HomeMy WebLinkAbout10-11176 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 11176
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11176 Address: 6712 DAIRY 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: 02- 26 -21- 0010 - 03800 -0000
Improv. Cost:
Date Issued: 11/19/2010 Name: LUSARE INVESTMENT HOLDINGS LLC
Total Fees: 25.00 Address: 28804 FALLING LEAVES WAY
Amount Paid: 25.00 WESLEY CHAPEL, FL 335435761
Date Paid: 11/19/2010 Phone: (813)679 -1883
Work Desc: FPM- SPRINKLER ANNUAL- PEDIATRIC PATNERS
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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." fraPP
Ara 427
P .411 . 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 11 `P Fax- 813 - 780 -0021
Permit Application
Date Received I 1 Phone Contact for Permit 14 21- 11 1 l g q 3
Owner's Name Prd in, -I It t Pr. N butt S J Owner's Phone Number / 3 178o I 1 4 v .
Owner's Address 6 7 / C^ U G f / f 2 /l �"/f if/ // 1 / - 3 j 3s 7 ‘� `
Fee Simple Titleholder Name / I I
Titlehoider Phone Number
Fee Simple Titleholder Address I
Job Address
Lot #
Sub Division 11 1 Parcel #
I Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier 0 or RQ Facility) ANNUAL
Comm Exhaust Kitchen Hood /Duct Ii Hood Installation
I Controlled Burn I LP /Natural Gas - Installation
El Emergency Generator < 30 kw Ii LP /Natural Gas - ANNUAL Sale
n Emergency Generator> 30 kw I I Places ofAssemb:y- ANNUAL
I CI Fire Protection Maintenance - ANNUAL EI Recreational Bum
lQO ❑
IYI 'Semi' �n ml� 'O I
n Sprinkler Sparklers
Fire Alarm El ❑ ❑ ❑ J J 1 l Sprinkler System Installations
Hood Cleaning CI [7 0 I I I J Standpipes (Sprinkler Sys)
❑ Hood Suppression ❑ ❑ ❑ I I I I Torch Roofing /Tar Kettle
n Fire Alarm Installation 1 I Waste Tire Storage ANNUAL
n Fire Pumps
7 Fire Works
n Flammable Application- ANNUAL I I
EI Valuation of Project
Fuel Tanks
n Other: I
Contractor
I Company A -,-
o�i �{io
Signature
Registered Y / N 1 Fee e Current Y/ N
Address 3531 111015.1.0ne, I License # I qg 35 31(0 la oo z I
ELECTRICIAN' I Company
Signature Registered I Y/ N J Fee Current I Y / N I
Address I I License # I
PLUMBER I
Signature Company
1 Registered I Y/ N I Fee Current I Y / N I
Address I I I
License # I
MECHANICAL' I
Company I I
Signature Registered Y/ N, Fee Current I Y / N I I
Address I I I I
License
OTHER
I Company I I
Signature I
Registered Y N ] Fee Current L Y N
Address I
License #
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 (httpl/appraiser.pascogov.com)
s A TOTAL SOLUTION, Inc BOSCH
SECU 1 1 & FIRE PROTECTION
ION
Total Systems Integration Certified Security Dealer
Installation, Service, Design & Inspection:
November 16, 2010
City of Zephyrhills
5335 8th Street
Zephyrhills, FL 33542
RE: Inspection Permit
To Whom It May Concern:
Enclosed is a check for $50 for permits. Please break it up as follows:
$25 — Annual Fire Alarm Inspection
$25 — Annual Fire Sprinkler Inspection
Sincerely
Amanda Stephan
A Total Solution, Inc.
amanda@atotal solution. com
Phone: 727 -942 -1993
Fax: 727 -943 -5919
3531 Keystone Road, Tarpon Springs, Florida 34688 -7815
Local (727) 942 -1993 Central Florida 1- 888 -ATS -FIRE Fax (727) 943 -5919