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<br />APR/II/2007/WED 02:41 PM ZEPHYRHILLS BUILDING <br /> <br />813-78()'()020 <br /> <br /> <br />P. 004 <br /> <br />F~-813-780-0021 <br /> <br />. '1.. <br />.", <br /> <br />::i' <br /> <br />Date Received <br />. <br /> <br />Owner'5, Name . <br /> <br />Fee Simple Titleholder NaITlB <br />~ee Simple 'TItleholder Addre88 <br /> <br />FG a <br />TltIehold~ Phone Num~r . L N,{] .L <br /> <br />J'L <br /> <br />OwrIer's Addre&& <br /> <br />Job Address <br /> <br />Sub Dlvlslon <br />i JI <br />D <br /> <br />.~ <br /> <br />Or <br /> <br /> <br />. \'"1,;1 Is' FL. 3~Yo <br /> <br /> <br />PBrceI #. <br /> <br />Cof\trIIctol' <br />SIgnature <br /> <br /> <br />i <br />. Bio-Huard W88te Storage -ANNUAL 0 <br />Comm ExI1sUlit K1t!ltlen HlIOd/Duct D <br />Contrallfld Bum 0 <br />I::rnergenoy Gensta10r .:.: 30 kW .8 . <br />erriBrgencY Generatei' ;>0 30 kw <br />Fire Protection MalntenallCle - AtlNUAL , <br />. ~ 'I!!!!.I ~ IUIfIIlI' . <br /> <br />:~:~ ~D ~ ~ ~ ~ =natBu~ <br /> <br />Hood ClMni~ 0 CI 0 t::J. Sprinkler Sy8Wm InstaIlaIloII& <br />Hood SuppnnWon tl X [] 0 ~dplpee (spdnkJer Sys) <br />FlreA~nn'lnstalllltlon eWe- ~ocJ o..lr~j ~ E3 TOl1lhRoofing/l'arKettIIJ <br />Fire Pu~ .~' I ('\ sp~.c.:\.-'I~" ~ '" Waste Tk& Storage ANNUAL <br />Fn \lYcrb \ loB n:::..\: "'~\., \Nt.. ~ <br />Fl8mmabIIiAppllcaUon-ANNUAL "~c:k.J,' 0" PlV:-~'+ J$IO~ Oc:> ,I Valuation ofProjeQt <br />J=U81 Tanks <br />Other: <br /> <br />F~mlga~n Tent <br />HlIZaIdous Material (TIer Il or RQ Facility) AIoINUAL <br /> <br />Hood Installation <br />LP/Natul'l.l Gas-Installation <br />lP/Natural Ge&-ANNUAl ~ <br />PlslHlS of Ae&lirnblyoANNIJAL <br /> <br />II <br /> <br />I <br />l <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />, = IE~~.J~~~~I~~~.e~'pl~" <br />'... L~#_, .101.;l8JCDOOI (9~1 ] <br /> <br />::cs F-v I N-:]F..c~ C Y I ~ <br />Llcelllle " I I <br /> <br />=':ct rv / N F.. CU1TerIt -, V / N I <br />license # L -J <br />f-~/N <br />I <br />=1 V/N <br />LIcemIe * -l <br /> <br />Address <br />El.eCTRlClAj <br />Signature <br />'Address L <br />PLUMBER I <br />Slglllll;lr& <br />Add.... f <br />MEOCHANICAL[ <br />Signature <br />AddlU5 I <br /> <br />~~'I' <br />AddIus I <br />!lre~onli: <br /> <br />Company <br />Rsgl&tered. <br /> <br />, LIGeI1&B # <br /> <br />~ <br /> <br />F.. C\Jr\'ent l-.Y' I N ) <br />" <br /> <br />F.. CUl'I'ent <br /> <br />1- V/N I <br />~I <br /> <br />Fill out applieQon campletely. . . . <br />OwrIer " C:~r sign baok of 1lPPI1aatIon. nclarizIId (Or. copy of sigl1lld contI1ICt with owner) <br />If over 12600., NQ\toe of Commencement Is required,(MeohiI~1 WbIi< over $GIlDO) , <br />Supply two (2) 8Bt& of dtaWlngs with .ppli~b" documentllliCKl . . <br />Allow 10-014 days for revl_lfter submittal date. ~I i# - obl&lllMld fmm ~perty TIDC NotIce (http:t/appnllllier.plllCOllOV'.com) <br />