PDF-XChange Viewer is a fast and lightweight PDF viewer with a lengthy list of useful features.
The program loads even the most complex PDF files quickly, for instance, and supports all the viewing options you need. So there are plenty of zoom and rotate options, bookmarks support and more.
Annotation options allow you to highlight, underline or strike out text; draw lines and shapes; add stamps ("Approved", "Confidential", "Top Secret" and so on); add text boxes, sticky notes and more.
Your tweaked files can easily be exported to images, either as individual pages, or with all pages saved to a single image file.
The program can complete and saved Adobe Forms to disk or email (this now includes XFA and dynamic forms).
An OCR tool allows you to transform your image-based PDFs into fully searchable files.
And there are plenty of other handy settings and options, everywhere you look.
If this still isn't powerful enough, though, authors Tracker Software also produce several more powerful PDF annotation and creation tools which include many more features. Prices start at $24 and the Product Comparison Chart will tell you more about what each program can do.
Version 2.5.312.1 is a maintenance release. (Changelog)