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<br /> • 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received . Phone Contact tor Permit 813 621 1357
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<br /> owner's Name TOWNVIEW RETAIL LLC owner's Phone Number � � �
<br /> owner's Address 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102
<br /> Fee Simple Titleholder Name TiUeholder Phone Number � � �
<br /> i Fee Simple Titlehoider Address , '
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<br /> JobAddress 7340 GALL BLVD, ZEPHYRHILLS FL �ot�t
<br /> suboivision CITYOFZEPI=IYRHILLS parce�# 35-25-21-0010-0880-0000
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<br /> � Bio-Hazard Wasle Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Burn � Hood Installation
<br /> � Emergency Generator<30 kw � LP/Natural Gas-Installatio�
<br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale �
<br /> � Fire Protectlon Maintenance-ANNUAL � Places of Assembly-ANNUAL Q�
<br /> t y emi �n er �/��
<br /> Sprinkler � � ❑ ❑ � � Recreational Burn \
<br /> Fire Alarm � O ❑ ❑ � � Sparklers Y
<br /> Hood Cleaning � ❑ D ❑ � � Sprinkler 5ystem Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alartn Instaliztion � Torch Roofingrfar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable ApplicaGon-ANNUAL $25.00 � Valuation of Project
<br /> � Fuel Tanks
<br /> � Other:
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<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 Li�ense#
<br /> MECHANICAL Company �
<br /> Signature Registered Y!N Fee Current Y/N
<br /> Address License#
<br /> OTHER �EFFERY D. BURNWAM �ompany RODAN FIRE SPRINKLERS, INC.
<br /> Signature Regfstered Y/N Fee Curcent Y/N
<br /> Address . A W Y V IT A L 1 _.,. �icense# 831 531 0001 200
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<br /> Directions:
<br /> Fiil out application completely.
<br /> Owner&Contractor sign back of applicalion,notarized(Or,copy of signed contract with owner)
<br /> , If over�2500,a Notice of Commencement is required(Mechanical work over 55000)
<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)
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