HomeMy WebLinkAbout11-12316 ..�.
CITY OF ZEPHYRHILLS
5335 - 8TH STREET �
(si3) �so-oo2a 12316
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12316 Address: 38051 MARKET SQUARE DR
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-2 6-21-0010-03900-0020
Improv. Cost:
Date Issued: 9/02/2011 Name: FMC MARKET SQUARE INC
Total Fees: 25.00 Address: 38135 MARKET SQUARE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/02/2011 Phone:
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 costs of Fre
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 Acrnmpany 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 INSPEC7ION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
ais-�ao-oo2o City of Zephyrhills Fire
Fax-813-780-0021
- Permit Application
Date Received r
•--.—.—.,. Phone Contact for Permit 813 621 1357
owners Name FLORIDA MEDICAL CLINIC �� �� ��
Owner's Phone Number
owner'sAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33542
Fee Simple Titleholder Name (�� � ��
Titleholder Phone Number L ��
Fee Simple Titleholder Address
JobAddress 38051 MARKET SQUARE DR., ZEPHYRHILLS, FL ��
Lot #
sub �ivision CITY OF ZErHYRHILLS Parce� # 02- --
� Bio-Hazard Waste Storage - ANNUAL �
� Fumigation Tent
Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale
a Fire Protection Maintenance - ANNUAL a PlaCes of Assembly-ANNUAL
� r y emi � er ❑
Sprinkler � ❑ ❑ Recreational Burn
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression � ❑ O O�� � Standpipes (Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL $25 00
� Valuation of Project
Fuel Tanks
Q Other•
Contractor � ; �,� �
Signature Company
Registered Y/ N Fee Current Y/ N
Address
License #
ELECTRICIAN
Signature Company
Registered Y/ N Fee Curcent Y/ N
Address
License #
PLUMBER
Signature Company
Registered Y/ N Fee Current Y/ N
Address
License #
MECHANICAL
Signature Company
Registered Y/ N Fee Curcent Y/ N
Address
License #
OTHER ,JERRY T BARR Company R N FIRE SPRINKL , INC.
Signature
tered Y N Fee Current Y N
Address 2501 N. 7 TH T. TAM �
�icense # 4 4 20 011���
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 (Mechanical work over $5000)
Suppiy two (2) sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com)