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10-10203
CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 10203 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 10203 Address: 6938 MEDICAL VIEW LN 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: 02 26 - 0290 - 00000 - 0070 Improv. Cost: Date Issued: Name: LENDALL, KNIGHT& CHRISTINA Total Fees: 25.00 Address: 4901 SEMINARY RD Amount Paid: 25.00 ALEXANDER VI 22311 Date Paid: 3/05/2010 Phone: (571)312 - 1243 Work Desc: FPM -FIRE ALARM ANNUAL- NORTH WIND PROPERTIES A, a _ m r ,, ` .. "' 3= � �. � .> g.a; :: W7( E x..; •.... , 07 ov " AT• AL •LU I4N, IN FI 'ERMIT ES 25.00 c FIRE A E-TA 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." tar 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 -, 80 -0020 City of Zephyrhills Fire I 0 -I 3 Fax -813- 780 -0021 Permit Application [ Date Received I 1 Phone Contact for Permit 1121 1 ti 2 1 q q 3 Owner's Name G ! , I. ,, i , J / `r , ` L L Owner's Phone Number fr/ 3 1 7 O 0 ' . &d Owner's Address 5 F 5a C A /M,• /eal/ ' !!A/ Ire 916 4I,P_)(drt VII (;),230 3 Fee Simple Titleholder Name ( Titleholder Phone Number Fee Simple Titleholder Address I l ., , .. __ _ ...s�ars� / 'Ifs I LA . ,:,::� , .. _....: _ Job Address 9 3 / rA / 1/,.... r ‘.4. - f 1 2 e A 1 J f (5, r l )31 / Lot # Sub Division Parcel # Li Bio -Hazard Waste Storage - ANNUAL a Hazardous Material (Tier II or RQ Facility) ANNUAL El Comm Exhaust Kitchen Hood /Duct n Hood Installation n Controlled Burn = LP /Natural Gas - Installation n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale In Emergency Generator> 30 kw n Places of Assembly-ANNUAL © Fire Protection Maintenance - ANNUAL n Recreational Burn IQtrly) emi lid Other Sprinkler El ❑ ❑ ❑ El Sparklers Fire Alarm ® ❑ ❑ I 1 n Sprinkler System Installations Hood Cleaning ❑ ❑ ❑ I I Ej Standpipes (Sprinkler Sys) Hood Suppression 0 ❑ ❑ ❑ I I = Torch Roofing/Tar Kettle ri Fire Alarm Installation = Waste Tire Storage ANNUAL n Fire Pumps n Fire Works Li Flammable Application- ANNUAL I ( Valuation of Project E Fuel Tanks ❑ Other I .. _. .a_..� '...n ...s-,..:,.. ;: ._. e_.�L v�:c::. __. :tu _?si.a -- - v:t.:mxi:3z' � _or.;ri a3" -- ... _+:.. , :ii ivnik « �1..k.s._.n._ -_. . ... . . . Contractor Company A T 4 S ItA :-►•on . t. I Signature Registered Y / N Fee Current I Y / N } Address 3531 1'+¢9 .54 -en Rest. I License# ( EVOOOO 2 14i 1 I ELECTRICIAN Company Signature Registered Y / N I Fee Current I Y / N I Address I License # PLUMBER I Company Signature I Registered Y/ N I Fee Current I Y / N I Address I I License # I MECHANICAL Company Signature Registered Y/ N 1 Fee Current I Y/ N I Address I License # OTHER Company Signature Registered Y/ N I Fee Current I Y / N I Address I I License # 1 I Directions: Fit out application completely. Owner 8, 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)