HomeMy WebLinkAbout10-11306 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 11306
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11306 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: 12/13/2010 Name: HCR MANOR CARE
Total Fees: 25.00 Address: 38220 HENRY DR
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/13/2010 Phone:
Work Desc: FPM- SPRINKLER QUARTERLY HEARTLAND MANOR CARE
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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." �!
s -
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 k l (✓"
City of Zephyrhills Fire Fax- 813- 780 -0021
Permit Application
Date Received I 1 Phone Contact for Permit I} z-+ 1111-11 I I I
Owner's Name IMIVESIBEIMM . G / Owner's Phone Number 1 3 I 775-11 /59q1
Owner's Address I D i 3- i ), 0 1_/ 6v / y P.i . Ztof {1 ( AIM A7, 3s I
Fee Simple Titleholder Name
Titleholder Phone Number I 1 1 11 I
Fee Simple Titleholder Address
Job Address
I Lot # I
Sub Division I I Parcel # I I
I Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
ED Comm Exhaust Kitchen Hood /Duct El Hood Installation
El Controlled Burn Q LP /Natural Gas - Installation
LI Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale
n Emergency Generator> 30 kw n Places ofAssembly- ANNUAL
I x I Fire Protection Maintenance - ANNUAL
Recreational Burn
IQtrlyI I Semi I MI'Other 1
Sprinkler 15 (1 ❑ ❑ I Sparklers
Fire Alarm [] ❑ ❑ ❑ I I I I Sprinkler System Installations
Hood Cleaning ❑ ❑ ❑ I n Standpipes (Sprinkler Sys)
Hood Suppression 0 ❑ ❑ 0 I 1 1 I Tor ch Roofing/Tar Kettle
Fire Alarm Installation n Waste Tire Storage ANNUAL
El Fire Pumps
n Fire Works
n Flammable Application- ANNUAL I
Valuation of Project
Fuel Tanks
n Other: I
Contractor -r•- _. ,,::: _ _: _ -.
g I Com I A To la I So Iu4i o I
Signature 1}
Registered Y / N Fee Current Y / N
Address 3531 I', ,.}.one,
I I
License# ( Qg35 3S000lA0oA,
ELECTRICIAN I
Company I
Signature Registered Y/ N I Fee Current I Y/ N I
Address I
1 License # I
PLUMBER I
Signature
Company I I
Registered 1 Y/ N I Fee Current I Y/ N I
Address I I I
License # I
MECHANICAL' I
S
Company 1
Signature
Registered Y/ N j Fee Current I Y/ N I
Address
1 License # I
OTHER I I
Company I
Signature I
Registered Y/ N ] Fee Current I Y/ N I
Address I I 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 (http: / /appraiser.pascogov.com)