HomeMy WebLinkAbout09-9928 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9928
ANNUAL FIRE PROTECTION MAINTENANCE
1 - "' :. "° d . s ' ' P 43 � " ... a > >; 4 ;r `y :T;7 - � Par 7 ' 'x'
Permit Number: 9928 "° ;
Addres 5050 GALL BLVD
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: 11 26 - 0000 - 01400 - 0000
lmprov. Cost: 7, ,,
Date Issued: 12/28/2009 Name: DOMINOS PIZZA
Total Fees: 25.00 Address: 5050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/28/2009 Phone:
Work Desc: FPM -HOOD SEMI - DOMINO'S SCH 12/23/09
UNIV - =V d b a - L FIR 4 25.00
FIR A P ANC 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."
I
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
813 - 780 -0020 City of.Zephyrhills "Fire -kRq Z 6 Fax - 813- 780 -0021
,p Permit Application
Date Received - FaK 12. 23 05 Ph Permit Contact for Pe t-
® _
Owner's Name 6 A SI a / 7 . ,L - l A q�sll
LO IVR V? /9Y Owners Phone Number O 4' J 3s J
Owner's Address 70 Bar - 9 7 3 8 - 7 - 4 - / 1 T /9 - FL- 33674E-
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
, ,,f,,.a .217 F — '' t ,0-- =w-,,, , , - ae- , - � . . . . -: ... --. & „,:ro. - :... . x':,, .'c ),•:;#, ri, :,- :t3;€a ,.' - .n.ft. ;
Job Address Wy /A/O 1 ' / 22 4 SVSQ 7 Si-1/1), Lot#
Sub Division Parcel #
Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent
Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL
I Controlled Bum [ I Hood Installation
I - I Emergency Generator < 30 kw - n LP /Natural Gas - Installation
I Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale
I Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL
IUtriyl IbemiI Other
Sprinkler n ❑ ❑ ❑ I I Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I I I Sparklers
Hood Cleaning 17 Er ❑ I I I I Sprinkler System Installations
Hood Suppression D ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys)
I Fire Alarm Installation I I Torch Roofing/Tar Kettle
I Fire Pumps I Waste Tire Storage ANNUAL
I Fire Works
n Flammable Application- ANNUAL
1 1 Valuation of Project
Fuel Tanks
I Other: I
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Contractor `�fZ"( Company Z /AM U 'i 10 ffs
Signature _ Registered L —P- / N I Fee Current J Y / N
Address I I License* ( I
ELECTRICIAN Company I
Signature Registered Y / N I Fee Current I Y / N J
Address I I License # I I
PLUMBER I Company I
Signature Registered Y / N „I Fee Current I Y / N I
Address I I License # I
MECHANICAL Company
Signature Registered Y / N j Fee Current I Y / N j
Address I I License # I I
OTHER Company
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)