br />[=1 Fire Works ' I EJ WiIISUo '('Ire eton!lgt ANNUAL. ~
<br />LJ ' Flilmmable Appll~t1on:- ~NNlJAL. C' ......:. ] , {: " '. "
<br />[=1 F~.I Tanlu; , , , " ',' " valuatioh Qf Proj~ '
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<br />AddrClSU[,=== . 1 UCIMIII\III 'I: '. . r ' r .,' " ,. .' '
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<br />Signature . L,~ .' ~l$lred. Y I N Fee Cumint [. Y I N I
<br />Add,ms:: [ 'I' Llc~,d I ' I I
<br />PLUt:-16ER [. ,. 'ColfIl)6n}' ".~ ,'~' ' "
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<br />, MEC~ANIC'JI'l[ I. "'''"''''''' ..... ., :y: ~ ..
<br />. SigmRurll . ' Regilrlllmp. Y N . Fse ClUrIljnt
<br />A~~rCl;:1 l:_ J' ~cenoe to I 'I "
<br />OTHER [ ] com~ln)' I :
<br />Signature _ ReQl'rtlJ18d. Y I N J Fee Cc.lrr~t Y I N I
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<br />, 1"01 olltllr:tpllcallon compleia\Y.', '" ' , , , ' , , '
<br />OWner 5: Convactor .lgl'll:l,,~,ot .~pllClliion. 'ntltarlzed (Or, cop)' of eigne!;! oonfJact with owner)
<br />tr 0'<'81' ~600, a,Notice of Commencement la required (Meohan1aalwI7l'k over It!IOOO)
<br />Supply two (Z) sats at tll"lwiOS& M41h applicable dOCUl11entalion
<br />Allow 10-14 clays forrevlaWiI'fter 8ubmltlBlltata.
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