HomeMy WebLinkAbout11-12000 CITY OF ZEPHYRHILLS �
` 5335 - 8TH STREET
�si3) �so-oo20 12000
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12000 Address: 7350 DAIRY RD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35-25-21-0010-06900-0020
Improv. Cost:
Date Issued: 6/14/2011 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/14/2011 Phone: (407)975-3000
Work Desc: FPM- SPRINKLER QUARTERLY- ZEPHYRHILLS REHAB & HEALTH
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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."
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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
813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
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Date Received ZLS /� Pho o t gSf � {P S� /.� S x
ne C ntact for Permi V
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Owner's Name �L � y Lj �� d' C�A Owner's Phone Number �I 3 7 gp ��
Owners Address `73Sf1 �A%Ie /� �� R �L% «'/� / �-` 3� sy�
Fee Simple Titleholder Name Titleholder Phone Number �� �
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 a Hazardous Material (Tier II or RQ Faciiity) ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Instailation
� Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale / ��/,
� Fire Protection Maintenance - ANNUAL Places of Assembly-ANNUAL �{/ V
tr y emi �n t er �
Sprinkler � �► ❑ ❑ B � Recreational Burn
Fire Alarm � ❑ O ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression � D ❑ ❑� � 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
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Contractor ' Company j�t L� %I/1G
Signature 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 Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
OTkiER Company
Signature Registered Y/ N Fee Current Y/ N
Address 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 �ftgr submittal date. Parcel #- obtained from Property Tax Notice (http.//appraiser.pascogov com)