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s�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 813 621 1357 <br /> owner's Name TOWNVIEW RETAIL LLC Owner's Phone Number 88� 777 3557 <br /> Owner's Address 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> JobAddress 7346 GALL BLVD, ZEPHYRHILLS, FL �ot# � <br /> Sub Division CITY OF ZEPHYRHILLS Parcel# 35-25-21-0010-0880-0000 <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> a 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 /> QEmergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale �/ <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL / /� n � " 1 <br /> r y emi �n er / �� <br /> / <br /> Sprinkler � � ❑ ❑ � Recreational Burn ( <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � 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.�0 Valuation of Project <br /> � Fuel Tanks <br /> Q Other� <br /> - . - . . . . - . . . • <�,�,. > > . �, ;,..� : :.�:s=�� _ <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# � <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# � <br /> OTHER �EFFERY D. BURNHAM /�,�� company RODAN FIRE SPRINKLERS, INC. <br /> Signature �/ Registered Y/N Fee Current Y/N <br /> Address 7 �-{ 1' License# 1 1 <br /> Directions: <br /> Fill out appiication 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 />