HomeMy WebLinkAbout11-11998 CITY OF ZEPHYRHILLS /
,, ' S335 - 8TH STREET '
(si3) �so-oo20 11998
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11998 Address: 7050 GALL BLVD
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: 30-26-20-0000-00200-0010
Improv. Cost:
Date Issued: 6/14/2011 Name: FL HOSPITAL OF ZEPHYRHILLS
Total Fees: 50.00 Address: 7050 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/14/2011 Phone: (813)783-6189
Work Desc: FPM- SUPPRESSION SEMI/ SPRINKLER ANNUAL- FLORIDA HOSPITAL
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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 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."
�
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 Fax-813-780-0021
Permit Application
Date Receiveu► L � ��/ Phone Contact for Permit � ��'Q �7
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Owner's Name �/Ci�i1/a y � �� ����� Owner's Phone Number ��3 7�3 �p ��J Y
Owner's Address /�jl�' V`fjl � �!� Lj �� �`, 33�
Fee Simple Titleholder Name Titleholder Phone Number �� � I I
Fee Simple Titleholder Address �
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Job Address ��
Lot #
Sub Division Parcel #
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Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL /� Q�
tr y emi �n t er ❑ ,�/� y�
Sprinkler ❑ p p /(X �
� Recreational Burn '.� � �
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � p ❑ ❑� � Sprinkler System Installations
Hood Suppression � ❑ � ❑ � � Standpipes (Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL Valuation of Project
� Fuel Tanks
Other �r ittsidh A iljRE � j �tu L
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C ontractor . ., . ° ,_. � . ,� .°<3 . �.�. .�,� , � �': �•. �°a.� .,�,.
Company iitst �
Signature N ��
Registered Y/ Fee Current Y/ N
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
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
License #
OTHER
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
x. . License #
Directions: 1
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 htt //a
( p: ppraiser.pascogov com)
8 � s-7so-aozo City of Zephyrhills Fire
Permit Appiication F�'813-780-0021
Date Receivftd �' I ��� Phone Contact fnr Permit 4! G,�j
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Owners Name y � s�n� � jj '[� S Owner's Phone Number ��.+ 7
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Owner's Add�ess /[JSo ,QCL f�l,�r.� � 'L�3" L, �3sY��
Fee Simple T�tleholder Name Titleholder Phone Number ��� �
Fee Simple T"�tlehoider Address
Job Address �
Lot #
Sub Division -
Parcel #
� Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct Hazardous Material
� � (Tier II or RQ Facility) ANNUq�
Controlled Bum � Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
� t y emi � t er ❑ (,�• /� Q�
( � �I (/
Sprinkler ❑ ❑ Recreational Bum � �
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
� Fire Alarm installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Fiammable Application- ANNUAL
� � Valuation of Project
Fuel Tanks
Q Other•
M� �:. � �:;::���: �:��� _
Contractor �.
Signature - -
Company i�y
Registered Y/ Fee Current Y/ N
Address
License #
ELECTRICIAN
� Company
Signature Registered Y/ N Fee Current Y/ N
Address
License #
PLUMBER
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
License #
MECHANICAL
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
License #
OTHER
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
�'��_� < License #
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Directions: . �. �e�:.,.;:�:�.�-��,.,-�-�.:,:�.,„..,W....
..a .,�.�e �.,. ���::35.,��,:,�a���.�"��'°a'3'�».'i�:a���
Fill out application completety
Owner 8 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 1 D-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com)