HomeMy WebLinkAbout09-9449 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9449
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Nu
tuber: 9449 Address: 551 19TH ST
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN.E Township: Range: Book:
Proposed Use: CHURCH Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11 26 - 0010 - 14300 - 0000
Improv. Cost:
Date Issued: 8/24/2009 Name: FIRST PREBRYTERIAN CHURCH OF ZEF
Total Fees: 25.00 Address: 5510 19TH ST
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/24/2009 Phone: (813)782 -7412
Work Desc: FPM- ANNUAL FIRE ALARM- FIRST PRESBYTERIAN CHURCH s Of , I ` 63.2/ -vq
#a` w . pay, A y., r k �t `.` "` , . -s, �. �i s, ''o' e
RAL A I0N V I • BA UA RE 'E RMIT E 25.00
W �
FIR A P AN
F inal
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."
aril"
ArSi
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 4 ! Fax -813- 780 -0021
Permit Application I
Date Received 1 I Phone Contact for Permit
Owners Name F7 F � " Owner's Phone Number I 'f 3 1 c ;.. , 17�� I
Owner's Address 5 (0 / r) , ,V e - � /t l 5 3 3� 0
Fee Simple Titleholder Name 77 Titleholder Phone Number I
Fee Simple Titleholder Address
Job Address
Lot #
Sub Division Parcel #
Bio- Hazard Was ; �,.. �.F „�..,:• u .�, ,.,,.v,� _ ",._. __ ;.� _
I I to Storage - ANNUAL pi Fumigation Tent
pi Comm Exhaust Kitchen Hood /Duct IT Hazardous Material (Tier II or RQ Facility) ANNUAL
I I Controlled Bum I Hood Installation
F 1 Emergency Generator < 30 kw I] LP /Natural Gas - Installation
I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale
{I Fire Protection Maintenance n Places of Assembly- ANNUAL
gag Isemil 621 tither
Sprinkler ID ' p / Recreational Bum i'' 1 Fire Alarm I ❑ ID ffi I I 1 I Sparklers Hood Cleaning I ❑ ❑ ❑ I I Fl Sprinkler System Installations S" ff v
Hood Suppression IT ❑ ❑ ❑ I 1i Standpipes (Sprinkler Sys)
f 7 Fire Alarm Installation I I Torch Roofing/Tar Kettle
ri Fire Pumps n Waste Tire Storage ANNUAL
I Fire Works
Flammable Application- ANNUAL
1 ( Valuation of Project
f 1 Fuel Tanks
I Other I
...A: " _ ...... .... i . ..... / .� K.�#`-.,� �::€ / Paz�t. ...& a1�..nzz..,t, ate ✓.....<.., x.Y .. .,.:;
/ ,Wi. 6-`1440,r, BRA
Contractor rip /�l P�f C� �:�...�...:
Company c( CQ2Aa�
Signature Registered Y/ N I Fee Current Y / N I
Address I License # I
ELECTRICIAN Company
Signature Registered Y/ N j Fee Current I Y/ N I
Address 1 I License #
PLUMBER Company
Signature Registered Y/ N 1 Fee Current I Y / N I
Address 1 I License # I
MECHANICAL Company
Signature Registered Y / N J Fee Current I Y / N I
Address I I License #
OTHER Company
Signature Registered Y/ N 1 Fee Current I Y / N I
Address I
_.,
1 License #
Directions:
..... _ a.....a ,. z ...,. * . �.:
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)
padwe ;s Jo pa ;uud `pedks /Je;oN }o aweN padwe ;S Jo pa ;uud `pad/(; IGe ;oN }o aweN
•oN uoiss!ww00 •oN uoissiwwOO
oijgnd lJe ;oN
oiIgnd lie ;oN
•uoi;eogquap! se uogeogguap! se
peonpoid aney/sey Jo ew o; wow{ SpeuosJed aJe/si oym peonpoid aney /sey 10 aw o; uMouj Aneuosiad aye /si oqM
Aq Aq
awig}e Jo) o; worms pue paquosgns siy; ew aio}aq (pawig }e Jo) 01 woMS pue pequosgns
aw aJO }aq (p 1N3 W 2!O b3NMO
aOlOy211N00
(EO'L66 • S•d) vaI Old
'1N3W33N31101103 AO 33110N 2lfOA 0NIO21003Z132l0I38 A3N21011V NV SO 2130N311ifOA HlIM ONIAVd
IflOA NI l� `JNS3N I AVIN N3W3ON3WWO0 O noA AI 30110N V d 02�O0321 01 32if1 Id afOA a3NMO 1 ONIN2lVM
2lf10A NI fl
•pauopuege paJap!suoO s! qof ay4 `si(ep an!}noesuoo (06) /(;aup Jo4 saseao )!JOm 41 'uoisua4xe ay; JO4 asneo aIge!4!4sn(
a4eisuowap I!!m pue sip (06) /gaup paaoxe o; 4ou po!Jad e Jo4 18!Og4O 6uiplln8 314; W04 `6u!4!Jm u! `pe;sanbeJ eq Aew
uo!sua4xa ud 'paouawwoo s! vOM ay; aw!4 ay; Ja448 sy4uow (9) x!s 40 pouad e Jo4 pauopuege Jo papuedsns s! 4!wJed 3144
Aq peZIJOglne Tom 4! Jo `aouenss! 4!wiad 4o SLi4uow x!s u!Li4!m paouawwoo s! 4!wJad Lions Aq pez!Jo44ne VOM ay; ssa!un
menu! awooaq 'legs panss! 4!wJed Aien3 'sapoo Aue 4o suo!;eIO!n Jo uo!4OnJ1suoO `sueld u! SJOJ o uoo 6 ue bas
,34483,3144 woJ41epl44O 6u!pling ay4 4uan3Jd puled e 4o aouenss! !legs JOU `sapoo leo!U139 3144 Jo s s aq Heys Aue 3 e l a
Jo `Jape 'Iaoueo `948101A o; �(;uog4n8 se 40u pue Tom 9144 44!m pee3ad o; asuao!! a aq o; p ; q II 14 P 4.
v •uol4e3!ldde ay; u! papnpu! A!Ieoupads lou suo!4e1184sU! J9144O .10 `se6 `6u!uo!;tpuoO J!e `stood Vann `su6!s `6wgwn!d
VOm 189/49313 Jo4 p3JmbaJ eq Aew puled a48Jedas a leg} pue ;sJapun 1 •uo!;9nJ4suo3 6upuawwoo o; Jo!Jd 4lnepl44e sly;
u! Lipo41as suo!;!puoo 6u!;41wied 344 40 J3UMO ay; wJO4u! o; 44!84 pooh u! eslwoJd I `213NM0 3H12iO11N3JV 9141 we 141
•e3ue!!dwoo u! aq o; ale4 4snw
suo!43e 4e1M f4!4uap! o; A;!I!q!suodsei Aw s! 4! ley; pue `Tom papuelu! ay1 o1 A1dde Aew sa19u36e ;uawuJano6
Ja144o 40 suo!481n6aJ ay; ;844 pue4sJapun 1 4814; A4!4Ja° ow 1 'uo!4O!psunf ay4 w suo!4eln6aJ 4uawdoIanap
pue! pue 'suo!4ein6aJ 6u!uoz `sapoo 1(4!3 pue A4uno9 `UO!49nJ ;suo3 6u! ;eln6aJ smel lle 4O spJepuels 4aaw
o; pupped aq II!m Tom 11e ;8144 pue puled a 4o aouenss! o; Jo!Jd paouawwoo sm.! uol ;epelsu! .10 ){JOM ou 48144
A4!4Ja3 1 'pa4e3!pul se uo! ;elle4su! pue il.iom op o4 41wled 8 we4go o; apew AgaJay s! uo!4e3!!ddy ' ;uawdolanap
pue pue 6u!uoz `uo! ;on.14suoo 6u!;e!n6aJ Sme1 algeo!!dde lie 44!m aoue!ldwo3 u! auop eq Him Tom lie 4814;
pub a4e1n9Oe s! uo!;eo!Idde s!y4 u! uol;ewJO4u! 3144 Ile 48144 41 I •11AVGIAAV a u 2 awwo 0 IS, o 0 3 „19U/NO„ I1N 8 144 0; 4! Jan!!ap
04 Li4!e4 pooh u! os!woid pue 4uawnOOp paquosap anog8 344 4o Adoo e pau!e4Q0 aney 1 48144 /(4!439 1 `Jaumo„ 3144 uao4 Ja144o
auoawos s! ;ueO!IddB 3144 pue ein;!nop6y 40 4Uaw4Jedap epuold 3144 Aq paJedeid « ap!nO uo!49a4ad
41 SJ!e 4}14 Jawnsuo O P
s,JeumoawoH —met u3!l uo!4OfJ4suoO epUOld 344 4o Adoo 8 44!m p3p!no1d uaaq aney ` ;ue3!Idde 0144 `1 leg; '4!Pao
I 'WOW Jo 00 s! )jJOM 4o u0! ;enIen 41 :(pepuawe se `sa ;n ;e;$ epIJold `ESL Je ;de40) MV1 N3fl N011Of1S1SNO3
posed u! sa6a1!AIJd 6u!,4!WJad o; pa14! ;ue 4ou s! pub pasuaO!l Apad0Jd 4ou s! ay 48144 uo!48O!pu! ue aq Aew 48144 'J049814UO3
ay4 se u6!s Jaumo ay; se `not( 41 'a1q!suods9J aq 1I!m A3141 Li9!14m J04 uo! ;BO!Idde s!44 40 „ 10018 Jo;OeJ4UO3,, 3144 4o suo!4Jod
ane 04 as!n a s! a SJO ;OeW ;uo3 Jo Jo4oe.4uo9 8 paJ!14 s814 Jaumo 0144 4! `aJOwJa44Jnd •6008
u6!s (s)JO4OeJ4uo9 8144 Li ; P P 4 � o4
- LPP8 4e uo!49as 6u!suao!l— uo!s!n!Q u0!40adsul 6u!plm Oe uoO 8 k4uno3 posed ay4 4 ; pas!n 918 ICa44 `)lJOm papua4u!e s Ja un
344 Jo4 �Cidde Aew s4uawei!nbeJ 6u!sua3!I let” 04 se u!8;Ja3un ale Jo ;OeJ4uoo p8Pu W! J se 331439
m 1 ! ou M81
s! a 848 J9 uof
uo! ;e1o!n Joueawaps!w 8 Jo4 pap aq /Sew JopeJ4U09 pue Jaumo 814; a nb3J 1 � a e a un o; sJO;9eJ4uo3
3144 41 •suo!481n69J 18901 pub 8484s 14 ;!m a9uepJO998 u! pasua9y aq o4 p a q Aew Aa S8 q4 `� )i P
Jo Jo4O8J1U09. 8: paJ!4 sey Jaumo 0144 41 :53111I81SNOdS3 . 801OV I1N00 0NV S21010V2l1N00 03SN3
•suo!4O!J4saJ paap a!q i
Cue 44!m aau8!1dwo3.JO4 i(4!1!q!suodsa sawnsse pau6!SJapun ay1 'suo!481n68J /C4unoO uey4 3n!4OU4sa1 a1Ow eq Aew 14O!14m
,suo!4O!J4sal.paap „- 04.4Oafgns eq Aew 4lwJed 3!44 4ey4 spue4sJepun pau6!sJepun 8141 :SNO1101S1S321 4330 30 33110N