HomeMy WebLinkAbout10-10664 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10664
ANNUAL FIRE PROTECTION MAINTENANCE
IFFTlar
Permit Number: 10664 Address: 38220 HENRY DR
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:
Improv. Cost: NI * 0'T.:.,ti _ ' 77c `°°. FIfti*VN
Date Issued: 7/29/2010 Name: HCR MANOR CARE
Total Fees: 25.00 Address: 38220 HENRY DR
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/01/2010 Phone:
Work Desc: FPM - QUARTERLY FIRE SPRINKLER FOR HEARTLAND HCR MANOR CARE
A •TAL •Li I•N INC IR P - M F 25.00
0 (0
FIRE A EPTA., aI '.F.�., >.� , �g.
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."
BIEL-
Ari
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
A TOTAL SOLUTION, INC.
. City Of Zephyrhills 6/29/2010 14631
4999999 • Cost of Goods Sold:5049999
4999999 • Cost of Goods Sold:5129999 •
4999999 • Cost of Goods Sold:5299999 • Inspection Permits
175.00
(i
Cash in Bank - Bank o Permit
175.00
813- 780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021
Permit Application
Date Received I 1 Phone Contact for Permit 112'} 111441 I I i g 4 3
Owner's Name Ye et/ 1-/F (A [-i r k /77n-O! 6,/ f I Owner's Phone Number 19/3 let
Owner's Address 1 1g Pe, i Dr. Ze f � y A / (C pi. 3 7 57 f
Fee Simple Titleholder Name I // / I Titleholder Phone Number I I I I I
Fee Simple Titleholder Address 1
Job Address ("TPA' Ff.. 2 e 4 r/ / //s -/ - 3 35Y) I Lot # I
Sub Division Pa
Parcel #
ri Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Comm Exhaust Kitchen Hood /Duct n Hood Installation
ri Controlled Burn n LP /Natural Gas - Installation
El Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale
I - ( Emergency Generator> 30 kw E] Places of Assembly-ANNUAL
71 Fire Protection Maintenance - ANNUAL ni Recreational Bum
(,J eml gm ter
Sprinkler n 1 ❑ ❑ 1] Sparklers � /J
Fire Alarm CI ❑ ❑ ❑ I I I Sprinkler System Installations r F!
Hood Cleaning 0 ❑ D ❑ I 1 I I
Standpipes (Sprinkler Sys)
Hood Suppression ❑ D ❑ I I I I Torch Roofing/Tar Kettle
n Fire Alarm Installation I I Waste Tire Storage ANNUAL
n Fire Pumps
7 Fire Works
n Flammable Application- ANNUAL I
El Fuel of Project
Fuel Tanks
Ei Other: I
Contractor I Company --
o{G S
Signature R r C Current o� c.
1
Registered Y/ N J Fee Current Y/ N I
Address 353, 111e454.one, ( License# gg 35 3 g000 lap02, I
ELECTRICIAN I Company I
Signature I Registered Y / N I Fee Current I Y / N I
Address I I License # I
PLUMBER I I Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address
MECHANICAL I License # I I
Signature
I I Company I
Registered Y/ N J. Fee Current I Y/ N
Address ( I License #
OTHER I Company I
Signature I Registered Y / N j Fee Current I Y / N I
Address I I 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)