HomeMy WebLinkAbout10-10107 CITY OF ZEPHYRHILLS
• 5335 - 8TH STREET
(813) 780 -0020 10107
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 10107 Address: 5130 GALL BL VD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN.E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11 26 - 0010 - 07000 - 0012
Improv. Cost: .
Date Issued: 2/09/2010 Name: LUPTON
Total Fees: 25.00 Address: 5130 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/09/2010 Phone:
Work Desc: FPM- HOOD CLEAN QUARTERLY- LUPTON - DONE 1/12/10
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RVIC LL 25.00
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IR A E ANC 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."
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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 I Di 01 Fax- 813- 780 -0021
Permit Application
Date Received I I Phone Contact for Permit 1
1 b $i - ' I his 1/ //n 1
Owner's Name �^ n � 1 Own er's Phone Number I
Owner's Address I I
Fee Simple Titleholder Name I I Titleholder Phone Number I
Fee Simple Titleholder Address
,lob Address 5/ 0 C- LL ALV D Yai is, R. 3 Lot#
Sub Division 1 Parcel #
n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
F Comm Exhaust Kitchen Hood /Duct n Hood Installation
JJ Controlled Burn n LP /Natural Gas - Installation
n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale
0 Emergency Generator > 30 kw n Places of Assembly- ANNUAL
i::
F
Fire Protection Maintenance - ANNUAL n Recreational Burn
❑ (Qtrlyl emi Mal Other
Sprinkler ❑ ❑ ❑ n Sparklers
Fire Alarm I=1 ❑ ❑ ❑ ( I n Sprinkler System Installations
Ia.� I O ( I
Hood Cleaning � { ❑ ❑ I 1 0 Standpipes (Sprinkler Sys)
•o. uppression ❑ ❑ ❑ n Torch Roofing/Tar Kettle
El Fire Alarm Installation n Waste Tire Storage ANNUAL
EJ Fire Pumps
n Fire Works
n Flammable Application- ANNUAL ( ( Valuation of Project
n Fuel Tanks
Q Other:
Contractor
Signature _ - -_ �
— Company II Opt) V R.VI
Registered Qiv7 Fee Current M =V*
Address License #
FI_ECTRICIAN 3 syy Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address
1 License # I I
?._UMBER Company I
Signature Registered Y/ N I Fee Current I Y/ N
Address
I License # I I
MECHANICAL Company
signature Registered Y/ N I Fee Current I Y/ N I
Address I I License # I
ETHER Company I
signature Registered Y/ N I Fee Current I Y/ N I
Address I 1 License #
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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
c:; Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
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