HomeMy WebLinkAbout09-9554 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9554
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 9554 Address: 38220 HENRY DR
Permit Type: FIRE PROTECTION MAINTENANCE 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:
Improv. Cost : ii
,
Date Issued: 9/17/2009 Name: HCR MANOR CARE p ., , zap
Total Fees: 25.00 Address: 38220 HENRY DR
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/17/2009 Phone:
gg
Work Desc: FPM - SPRINKLER SEMI- HCR MANOR
` $ 5 '. 4 9 u 3 M.. ia €SLF .i .. P te :,.. . g ', ,.
AT•TAL •LU 10 N, INC FIRE PER IT EES 25.00
Ci OD
u
•
FIREA EPTAN E 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 City of Zephyrhills Fire 4 q 55 ((,,
Fax- 813- 780 -0021
Permit Application
Date Received
!RIM 0 Phone Contact for Permit I} 21- 111 z 1 1 1 q q 3
Owner's Name M 6N " L �., r I Owner's Phone Number I
• Owner's Address ?•a y / pr. 2 { /� 4 r l/� `/- ??5-11.: !
Fee Simple Titleholder Name I I I I I I I I
Titleholder Phone Number
Fee Simple Titleholder Address I
.
Job Address e f
rPr. 2f �4
11 / / ?3f9)i i
Sub Division I i ' Parcel #
I
I Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Comm Exhaust Kitchen Hood /Duct n Hood Installation
n Controlled Burn In LP /Natural Gas - Installation
n Emergency Generator < 30 kw I I LP /Natural Gas- ANNUAL Sale
1 1 Emergency Generator > 30 kw I I Places of Assembly- ANNUAL
r KI Fire Protection Maintenance - ANNUAL r Recreational Burn
IQtrlyl ISemil Fri, Other
Sprinkler n ❑ ❑ ❑
Sparklers
Fire Alarm ❑ ❑ ❑ 1 ( I I Sprinkler System Installations
I I
Hood Cleaning ❑ ❑ ❑ I 1 I I Standpipes (Sprinkler Sys)
Hood Suppression I ❑ ❑ ❑ I 1 1 Torch Roofing /Tar Kettle
n Fire Alarm Installation I Waste Tire Storage ANNUAL
I I Fire Pumps
El Fire Works
F Flammable Application- ANNUAL I I
r Valuation of Project
Fuel Tanks
Fl Other: I
1
Contractor I Company -
Signature o Sn �ti 44 0
Registered Y/ N 1 Fee Current ? Y/ N I
Address ( 3531 K ,54-a „E, I License# ( 42353go0o la I
ELECTRICIAN I I Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address I
1 License # I
PLUMBER I Company
gnature Registered Y/ N I Fee Current I Y / N I
Address I
I License #
MECHANICAL' I Company I
Signature Registered Y/ N j Fee Current I Y/ N I
Address I I License #
OTHER I Company
Signature Registered ( Y/ N I Fee Current I Y / N I
Address I I License # I I
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)