HomeMy WebLinkAbout10-10595 CITY OF.ZEPHYRHILLS L
5335 - 8TH STREET
(813) 780 -0020 10595
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 10595 Address: 39735 CHANCEY RD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 24- 26 -21- 0000 - 00100 -0050
Improv. Cost: > .., : 2 ,a,, : 1,, ANSICS7kePo _
Date Issued: 6/15/2010 Name: AGAPE BAPTIST CHURCH
Total Fees: 25.00 Address: PO BOX 1505
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33539
Date Paid: 6/15/2010 Phone: (813)788 -0283
Work Desc: FPM - ANNUAL FIRE ALARM FOR AGAPE BAPTIST CHURCH
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P IAL Y L R• 1 EM . IN IR PERM E 25.00
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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."
P �• IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - S HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041
813- 780-0020 � City of Zephyrhills - Fire-
Fax - 813 -780 -0021
� a Alt 5 Permit Application . 7
)ate Received 17 1 - Phone Contact for Permit ,
)wner's Name f c•;\°‘ S f- e_.-.114t. rc t 1 Owner's Phone Number 1 di 3 I }7 d / ,
owner's Address 39 / 3 5 dial( , c e P-4 b' I5o 5 le- I �► �i �l5 ' 1. 33 5 3 7
:se Simple Titleholder Name 1 I Titleholder Phone Number I ( 1
:es Simple Titleholder Address
Job Address 39 135 C h a ,k. Y► t- Z ` Ze a 4 3 35 o Lot #
Sub Division r %11® Parcel # - •, . -, - ..„0•0 • 100 - e.)056
d
n ' Bio-Hazard Waste Storage - ANNUAL ED Fumigation Tent
EI Comm Exhaust Kitchen Hood/Duct ED Hazardous Material (Tier II or RQ Facility) ANNUAL
n Controlled Bum n Hood Installation
n Emergency Generator < 30 kw n LP /Natural Gas - Installation
Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL [
/0 19'j ..../ e; 'semiI (� Vther
Sprinkler n ❑ ❑ ❑ n a Recreational Bum {
Fire Alarm E ❑ ❑ , 1 n Sparklers
Hood Cleaning ❑ ❑ ❑ 1 1 u Sprinkler System Installation - -• - --- e
Hood Suppression 0 1:1 CI I 1 a Standpipes (Sprinkler Sys) / I
i' M
Q Fire Alarm Installation n Torch_ Roofing/Tar Kettle /
R Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL 1 I Valuation of Project
Fuel Tanks
Q Other. I
Contractor . Company • , c r:[ ✓�•riE L.t� $ ' 013
Signature : c Registered / Fee Current
�Y
Address S1 11:111 11ST�itt�w� �
•�a. 4J License # F. 1000 164 tp I
ELECTRICIAN Company
Signature Registered Y/ N I Fee Current 1 Y/ N 1
Address 1 I License # I
PLUMBER Company
Signature Registered Y / N I Fee Current Y/ N 1
Address I I License # I I
MECHANICAL Company
Signature Registered Y/ N I Fee Current I Y/ N 1
Address I I License # I
OTHER Company
Signature Registered Y / N Fee Curren Y / N
Address License #
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
If over 52500, 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:l /appraiser.pascogov.com)