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- MAR128/2007/WED 07:20 AM ZEPHYRHILLS Bl1ILD1NG EAX No, 813-780-0021 P. 001 <br /> 81�78o-onz0 City vfZAphyrh1116Fi�er Fax.staaeo-ao21 '!; <br /> Penntt Appllcation .__ <br /> Date Receiv9d •Phona Confacfior Pam►It � <br /> Ownere Narne Owna's Phono Number � � <br /> . <br /> Oumera Addresa <br /> Fee simple Titleholdor iJame � ' ' Titleholdar Phone Number � � �� <br /> KaeSimplelltleholderAddress • � � ` <br /> Job Addres9 ' Lot� <br /> 5ub Diviclon Perce11F <br /> � Blo-Hazard Weete Stocape—ANNUAL ` FumlqeUon 7ent , <br /> � Comm Fxhaust K�cfien HoOd/DUCt � Haardous Mate�lal(lier II or RQ Fedliry)ANNUAL , <br /> OConiroNed Bum Hood fnstalletbn <br /> � �mergency C-,anerator<30 kw � Q LP/Natur'e16es-Inatallatlon ' <br /> ••� �•Emergency Gensrator>30 kw � ,LPMatursl Gas-ANNUAL Sals , <br /> FtreProtBCtionMal►►t9nence=ANNUAL . � PIaCCSdAssembly-ANMUAL <br /> �I�' �' �L___� C� t 'of�. <br /> sprinkle� Reoreaaons�sum . <br /> � Fre Alerm � ❑ f7' ❑ C� � SpwMors : • c���l„nl \�� � <br /> Hood qeanin ❑� ❑ p 3prinider'S tem Installations '�Jf ��U.(J U <br /> Haod 5uPP+e slo� � p D o � � Stendpip SprhNclerSys) � �y 1 tS I� <br /> � Flre Alarttt InBtapaflon � TotCh Roo$nylTM Ke@le , � <br /> Fke Pumpa Waate Tho Storage ANNUAL <br /> Rre worko � <br /> Flammabie Apnficauon-ANNUnI • Valustion of P[oject <br /> Fuel Tanks <br /> Q • Other: � . <br /> Contreclor t . Company 1 <br /> Signawro ' Ftegictared N Fee Current /N • <br /> Addrasa License# <br /> EI.ECfRICIAN � COmpenY <br /> Signatutt Re9�s��aa• Y/N Fee Curtent, Y/N <br /> Addrese Licer,se�i ' <br /> PIUMBER Company <br /> Slg�ah,re � Raplstered Y/N Fee Current Y/N <br /> Addross � Llcenae� • <br /> MECHANICAI_ ���y <br /> signature Rtg[stered Y/N Fao cument 1(/N <br /> Addreas •Lbenee# <br /> OTHER ' ��y • <br /> Signature Ftegiefered Y!N Fea Curtent / <br /> Addreee - Ltcanoa# � <br /> D�f9c1Wh5. '� r wsy I�W� <br /> FlU out application complately. <br /> Owner b ConlrACtor eign baok of applicatioh,nola�kted(Or,eopy of eigned contrad wlth ovimer) <br /> If over 52500,a NotlCe oF Commshcement ia requlred.(Mechenical work ovar 36000) <br /> 5upply lwo(2}se�of dtawinpa vnlh appllcable documentadon <br /> Allow 70-14 daye for revlow atter submiltal dale. Peicel#-obtalned from P�operty TaX IJOUce(httpJ/appteieer.pdSCOgov.com) <br />