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<br />FROM <br /> <br />R&L CLEANING <br /> <br />FAX NO. <br /> <br />813-737-21218121 <br /> <br />Ma~. 1216 21211218 11:28AM Pi <br /> <br />F.i~:,..7So-002[\ <br /> <br />City of Zaphyrl1i~ls ;:. ir(' <br />P:;rmit ~.:i..p~~!G~~tlO~.' <br /> <br />tf 1~3V <br /> <br />r'i'1x-I:i'L;F{d(I-IIi.1~~ <br /> <br />. .~IL".-U='= <br /> <br />"l"t~' i<2c"'.lvSd) .\ .' PI'?~~ ccn;:;:c1 for.Psr:'!;i: <br />.:':"~":~'--~M~~'~"'" .~:-.r_tW.""""'''oI_"""","",",~' '':'.'~.;..~~~~~~~..::.~~l:''r.~~_#.. <br /> <br />':;:::r'$ N<l~~ ., - . F-?a..~~ ~ ""~ > "'> \ 'Z1..Ac I {)...,~~h; Ono:!s f~r:lbSl <br />L)~s..O G~,,\-.t?-:\u; 2 ~~~,\\,>, \-L <br /> <br />. .- . <br /> <br />is\~ <br /> <br />II ""'\~ .~ <br /> <br />()wnil,'S Addrcss <br /> <br />! I <br /> <br />F('!r~ Simple 'Ti!leho!oe, N;;rrI~ <br /> <br />I I <br /> <br />~.~---..~-~ <br /> <br />i <br /> <br />Sub Di\~si"n 1 . <br /> <br />""~~.- .~."'~ . ..""--,- '"' <br />.0 BilrH22.2ro Waste Sii.:ll'2ge - ANNUAl. <br /> <br />~~~- <br /> <br />I <br />I Tilleho!der Pl":-one Numb€r <br /> <br /> <br />,....~~~~~~~~"].~;~~~-~,~~ <br />j Loti I <br /> <br />~. <br />Fee Simple Til1eholder Addt$$s <br />r~~~~~~.--~:.d:! <br /> <br />,..--..." - <br /> <br />Job Acidres.'< <br /> <br />. Parcel # <br /> <br />T t..~ 7"" <br /> <br />..,.J.~~;~~ : <br /> <br />{v~l.....IKl::w rKulVll'!KUt'!:~ll ,rIA NUllltCj <br />r: ...- __.__1- u ...._~.:--.....~,_..........._A.f.t...m-- <br /> <br />Sprinkler <br />Fire Alaml <br />Herod Cle::lrJSL.lp~ression <br />Fire A1slTn Insia~gr, <br /> <br />jI <br />~ <br />'I \ <br />t?SI <br /> <br />o :::umigatlc:1 Tent <br />o H~"'2TC:CUS Matenal (1:~ II or RQ FaaTII:y) M"NUAL <br />D Hoac! lnstalation <br />o LP;N.a~ Gal!.::l..et5f!ation <br />D LPINar.r.ll ~ANNUAL SaJe <br />o Places of ASsembly-ANNUAL.. <br />o RG-=r.;:a~r.31 Bl.:r:t <br />o S;lat<len> <br />D Sprinkler System Installations <br />o Slal".dplP=5 (S~nnl<:~ S>'S) <br />o lo:"e.1<\ Rc~fi.-:g <br />D Waste TIre Storag; ANNUAL. <br /> <br />.....---: <br />L..J Comm EJchaust l<It::hen l-lOO;:!jDllct <br />o Controlled ~lI~m <br />C Emergency Gel"lli::"atDr <. 30 ~ <br />D Emergency G-o...nerstor ~ SC h~' <br />~ R!'9 Protec'jon Maintenanc~ - ANNUAL <br /> <br />D. <br />o <br />o <br />o <br />o <br />D <br /> <br />Fire Pumps <br /> <br />FiTB Works <br />Flammable Appf=h,... ANN'JAL. <br />Fuel Tanks <br />Oi:ho....r: <br /> <br />! <br /> <br />. , Valuatiqn of Project <br /> <br />Cormaci.or <br />Signa!Ul'& <br /> <br />Address <br /> <br /> <br />--; <br /> <br /> ~rnpa.iy I <br /> Registered. ! Y/N <br /> . <br /> ~s#- "[ <br />I. ~m;lany I <br />Reg'.stei2d' \: YiN <br />'1 !.lcense# ) <br />I Company r <br />:LYi~ <br />. Registe;ed <br />I L.iCerl5e # J <br />I. company [ <br />I RegistefWd Y/N r <br /> I <br /> LJceose'i:. L <br /> <br />Fee Current <br /> <br />ELE:CTRICLl\N <br />Signst'.I/'l:\! j <br />. A.citlress I , <br /> <br />~~U~SER I <br />Slgnl~;um . <br /> <br />AdQl1;!SS ~ <br />MECHANICAL If"" <br />. Sigl18tur'e . <br /> <br />Adcll'e$s L <br /> <br />OTHER' I <br />Sigl1Cl.turC . . <br /> <br />Fee Cu~ <br /> <br />Y/N <br /> <br />YtN I <br />r <br /> <br />f <br />I <br /> <br />- <br /> <br />FeeCUTIilo"lt I <br /> <br />y~~ j <br />j <br /> <br />~ <br /> <br />ree Cummt <br /> <br />YiN <br /> <br />II!. .~re::J.-,. -'f .,~~' <br />PireC!;ar.!!: <br />rill OJ.r ap~lIc:at1on c:om;lle!eiY." . <br />9\\1ner & ~crrtr;lctor.Sign Cc:::" of a;:;fi::i!.tiC!~..r.o".anzed {o:-, copy Qf signoocl ~;t \~ O\\'!1er) <br />IT over ;2500, a Notice cf C::l,rnznencemer:: is .e:jl.:ired (Mech6nlcs! WG~ ;~.~ $5000' <br />Suppl~ b,vo (2) se!$ of dra~.m~ with a~PIicat:9 Coc:.!mt!lllallOll ' <br />~J19w "\ 0-14 days to: revIew Efier s:;i;;mj~ dare. <br /> <br />.. .......:.:....----.-'.. ........ <br /> <br />t <br />_:'_.~_.=- -=1 <br /> <br />C ' <br />ompany ! <br />R~.s'Sd i Y1N I FeeO~ LYJN i <br /> <br />I L.i~....:::..J.r _, :~.._._____.__......__ ___...:] <br /> <br />'WP'U;" ...~ <br />