HomeMy WebLinkAbout08-8629 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8629
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 8629 Address: 5118 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-07000-0011
Improv. Cost:
Date Issued: 12/10/2008 Name: FUNG GARDENS
Total Fees: 25.00 Address: 5118 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/10/2008 Phone: (813)788-4586
Work Desc: FPM-4 MONTH SVC- FUNG GARDENS-DONE 12/10/08 ,9a,r
UNIVERSE SERVICES d/b/a LASZLO H FIRE PERMIT FEES 25.00
FIRE ACCEPTANCE Final
Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the costs of fire
prevention and protection related activities such as inspections, plan review,administrative fees,and other
costs related to the aforementioned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of
the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final
inspection shall be charged double permit fee per day of operation or a minimum of$100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041
813-780-0020 TW 1111010j City of.Zephyrhills'Fire ( 1 �KJ v"� Fax-813-780-0021
Permit Application I
Date Received iz D1ü I - Phone Contact for Permit
Owners Name LS Owner s Phone Number 2/
Owner's Address p Q T73S 74M1 3 3
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
Job Address L4/V (j [/ ST/ c v v Lot#
Sub Division Parcel#
s ..
Bio-Hazard Waste Storage—ANNUAL Fumigation Tent
Comm Exhaust Kitchen Hood/Duct [ ] Hazardous Material(Tier II or RQ Facility)ANNUAL
Controlled Bum Hood Installation
Emergency Generator<30 kw [ ] LP/Natural Gas-Installation
Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL
y emi Other
Sprinkler ❑ O O Recreational Bum
Fire Alarm ❑ O O I Sparklers
Hood Cleaning ❑ ❑ ❑ fl Sprinkler System Installations
Hood Suppression ❑ O O I El Standpipes(Sprinkler Sys)
Fire Alarm Installation Torch RoofinglTar Kettle
Fire Pumps a Waste Tire Storage ANNUAL
El Fire Works
El Flammable Application-ANNUAL I Valuation of Project
El Fuel Tanks
El Other:
Contractor Company
Signature Registered Y/N Fee Current I Y/N
Address License#
ELECTRICIAN Company
Signature Registered Y/N Fee Current Y/N
Address j License#
PLUMBER Company
Signature Registered Y/N Fee Current Y/N
Address License#
MECHANICAL Company
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N I Fee Current Y/N
Address License#
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/appraiser.pascogov.com)
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ROPERTY, & CASUALTY
INSURANCE COMPANY
Premium Quotation
i Rislc;Information
Effective Date: 12/9/2008 Expiration Date: 1/8/2009
Business Name: Universe Services Quote ID: 10935
First and Last Name: Laszlo Horvath
Classifications.
Code Premium Basis / �
Description Limit of Liability Premium
96816 JANITORIAL SERVICES _ �._ ,,__�_ _._16,700
(p) 304.00
Sub Total: 304.00
Coxrelrea
General Aggregate Limits(Other than Products Completed Operations) 600,000 Included
Products-Completed Operations aggregate Limit 600,000 Included
Each Occurrence Limit 300,000 Included
Personal and Advertising Injury Limit 300,000 Included
Medical expense Limit(any one person)
5,000 Included
Fire Damage Limit(any one fire)
100,000 Included
Sub Total: Included
Terrorism Coverage, _.. ., �_ Y.
Included
Sub Total: 0.00
Property Damage claim)
500 Included
Premium A4jutments&AOther barges -`
EMPA
FHCF 2.00
Policy Fee 5.00
Minimum Premium Adjustment O R I 25.00
146.00
Sub Total: 178.00
$;PAID Total Estimated Premium: $482.00
ayrii illt #ioet5 �� Installment'
Down'Payment Payments?
Four Payment Plan (Direct Bill)
Single Pay at Issuance
( 5 00 118.00
482.0 0.00
This estimate is based on preliminary information provided for the sole purpose of approximating the premium to be charged for the coverages presented.Rates and factors are
based on those in effect on the date of this quotation and are subject to change by Cypress Property&Casualty Insurance Company at time of issuance.An installment fee is added
to all payments after the initial down payment.