HomeMy WebLinkAbout11-11513 CITY OF ZEPHYRHILLS
5335 - STH STREET
(sis) �so-oozo 11513
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11513 Address: 5048 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0000-01400-0000
Improv. Cost:
Date Issued: 2/16/2011 Name: CUMBERLAND FARMS (NAK MOM)
Total Fees: 25.00 Address: 777 DEHAM ST
Amount Paid: 25.00 CANTON, MASS
Date Paid: 2/16/2011 Phone:
Work Desc: FPM- SEMI SUPPRESSION - HOLE N ONE DONUT
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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 INSPECTlON - 8 HOUR NOTICE REQUIRED
ZEPHYRHiLLS FiRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
813-780-0020 City of Zephyrhills Fire
Fax-813-780.0021
Permit Application
Date Received Phone Contact for Permit ���
Owner's Name p���{/- ��.,v� a.r �1 J f �� ��'
Owner's Phone Number
Owner's Address � � ��
Fee Simple Titleholder Name r� ��
Titleholder Phone Number L
Fee Simple Titleholder Address
Job Address �
Lot #
Sub Division
Par�el #
� Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent '
a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Faciliry) ANNUAL
� Controlled Bum � Hood Installation
� Emergency Generator < 30 kw
� LP/Naturai Gas-Installation
� Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
❑ � emi � er ❑
Sprinkler O ❑ ❑ Recreational Bum
Fire Alartn � ❑ ❑ ❑ � � Sparklers
Hood Cleaning �❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression �❑ � p�� � Standpipes (Sprinkler Sys)
� Fire Alarm installation � Torch Roofinglfar Kettle
� Fire Pumps a Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL
Valuation of Project
Fuel Tanks
Q Other:
a ..� r... �, x'• . � . �.na '.?.a. �Sa .��'tlsT � ��'r'^ m, �. e .
CO�tfaCtOf � '" ' " . -
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
License #
ELECTRICIAN
Signature �
Company
Registered � r i ni � Fee Current Y/ N
Address
License #
PLUMBER
Signature
Company
Registered I Y� N I Fee Current Y/ N
Address
License #
MECHANICA
Signature
Company
Registered I T% ry I Fee Current Y/ N
Address
License #
OTHER
Company n � p�.se LL �°
Signature ��1 Registered / N� Fee Current �/ N
Address
. �� ����.': .:,.,, : License # S'��J do4ri'S9G
Directions: _ .. �...5 � »:..�«..�, ,.m...�.. ...�.._..,,;.:<�: . ... �nz ; ��=.r� v: '
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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 dxumentation
Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:!/appraiser.pascogov.com)