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- 813 - 780-0020 Cry ofZephyrhillsTil Fax -813-780-0021 <br /> ParmitApplication - <br /> Date Received - PtleneConlactiorPermit - <br /> Owners Name �: • : • _ AMe a Phone *new 413 1 I7 P7 1 1 c?? <br /> owner's Address 138 4.3 / Nay S'l E Zc fah yr1 tlhf Fz <br /> Fee Simpe1MlehoiderNome f I Tilleholda Phone Number I I1 1 <br /> Fee SimplellinhotderAddress <br /> Job Address Lott <br /> Sub Division Pseei# <br /> [2:1 Bio- Hesard Wads Slone, -AN UAL El RiAgeMon Tint <br /> a Dawn 6heuat Kitchen Hood/Duct o Hazardous Materiel (liar M or lO Fd1y)11IMNlAL <br /> E l Controlled Bum o <br /> p Emergency Hood Inebrnallon <br /> Generator <30 k w LPINeltindElswinelainitan <br /> Emergency Generator> 30 kw LAMekaal GenANORIAL Sale <br /> Rre Pratedion kleinrnenoe- ANIMIAL Places ofAseandy NUAL <br /> EMS MIS OM is ate 0 0 0 M Recreation'. Bum <br /> Fie Hann 0 0 0 <br /> Hooaaasdrl9 0 0" 0 all SprialderSpilem rsilLI <br /> Hood Suppression 0 b 0 Standpipes ( +iderSye) <br /> Re Alain iateMei .n Torch lioaigffarKatie <br /> Rae Rasps D Waits Tie Stamp. ANNUAL. <br /> Fie Wain <br /> Flemmaible Application- ANNUAL <br /> Fuel Tanks <br /> 0 outer: I <br /> Contractor <br /> Signature ' 1 lieifalend I Y/ N I Fee Current ( Y/ N I <br /> 1 Neyhlered Y N_ Fee 8taierrt J Y t N 1 <br /> Addams I <br /> 1 License# ` <br /> PLUMBER I Company <br /> - Registered I YI Fes Calmat <br /> Address { (License* <br /> �1A I <br /> acre I I Company <br /> Registered Y/ N Fes Current I Y/ N <br /> Address I I Craw# I <br /> OTHER I - <br /> Signature ,,,lrC;tl,�l.-( 1 Company S.�..�R Fee ,,z E o <br /> ,Q <br /> RplpMed 1 _ <br /> _ Fee Ciebat N <br /> Address ilf7 .* i .'AIIIIIIIIII License# 40 00 <br /> FM out appilcelion completely, <br /> Omer a Contractor aim beak of application. rralarrsd (Or. copy of signed contract wlh owner) <br /> If over S2500, • Noise dtommarrowrrwrt is required Ginchenicel work over 85000) <br /> Supply law (2) sets of drawings war appMeable doormen dlon <br /> A1loer 10-14 dugs tormenter alter submits! date. Parcel .1- obtained from <br /> Properly Tag Notice (psafaar.Puecopovoom) <br />