HomeMy WebLinkAbout11-12274 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(si3) �so-oo20 12274
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12274 Address: 5048 GALL BLVD
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: 11-26-21-0000-01400-0000
Improv. Cost:
Date Issued: 8/18/2011 Name: CUMBERLAND FARMS (NAK MOM)
Total Fees: 25.00 Address: 777 DEHAM ST
Amount Paid: 25.00 CANTON, MASS
Date Paid: 8/18/2011 Phone:
Work Desc: FPM-SEMI ANNUAL HOOD CLEANING FOR HOLE IN ONE DONUTS
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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 Fira 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
�)� � Fax-813-780-0021
ei3-78o-0o2✓/y�- City of.Zephyrhills Fire•
L �t'1 C - Permit Application
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)wners Name Owners Phone Number
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ee Simple Titleholder Name Titleholder Phone Number � C� �
ee Simple Titleholder Address _ __
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Parcel #
�ub Division - _
� Bio-Hazard Waste Storege - ANNUAL a Fumigation Tent
a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Faciliiy) ANNUAL
a Controlled Bum � Hood Instatlation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Gene2tor > 30 kw a LP/Natural Gas-ANNUAL Sale
a Fire Protection Maintenance - ANPtUAL � Places of Assembly-ANNUAL _
❑ r y aemi X�nT� er °•y
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Sprinkler ❑ � � � � Recreational Bum /
Fire Alartn � � � � � � Sparklers /7 �/y
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Hood Cleaning �❑ EY � � � Sprinkler System InstallaGons I I
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) \
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps a Waste Tire Storage ANNUAL
a Fire Works
� Flammable Application- ANNUAL Valuation of Project
� Fue( Tanks
a Other:
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�ontractor Company � `
Signature Registered l� � Fee Current Y 1 N
Address License # �— �
ELECTRICIAN Company
Signature Registered Y/ I�l Fee Curre�t Y/ N
Address License i� �— �
PLUMBER Company
Signature Registered Y/ Iv Fee Current Y/ N
Address �— _ License !�
MECHANICAL Company
Signature Registered Y/ f�l Fee CuRent Y/ N
Address License #
OTHER Company
Signature Registered �' /(�l Fee Current Y/ N
Address License #
Directions:
FII out application completely.
Owner 8 Contractor sign back of application, notarized (�r, copy of signed contract with owner)
if over 52500, a Notice of Commencement is �equired (Mechanical work over $5000)
Supply iwo (2) sets of drawings with applicable documentation
Allow 1Q14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com)