|
, 813-780-0020 City of Zephyrhills Fire Fax-alsaeo-oo2�
<br /> Permit Application
<br /> Date Received P 813 621 1357
<br /> hone Contact For Permit
<br /> .:�..;.;:;..::.::.:...: ....-.�: . .- . , --•:: ,. ., ,- ... _�......,...u.-.,..._ . . .< . . .,.,.r,...._.N..
<br /> . . . , .,.._ . ...: ....:<;.,. .:...,.._..::.._:-:.:.,,.:.. . .:..•,.-�:...:....:.:.�.:..:_..:s.-:.: :.:.......: .. •.. .... _ _ -
<br /> owner's Name TOWNVIEW RETAIL LLC Owners Phone Number 888 777 3557
<br /> Owner'sAddress 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address
<br />�. .. ....... .... ... ...... . .......... ............ ..:..........:.......... - - - ::1.....J:;;::�.r:a::.:::_......R:�.
<br /> ....:.::.�:::..:. .....�'.' '... .. :..:^'.:.:::.':'.::':_• . . � ..... .�.. '
<br /> n , r i
<br /> :'...:..._.......:�;:=":..'.:''':':;:{ -. :...
<br /> . ..Y..['.":::.._.�' ... . � . ..�.s:�'�":.�L�.. ;
<br /> ..... .......':. .. .:........_..........._....:..._..._:.,::. .:::....:..�:.: .. rt... :i�.ti.:_ �. .. .. ::.�...�.i:':n:v..a�..-'-�.'...
<br /> JobAddress 7346 GALL BLVD, ZEPHYRHILLS, FL �ot# �
<br /> sub Division CITY OF ZEPHYRHILLS Parcei# 35-25-21-0010-0880-0000
<br /> . .. . ... .............................:.__:...,...:,..::....:.:..........,,.:_... - - - - - - - �
<br /> . . . . _... :.::...:..::..:.....
<br /> ,.:.
<br /> :..:....,.::.......:................:...:..:. ....,.:.....:..:.;:._:..:.....,.:.:,.:.....::.:...:::...:.:...._.�..:.......:................:..,.::..:..:.:_.:.....:...:......_.:<...:�_:......-...�:,..,.,..................,..,.:......._........._.,�....<........_....._, ........ .... ........._.........�,. ....z,,..._
<br /> a BiaHazard Waste Storage-ANNUAL ' � Fumigation Tent
<br /> � Comm Exhaust Kitchen HoodlDuct a Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Burn � Hood Installalion
<br /> � Emergency Generalor�30 kw a LP(Natural Gas-Installation
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale ��
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL ��
<br /> ��y emi �n er \
<br /> Sprinkler � � ❑ ❑ � Recreational Bum �
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppression � � ❑ ❑ � � S[andpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch RoofinglTar Kellle �
<br /> � Fire Pumps � Waste Tire Slorage ANNUAL
<br /> � Fire Works
<br /> — � Flammable Application-ANNUAL $25.00 Valuation of Project
<br /> � Fuel Tanks
<br /> � Other:
<br /> ._., .,. , ....::;->: - - � � - .
<br /> :.�� ...�:.: .: .....�:�: �r . x-. -�.,- . ..�.•. .,, e..w 4... . . . ., . . . . . .
<br /> ConUactor Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> ELECTRICIAN Company
<br /> Signalure Registered _ l�/N Fee Curcent Y/N
<br /> Address License#
<br /> PLUMBER Company
<br /> Signalure Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MECHANICAL Company �
<br /> Signature Registered Y�N Fee Curtent Y/N ,
<br /> Address License#
<br /> OTHER �EFFERY D. BURNHAM �ompany RODAN FIRE SPRINKLERS, INC.
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address A WAY VE F �icense# 831 531 0001 2006
<br /> ::....--.:.. . _:_, ...... ..... .. .::...•.:. . .,.•,�.. . ......_......_,... . . ,_,.... ._.. �.,_ .._�.. . ......... _. �. , , ,
<br /> .. . .::..�.,..:...:.� ._:. �_____.....
<br /> Directions:
<br /> Fill out application�ompletely.
<br /> � Owner&Contractor sign back of application,notarized(Or,copy of signed conVact with ownerj
<br /> If over 52500,a Notice of Commencemeni 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:/lappraiser.pascogov.com)
<br />
|