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<br />JUN/26/2007/TUE jl:09 PM ZEPHYRHILLS BUILDING <br /> <br />FAX No, 813-780-0021 <br /> <br />p, 002 <br /> <br />'~,i .~.RecejV8d . '/ <br /> <br />Owner's HeIne ~ T <br />Owf\8r's Address .5 OJ 3 ~5 <br /> <br /> <br />City of Zephyrhllls'Fire.: '. . <br />Permit Appicatlon <br />. :.' ': -., . :Pt;;):~for Permit ~ <br /> <br />~. ~8 Phone Number .1 <br /> <br />1l.x..813-780-0021 <br /> <br />813-7SD-0020 <br /> <br />. ~~ <br /> <br />~.~ <br /> <br />I. <br /> <br />PaRl8l* <br /> <br />; : <br /> <br />J Lotti <br /> <br />I <br />l <br />r ' 1 <br /> <br />Fee Simpls T1l1eholder Nam. <br />Fes Slm..'lllIehoIdsr Ad.4I1lH r <br /> <br />:= I ~~E- <br /> <br />"T\tI~~ PII~ Number .I <br /> <br /> <br />o Bio-Hu8rd Wa&1e StarSllS ..ANNUAL :D Fumlglllion Tent .' <br />D' Comm Exheu&t Ki~" HoodIDuct . '0 Hazafdau& Materiel (TIer II or RQ FadIlly) ANNUAl... <br />o CQntralled Bum . D Hood instillatiOn <br />D Emergerq Genendor ~ 30 kw . 0 LP~\UI'al cm-InSlalldon <br />~ 'Emergency Gener*r > 30 kw. . D lP/NatWa! Gas-ANM~AL Sa. <br />. Fir~ ProMIellon MsinlItnance. NI~ I!!!!!J ~rm" '. . D . Places of Assembl)'-ANNUAL <br /> <br />Spflnkler '. ~. . ~ , ..0 '. D ~8um <br />Fire Alarm 0 0 .' D Spartdef's <br />Hood Cleaning 0 1:1 0 0 Spl1nkler Sy&18m In8IIlIIiIllons . <br />Hood Suppmeion. 0 o. 0 0 . D standplpss (Sprlnld&r Sys) <br />Fire AIann Inftllllslion '8 1'orch RoolIngITllI' KeltIe <br />Fire Pump9 Waste TiI'8 ~1I ANNUAL <br />FII1I Works. <br />F\ammIIble Applimian- ANNUAL. ) -J Valuation o~ Project <br />Fuellenka . <br />other: <br /> <br />co~r v . ~ny ., c.~..z:-~L~~/c.. 5eCu&ITY <br />Signa1U'e ^ c." . . . R8g1stered'. (Y>iNI Fee ClImlnI . ~ 1-' sY.5~. <br />EL=~'110 ;J. J.WIg. r~ I.kc:!1tt// :::r~.=:-1*E ~ta20':l4: : f..dC' <br /> <br />Signature L . -----=-.:.... RsgIslol1ld trrN _ Fee CuI!1ll1t _ Y I N _ . <br />AddnIIi& I r' Licsn&ef I l <br /> <br />= I 1 .= I Y/N r=.ec:unent LY/N I ~ <br />Address I I UClInIe" l I <br /> <br />==CAL! I :~ Iv I N I Fee CumIftt 1 Y'I N I <br />Addfe8a I I .licsnse , c::. I <br /> <br />:::.. I ~~ r YJN l'eeeun.nt V/N <br />AddAlA j I Ucen&8 fI ~ <br />Di~OI'\I: <br />F1I"outlllJlllllll:8tjon ~. <br />Owner & Connclor sign b80k at lIPPIicIItion. noIartzed (Or. cap)' of sIgnsd con1l'aCt IIVIlh 0WIl8r) <br />If over $2600. . Nab at CarnmencelY1lri "lWqUIred.(~I_rk _16000) . <br />Supply two (2) .... of dnIwing& with applicable daculMnlatlon . <br />Allow 10.14 da)'& for review.,. Bubmlllal d8le. P81'C9!i#.- obtained from PropenyTax Noitce (h1lp:/IappraIser.pucagov.com) <br />