HomeMy WebLinkAbout10-10057 CITY OF ZEPHYRHILLS
5335 - 8T1-1 STREET
(813) 780 -0020 10057
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 10057 Address: 37900 DAUGHTERY RD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03- 26 -21- 0010 - 00100 -0010
Improv. Cost: i ; : ®.,
Date Issued: 1/28/2010 Name: DAUGHTERY ROAD PROFESSIONAL CN fl
Total Fees: 25.00 Address: 6719 GALL BLVD STE 106
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/28/2010 Phone: (813)973 -2657
Work Desc: FPM-SPRINKER ANNUAL- BAY AREA MEDICAL- SCH 1/28/10 _
SAP A • MA PRI KLE' AND PI FIRE P - MIT E 25.00
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IRE AC EPTANCE 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."
ICY
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 - 0020 City of Zephyrhills Fire 4 ( 00 6 1 Fax - 813 - 780 - 0021
Permit Application
Date Recewe0 Phone Contact for Permit J 7 seY t v i�P1J
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Owner's Name I t) JY J\ REA >> ETD l r AL C 1. I N t c i P, Ai Owner's Phone Number 18 13 1 I) 1 S 1 1414141,6 . I
Owner's Address 137160 DA( LG Ro. ZEPHYRN ILLS FL 3�5 l I
Fee Simple Titleholder Name I Titleholder Phone Number I I I
Fee Simple Titleholder Address
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Job Address I3770 DA(A. (TA F Rn. ZEPHYRL-1 (I`.L- S a- 3351 / Lot#
Sub Division IC ITY OP ZI_ P4YR 14 1LL S Parcel # I °3 16 OOtO 00/00
n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Comm Exhaust Kitchen Hood /Duct n Hood Installation
n Controlled Bum n LP /Natural Gas - Installation
El Emergency Generator < 30 kw El LP /Natural Gas - ANNUAL Sale
n Emergency Generator > 30 kw n Places of Assembly- ANNUAL
n Fire Protection Maintenance - ANNUAL n Recreational Burn
(Qtrtyl ISemil UM Other
Sprinkler ❑ ❑ n Sparklers
Fire Alarm ❑ ❑ El I 1 n Sprinkler System Installations
Hood Cleaning n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys)
Hood Suppression El ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle
n Fire Alarm Installation n Waste Tire Storage ANNUAL
n Fire Pumps
n Fire Works
n Flammable Application- ANNUAL I I Valuation of Project
n Fuel Tanks
0 Ot er I
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Contractor i Company RSA P UTW ATIC 5 (kttivKLti S APO PIII4
Signature ' 'b G- 4..02-L
.I g.-0 r. SAu.er- Registered Y / N Fee Current Y / N
Address - Q,-Z( aTThnitpee SL. L. it; ekGo 337 1 License# I
ELECTRICIAN Company
Signature Registered Y / N I Fee Current I Y / N I
Address I
I License #
PLUMBER Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License #
MECHANICAL Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address ( I License # I
OTHER Company I
Signature Registered Y / N I Fee Current I Y/ N I
Address
License #
Directions:,,, <.a•E. >,.. ..., .. .,
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)