HomeMy WebLinkAbout11-12334 CITY OF ZEPHYRHILLS /
- , , 5335 - 8TH STREET �
�sis� �so-oozo 12334
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12334 Address: 7050 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN ownship: Range: Book:
Proposed Use: MEDICAL Lot s:
Square Feet: � � Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 30-26 -20-0000-00200-0010
Improv. Cost:
Date Issued: 9/08/2011 Name: FL HOSPITAL OF ZEPHYRHILLS
Total Fees: 50.00 Address: 7050 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/08/2011 Phone: (813)783-6189
Work Desc: FPM- SPRINKLER QUARTERLY/ALARM SEMI - 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 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 activi without an a
inspection shall be charged double permit fee ty pproved final
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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PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSP �pN OFFICER
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
a�3-�so-oo2o City of Zephyrhilis Fire
Permit Application Fax-813-780-0021
Date Received ' � Zp��
Phone Contact for Permit C -== � _ J lasQ
owner's Name ��n��,(,4. �1�/ ,� L B � 3S
Z� h "%�� Owner's Phone Number ��� �
Owner's Address 7� GA� /JL � z /� Rh� �S ��, 33S'//�
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Fee Simple Titleholder Name � �� ��
Titleholder Phone Number
Fee Simple Titleholder Address
Job Address ��
Sub Division Lot #
Parcel #
� 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
� Fire Protection Maintenance - ANNUAL � % � �7 � / /
Places of Assembly-ANNUAL � /5 `�
tr y emi � t er ❑ J
Sprinkler � � �
� Recreational Burn
Fire Alarm � � � �I ❑
❑ L_J Sparklers
Hood Cleaning � � � � ❑
❑ Sprinkler System Installations
Hood Suppression ❑ � � ❑
� Standpipes (Sprinkler Sys)
Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps �
❑ Waste Tire Storage ANNUAL
Fire Works
� Flammable Application- ANNUAL
� Valuation of Project
Fuel Tanks
0 Other
Contractor
Signature ` /' Company �� . ���
Registered Y/ Fee Current Y/ N
Address
ELECTRICiAN License #
Signature Company
Registered Y/ N Fee Current Y/ N
Address
License #
PLUMBER
Signature Company
Registered Y/ N Fee Current Y/ N
Address
License #
MECHANICAL
Signature Company
Registered Y/ N Fee Current Y/ N
Address
License # �
OTHER
Signature Company
Registered Y/ N Fee Current Y/ N
Address
Directions License #
Fill out application completely
Owner & Contractor sign back of applicahon, notarized (Or, copy of signed contract with owner)
If over $2500, a Notice of Commencement is required (Mechanical work over $5000)
Supply two (2) sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date Parcel #- obtained from Property Tax Notice htt //a
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