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<br />n /~In''-'' <br />..'':'/ L '_.".) <br /> <br />813-780.0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Ownlilr's Addre6s <br /> <br />I' n ,...., <br />J J : IJC <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No, 813-780-0021 <br /> <br />P. 003 <br /> <br />.Clty ofZ ) phyrhills Fire <br />Permit ppllcation' <br /> <br />Phone Contact fur PerrT1i~ <br /> <br /> <br />(pIa <br />I ~~4 K~JO up .(>1~V f? <br />..fLP6lJ~~0..v;O ... ...1... '. <br /> <br />I. :.' . :... .... .., . ..1..'," pSmll.# ./.... .'., .'~"" ",'., ' ". '." <br />: "(UtlIAIN~l.lFRU~fJKUPI;R y. .'AANOfll;l::) <br />, l 1 n <br />10 FumigatIon Tent .' .' '. <br />/' EL. twardous MaterLilI (Tl~rUotRQ F~eilitY) ANNUA~ ' <br />, D. Hood Installation " '.' '. " <br />, ,0 'LP/Na~ Ga&-Install~tion . <br />: ~,' LPI ral,GaS--J:oN. NUAL Sale, <br />'. Places of A5l;ernbly-ANNUAL , <br />. D Reerealiolllill.Bum <br />. D, Sparklers <br />o . Sprinkler System .lns~Uatiom; <br />D standpipes (Sprlnlder Sys) <br />D . Torch Roofing <br />'D Waste,Tlre Storage ANNUAL <br /> <br />Fee Simple Tlttaho!der Name <br /> <br />.... ~. <br /> <br />,Fee Simple Titleholder Adclress <br /> <br /> <br />. Job Address <br /> <br />SubDIvision , <br /> <br />tJ <br /> <br />.0 <br />D <br />D <br />D <br />.'D <br />"D <br /> <br />"'D <br />O' <br />D <br />o <br />D <br />D <br /> <br />Contractor I <br />Signatur,' " . , <br /> <br />Address j. <br /> <br />E,LECTRIC. IANI <br />Slgl'lalllre , <br /> <br />. . AddTEi6s " <br /> <br />,PLUMBER' ' .' <br />Signature " <br /> <br />Address i <br /> <br />MECHANICAL .' <br />., Signature . <br /> <br />Addresll <br /> <br />Blo-Hazard Waste storage ;, ANNUAL ' <br />" Gomm Exti"aust Kitchen Hood/Dud <br /> <br />. Controlled Burri . . <br /> <br />EmliIrgetlcy, Generator '<: 30kw <br />Emergency G8neretoi>'~ kw' <br />, I=lre Prqteelion MaintenanCe - ANNUAL <br /> <br />Sprinkler <br /> <br />'0 . <br />D. <br />:0.' <br /> <br />Fire Al3rm <br /> <br />. Hood Clean/SUppression. <br />Fire Alarm Installallon <br /> <br />Fire l"umps <br /> <br />Fire Work6 . ' <br />. Flammable ApplicatiQr>- ANNUAl. . <br /> <br />Fuel Tanks <br /> <br />Other: ' <br /> <br />.~ '. <br /> <br />OTHER <br />Signalllre <br /> <br />, Fax.-813c780"0021 <br /> <br />flf7w:' IJ~)" <br /> <br />I. <br /> <br />, "/]13' <br />7-fp~ '}(~ ~ . f"l J <br /> <br />1J18'~ I ]~lo.<.f31 <br />~~5l{~~ 1 <br />" .Lot#. '.1 I <br />I <br /> <br />:..~~ <br /> <br />f' <br /> <br />l ' Valu.ation of Project <br /> <br />~;::~~d '::1. <br /> <br />UCElnse # I <br /> <br />~;:t:d'J <br /> <br />. Ueense t# .1 <br /> <br />co~panY"',1 <br />RegiStered , <br /> <br />l.icliIn6li!# I' <br /> <br />,Company '1 <br />Registered. , <br /> <br />License # I <br /> <br />Company. I <br />Regll!itered <br /> <br />Y/N <br /> <br />Fee Current Y / N I <br />I <br /> <br />-, . l=eeCurrent ../ ~y INl" <br />I <br /> <br />Fee Current , '" Y / N I <br />I <br /> <br />I <br /> <br />.Y/N <br /> <br />Y/N <br /> <br />, Y / r-r-I. Fee ClllTent <br /> <br />Y IN'I.' <br />I. . <br /> <br />Yi N I, Fee Currant r Y I Nl <br />