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HomeMy WebLinkAbout10-10938 CITY OF ZEPHYRHILLS L/ 5335 - 8T1-1 STREET (813) 780 -0020 10938 e� ANNUAL FIRE PROTECTION MAINTENANCE °`3' Jinx 'F Yn uw W:» : •? i, i x�3 T �k.. „h. 8 ,: h Permit Number: 10938 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: Date Issued: 9/17/2010 Name: HCR MANOR CARE Total Fees: 50.00 Address: 38220 HENRY DR Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 9/17/2010 Phone: Work Desc: FPM- SPRINKLER QUARTERLY /FIRE ALARM SEMI - HCR MANOR CARE A • AL • 1 •' , - - - ♦ 50 C (C)Sre—: I 0 ina 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." orIPP �i ICY 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 . 813-780 -0020 City of Zephyrhills Fire ax -81., 780 -0021 Permit Application Date Received 11111/klig/11" Phone Contact for Permit 1 Q I 1 t q q Owners Name �cr-/ ,/- f ae-4 - 0 I ,� / 1 177K11/3? q 1� �it�L l I Owners Phone Number n / Owner's Address J saa 0 Ye/t � y 0t ?e fAxrh/#5 F/ 3 .5S Y/ p Fee Simple Titleholder Name ( / b / \ I Titleholder Phone Number I I I 1 Fee Simple Titleholder Address I Job Address 3 g 0 /l ex ( Pt at-4 r f /P F 3 3 5 Y) Lot # i r r I Sub Division Parcel # I D Bio -Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL n Comm Exhaust Kitchen Hood /Duct n Hood Installation n Controlled Bum n LP /Natural Gas - Installation n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale n Emergency Generator> 30 kw n Places of Assembly-ANNUAL © Fire Protection Maintenance - ANNUAL n Recreational Burn IQtrly Semi) Mil Other Sprinkler ❑ ❑ 12 I 1 El Sparklers Fire Alarm ❑ .1( ❑ I I n Sprinkler System Installations Hood Cleaning D ❑ ❑ ❑ i I 0 Standpipes (Sprinkler Sys) Hood Suppression ❑ ❑ ❑ ( n Torch Roofing/Tar Kettle n Fire Alarm Installation I Waste Tire Storage ANNUAL I Fire Pumps EJ Fire Works n Flammable Application- ANNUAL 1 ' Valuation of Project 0 Fuel Tanks ❑ Other: I Contractor Company A "T Signature (4.4 !- So Ion . re Registered Y/ N i Fee Current I Y / N l Address I 3531 VI ey,4,c o, Ra, I License # >` F0000 14 L4 I I ELECTRICIAN! I Company Signature Registered Y/ N I Fee Current I Y / N I Address I License # I I PLUMBER Company Signature Registered Y/ N I Fee Current I Y / N I Address I License # I MECHANICAL I Company Signature Registered Y/ N I Fee Current I Y / N I Address I I License # OTHER I Company Signature Registered Y / N I Fee Current I Y/ N Address I I License # I 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) 813- 780-0020 City of Zephyrhills Fire 1 16938 Fax -813- 780 -0021 Permit Application Date Received `lliff'rnallin Phone Contact for Permit 11- 1-7- 119LI Z 1 I l g Q3 I Owner's Name Mii I • • 2QQ-� � / r - 9 Owner's Phone Number I 1 1 1 I Owner's Address I / V? O /re N �r y . �f Z't° /! yik7/S / JS / d 11 Fee Simple Titleholder Name I / i ' Titleholder Phone Number I I I I I Fee Simple Titleholder Address - 1 3 )� ffen,/ �If Job Address y Sub Division ( � �/ � ?.3 S/ � Lot # I Parcel # I Bio- Hazard Waste Storage - ANNUAL El n Hazardous Material (Tier II or RQ Facility) ANNUAL Comm Exhaust Kitchen Hood /Duct Hood Installation n C Burn ED LP /Natural Gas - Installation 0 Emergency Generator < 30 kw ED LP /Natural Gas - ANNUAL Sale E Emergency Generator > 30 kw t IX I I Places of Assembly- ANNUAL Fire Protection Maintenance - ANNUAL �� Recreational Burn I Qtrl Y� � I " "' I (Other I Sprinkler �( ❑ ❑ j I - 1 ]� L _ j Sparklers S i © Fire Alarm a ❑ ❑ ❑ I I I I Sprinkler System Installations Hood Cleaning 0 ❑ ❑ I I I p VI El (Sprinkler Sys) -t Hood Suppression ❑ ❑ ❑ [ I I I Torch Roofing /Tar Kettle t l Fire Alarm Installation I= Waste Tire Storage ANNUAL I I Fire Pumps r - i Fire Works 7 Flammable Application- ANNUAL J Fuel Tanks Valuation of Project Q Other: I I Contractor Signature .1 4 - 41. i . Company I A To 1 3a64io I Registered Y/ N Fee Current j Y/ N I Address 3531 110154.one. I License # I9g 3531/ 0001A002, I ELECTRICIAN' I Company I Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I I PLUMBER I Signature I i Company Registered Y/ N I Fee Current I Y / N I Address I I I License # I MECHANICAL' Signature Company I Registered Y/ N j Fee Current I Y/ N I Address 1 License # I I OTHER j Signature I i Company I Registered Y/ N j Fee Current I Y/ N I i Address Directions: License # 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) A TOTAL SOLUTION, INC. 14769 City Of Zephyrhills 9/15/2010 4999999 • Cost of Goods Sold:5049999 4999999 • Cost of Goods Sold:5129999 50.00 4999999 • Cost of Goods Sold:5299999 • Inspection Permits Dispatch 77312 & 77311 50.00 Cash in Bank - Bank o Permit