HomeMy WebLinkAbout09-9438 1 _ CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9438
ANNUAL FIRE PROTECTION MAINTENANCE
t�� �,_l .p '{ ,. g'c''?:., ��' i....t��.s`v ;°: . ,...:., = -= y : - aft
Permit Number: 9438 Address: 7441 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: 34 25 - 0000 - 00300 - 0040
Improv. Cost: 4:7 77, , ..:, 'w
Date Issued: 8/18/2009 Name: LONG JOHN SILVER
Total Fees: 25.00 Address: 7441 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/18/2009 Phone:
Work Desc: FPM- HOOD CLEAN QUARTERLY -LONG JOHN SILVERS- SCHEDULE 8/18/09
PA •A I- A - N F1' fw- - MI F 25.00
ato"5)?cP
v,: ^.. stn,,., .. ,... R
FIR A PTA E 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." �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
813- 780 -0020 City of Zephyrhills Fire. '� ( Fax -813- 780 -0021
Permit Application
Date Received Phone Contact for Permit I , I (
Owner's Name Jo ft me W `ion) t Jot," h s:1 Ow ner's Phone Number e 1 3 7/ s
, 4S/3
Owner's Address
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
, ,,..U.. :1 , MY,ti& .,, , r! :i w. " b <o.Argo, oioxem .,�;". fi 2'�.,�,o -Inv,. > +,:v , ,. , F. .. m ik„,,..,,,,,, o ,, , ,,,
Job Address 7L{yf &all. ?tv/P 2efkm,:111 Fc 3 3S `1 1 Lot#
Sub Division Parcel #
.. .. w... -.E. �,-. �.,. "gym,, i x -mAmm, �, 33; i' t, wt
` k , ...,,111.E iso,z... ,:1 <�" a Qa ,...:it �_. 1,... .....,. ,.r �-
n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent � ��
n 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
n Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale 3
n Fire Protection Maintenance - ANNUAL n -1
Places of Assembly- ANNUAL ' 9V
IUtriyl Semi] tither 1
Sprinkler n ❑ ❑ ❑ n Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I I I Sparklers
Hood Cleaning S y ❑ ❑ I I n Sprinkler System Installations
Hood Suppression n ❑ ❑ ❑ I I I Standpipes (Sprinkler Sys)
n Fire Alarm Installation I I Torch Roofing/Tar Kettle
FT Fire Pumps n Waste Tire Storage ANNUAL
n Fire Works
Flammable Application- ANNUAL I ( Valuation of Project
pi Fuel Tanks
n Other: I
- .. �_.. 3, .. �. e. e ��?�."; au �> �' x:+" �u� z:... ��5w.. � 'z� aaa �r. . . ..�.,.na..,.z� -tom- .;.� €�'e.F: a<;�r ,a �. �:a.. ., �''�: wz..�..,;u�", �'�s:.
Contractor Company 5,l/j9 6 1 �D fps 7 I
Y'
Signature 1) rr Registered Y / N I Fee Current I Y / N
Address 14 20 MArdox CA men; 0 1w..z L I License #
ELECTRICIAN Company I
Signature Registered Y / N I Fee Current I Y / N I
Address I
I License #
PLUMBER Company I
Signature Registered Y/ N I Fee Current I Y / N
Address I I License # I
MECHANICAL Company
Signature Registered Y / N I Fee Current I Y / N
Address I
I License #
OTHER Company I
Signature Registered Y / N I Fee Current I Y / N I
Address 1 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)
padwe4s Jo pa4uud 'peal /Je4oN ;o aweN pedwe4s Jo pa}uud 'padk fue }oN ;o aweN
•oN uolss!wwOO 'oN uolsslww00
ollgnd lueloN
ollgnd l�e4oN
•uol4eogl}uap! se •uogeogguapl se
paonpoid aney/seg Jo aw o} uiowl ApeuosJad we/s! oUM peonpoid a/key/sal Jo ow o} uMowl AlleuosJad we /s! ow
Aq Aq
s!y} aw eio;aq (pewiy4e io) o} worms pue pagposgns s!.} aw aio ;aq (pewitj a Jo) o} worms pus paquosgns
21OiOd2I1NO3 1N30Y 210 213NMO
(E01.1.6 • s'd).Lv InrtaI o1d
'1N3W30N3WW03 AO 33110N dfOA JNIa2100321 A3N2J011H NV HO 2130N31 HlIM
1lfSNOO 'ONIONVNIA NIV180 01 IN31N1 f1OA AI 'Al213d021d 2il0A cu SIN3W3A021dWI O 133IM1 ONIAVd
2il0A NI 11f1S321 AVW 1N3W33N3WWO3 d0 33110N V a2100321 01 3211111VA 2lfOA ?13NMO 01 SNIN2iVM
•pauopuege paJap!suo3 s! go( ay} `sAep angnoasuoo (06) A4aulu JoJ saseao )1J0M II 'uolsua}xe ay} JOJ asneo alge!Jl4snf
a4eW4suowep IIIM pue sAep (06) A4eulu peeoxa o} }ou poued e JoJ le!o!}JO 6ulpl n9 ay} woJJ '6ul4pM u! 'pe4senbaJ eq Aew
uolsua4xa uy 'paouawwoo s! )1JOM ay} aw!} ay} Ja}Je sy}uow (g) xis Jo pouad a JoJ pauopuege Jo pepuedsns s! 4lwJed ay}
Aq paz!JOy}ne )IJOM J! JO 'aouenss! 1!WJad Jo sy}uow xis u!y }!M paouawwoo s! 4lwJed yons Aq pez!Joy4ne vOM 8q4 ssaiun
p!Ienu! awooaq Heys panss! }lid AJan3 . sapoo Aue Jo suo!4eloln JO uol4OnJ4suoO `sueld u! sJOJJe Jo u0!4OaJJOO a 6uuinbaJ
Ja4JeaJay} woJJ le!OiJO 6u!pling aq4 4uenaJd }pied a Jo aouenss! pegs JOU `sapoo leo!uyoa} ay} Jo suo!s!noJd Aue apse }as
Jo 'Jame 'Iaoue° `a4elo!n o} A4uog1ne se 4ou pue vOM ay} y }!M peaoOJd o} asueoll e aq o} panJ4suo3 aq Heys panss! 1!WJad
y •uol48O!Idde ay} u! papnlOU! /(l!eo!}!oads 4ou suo!}efe}sw Jay40 JO `se6 '6u!uo!}!puoo J!e 'stood 'span& `su6!s `6u!gwnld
')IJoM Ie0IJ }0ala JoJ peilnbai aq Aew 4lwJed a4ejedas a leg; pue4sJapun 1 . uo!4OnJ }suo3 6upuawwoo o} Ja!Jd }lnep!JJe SIy4
u! ypoJ ;as suo!}!puoo 6ul44!wJad ay} Jo J9UMO ay} wJOJu! o} y }!aJ poo6 u!: as!woJd .1 `2i3NM0 3H12JOd 1N39V ay} we 1 II
'aouelidwoO w aq o} eNe} 4snw
1 suo! }Oe 48 4M AJ!4uep! o} A4!glsuodseJ Aw s! }! ley; pue 51JOM pepua }u! ay} 01 AIdde Aew saIOU86e 4Uawuieno6
Jay }O Jo suo!4eln6aJ ay} ley; pue4sJapun 1 ley; AJ!4Ja° ow 1 . uol4O!psunf ay} u! suol4e1n6aJ }uawdolenep
puel pue 'suo!4e1n68J 6uluoz `sapoo A4!0 pue A4uno0 `uol4OfJ4suoO 6u! }ein68J sMel Ile Jo spJepue4s 4aew
o} pewioJJad aq p!M ){JOM lie }e4} pue }!wJ8d a Jo aouenss! 01.100 paouawwoo sey uo!4elle}su! Jo )1JOM ou 4814}
AJ!}Jap 1 'pa4e3!pu! se u0l1e1e4su! pue Aim op 04 4lWJad e u!e4go o} spew Ageieq s! u0! }e0llddy ' }uawdolanap
puel pue 6uluoz 'uol4OnJ4suo0 6ul4eln68J SMeI alge0lldde ile y41M aoue!Idwoo u! auop aq IIIM )IJOM 118 ley;
pue a4eJnOOe s! uo!4eo!Idde s!44 u! uo!4ewJOJu! ay} Ile }e41 AJ!4Jao 1 :11AVaIddt/ 5,213NM015,21010V211N00
•4uawaOUawwoO o4 Jo!Jd „J8UMO„ Mil 041! Janllap
04 y4!eJ poo6 u! as!woid pue 4uawnOOp pegposap anoge ay4 Jo Adoo e peule}go aney 1 }e44 AJpJ3° 1 '„Jaunno„ a44 uey4 Ja440
auoawos s! 4ueOpdde ay} J1 . sJleJJV Jawnsuo0 pue aJn4lnou6y 4o }uaw4Jedea ep!Jold 844 Aq paJeda.d „Grano u0!4Oa4oJd
s,J9UM0OW0H — Me1 ual u0! }OnJ4suo0 ep!JOld, ay; Jo Adoo 8 y }!M paranoid uaaq an814 `4ue3lldde 3144 '1 4e44 Alp e°
'3JOW .10 00 "009Z$ S! )1JOM Jo uol4enlen II :(pepuawe se 'se ;n ;e ;S epuolI `S1.2. Je4dey0) Md1 N317 NOI10f1211SNO0
- A4unO0
Dosed u! sa6a1lnud 6u!flwJad o4 pa14l4ua 4ou s! pue pasua011 A1JedoJd 40U s! ay ley; uogeOlpUI u8 aq Aew ley; 'JO4OeJ }uo0
ay} se u6ls J3UMO a44 se `noA 4.1 •alq!suods3J eq IIIM Aay4 yO!yM J0J u0!4e3lldde s144 4.0 ?loo18 Jo4O8J4uo3 9 144 4.0 suo!4Jod
u6ls (s)Jo4Oe.4uo3 a44 ane4 0} pas!npe s! ay `sJO4O8J 1UOO .10 Jo40e.4uo3 8 p8J14 sey JeUMO ay} J! `aJOwJa44Jnd '6009
-Li'9 4e U0!40as 6u!suao!l— uols!n!O u04O9dsul 6ulppn9 A }uno0 Dosed 9144 }Oe }uo3 o4 paslnpe 3Je Aa44 `)IJOM papuaiu!
ay; JoJ Aldde Aew s4uawaJlnbeJ 6ulsua3!l 4e4M o4 se we4Ja3un ale Jo }OeJ4uoO pepua4u! .10 J8UMO ay} JI 'Mel 848 }s Japun
uol4eloln Joueawapslui 8 Jo} p8410 eq Aew Jo4OeJ4uoO pue J3UMO ay} 44oq 'Me! Aq paJlnbeJ se pasua011 4ou s! Jo }O8J4uo3
ay} 4.1 •suol4eIn6aJ 18001 pue awls y4!M aOU8pJ000e u! pasua011 eq o} peJ!nbeJ eq Aew Aay4 '){JOM a)Iepepun o4 sJO40eJ4UO0
Jo Jo40eJ4un0 a pally sey J3UMO ay} 41 :531111I8ISNOdS32i 21013V J1N00 QNY S2i01OV211N00 a35N3011Nl
•suo!}O!J}saJ peep alge3pddB
Aue 441M aOUe!Idwo3:JOJ A4lIlq!suodseJ sawnsse pau6lsJapun 841 . suol4eln6aJ A4un00 uey4 0n140!J4SeJ &IOW aq Aew 1O!yM
suol4O!J}saJ;,,paap }:4Oafgns aq Aew ;pied s!141 4e44 spue4siapun pau6!sJapun 3141 :SNOI10R11S321 9339 AO 33110N