HomeMy WebLinkAbout11-11562 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
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ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11562 Address: 38107 MARKET SQUARE DR
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost:
Date Issued: 2/25/2011 Name: FLORIDA MEDICAL CLINIC
Total Fees: 25.00 Address: 38107 MARKET SQUARE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/25/2011 Phone:
Work Desc: FPM- QUARTERLY SPRINKLER - FLORIDA MEDICAL CLINIC
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A inal
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 pertormed 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."
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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
313 % 0 �'il�/ OT Z. ephyrhius Fir rax-o � o-r ov-w� i
Permit Application — -
Dats Receiv�d - Phone Con;act for Psrtnit 81'J LZ� �°Sj7
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Own=r's t�am� r�(.(�Zi� (�1C�e— L-`1.�n�C. Owners Phone tJumber �� �
Owner`s Address 3�S �U1 /m�R..kC.''� V�LZ.C+ 7� 4�..��}l(1.b 3 3�Z
Fee Simple TiUeholder Name Titlshold=r Phone Number �� ��]
Fee SimpieTitlshoiderAddrsss
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JobAddress ?3 C)'� l�'Q-YC.� S (J�'dLL �2. (L1-;'IL(rS �'r(, Lot� ��
Sub Division L. � 1`� � Parcel #
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� Bio-Hazard Waste Storege - ANNUAL � Fumigation Tent
a Comm Exhaust #Citchen Hood/Duct � Hazartious Material (Tier Il or RQ Facility) AHNUAL
Q Controiled Bum a Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emerae�cy Generator> 30 kw a LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance -ANNUAL � Places of Assembly-ANNUAL �
tr y emi �n nar J K �
Sprinkier �'J p ❑ � � Recreationai 0um I�' ✓
Fire Alarm � ❑ O ❑ � � Sparkl=rs
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Hood Cleaning � � ❑ ❑ � � SprinklerSystem (nstallations
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
� Fire Alarm Instailation a Torch Roofinglfar Kettle
Fire Pumps � Waste Ttre Storaga ANNUAL
Fire Works
Flammable Application-ANNUAL �S'� Valuation of Project
Fuel Tanks
Q Other:
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ConUactor Company
Signature Regist�red Y/ N Fee Cutrent Y/�
Address License �
ELECTRICIAN Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
PLUMBER Company
Signature . Registered Y/ N Fee Current Y/ N
Address License �
MECHANICAL Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
OTH�R "�:.�L2�1 '(Z Company �pZjar� �IIZ�G. �rZ.�A1,K1.k�S I��
Signature Registered Fea Current � N
Address � . , � . '� License �
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�Dire�tior,s:
Fiil out applicafion completely.
Owner 8 Con;ractor sign back of aoplication, no;artzed (Or, copy of signed contract with owner)
If ovsr 52500, a Notice of Commencement is required {Mechanical work over 55000)
Suooly two (2) s=ts of drewings with applicabie documen;ation
Allow 10-14 days for review aft=r submi;taf date. Parei r- obtained from Property Tax No;i�e (http�/a��aiser.oascogov.com)