HomeMy WebLinkAbout09-9040 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9040
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 9040 Address: 38250 A AVE
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: 14-26-21-0010-01300-0010
Improv. Cost: :. .3'
Date Issued: 4/20/2009 Name: ZEPHYR HAVEN NURSING HOME
Total Fees: Address: 38250 A AVE
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: Phone:
Work Desc: FPM - SPRINKLER - ZEPHYR HAVEN - CREDIT FROM PRMT UNDR CK #3045450
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FIRE ACCEPTANCE 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." e,•
/r
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
04/17/2009 11:51 FAX Q1002
8137& -0020 City of Zephyrhilis'Fire it 9 /'O Fax- 813- 780 -0021
Permit Application
Date Received I ®11 � Permit �; az"
Phone Contact for P
Owners Name 1 5rmpI eXGI rune 1' 1 Owner's Phone Number I 1 1 1
Owners Address 1 4 170, Der It i i; Qia4. ^ - l c, gyp& 1 F L 3 36 l 0
Fee Simple Titleholder Name I - . 1 Titleholder Phone Number I I
Fee Simple Titleholder Address I I
Job Address ( 3 8 SO A Avenue_ Zcphi. rhif . L- 335‘11 Lot#
Sub Division 1 1 Parcel # 1 I
ED Bio -Hazard Waste Storage -ANNUAL n Fumigation Tent
ED Comm Exhaust Kitchen Hood/Duct = Hazardous Material (Tier II or RQ Facility) ANNUAL
a Controlled Bum [7 Hood Installation
ED Emergency Generator < 30 kw ED LP /Natural Gas - Installation
• I Emergency Generator > 30 kw Q LP /Natural Gas - ANNUAL Sale
0 Fire Protection Maintenance - ANNUAL Places of Assembly - ANNUAL
® uii�
Sprinkler El ❑ ❑ ❑ n Recreational Bum
Fire Alarm = ❑ ❑ 0 1 ( n Sparklers
Hood Cleaning E ❑ ❑ ❑ 1 1 El Sprinkler System Installations
Hood Suppression ❑ ❑ ❑ 1 1 EJ Standpipes (Sprinkler Sys)
ED Fire Alarm Installation a Torch Roofing/Tar Kettle
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL I 1 Valuation of Project
Fuel Tanks •
b!I Other: Srd•M 4 Toyarai gr/fil .
Signature Registered Y `� t I • Contractor ` Company
/ N I Fee Current / N I
' Address I . License*
ELECTRICI Company I
Signature Registered Y/ N I Fee Current I Y/ N I
.Address I I License* I I
PLUMBER Company
•
Signature Registered Y/ N J Fee Current I Y / N I
Address I License # _ ( • 1
•
MECHANICAL • Company • I
Signature Registered Y/ N I Fee Current I Y / N 1
. Address I I License # I I
OTHER Company I
Signature Registered Y/ N I Fee Current 1 Y/ N J .
Address 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) .
04/17/2009 11:51 FAX Z001
SimplexGrinnell
qCO
4701 Oak Fair Blvd.
Tampa, FL 33610
Fire & PHONE: 813 - 623 -2991
Security FAX: 813 - 664 -1731
SimplexGrinnell
cbrackett @simplexarin nell.c
TeleFax Transmission
This facsimile transmission may contain confidential and/or attomey /client privileged information
belonging to the sender. This information is intended only for the use of the individual or entity named
on this transmission sheet. If you are not the intended recipient, or the employee or agent responsible to
the intended recipient, you should return to sender immediately. You are hereby notified that any
disclosure, copying, distribution or the taking of any action in reliance on the contents of this telecopied
information is strictly prohibited.
2417 Emergency Service
• Fire Sprinkler Systems
Date April 17, 2009
• Fire Detection & Alarm
Company City of Zephyrhills
• Fire Extinguishers
Attention Jackie Boges
• Range Hood Systems
Fax No. 813- 780 -0021
• Special Hazard Systems
From Christopher Brackett
• Integrated Security Applications
Subject Permit Request
• Healthcare Systems
No. of pages 3
• Sound & Communications (including this one)
• Time & Workforce Management Message:
Jackie, Attached is a request for a permit for backflow
• Emergency Lighting repair work at Zephyr Haven Nursing Home. Also
attached is the letter showing a $25.00 credit on our
• System Design & Installation account. Please apply that amount toward this permit. If
• Project Management you have any questions, please call me at (813) 623
2991 ext 235. Thank you very much!
• Inspection & Testing
• Preventive Maintenance
Over 150 offices in principal cities
throughout North America.
For marketing brochures regarding
SimplexGrinnell systems and
services, call 1 - 800 - 746 - 7539.
Fax Cover Letter - Page 1
04/17/2009 11:52 FAX W]003
City of Zephyrhills
- ° Bu Department
5335 Eighth Street Zephyrhills, Florida 33542 (813) 780 -0020 Fax (813) 780 -0021
March 17, 2009
W.A. `Bill" Burgess
Director of Building Simplex.Grinnell
Licensing & Zoning . 4701 Oak Fair Blvd
Tampa, Florida 33610 -7386
_ Dear Chris Brackett,
We received a check #3045450 in the amount of $200 for maintenance permits.
The permit for Fl Hospital of Zephyrhills fire pump annual should fall up under
the sprinkler permit per the Fire Marshall you do not need to submit permit for
the fire pump when the time comes for the maintenance to be done please submit
with the sprinkler. This will give you a credit of $25.00 for your next permit.
- If you have any question concerning this please contact our office at 813-780 -
0020 my extension is #3513.
Sincerely,
Jackie Boges
Code Support Specialist