HomeMy WebLinkAbout09-9891 • CITY OF ZEPHYRHILLS
5335 - 8Th STREET
(813) 780 -0020 9891
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9891 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: , =:;Zarnir m 72V725 � ' a
Date Issued: 12/14/2009 Name: HCR MANOR CARE
Total Fees: 25.00 ( f-- Address: 38220 HENRY DR
Amount Paid: 25.00 sit ZEPHYRHILLS, FL. 33542
Date Paid: 12/14/2009 Phone:
Work Desc: FPM- SPRINKLER QUARTERLY- HCR MANOR CARE - CREDIT PRMT#9741
A • 'L • U I•N IN 1'E ` 'MI E 25.00
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1 A - TAN inal
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." gierAPP
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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 Fax -813- 780 -0021
Permit Application
Date Received I I Phone Contact for Permit 1 21. 19S-I R 1 I q q3
Owner's Name 14 eA1 1 rart,d - He ,Z / 1GN4e L i Owner's Phone Number
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Owner's Address 3 a 116417 Pr. Z� hf6 /, / 33 5ef
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
Job Address 3 t'dAo /A Pr. 20y1)7(//,s I/• 7 K✓74 Lot #
Sub Division Parcel #
I I Bio- Hazard Waste Storage - ANNUAL pi Hazardous Material (Tier II or RQ Facility) ANNUAL
I Comm Exhaust Kitchen Hood /Duct I Hood Installation
I — I Controlled Burn I LP /Natural Gas - Installation
Emergency Generator < 30 kw I I LP /Natural Gas - ANNUAL Sale
7 Emergency Generator > 30 kw I I Places of Assembly-ANNUAL �� _`\
I x I Fire Protection Maintenance - ANNUAL Recreational Burn
tQtrly1 eml Fn LOther „ A�
Sprinkler 1 ❑ ❑ I Sparklers Vv {
Fire Alarm I Imo` — I El ❑ I n I� Sprinkler System Installations . Q ” I ,r
Hood Cleaning
9 ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys) 14'
-4 e Hood Suppression C ❑ ❑ ❑ 1 1 Torch Roofing/Tar Kettle ^^�
Fire Alarm Installation I I Waste Tire Storage ANNUAL i`
I I Fire Pumps ti i 1
I I Fire Works
7 Flammable Application- ANNUAL
1 Val Uatlbn 4€ PfOjeCt
n Fuel Tanks
7 Other: I
Contactor Company A "TiDta 1 5o lu 4-■ o
Signature •r i Registered Y / N I Fee Current 1 Y / N I
Address 1 35 3 1 I'eL &konE, 1 License # I qg 35 31000 I AQo 2, I
ELECTRICIAN Company
Signature Registered Y/ N I Fee Current 1 Y / N I
Address I I License #
PLUMBER l Company
Signature I Registered Y/ N I Fee Current I Y/ N I
Address I I License # i
MECHANICAL Company
Signature Registered Y/ N . 1 Fee Current I Y / N 1
Address I License #
OTHER I Company
Signature I Registered Y/ N I Fee Current I Y / N I
Address 1 I License # 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 $5000)
Supply two (2) sets of drawings with applicable documentation
Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
D
A A TOTAL SOLUTION
FIRE PROTECTION GROUP
3531 Keystone Road
Tarpon Springs, Fl 34688
FAX: (727) 943 -5919 TEL: (727) 942 -1993
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FAX COVERS 2
HEFT
DATE: l 1( o
FROM: 7Iic v ;1 Phone Number
TO: C .7 d� � fr , 4 1, Li Phone Number
NUMBER OF PAGES: _ FAX NUMBER: 77 3 `7$D —00.21
MESSAGE
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"ONE CALL DOES IT ALL"
Please visit our website - http: / /www,atotalso.ution.com
Forms S Drive 11/02 JSR
STATE OF FLORIDA - �. ,,
DEPARTMENT OF FINANCIAL SERVICES T r';
DIVISION OF STATE FIRE MARSHAL
TALLAHASSEE, FLORIDA
CERTIFICATE OF COMPETENCY
THIS CERTIFIES THAT: DOUGLAS A JONES
3531 KEYSTONE ROAD •
TARPON SPRINGS, FL 34688 -
BUSINESS ORGANIZATION: A TOTAL SOLUTION, INC
CONTRACTOR 111S LIMITED TO THE EXECUTION OF CONTRACTS REQUIRING THE ABILITY TO LAYOUT, FABRICATE, INSTALL INSPECT,
ALTER, OR SERVICE WATER SPRINKLER SYSTEMS, WATER SPRAY SYSTEMS,TOAM- WATER SPRINKLER sys`rEms, FOAM-WATER
SPRAY SYSTEMS, STANDPIPES, COMBINATION STANDPIPES AND SPRINKLER RISERS, ALL PIPING THAT IS AN 11■ITEGEAL PART OF THE
SYSTEM BEGINNING AT TH POINT OF SERVICE, SPRINKLER TANK HEATERS, MR LINES, THERMAL. SYSTEMS USED IN CONNECTION
WITH SPRINKLERS, AND TANKS AND PUMPS CONNECTED THERETO, EXCLUDING PRE-ENGNEERED SYSTEMS.
1
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Chief Financial Officer
07 01 2008 07.16 Pinellas 92353800012002 0741800360 150.00 06 3012010
Issue Date Type Class County License/Permit Number 7 Application 4 Taxes'42 Fees Expire De
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