HomeMy WebLinkAbout09-9464 CITY OF ZEPHYRHILLS
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5335 - 8TH STREET
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(813) 780 -0020 9464
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 9464 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 _,
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Date Issued: 8/24/2009
Name: CUMBERLAND FARM (NA MOM)
Total Fees: 50.00 Address: 777 DEHAM ST
Amount Paid: 50.00 CANTON, MASS
Date Paid: 8/24/2009 Phone:
Work Desc: FPM- HOOD /SUPPRESSION SEMI- HOLE IN ONE DONUT
E UR R •UIPTEN LL IR P - MI F S € _,
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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."
. 10 1 2 , -
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 r
1 Phone Contact for Permit
Owner's Name Owners Phone Number. 1 1 9 Lcryo
Owner's Address
Fee Simple Titleholder Name Titleholder Phone Number 1
Fee Simple Titleholder Address
Job Address Lot #I
Sub Division
Parcel #
., � �. ...
l I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
Controlled Bum n Hood Installation
n Emergency Generator < 30 kw n LP /Natural Gas - Installation
n Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale
n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
!Carly' 'Semi J" Fi I Uther
Sprinkler 7 ❑ ❑ ❑ I I Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I Sparklers
Hood Cleaning ® ❑ ; ❑ I I n Sprinkler System Installations
Hood Suppression [2L❑ X ❑ I 1 1 1 Standpipes (Sprinkler Sys)
I I Fire Alarm Installation I I Torch Roofing/Tar Kettle
7 Fire Pumps n Waste Tire Storage ANNUAL
I 1 Fire Works
Flammable Application- ANNUAL 1 ( Valuation of Project
-
� ; , I � Fuel Tanks
n Other: 1
.
C ontractor , . ., . . . .. ... u.... .. . M k., . �...�__ „.,
Company
Signature
Registered Y / N I Fee Current I Y / N I
Address ( I License #
ELECTRICIAN Company
Signature Registered Y / N I Fee Current I Y / N
Address I
1 License #
PLUMBER Company
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 1 License # I
OTHER , Company _ _
Signature r' v�l Registered 9 mum Fee Current 411101011
Address l 1 License # 1
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)
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Jacqueline Eloges
From: Jacqueline Boges
Sent: Thursday, August 27, 2009 2:04 PM
To: Kerry Barnett
Subject: CREDIT GIVEN PRMT #9464
Kerry
Security fire Equipment pulled a permit for suppression & hood maintenance for 5048 gall blvd — hole in one donut shop
. I credit the permit # 9464 because the maintenance has already been done.
Thanks
Jackie Boges
Code Support Specialist
ext. 3513
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