HomeMy WebLinkAbout09-9432 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9432
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 9432 Address: 5048 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 -21- 0000 - 01400 -0000
Improv. Cost: ,_ ;g qk
�'_ _•• •,t
Date Issued: 8/14/2009
N ame: C UMBERLAND FARMS (NAK MOM)
Total Fees: 25.00 Address: 777 DEHAM ST
Amount Paid: 25.00 CANTON, MASS
Date Paid: 8/14/2009 Phone:
Work Desc: FPM- HOOD CLEANING SEMI -HOLE IN ONE- SCHEDULE 8/12/09
UNIV - - VIC d/b a LO H Fl - P R 1 ES 25.00
ev ( Of
so(
‘P
FIR AC EP AN 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."
ir
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. C � . Fax- 813 -780 -0021
Permit Application
Date Received i W a 0
- Phone Contact for Permit
Owner's Name L 4S2 L.Q i LTO V 4 Owner's Phone Number .e / r -s
T c --- , ?3
Owner's Address ?O 1ji q2? 'H 3 3
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
.HZ� }S.,. ,y. z.;. ' ^, 4,.u,Mr, x . -,e, -. . ` ''' •.,-• , ,,, h ta:x ads /' ,,,,,,,,, r pf, , -- . r ` '_, ter: =ttk . = > 't
Job Address (r L � i //(/ 7, !JC J/V SO4S YILt 2 L1' Lot#
Sub Division Parcel #
I Bio- Hazard Waste Storage — ANNUAL n Fumigation Tent
I Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Controlled Bum n Hood Installation
n Emergency Generator < 30 kw n LP /Natural Gas - Installation
I I Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale
I I Fire Protection Maintenance - ANNUAL ( I Places of Assembly- ANNUAL
Iutrlyl IbemiI J Uther
Sprinkler n ❑ 0 I I Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I I Sparklers
Hood Cleaning c/ I ❑ V ❑ I I I Sprinkler System Installations
Hood Suppression I ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys)
I Fire Alarm Installation I I Torch Roofing/Tar Kettle
n Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL I I Valuation of Project
Fuel Tanks
Ti Other: I
Contractor Company CV/ fr rs S ' 0 UJGE.S
Signature < =3 Registered Y / N Fee Current I Y / N
Address I License # I I
ELECTRICIAN Company
Signature Registered Y/ N I Fee Current I Y/ N
Address I I License # I
PLUMBER Company
Signature Registered Y/ N I Fee Current Y / N
Address I License #
MECHANICAL Company
Signature Registered Y / N _ Fee Current I Y / N j
Address I
I License #
OTHER Company
Signature Registered Y/ N 1 Fee Current I Y / N j
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 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)