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813-780-0020 City pf 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 L�C Owner's Phone Number � � � <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 /> r . - . S .� .. . . @GS",-�:E.�. :.,& , ..4 ..,�Jy � . <br /> :i. <br /> JobAddress 7340 GALL BLVD, ZEPHYRHILLS, FL �ot# � <br /> sub oivision CITY OF ZEPHYRHILLS Parcel# 35-25-21-0010-0880-0000 <br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent t <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-ANNUA� � !✓ <br /> ry emi �n er / � %) � : <br /> t v <br /> Sprinkler � � ❑ ❑ � Recreational Burn � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers ` � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Instaliations <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 /> aFlammable Application-ANNUAL $25.QQ Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> , . , -. . ,•� , „ . , _ , . . . �;.�,: �..�4 ,-,?.. ,. -.�:°�:. <br /> Contractor <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER JEFFERY D. BURNHAM ��. Company RODAN FIRE SPRINKLERS, INC. <br /> Signature Registered Y/N Fee Current Y/N <br /> Address N T F 1 License# 1 1 2 <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 />