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11/13/2013 16:40 7275310596 COMMERCIAL FIRE PAGE 03 <br /> 813-zeo-aQ2o City ofZephyrhitEs'Fir�• F�.���7�o2i <br /> Pennk Appllcetfon <br /> r------�• <br /> �ta Roeelvcd • .Phori9 Cohtectivr Penr+lt 'pZ, <br /> �vners Name Q, • � Own�s Phone Numbsr . $'�� �.� <br /> vners Address ���^��� � g <br /> e Simplo Tldeholder Narmo TMleholder.Pfmns Number � � � <br /> e SkfTiAle T1Ueholder Address <br /> �Address Sa�) �- �� (��o�.�. � r�c�. � <br /> S� Lot# <br /> b Divi9lon p��� ' <br /> Q BlaHazarr)Waste Smrage-�IANNUAL �� pumlgatlon Tent <br /> � Cemm Euhoust Kltchon Hoodlbuct � � Floz�rdot�s INatariel�Tler II or RQ Faclllty)/WNUAI. <br /> � Contevlled Bum yupd Ins}alletlon <br /> QEmergerny Generator<3p kw � I.P/Natural Gs�l�liatlon <br /> Q Emerpency Genorator a 30 leuv Q LA/Natural Gea,ANNUAL 9ale <br /> � Fira Prvtec.ylon Matrxenance-ANNUAL � Pleoee of Asaetnbly,qpINUAL -.� � �"f <br /> � errn � r (� <br /> Sprinkler n p O D � � ReaeaHor�al Bum -{�J 1 <br /> a � � �� � l � <br /> Fire Alarrn s��� _� <br /> ������ ❑ o 0 0 � 0 s,�s,�,,,M��� ��! j � 17 �� <br /> Hood SuPPresalan � O ❑ a � ..� � SbndplPes(9v►�nMerSY:) '�"f <br /> � Fire Alartn Instatlation � Torch RooNnglTar Kattle <br /> Fl��m� � Waste The SWrage ANNOAL <br /> �He works ' <br /> Fl�rr�mable Applicatlon-ANNUAL (� � � Valuation of Pro�ect <br /> Fuel Tanks <br /> � �1e � <br /> nrectcr <br /> �y SOc�[I1 p Z� <br />'B� ' Reeh�e�d Y!N Fee C�merd Y N 1 <br /> /+ddrasx ' ��T.� <br /> LJcense� • <br /> EG"TRICIaN • �. .� � <br />�� � ' Repts�rsd Y/N Fsa Current Y/N <br /> Address <br /> LlCerue# <br /> IMe$R ��nY _��,_,,,,. <br /> re�re <br /> �91st�ed Y/N Fae Cu�mt Y J N <br /> Addreas <br /> lacerne# <br />:HANIOAL --- <br /> NO. 045438 <br /> COMMERCIAL FIRE <br /> & COMMUNICATIONS, INC. <br /> PO.BOX 1350 REGIONS BANK 63 4ss <br /> LARGO,FLORIDA 33779-1350 s3i <br /> PHONE 727-530-4521 <br /> � . • <br /> ZZ ���'•/�Q1�_; cL1. �� <br /> �'IFTY AND t�t�/ ] t�t� Di�LLt�RS <br /> COMMERCIAL FIRE&COMMUNICATIONS,INC. <br />�E c;I7`Y MANAGER <br /> IOF 5335 8TH SThEET - <br /> uEPHYRHILL�+ FL -;354� M' <br /> AUTHORIZED SIGNATURE <br /> ii'04 54 38��' �:06 3 L04668�: 00 56 3 2 5 3 20��' <br />