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From• , 06/06/2011 Q9•43 #363 P.0011002 <br /> a�saeo-oo20 Ciiy of Zephyrhills Fire Fax•8i3-le�-oo2� <br /> i'ermit Applicaaon <br /> te Reodivetl Pi�one Cpnfact fo► Permk rf ��� , � J <br /> � �•• n.t��JV' 2'W9,M.: � .t7SGWy.r:4a .. . .. . �k1'nIAVR[lr <br /> mer's Nema CS �� �'�l Ovrner's Phon� Number ��� <br /> msrs aadres6 3� � L.4ke 31 ��3 �►tl � l 1��' <br /> a Simpie TiHeholdor Name Tdi�hddor Phone Numbar �� � <br /> e S'Mnpte Titieholdsr Addrasa <br /> :'z�:-;`•,:�:tk�,�3F�i�.A�.'� , " ••i��;afN�Ft'1k�1�1lIMI95��ie��'�E+�%��;;a'*;St�M•x.F'.9i+r; <br /> >��� `7q� � I 13� . ��p.h �Rt+tlls �L. � �t# [� <br /> b Division 4�t S Psrce� # <br /> W7�A, ..'!��(J4.eU� . .1� :�:. . . :'N <br /> a Bto-H�rnM Weate Stor�ge -/WNUAL ��umigslion 7ont <br /> � ConYn Exhaust Kltchen HoodlGuct � HaYardeus Materla� (Tler I� or RG Faciiity) ANNURL <br /> � ConUofled Bam � Hood k�stalta0io�+ <br /> � Eme�gencv Gene�ata < 3o kw t.PM6Kur�1 Gpe-hstalbtlon <br /> � Ertw�gency Generatot a 30 kw lPMatunll Oas-ANNt�AL 5ale <br /> � Fire PrptecUon Maln�rence • ANNt1AL Placas c/Assembly-JWNUAL <br /> � �� <br /> SD►�nk19r � Q ❑ Q� � 1ZeC/e9ti0nd1 purA <br /> Fi�'V Alamt � O D O� Spark)ers <br /> Hood Clesnfig �❑ Q p� g Sptinldat Sysfem Installadorro <br /> Hood Sur�vression � q O C] Q Q StartdplPes (Sprl�kier SYs) <br /> � Fire Alann Inatapation a Torch Roofing/Tar Keak <br /> Fir� Purnps � wasce nre sw�aoe r�NU� <br /> � Fire WoAce <br /> flamma6le AppNeatlon- MlNUAL Valuation of ProjeCt <br /> a Fuel Tanks • •• � �� <br /> � Other: – � � <br /> �IS: N :'�,Iki,'I Y.{y�y'M . ly{ .�,�w � <br /> �V:. :fli4ik�C':'.{i.!.`.1.�lI(4 �k^.'�al.r <br /> H1�6N �� Cpll�gAy } � • <br /> ��� Registered Fae Cument N <br /> Md/ESS � LioenSe �F <br /> .ECTRICU4N �mpARY <br /> �nature t�tegistvred Y/ N Fae Cunreru Y! t� <br /> Add°°SS Lltanse # ' — <br /> ,UMBER �P��Y � <br /> �""i"''Q Re�ktsnd Y/ N wee cur�snc Y I N{ <br /> Adprass �iearqe N <br /> 2CHANICAL ComoanY � <br /> �'��'° Re�tstered Y/ N r-�o cu►�era Y/ N <br /> Address Ucense # <br /> r►tsa C�� � <br /> �nature " Reglaterod Y/ N Fee CuRer►t Y/ Ai <br /> Address ' <br /> ��. � . �P::T�.... •• .nv�w�rn � •..... � ...r.v. _...� ... ....�a^r 1 '1� <br /> �.ICCIIS6 # �� <br /> . , ..� ... .w,,,. „N,.., . , .. . , „ . , <br /> �ections: .. . .. . .. . . . . . .. .. . . ... . . . ��r�^ , . <br /> Ftl! o� appfiqqpn ��vly. <br /> Owner & Contraator sign back of appliCaEion, npiarizec! (Qr, copy of siqrwd cantract with owne�) <br /> If over 52500, e Notbe af Commencement Is requkad (Mecnankai work over S5o0o) <br /> Supply two (2) sets of drawlrgs wNh nppqcYble documantsupn <br /> ktbw 10-14 days for revlew aRer submiltal date. Pareel #� obtalned from Proprrty Tax Notice �httpJ/appraiser,pascogov,com) <br />