HomeMy WebLinkAbout11-12035 CITY OF ZEPHYRHILLS
5335 - 8TN STREET
(sis) �so-oo20 12035
' ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12035 Address: 38220 HENRY DR
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: 02-26-21-0080-OOA00-0122
Improv. Cost:
Date Issued: 6/22/2011 Name: HCRA PROPERTIES I LLC
Total Fees: 25.00 Address: 333 N SUMMIT ST
Amount Paid: 25.00 TOLEDO OH 43604
Date Paid: 6/22/2011 Phone: (813)788-7114
Work Desc: FPM- QUARTERLY SPRINKLER HCR MANOR CARE
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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
CA�L FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
813-780-002D Gty of Zephyrhills Fire Fax-8�3-780-OC2t
Permit Application
Date Received � � _ _ Phone Contact fOr Permit �} �'�- q y Z � Li Ct 3
Owner's Name u � --� G , r � �� Z� �(/
� Owner's Phone Number �---�-1_LJ L%_G_�� � L
� 35 Owner's Address P �
Fee S�mple Titleholder Name Titieholder Phone Number �� �
Fee Simple Titleholder Address
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Job Address �j P z C (��
� J Lot # u
Sub Division _ Parcel # i
� Bio-Hazard W2Ste Storage - ANNUAL � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Comm Exhaust Kitchen Hood/DuCt � Hood Installation �
� Controlled Burn Q LP/Natural Gas-Instaliation ' 1 ��
� Emerqency Generator < 30 kw � LP/Natural Gas-ANNUAI Sale ��
� Emergency Generator> 30 kw �---� � n places ofAssembly-ANNi.I.q!
� Hre ProFeCUOn Maintenanc � AL � �
Recrzationa� ourn
try emi � e� ❑
Sprinklei � � � �
Sparklers
Fire Alarm ❑ ❑� � Sprinkler System Installations
Hood Cleaning ❑ ❑ 17 ❑ Standpipes (Sprinkler Sys)
Hood Suppression � � ❑ O�� ❑ Torch RoofinglTar KEttle
� Fire Alarm Installation � Waste Tire Storage ANNUAL
❑ Fire Pumps
� Fire Works
� Fiammable Application- ANNUAL ��
❑ Valuation of Project
Fuel Tanks
Q Other
Contractor .. .. , -- - -- - - ._. ,__.,: - .-_ -= °- ° - -
Company - T--
Signature �
Registered Y/ N Fee Current Y/ N
�aaress 3g31 Vte �on �icense# q
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cLECTRfCIAN
Signature
Company
Registered Y/ N Fee Current Y/ N
Address
License #
PLUMBER
Signature
i,ompany
Registered Y/ Pd Fee Current Y/ N
Address
license #
MECHANICAL _
Signawre
Company
Registered Y/ N Fee Current Y/ N
Address
license #
uTHER ;
Sigra'ur� � Company --�
Registered Y/ N Fee Current Y/ N
Address
Cirec;�ons. _ -. _ . .
License #
Fill out application COmpietely
Owner 8 COntractor sign back of appiication, notarized (Or, copy of signed contract with owner)
If over 52500, a Notice of Commencement is required (Mecharncal work over $S0o0)
Supply two (2) sets of drawings with applicable documentation
Allo�,v 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:l/appraiser pascogov com)