HomeMy WebLinkAbout09-9745 CITY OF. ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9745
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9745 Address: 7050 GALL BLVD
PermitType: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 30- 26 -20- 0000 - 00200 -0010
Improv. Cost: 7i:; , tLc; t.,
Date Issued: 11/09/2009 Name: FL HOSPITAL OF ZEPHYRHILLS
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 11/09/2009 Phone:
Work Desc: FPM- SUPPRESSION - KITCHEN IN HOSPITAL - WEDNES 11,09
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IR A 'TAN 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." _ _
1i
P T ' 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
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.,813- 780 -0020 City of Zephyrhills Fire Fax- 813- 780 -0021
Permit Application
Date Received I ( ) 9- 0 9 ( Phone Contact for Permit 19 V/ 1 -lei 2 j
Owner's Name I V /Of ( H ✓ .. fZ& f I Owner's Phone Number lg 3 7 ' 1 o(-41/ I
Owner's Address 1 470 9' 6"!f9-/1 8/.1)'•
Fee Simple Titleholder Name I Titleholder Phone Number
Fee Simple Titleholder Address I I
Job Address V ni 1 f? I V 0 Lot #
Sub Division Parcel #
Q 2 — ). ( -a) x,6 -02sco
Li Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
El C - omm Exhaust Kitchen Hood /Duct n Hood Installation
n C - ontrolled Burn n LP /Natural Gas - Installation
n E - mergency Generator < 30 kw I I LP /Natural Gas - ANNUAL Sale
n Emergency Generator > 30 kw n Places of Assembly- ANNUAL
n Fire Protection Maintenance - ANNUAL n Recreational Burn
1Qtrlyl 'Semi I IAni I Other
Sprinkler 0 ❑ ❑ ❑ 1 1 Sparklers
Fire Alarm n ❑ ❑ ❑ ( I 1 11 Sprinkler System Installations
Hood Cleaning ❑ ❑ ❑ 1 1 1 1 Standpipes (Sprinkler Sys)
Hood Suppression Rf ❑ X ❑ 1 1 n Torch Roofing/Tar Kettle
n Fire Alarm Installation n Waste Tire Storage ANNUAL
n Fire Pumps
pi Fire Works
Flammable Application- ANNUAL I ?Qd , 0 U I Valuation of Project
n Fuel Tanks
n Other: I I
Contractor ,` t • Company ( / � %t - R 1 r - I rci t -i w
Ir
Signature Registered Y/ N I Fee Current I Y / N I
Address , • -D , f (nit ) r l/jV ' 336 - License # I
ELECTRICIAN 1 Company 1
Signature Registered Y / N I Fee Current I Y/ N 1
Address ( I License # I I
PLUMBER Company 1
Signature Registered Y/ N I Fee Current I Y / N I
Address I I License # I
MECHANICAL Company 1
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License # ( I
OTHER Company 1
Signature Registered Y/ N I Fee Current 1 Y/ N I
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)