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11n/IU /ZUUI /i+IUN 11:44 A_M Ltr.tillft11LL;3 litJ1 Li) IP& NIA NO, if1J'1J1.1-UUL1 t� r. UUL <br /> 813:760 City ofZephyrhfls ll 0:::.: T D Fax-1313-780-0021 . i!s i <br /> - Permft Appllcatbn. .. -: sae <br /> Date ed Receiv _I f 'Phoria cnntectfor Permit • L1 1 <br /> Owner's .lame /� 11 Owner Phone Number 1.-/3 ` ^ { O / G CI <br /> Owner's Address 712s' Co / / 73 /v - 26 - /// r --5-5-4 <br /> (• t b <br /> Fee Stmplel ltlehelder Name I_ I TitIAholder••Phone Number I i ,) 1 1 1 <br /> Fee Stmpie`ltleholder•Addreea 1 • 'I <br /> :.:. ... VIIMENNIMININI <br /> Job Address _. _ -. _ 1 tot# 1 I <br /> SubDiwialon >> 1 - Parcel # .1--- <br /> D Rio -Hazard Waste Storage -ANNUM. • n F umigation Tent - <br /> R - Comm Exhaust Kitchen Hood/Duct D Hazardous Material (Tier II or RQ Facillty) ANNUAL. <br /> r:--1 n H ood Installation <br /> Corrtrdled Bum• <br /> .1=1 Emergency Generator.< 30 kw r} . LP /NMWral Gas- kwtailation C4-641\11 / <br /> VC-) <br /> Q •Emergency Generator P. 30 kw n L P/Natural Gas- ANNUAL Sale / / `� / <br /> U Fire Proieo6on Maintenance - ANNUAL • D Places Of A6sernbiy- ANNUAL $ n c- <br /> Sprinkler 0 ❑ ❑ ❑ ^ n R ecresUonai Pup. /// 7/// <br /> Flm Alarm ❑ ❑ ❑ 1 .' • 1 1 Spurs <br /> • <br /> Hood gsarang ❑ ❑ F l sprinkler System tnstallallons <br /> Hood Suppreeeion ❑ 0 ❑ ( Standpipes (Sprinkler Sys) <br /> • 0 time Alarm Instillation = Torch Rootingft ICeate <br /> III R Ma Pumps © Waste The Storage ANNUAL . <br /> Fire Works • <br /> ") Flammable Application- ANNUAL r •$ Valuation of Project <br /> R Fuel Tanks <br /> Other. <br /> Contractor SIgradure r / - Registered Y1 N 1 Fee Current I Y/ N 1 I <br /> Address' /'C' /•3 c (t 30-7 7 , ' . j �„ License# _ I • -- <br /> ELBCTRI L/� /L Eli 'Vol, - / - 3 i & G7 . rY IN I Fop I ee c u Y / I <br /> Signature � 1 <br /> Address I I - • license* —..-1 <br /> • <br /> PLLINBER Company I. <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address License# I I - <br /> • MECHANI <br /> Signalize - Registered I YIN I . Re Current I YIN I { • <br /> Address I - - License# <br /> OTHER I Registered Fee Current S nt t'l� Signature ure istered - <br /> Address License# <br /> „ . <br /> bueotloia <br /> FM an application completely. - - <br /> Ow Owner 8 Contractor sign back of application. notarized (Or, copy of signed contract with owner) • <br /> if over $2800. a Nonce or Conurmnceorent ds r egrdr d.(Mect>arrr aI work over $5000) - <br /> Suppiy two (2) seta of drartm s with applicable documentation Maenad A - rJ ,tatn►d from Property Tex Nadce /a r rr oom) <br /> AUkwr10-14Auntie review.P — ( ppmtee .pastog e <br /> STEAM & PRESSURE CLEANING <br /> Building Exteriors Air Duct Cle <br /> Exhaust Cleaning <br /> Hiigh Rise <br /> H <br /> Commercial Sidewalks <br /> Industrial Concrete <br /> Bruce Anderson _ .. _. _.. _— <br /> Phone: 1-888- CLEAN -18 Licensed, Bonded, Insured <br /> Cell: 863 -224 -1155 Serving Florida Since 1989 <br /> Email: preeeereeerrfatempeberaceeni <br /> �7 Free Estimates <br /> i3d•vct_ C' /z"SSvteS —G/V. Nr / <br />