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09-9742
CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9742 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 9742 Address: 39602 AMETHYST WAY LOT 5 Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL. Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: EMERALD POINTE RV RESORT Est. Value: Parcel Number: 24- 26 -21- 0020 - 00000 -0050 Improv. Cost: " Date Issued: 11/06/2009 Name: EMERALD POINT RV Total Fees: 25.00 Address: 39602 AMETHYST WAY LOT 5 Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/06/2009 Phone: Work Desc: FPM- SPRINKLER ANNUAL BACK FLOW •., >_. �h..... E 1 ., m � Yy ? > °., s E _ x, 3z'•,, k' v •9 .. 3 ATO AL •L * 1 N, INC F1 = ER 1 E 25.00 C 0.S901 ,zz -07 F I E A = AN 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." eraP Ari 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 Irq l Fax - 813 - 780 -0021 Permit Application Date Received . f 1 • Phone Contact for Permit 114 it I I t . 1 z I I 1 g q I Owner's Name ^ ,�� �� � � B f ~ >l� Owner's Phone Number ' s 1,// Ze A dt/ /s P. 35 I 1 Owner's Address I -3 y �a �C t � // / � �� i Fee Simple Titleholder Name • l Titleholder Phone Number I I I I I Fee Simple Titleholder Address I Job Address / w y Ze. 4 /A I/5 r/. Lot # I i Sub Division Parcel # n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL I Comm Exhaust Kitchen Hood /Duct I , Hood Installation Controlled Burn = LP /Natural Gas - Installation n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale n Emergency Generator> 30 kw I I Places of Assembly- ANNUAL IX 1 Fire Protection Maintenance - ANNUAL l� �1 (Qtrlyl 1SemiI I 1 Other f ' Recreational Burn Sprinkler © ❑ ❑ �{ ae I I I f'� 1 Sparklers Fire Alarm n ❑ ❑ ❑ I I I I Sprinkler System Installations Hood Cleaning ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys) Hood Suppression n ❑ ❑ ❑ I I I I Torch Roofing /Tar Kettle n Fire Alarm Installation n Waste Tire Storage ANNUAL I I Fire Pumps n Fire Works I I Flammable Application- ANNUAL I r n Valuation of Project Fuel Tanks El Other: 1 Contractor Signature !‘ Company A -- - 1 5o 644 o I av I Registered Y / N Fee Current Y/ N Address 3531 Vlat54-one, I License # I q2 3531%000 12 oo z I ELECTRICIAN' I Company I Signature Registered Y/ N I Fee Current 1 Y / N I Address I 1 License # I PLUMBER I I Company Signature Registered Y / N I Fee Current 1 Y / N I Address I License # MECHANICAL' I Company Signature Registered Y / N 1 Fee Current I Y / N I Address I I License # OTHER I Signature Company I Registered Y/ N J Fee Current I Y/ N Address I I 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)