HomeMy WebLinkAbout11-12011 CITY OF ZEPHYRHILLS
�..-= � '
5335 - STH STREET
(si3) �so-oo20 12011
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12011 Address: 6834 MEDICAL VIEW LANE
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: OFFICE PROFESSIONAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0290-00000-020
Improv. Cost:
Date Issued: 6/16/2011 Name: HAITI INVESTMENTS I LLC
Total Fees: 25.00 Address: 6834 MEDICAL VIEW LN
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/16/2011 Phone:
Work Desc: FPM-FIRE ALARM ANNUAL- SELECT PHYSCIAL THERAPY
� �
��(�
��2
�
ina
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 A7TORNEY 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
sis-�so-oozo Ciry of Zephyrhills Fire Fax-813-780-002
� ' Permit Application
Date Received
_:.�,.-..�.._ _.._. ., .._. „�.:.—_,_.-.- _._.-_:._-: . — --- - - - - — -- - ��
_ -. ,,,-._..,.-..-;--_ -._. -__�,.-,:.,: - � � � -� � -
- -- .
Phone Contact for Permit ,�'Z 4�12 1 q
- --- ._. - --.- ;_�- .�- .,:........ ....: R. _ _ x --
�:: F��;_:,,; .. , ,_ .: . .....:.. ..... . . .... _
Owner's Phone Nu �{�'' � ���
Owner's Name ' 1—..9_�.[_...! L�LI
mber
Owner's Address �5 7 � �((� � w G Z P � �� '
Fee Simple Trtleholder Name l"itleholder Phone Nuntber L�1 ��
Fee S�mpie Titlehoider Address
- � :. -•-- _ - .. ..,, � - -
.:
_..._ -_... ..,. .:-:�r, . ._. . �F�,�� �i:�-�;�:., _ - - _- - : ��s: - - — - — _= -_ - - - •_, -
_ _._. ,..... •.,� a� :_...,.. ....,._. - _
_ ,._, - - -.� - =�a-�°F_. :. - - -
. . � .,�>�:a�.�-�-.,�,�-t�—�r�:�-,.:,� ..�
,,_ _...,�..,__��.
_ ��
Job Address � � � � � �3 / ' � j
� Lot # u
Sub Division Parcei #
_ .. , .._._ ._. ,....... .__. .__..
- :._ ._- __�.._���,-;:9;�::;�.��_,.,:.�,.-.�.�:art...a._.z.�=rr- _._,.. _ �,�_.. _..___ _ �.rt�; - _ � -- - -
� .-,_�.;,--_. -.;,_r:. .�,:� � ;_-- �:.:..�:�* .. �i..� __x "-:> .-_-__=_ . ,
� Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier it or RQ Facility) ANNUAL
� Comm Exhaust Kitchen Hood/Duct Q Hood Installation
� Con2rolled Bum � LP/Natural Gas-Instaliation
� Emergency Generator < 30 kw a LP/Naturai Gas-ANNUAL Sale
� Emergency Generator > 30 kw � P!2ces of Assambly-ANN�AI.
� Fire Protection Maintenance -ANNUAL a ReCreational Burn
ry emi � t er � {l
f
Sprinkler � ❑ ❑ ❑ � Sparklers �'
Fire Alarm �❑ ❑ �� � Sprinkler System Installations
Hood Cleaning �❑ ❑ O� � Standpipes (Sprinkler Sys)
Hood Suppression �❑ ❑ ❑� � Torch Roofing/Tar Kettle
� �ire Atarm Installation � Waste Tire Storage ANNUAL
� Fire Pumps
Fire Works
� Flammable Application- ANNUAL Valuation of Project
� Fuel Tanks
� Other:
._ _..,. - :..,;;���s-.=::_�..:�.�� - - -
_ _..�.._, .. . ..__ ..��•,�•,:rr ��=-- - �
__ ��_�_x _:.� ... .�: ._........ -� �. �,-�
.�...�.:.__; .`.___ -.- _ _.. -- _ -
_ _x _:_ --r._. � �� � ._ . ..M..� .__ _ _ - - -
��_.�. - �f.:�.sa_��:_—=-_-.�=���,�,_.:..=-
Contractor Company '""�" .}., ` tu �1'O „
S�gnature Registered Y/�1 Fee Current Y/ N
Address 3531 1�+¢ ��4,ane, Rd . license# �FOOOO�Iy�
ELECTRICIAN Company �
Signature RegiStered Y/ N Fee Current Y! N
Address
License #
°L'JMBER �
Company
S�gnature Registered Y/ N Fee Current Y/ N
Address LiCense # �
MECHANICAL Company '�"i
Signature I
Registered Y/ N Fee Current Y/ N
Address License �L
OTHER
Company "�'t
Signature I
Registered Y/ N Fee Current Y/ N
Address
. --.
_......_. .: ._.,m__,_:�,.=�,:_�._. _-.��.� _.,
�cense
--_._... _ . -_�_.._�-._. �--_-;;_.-_,_-..
Direct�ons _ -'-1_ -- --- • -- - - _ .. = -::_ _,: � .,�,;
Fill ou! application completely
Owner & ConVactor Sign back of apptication, notarized (Or, copy of signed conVact with owner)
If over S2500, a Notice of Commencement is required (MechaniCal work over 55000)
Supply two (2) sets of tlfawings with appliCBble documenletion
Allow 1 o-1a days for review after submittat date. Parcei #- obtained from Propsrty Tax Notice (http://appraiser.pascogov com)