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HomeMy WebLinkAbout11-12345 — CITY OF ZEPHYRHILLS � 5335 - 8TH STREET 12345 (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE Address: 5353 5TH ST Permit Number: 12345 ZEPHYRHILLS, FL. Permit Type: FIRE PROTECTION MAINTENANC Ran e: Book: Class of Work: FIRE-PROTECTION MAINTENAN E Lot sSh'p� Blo k: Section: Proposed Use: NOT APPLICABLE Subdivision: CITY OF ZEPHYRHILLS Square Feet: parcel Number: 11-26-21-0010-097 Est. Value: Improv. Cost: Name: HUSSEY, STEPHEN E Date Issued: 9/13/2011 Address: 5353 5TH ST Total Fees: 25.00 ZEPHYRHILLS, FL. 33542 Amount Paid: 25.00 Date Paid: 9/13/2011 Phone: Work Desc: FPM- FIRE ALARM ANNUAL- THE BROACH SCHOOL lJ�-� �" c - ��_����� � ina Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fre prevention and protection related a�iv� �'s�u� ��e�rementioned.1eW� administrative fees, and other 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 RECO �OR MPROVEMENTS COMMENCEMNT MAY RESULT IN YOU D TO OBT N CONSULT TO YOUR PROPERTY. IF YOU INTEN 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 s� �-�ao-oo2o City of Zephyrhills'Fire� Fax-813-780-0021 Perrnit Application • )ate Received = :�s+v�e_:;;¢c��;�-,,,,,, - Phona Contact for Pertnit hvne�s Nama � �� ~ e � CJ Owner's Phone Num6er y �� N � } 5 �� �1�] J' )wner's Addrass S 3 3 �e s !.3.35 �. ?ee Simpie TiUeholder Name TiHeholder Pfione Number C� �� -ee SimpleTitleholderAddress n. Job Addr=ss ,3 S � ,��-_��� 2� � t S � s�. �ot # � 5ub Di�ision � � � � Parcel # � . J � Q,r`/v ,. �C �d0 - dO 7!� � ���� :�:,�.r�.�:,��: Sio-Hazard Waste 5torage - ANNI! L � Fumigatlon Tent � Comm Exhaust Kitchen HoodlDuct � Hazarclous Material (Tler I� or RQ Facllity} ANNUAL � ConVolled Bum a Hood Installatlon � Emergency Generator < 30 �r � LP/Naturel Gas-Installation Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale Fire Proteation Mairrtenance -ANNUAL � places of Assembly-ANNUAL � � y emi nT er � Sprinkler O ❑ p Recreadonal Bum ���5 Fre Wartn � � � �� � SparWers � Hood Cleaning � ❑ p ❑ S rinkler ❑ � o P System Installatlons Hood Suppresslon ❑ ❑ O Standpipes (Sprinkler Sys) Q Fire Alarm Installation � Torcfi. Roofingf!"ar Kettle Fire Pumps o Waste lire 5torage ANNUAL Fire Works • Fiammable Applicatlon- ANNUAL ^---� Fue( Tanks � I Valuation of Project [� Other; Contraotor � � �\ m�,��_e,.n. Signature Y \ . Comparry << �` ,� � L. `.J � Yl Registerecl Y N Fee Current nj Address � � � License # � �y i � ELECTRICIAN Signature Company Reg(stered Y/ N Fee Current Y/ N Address Licanse # � PLUMBER Signature Company Address Registered Y/ N Fee Current Y/ N Ucense # MECHANICAL Signature Company — Registered Y/ N Fee Current Y/ N Address OTHER License # —"-� Signature Company Address Regiatered � 1f / IV � Fee Current �' / N ���'� _ Lioense # D aechons: `""`'�==-� =.�'-�-�...d.W°-° -- Fill out appUcation completely. x '"'" ''` � �� Owner & Contractor sign back of applica6or�, nota�ized (Or, copy of signed contract with owner) If over $250D, a Noti�e of Commencement fs required (Mechanica! work over 35000) Supply two (2) sets of drayvings uvith apPficab�e documentation � Allow 10-14 days for review aiter submittal date. Parcet #- obtained from Property Tax Notice (http://appraiser.pascogov.com)