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<br />ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P.002
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<br />City of,ZePhYrhillls'FIr.e.'"yf'. 155~ F811-813-7llOoOO21':I~
<br />Pennit Application ~ . 3~
<br />,;- .poor:;-eont.ctfDrPe~lt ~J7"2. -(~1liZ.' U ~~'YJJ
<br />;~~_17H-l'[3Z" n,50Cf~
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<br /> I Ucense _ '
<br /> "J Company
<br /> RegiBlBrfld
<br /> '~ ' Ucenee *'
<br /> 1 Company
<br /> , Registered
<br /> I Lice,.. it
<br /> '~' Company
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<br />
<br />FEB/25/2007/SUN 04:01 PM
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<br />613-780-0020
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<br />Date Received
<br />I ~,~ 'll
<br />
<br />Qwner'B Name
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<br />OwnIilr'S Addl'fi$
<br />
<br />Job AddrNIiI
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<br />Sub Olvlslon
<br />
<br />,L
<br />
<br />Bio-Hazard WB&te'Sto~e - ANNUAl
<br />Camm Exhaust Kitchen Hood/Ducl
<br />Controlled Bum
<br />Emergency GeTllll!'1ltcr < 30 kw
<br />Emergency Generator i>' SO 1M
<br />Pirg Protection Malntenarnlll- ANNUAL
<br />'D~~~,r9
<br />o C1 ,0 D t::::i
<br />'E1 ~ ~'~B
<br />
<br />D
<br />o
<br />D
<br />B'
<br />D
<br />
<br />Sprinkler
<br />
<br />FIre Alarm
<br />
<br />D
<br />..~
<br />D
<br />D
<br />
<br />Hood Claanlng
<br />I'Iood Suppl'N&lon
<br />Fire Alarm IMtalllltiQII
<br />Fire Pumps ,
<br />Fire Worl\&
<br />Flammable Applicallon- ANNUAl
<br />
<br />
<br />Cgntractor
<br />SigMtUrg
<br />
<br />Addre&ll
<br />
<br />ELECTRiclANj ,
<br />Signature _
<br />
<br />Addrssa C
<br />
<br />PLUMBE~ 'I
<br />Slgnaturg "
<br />
<br />, , Address i
<br />
<br />MECHANICALi '
<br />Signature L'
<br />
<br />Addl'N&. r
<br />
<br />OiHER [
<br />Signatul1!I ~
<br />
<br />'Add.!:e:!:
<br />Dlreo~:
<br />
<br />. ~'
<br />
<br />D. Fumigation ient . ' ,
<br />o Hazardous MatBttal (T18I'11 or Rq Facillty) "NNUAL
<br />D' 'HOod In'lallatlon " , , .....
<br />8 l.P/~tural Gaa-lnatallation . ' ' ...ll..{JJl t \ ~t (]J
<br />" LP/tllauiralGlIi.-ANNUAl8ale \ \/~&. 0,1/5 z,.
<br />G2f PlllC8S of Aaumbly-ANIlII,IAL '
<br />
<br />'~=- . .if;ll \ 3~ tJ
<br />. ,'SprlnklerSystem In,taUatlolll ,-\ . . " , '1 L
<br />standpipes (Sprlnklsr Sys) ,St,l).' ~~, , .;
<br />DTorch RoofjngITar Kettle , ,_ l~ ;,), i /.
<br />,D Wute Ti~ Stonlga .uaNUAl. " , ,p.} , 3') I ''1
<br />
<br />,I V~of;';'~~ Ut'J-
<br />, ,~(J~
<br />
<br />
<br />I
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<br />
<br />Fee Cu~
<br />
<br />F.. CI.Irrent
<br />
<br />Y/N I
<br />J
<br />
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<br />
<br />All out appllcB1lon cOmpllllel)', '
<br />Owner &. Conwotor sign back of applicetion, notartzed (Or, copy of signed c:ontnlct, with owner)
<br />If ovsr $2eOO. a No1lee of Commencement I, requil'lKl,(MeohanlcBl WD/1( over $$(00) ,
<br />Supply two (2) 1iIet& 01 drawlngl. with applicable documentation, ' ,
<br />Allow 10-14 days for review after :submltllll date. Parcel1f. - obtaloed from Property TBlt Notice (htIP;//apptalser.paeoogov.com)
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