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s�3-�ao-oo2o City of Zephyrhills Fire <br /> Fax-813-780-0021 <br /> ' Permit Application <br /> Date Received <br /> Phone Contact for Permit 813 621 1357 <br /> Owner's rvame TOWNVIEW RETAIL LLC r� �� � <br /> Owner's Phone Number L <br /> owner'sAddress 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102 <br /> Fee Simple Titleholder Name �� r—� �� <br /> Titleholder Phone Number I I <br /> Fee Simple Titleholder Address L•—� <br /> JobAddress 7340 GALL BLVD, ZEPHYRHILLS, FL ��� <br /> Lot# <br /> subflivision CITY OF ZEPHYRHILLS parce�# 35-25-21-0010-0880-0000 <br /> � Bio-Hazard Waste Storage-ANNUAL a <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> � r y emi � er ❑ <br /> Sprinkler � ❑ ❑ Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ �� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ C� ❑ Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL $25.�� <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other• <br /> � <br /> Contractor � ` � <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> 5i9nature JEFFERY D BURNHAM /�--� /Lr- Company RODAN FIRE SPRINKLERS, INC. <br /> Registered Y/N Fee Current Y/N <br /> Address 2 1 N. 7 TH T. TAMP F 1 <br /> License# 1 1 12 <br />�irections: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser pascogov com) <br />