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<br /> 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received Phone Contact for Permit 813 621 1357
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<br /> owner's Name TOWNVIEW RETAIL LLC Owner's Phone Number 610 667 5$00
<br /> owner's nddress 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address
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<br /> .JobAddress 7348 GALL BLVD, ZEPHYRHILLS, FL �ot# �
<br /> sub Division CITY OF ZEPHYRHILLS Parce�#
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<br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kilchen HoodlDuct � Hazardous Malerial(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Bum � Hood Installation
<br /> � Emergency Generator<30 kw � LPINatural Gas-Installation �
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale �
<br /> a Fire Protection Maintenance-ANNUAL � Places of Assembiy-ANNUAL ��/
<br /> t y emi � t er ,
<br /> Sprinkler � � ❑ ❑ � � Recreational Burn �
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � O ❑ ❑ � � Sprinkier System Installations
<br /> Hood Suppression � ❑ ❑ � � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Inslallalion � Torch RoofinglTar Kettle
<br /> � Fire Pumps. � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Applf�ation-ANNUAL �25.00 � Valuation of Project
<br /> � Fuel Tanks
<br /> Q 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#1
<br /> PLUMBER Company �—
<br /> Signature Registered �(1 N Fee Currenl Y/N
<br /> Address License#
<br /> MECHANICAL Company
<br /> Signalure Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> OTHER JEFFERY D. BURNHAM �ompany RODAN FIRE SPRINKLERS, INC. �
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address BR AY IT PA � �icense# 8 153100012 06
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<br /> Directions:
<br /> Fill out application complelely.
<br /> Owner&Contractor sign back of application,notarized(Or,copy of signed conVact with owner)
<br /> If over 52500,a Notice of Commencement is required(Mechanical work over 55000)
<br /> Supply two(2)sets oi drawings with applicable documentatlon
<br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Nolice(http://appraiser.pascogov.com)
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