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HomeMy WebLinkAbout10-10370 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 10370 ANNUAL FIRE PROTECTION MAINTENANCE ..dm n :.5: T y x ` '•'x. L - x. " t@ "• n i r Alg. E$r. Permit Number: 10370 Address: 6251 FORT KING RD Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL. Class of Work: FIRE - PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 03- 26 -21- 0010 - 09500 -0000 Improv. Cost: Date Issued: 4/16/2010 Name: ALLIANCE CHURCH OF ZEPHRYHILLS Total Fees: 25.00 Address: 6251 FORT KING RD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/16/2010 Phone: (813)782 -8865 Work Desc: FPM- HOOD SUPPRESSION- SEMI - ALLIANCE CHURCH - CREDIT OF $5.00 ;11{71.7 25.00 e U t, FIR A °elr P A 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." 3 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 v v `- vV ` , ' City of Zephyrhills Fire Permit Application 1 0 3 C Far-e1 7eaooal Dote Received 1 [ �fL+ "`• `�'Ot.r..r„aurvneK• Phone Contact for Permit 727 - 687 -128 Owners Name Alliance ce Church of Ze r h - fiills Owner's Phone Number 0 13 - 782 - 8865 _ Owners Address 6251 Fort Kin. Rd. Ze r h ills, Florida 33542 Fee simple Titleholder Name Alliance Church of Zep Fee Simple Titleholder Address 6251 Fort Kin. Rd. Ze r h rhills Florida 33542 Titleholder Phone Number 81 3 - 782 -8865 1 t'prra.:,':;;li!;� r:�r'rrt�nl;.mrt;ri Ictirirrtnr�n rfi �. r t .. Lrl!Y►a7TQi1M�.1',".t1l7PtL11 ,� -r ingrammintl' ' emeamirtiemsTIErsiaWfmlm" Job Address 6251 Fort Kin • Rd. Ze . h chills Florida 33542 n = ^ =`�= Sub DNlslon Lot # kn^rtss -, Parcel* 03 -26-21 -001 nxn !urrxrs,,,,ww,,antlIm mmrm+a m� *ter 0.0950 CD � a0000 Bk - Hazard Waste Storage - ANNUAL F t ' Fumigation Tent Comm Exhaust Kitchen Hood/Duct r-- t'J Hazardous Material (Tier tl or RQ Facility) ANNUAL Controlled Bum Hood Installation Emergency Generator < 30 kw n Emergency Generator 30 kw LP/Natural Gas -Installation I UD Fire ProlsvGun Maintenance - ANNUAL LP/Natural Gas - ANNUAL Sale ED Places of Assembly- ANNUAL f mr ® t7ther Sprinkler ❑ 0 0 Recreational Bum Fire Alarm � ❑ , C I D El Sparklers Hood Cleaning ❑ 0 0 u © 1____ E Sprinkler System InatallaHnns Hood Suppression ❑ ❑ 0 Standpipes (Sprinkler Sys) 0 Fire Alarm Installation rare Humps Torch Roofing/Tar Kettle Fire Works Waste Tire Storage ANNUAL Flammable Application- ANNUAL Fuel Tanks Valuation of Project ,.. rsfrr, �t 0 Other: ,.:�.. • .,., •.n• Erna rorcoirfio01191R?Tlril)SIENI n Contractor Kevin Hoch Signature Company Fire S sterns Inc. Address P.O.Box 48741 St. Petersbur , Registered Y / N Fee Current Y / N Florida 33743 -8741 License* ELECTRICIAN ttaZ +��f�� • • • / „uQ Ai Signature „pany Address Registered MEN Fee Current NMI PLUMBER Lirwcee ft � Signature Company Aooress Registered Y / N Fee Current MEM MECHANICAL license # Signature Company — Address Registered Fee Current NMI OTHER License # Signature Company Ad Registered �r Fee Current MEM "Dir art*fll^r 1 r Vlmrti: a,nrt:. S( L.,.. unnbwnmvmn .a ».mmgG:a »n.a.a;mtmlt:wpv u•r»nywavHrmrn.cuutnxmt:mruv al7f n Directions: license x ru, FIII out application " `•" ^ ^ rwmaw a .. uraw ..�., Pl• completely. �� _,:.,r,.r.:�.�,:;,.•,.,:nT. -.; ;. Owner R Contractor sign back of application, notarized (Ot, copy orsIgned contract with owner) If over $2500, a Notice of Commencement Is required (Mechanical work over 55000) Supply two (2) Bets of drawings with applicable documentation Allow 10.14 rtaye for review after submittal date. Parcel is . obtained tram Property Tax Notice (haplfappralser.paseogov.coM) • \\ 11-24-2009 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION 70 BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 11/24/2009 EXPIRATION DATE: 11/24/2011 PERSON: HOCH KEVIN FEIN: 200640754 BUSINESS NAME AND ADDRESS: FIRE SYSTEMS INC 2824 68TH ST N SAINT PETERSBURG FL 33710 SCOPES OF BUSINESS OR TRADE: 1- FIRE EXTINGUISHER SERVICE 2- FIRE SYSTEM INSTALLATION IMPORTANT: Purswht to Chapter 440. 09(141, F.S., en olHear of a corporation who elects exemption from MO chapter by filing a certllkate of election inter Ibis sectioe may net recover beneffls or compensation enter this cMplor. P.rssaht to Chapter 400.09(121, r -s.. Certificates of election to be exempt ,. apply only within trio or.r. M Mn enxlnnaa or traie lisr■d an Me neliee 01 election rat be .x0511. Potaexc 10 L hnplet 440.05113), F,S., Notices of election to be exempt and certificates of election to be exempt rh.H be subject to revseelion If, at any time otter the Itliap at mo 1100e11 or tM iaaemcr vl Orr urr.11ie►re, trio p wooed on thr wine or r.rllfIcete no linger meets the renoiremenls of this section for Iszaance of a cortilicele. The department shall revoke a certificate al any time for ware of the perm meed on the eertiilcale in meet the requirements si Mix seetlon, OWC -252 CERTIFICATE OF ELECTION TO. BE tX MPT REVISED 09 - 06 QUESTIONS? (8501 413-16D9 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE 6TATE of FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES .; s • y F DIVISION OF WORKERS' COMPENSATION Pursuant to Chapter 440.05(141, F.S. , an officer of a corporation who CONSTRUCTION INDUSTRY _ -' O elects exemption from this chapter by filing a certificate of election CERTIFlI:aTF OF ELECTION TO BE EXEMPT FROM FLORIDA d - • , . L under this section may not recover benefits or compensation under this WORKERS' COMPENSATION LAW D chapter. p EFFECTIVE 11/24/2009 EXPIRATION DATE: 11/24/2011 Pursulmt to Chapter 440,05(121, F.S., Certificates of election to be PERSON: KEVIN NOM H exempt„ apply only within the scope of the business or trade listed on FEIN; 200840754 R the notice of election to be exempt. BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 440.05(13), ES., Notices of election to be exempt nor sysTcars nve and certif ;cats& of election to be exempt shell be subject to rervnrntinn 38711 NTH IT N If, at any time after the filing of the notice or the issuance of the SAINT PETERSBUCC, FL 32710 certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shell revoke a certificate at any time for failure of The SCOPE OF BUSINESS OR TRADE person named on the certificate to meet the requirements of this 1- FIPC EXTINcu1SN¢R SERVICE, 2- FIRE SYSTEM nrSTALLATION Section. QUESTIONS? 16601 413 -1609 CUT HERE Carry bottom portion on the Job, keep upper portion for your records. OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 STATE OF FLORIDA �� r DEPARTMENT OF FINANCIAL SERVICES { f DIVISION OF STATE FIRE MARSHAL TALLAHASSEE, FLORWVA y FIRE EQUIPMENT DEALER LICENSE THIS CERTIFIES THAT: FIRE SYSTEMS INC 3300A 28TH S 1 KEET NORTH SAINT PETERSBURG. FL 33713 - QUALIFIER: KEVIN 3 HOCH HAS COMPLIED WITH FLORIDA STATUTES AND HAS QUALIFIED FOR THE TYPE AND CLASS SHOWN HEREON TO SERVICE, REPAIR, INSTALL OA INSPECT ALL TYPES OF PRE - ENGINEERED FIRE EXTTNOT TfSHINCT SYSTEMS, EXCLUDES ANY SERVICE, RECHARGE, REPAIR, INSTALLATION OR INSPECTION OF ANY TYPE OF HALON EXTINGUISHER. at ,„ • Chief Pinsnrisl Officer 01 101 12010 07 04 Pinellas 50454200012004 1722290001 1213112011 Issue Date Type Class County License/Permit Number Application # Expire Date •