HomeMy WebLinkAbout11-12315 CITY OF ZEPHYRHILLS "
5335 - 8TH SIREET �
(sis) �so-oo20 12315
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12315 Address: 38135 MARKET SQUARE 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: 02-26-21-0010-03900-0030
Improv. Cost:
Date Issued: 9/02/2011 Name: FLORIDA MEDICAL CLINIC
Total Fees: 25.00 Address: 38135 MARKET SQUARE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540
Date Paid: 9/02/2011 Phone: (813)780-8440
Work Desc: FPM- QUARTERLY SPRINKLER- FLORIDA HOSPITAL
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Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the wsts 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."
�
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-oo2o City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received Phone Contact for Permit 813 621 1357
owner's Name FLORIDA MEDICAL CLINIC Owner's Phone Number 813 780 8440
ownersAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540
Fee Simple Titleholder Name Titleholder Phone Number ���
Fee Simple Titleholder Address
JobAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540 �ot# Y �
sub oivision CITY OF ZEPHYRHILLS Parce� # 02- -- ' '
� Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Burn � Hood Installation
a Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator > 30 kw � LPINatural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
r y emi �n er
Sprinkler � � ❑ ❑ � Recreational Burn
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkier Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� FlammableApplication-ANNUAL $Z 0� Valuation of Project
� Fuel Tanks
Q other
Contractor Company
Signature Registered Y/ N 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 #
OTHER �ERRY T BARRO company RO AN FIRE SPRINKLE , INC.
Signature egistered N Fee Current Y N
a,ddress 2 1 N. 7 TH T. TA P �icense # 46 4 20001199
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 (Mechanica� work over $5000)
Supply two (2) sets of drawings with appticable documentation
Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:l/appraiser.pascogov.com)