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<br />MAR/04/2007/SUN 04:52 PM <br /> <br /> <br />81~780-0020 <br /> <br />Rbn R8c&lved' J, ' <br />ewner'li Name <br /> <br />ewn.r'. Addl1lU <br /> <br />ZEPHYRHILLS BUILDING F~Y N~ Q1Q_7Q~_~~~' ~ ~~~ <br />City of,ZePhyrhill~'~:~: ... '~' w ~~;( '1"' \ I ~ ....:~;:"" <br />Permit Application ( ~ _ .:\!il <br />, ," - .p~ Co,.ctfor PIIf11l1t 117 g' -=u Y' 8 8' JJ 7 5 ~ 7 " <br />. 'I " .,:.:"', <br />,8; .37 7/ ga~~ ' <br />;300 4-5 <br />/I <br /> <br />Vl <br /> <br />F.. SllYlplll TItleholder Nfrme <br />Fee Simple "ntIeholder AddI'8l!' <br /> <br />Jr <br /> <br />'" I <br /> <br />OTHIER <br />Signabon <br /> <br />Ad,"" 11 <br />otri.cuons: <br />FlU OIUppI1oaUon oamp1etely. <br />awn. & ConIraaIor etgn beak of~. I10tlIltDd (Or, copy of algned contnaot with owner) <br />If over $2eOO, 8 NotiotI of Commenoement II reqYiIWCl.{t.ted1an\C8I worlc owr $mO) <br />Supply two (2) .. of drawlrJgl with IppIlcIIble documentlllon . <br />AllOW 10-14 cWyll for revl" after ,lbnIttal d.... ,"-reel # - Qbtalned flum ~ Tax tolatIce (ht1p:II.prnl..r.~lClOVov.oom) <br /> <br />Job Address <br /> <br />Sub Dlvlllon <br /> <br />n <br /> <br />s <br />"~ <br />rCJ <br />r= <br /> <br />Contr.otor <br />Signature <br />Addtu. I <br />EI..~cmlc1 <br />Signature <br />Adclnl.. I <br />PL.UMB!R I <br />Signature <br />AdcII1IA r <br />MeCHANICALI <br />Slgnatu.-. <br />AddreA I <br /> <br />I <br /> <br />R 335'/;)- <br /> <br /> <br />F'IIrctNtI <br /> <br />8~Ha2:Ml wute a~ -.AMNUAL , <br /> <br />Cornm E;xhaust Kitchen l-\QadIOuct <br />Controlled Bum <br />EmtnVenCy Gene~r < SO kW <br />E/ner'gl!Inoy Genlnlor ;lo SO kw " <br />FIre Protecllon ....lnteruaftC8 . NfNUAL <br /> <br />"'~~~! <br /> <br />'aI c' ~ <br />, DOC) <br /> <br />'8' Fumigation Tent ' ' <br />, Haamou. Mate, 'o.l (n.r 11 ~ RQ Facility) ANNUAL r. ) <br />, Hood In&taIIatIon ' ' , 'lP~ <br />8 LP~I eu.ln8tallaUon ' 3~' 1) <br />, ' , U'/NaturaI Gaa-ANNUAL SBle '/'\ 0 i 1 <br />, . PI.ces of Adembly..ANNUAL '\ I <br /> <br />",~,~8um . <br />" Sparkle,. , <br />, 'Sprtnkler sYstem ~~8 <br />, ~ (Sprinkler Sya) <br />o Torah RooftngIT~r K4IltIe ' <br />D w... '\'Ire Storage ANNUJ,.L <br /> <br />r <br /> <br />~ <br /> <br />Sprinltler <br />fire Alann <br /> <br />Hoed Cleaning <br /> <br />t-toOd Suppmslon <br /> <br />Fire Alann Instau.tlon <br />Fire Pumps <br />Fire Wolfc8 <br />Flamrnabl. Appllca1lcn- ANNUAL. <br /> <br />Fuel Tanks <br />Other: I <br />. I <br /> <br />J V81~an of Project <br /> <br />I <br />r 1 n <br />= Pt~j~~"~~~,~CU\J~ <br />__,l..ice~f_, .1 I <br /> <br />= j Y/N fWCutlent I Y/NT <br />LleenM '" L J <br /> <br />=t Y/N I F..eurr.m 1 :ViM I <br />i.JCenSII III ' { = J <br /> <br />FV/N I F..CUrrenll Y./N\ <br />[ = I <br /> <br />I .Y / rt,,1 <br />, <br /> <br />I <br />,) <br />J <br />-I <br />,I <br />I <br />I <br />I <br />I <br />! <br /> <br />] <br /> <br />~ny <br />Regleterlld <br />'L.l~#, <br /> <br />~ <br /> <br />Comp8ny <br />RIIglatered <br />LIeenH ~ <br /> <br />Pee eurr.nt 1 Y / N I <br />.\W <br /> <br />01-05-2003 07:13 <br /> <br />PAGE3 <br />