HomeMy WebLinkAbout10-10110 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10110
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 10110 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 - 0000 - 01400 - 0000
Improv. Cost: _ ' : R F , s , — > - ro I'r ',
Date Issued: Name: CUMBERLAND FARMS (NAK MOM)
Total Fees: 25.00 Address: 777 DEHAM ST
Amount Paid: 25.00 CANTON, MASS
Date Paid: 2/10/2010 Phone:
Work Desc: FPM -HOOD SEMI- HOLE IN ONE - SCHE 2/10/10
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Fl - E A EPTAN ,,� AN 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." eriPP
�
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
%13-78010020 City of.Zephyrhills Fire. If ffitrf 1 010 Fax - 81:-780 -0021
Pe it Application ..
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Date Received I V / P hone Contact for Permit %�j
Owner's Name Z 0 --//04/47-1-/ Owner's Phone Number g /3 S
Owner's Address P o. gV'` q73 7>1 /i / / F `- 3i7
Fee Simple Titleholder Name ` 1``s) Titleholder umber
Fee Simple -fitieholderAddress I '1 l
,.
Job Address ( / , DOk C.- OL E /ii/ 0/VC DOW TS' S Lot#
Sub Division Parcel #
n Bio- Hazard Waste Storage - ANNUAL • _ - - • -
n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
Controlled Bum Hood Installation
I I Emergency Generator < 30 kw - LP /Natural Gas - Installation
) I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
I I Fire Protection Maintenance - ANNUAL l I Places of Assembly- ANNUAL
!(.ttrly! !berm] lAnl I tither
Sprinkler n ❑ ❑ ❑ ( Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I I I Sparklers
Hood Cleaning { ❑ cr ❑ I 1 I I Sprinkler System Installations
Hood Suppression I I ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys)
I i Fire Alarm Installation n Torch Roofingffar Kettle
n Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
I Flammable Application- ANNUAL f I Valuation of Project
I I Fuel Tanks
n Other: I I
Contractor / Company "' � �ii�r�7r1�
Signature ,,.. -c c Registered Y / N Fee Current Y / N
Address I I License # I I .
ELECTRICIAN Company I
Signature Registered Y / N I Fee Current I Y/ N j
Address I I License # I
PLUMBER Company I
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License #
MECHANICAL Company I
Signature Registered Y / N I Fee Current I Y / N I
Address I 1 License # I
OTHER Company I
Signature Registered Y / N I Fee Current I Y / N I
Address License # I
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)