HomeMy WebLinkAbout09-9304 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9304
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9304 Address: 6701 DAIRY RD
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: 02- 26 -21- 0010 - 03900 -0060
Improv. Cost:` `
Date Issued: 6/29/2009 Name: ALLEGIANCE SENIOR CARE
Total Fees: 25.00 Address: 6701 DAIRY RD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/29/2009 Phone:
Work Desc: FPM- HOOD CLEAN SEMI- WESTBROOK MANOR- CREDIT PRVOUS CK #1474
R & L CLEANING LLC FIRE PERMIT FEES 25.00
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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." �!
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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.Zephyrhiilsl try fq Fax -813- 780 -0021 #r
Permit Application
Date Received 1 1 - Prone Con act for Permit i mplow ( 1 I 1 lo Owner's Name I e 1pfOO V\ 4‘ 1 Owner's Phone I r 1 I 1 T 2 I E
owner's Address I loo \ �- a tl-'c W 7 Vevi \ kk ,' L I
Fee Simple Titleholder Name I 1 Titleholder Phone Number 1 1 1 I
Fee Simple Titleholder Address 1
Job Address I 1 Lot# 1 1
Sub Division I I Parcel # 1 I
❑ Bio -Hazard Waste Storage - .ANIMAL n Fumigation Tent
❑ Comm Exhaust Kitchen HoodlDuct n Hazardous Material (Tier II or RQ Facility) ANNUAL
❑ Controlled Bum . Hood Installation
n Emergency Generator < 30 kw n LP/Nahxal Gas - installation
El Emergency Generator> 30 kw n LP/Natural Gas - ANNUAL Sale
❑ Fire Protection Maintenance - ANNUAL ❑ Places of Assembly- ANNUAL
Sprinider ❑ 0 0 ❑ n Recreational Bum
Fire Alarm ❑ ❑ ❑ ❑ 1 ( ❑ Spam
Hood Clearing N l7 �"' 0 1 1 r n S i m
Hood Suppression 0 0 0 1 ( r Standpipes (Sprinkler Sys)
❑ Fire Alarm Installation n Torch Roofing/Tar Kettle
Fire Pumps ❑ Waste Tue Storage ANNUAL
Fue Works
Flamm Application- ANNUAL 1 I Valuation of Project
Fuel Tai*s
IIIII •e -r. I
. ........... CornixarlY
Signature IMF A - '' � � + A Registered Y / N ! Fee Current ! Y / N I
Address e.. _ - a c A e, 1 License #
ELECTRICIAN! Company
Signature I Registered Y / N I Fee Current I Y/ N,
Address ( 1 License # 1 I
PLUMBER Company I
Signature Registered Y/ N I Fee Current I YIN I
Address' 1 License # ( 1
MECHANICAL Company '
Signature Registered Y/ N 1 Fee Conant , Y/ N 1
Address
OTHER r
Signature — Y/ N 1 Fee Current 1 Y/ N 1
Address + Svo d O $L Q / 25 i
Directions:
n _
Fill out application completely. 4,... CC 4 arP OLt'
Owner & Contractor sign back of .
if over $2500. a Notice of Comrne
Supply two (2) sets of drawings a """----'
Allow 10-14 days for review after, ; ,_a _ , i- '' ax Notice (httpJ/appraiser pasaogov.com)
8137780-0020 City of Zephyrhills Firs Fax- 813 - 780-0021 _
Permit Application - ' --
Date Received Phone Contact
Owners Name r ■ Q O- 6a43 04— k_' � V.Aq� 1 owner' - Number -t i2 f t :6410
Owner's Address I ` 3 2 -kG2...\ �C‘S G ` 7 e\i∎lkk i ‘ cl..-
Fee Simple Titleholder Name 1 1 ■ - • ' - Phone Number I 1 1 1 1
Fee Simple lltleholder Address
Job Address Lot # ° I
Sub Division 1 1 - - # 1
❑ Bio- Hazard Waste Storage - ANNUAL Fumigation Tent
n Comm Exhaust Kitchen Hood/Duct ❑ Hazardous Material (Tier 11 or RQ Facility) ANNUAL
❑ Controlled Bum ❑ Hood Installation
❑ Emergency Generator < 30 kw LP/Natural Gas-Installation
❑ Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sale
ED Fire Places of Assembly- ANNUAL t, (
Fire Protection Maintenance - ANNUAL l_s i\-
Sprinkler ❑ ❑ ❑ ❑ n Recreational Bum
Fire Alarm ❑ ❑ ❑ • 1 1 n spate
Hood Cleaning ❑ ❑ - 1 1 n Sprinkler System Installations 1 I .�
Hood Suppression LJ ❑ ❑ 13 1 ❑ Standpipes ( Sprinker Sys) `/ [
❑ Are Alarm installation
Ei Torch Roofing/Tar Kettle . +
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL I Valuation of Project
Fuel Tanks
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ContractorVr �/
Company I
Signature 111M-4Milliampa_Lia.,„/„„„, Registered Y/ N I Fee Current I Y/ N I
! " License # I
Address 4 h. a _ _44:1
ELECTRICIAN Company i
Signature
Registered Y/ N I Fee Current I Y/ N I
Address I -, I License* I
PLUMBER Company I
Signature Registered Y/ N I Fee Current I YIN I
Address I / I License # ( I
MECHANICAL Company I
Signature Registered Y/ N I Fee Current I Y / N I
Address I I License # I
OTHER Company I
Signature Registered Y/ N 1 Fee Current I Y/ N I
Address License # f4:
Directions:
Fill out application completely.
Owner Contactor sign back of applcation, notarized (Or, copy of signed contract with owner)
if over 52500. a Notice of Commencement is required (Mechanical work over 55000)
Supply two (2) sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Panel # - obtained from Property Tax Notice (httpJ /appraiser.pascogov.com)