HomeMy WebLinkAbout11-12008 CITY OF ZEPHYRHILLS ��/
5335 - 8TH STREET
(si3) �so-oozo 12008
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12008 Address: 6937 MEDICAL VIEW LN
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: 02-26-21-0290-00000-0060
Improv. Cost:
Date Issued: 6/16/2011 Name: JG HOUSING SOLUTIONS LLC
Total Fees: 25.00 Address: 18711 CHAVtLLE ROAD
Amount Paid: 25.00 LUTZ FL 33558
Date Paid: 6/16/2011 Phone: (813)833-9301
Work Desc: FPM- FIRE ALARM ANNUAL- VA OUTPATIENT
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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
s�saao-oo2o City of Zephyrhills Fire Fax-813-780-002 �
Permit Application
� Phone Contact for Permit �,� Z 9 y�. ► 9 4 3
Date Received _ _
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Ownzr's Name P � rt/ � Owner's Phone Number
Owner's Address 3 � ��C k/ �° �� s'
Fe? S�mple Titleholder Name Titlehoider Phone Number +�� ��
Fee S�mpie Titleholder Address
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Job Address �/"l i � G� �n/ i � S Y Lot #
Sub Division Parcel #
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� Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Comm Exhaust Kitchen Hood/Duct Q Hood tnstailation
� ControAed Bum � LP/Natural Gas-Installation
� Emergency Generator < 30 kw � LP/Naturai Gas-ANNUAL Sale
� Emergency Generator > 30 !av C Piaces of Assembly-F�NNUAL
� Fire Protection Maintenance - ANNUAL � ReCreational Burn �
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Sprinkler � ❑ O ❑ � Sparklers Z V Cl
Fire Alarm �❑ ❑ �� � Sprinkier System Installations 7
Hood Cieaning � O ❑ ❑� � Standpipes (Spnnkler Sys)
Hood Suppression �❑ ❑ O� � Torch Roofing/Tar Kettle
� Fire Aiarm Instaliatlon � Waste Tire Sto2ge ANNUAL
� Fire Pumps
Fire Works
� Flammable App�ication- ANNUAL � Valuation of Project
� Fuel Tanks
� Other:
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Contractor Company T�,ea S �u �'O n
Signature Registered Y/ N Fee Current Y/ N
Address 3 5 31 1� ¢,�I,en � Rc�. License # E. F 0000 �f N�
ELECTRICIAN Company -�
S�gnature Registered Y/ N Fee Current Y! N
Address License #
PLJMBER Company �
S�gnature ( Registered Y I N Fee Current Y/ N
Adtlress License #
MECHANICAL COmpany --�
Signature Registered Y/ N Fee Currant Y/ N
Address License #
OTHER Company �
Signature Registered Y/ N Fee Current Y! N
Address LiCense #
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DirecLOns:
Fill ou! application completely
Owner & ConVactor sign back of application, notarized (Or, copy of signed conVact with owner)
If over 52500, > IVotice of Commencement is required (MeChaniCal work over 55000)
Supply iwo (2) sets of drawfngs with applicable documentation
Allow 10-�4 days for review after submittal date. Parce( #- obtained from PropsRy Tax Notice (http:l/appraiser pascogov.com)