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Home My WebLink About11-12378 CITY OF ZEPHYRHILLS _ 5335 - 8TH STREET ~ ' �sis) �so-oo20 12378 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12378 Address: 38220 HENRY 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: 02-26-21-0080-OOA00-0122 Improv. Cost: Date Issued: 9/22/2011 Name: HCRA PROPERTIES I LLC Total Fees: 50.00 Address: 333 N SUMMIT ST Amount Paid: 50.00 TOLEDO OH 43604 Date Paid: 9/22/2011 Phone: (813)788-7114 Work Desc: FPM- FIRE ALARM/SPRINKLER SEMI- HCR MANOR CARE , . 5. ` ��`� ( � -.� � � � �r, ina 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 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 aisaao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received � Phone Contact for Permit },q'} 9L.+Z ( q(�3 Owner's Name P/ — ��, p/ Gi.� Owner's Phone Number � 7� CC Owner's Address b p �( l � / � �. / � � � �'/ Fee Simple Titleholder Name �� Titleholder Phone Number Fee Simple Titleholder Address Job Address � �� Lot # Sub Diwsion Parcel # � Bio-Hazard Waste Storage - ANNUAL � Nazardous Material (Tier II or RQ ANNUAL � Comm Exhaust KitChen Hood/DuCt � Hood Installation � Controlled Burn a LP/Naturai Gas-Installation � Emergency Generator < 30 kw � LP/Natural Gas-ANNUAL Sale � Eme gency Generator > 30 kw � Places of Assembly-ANNUAL � Fire Protection Main!erance - AkNUAL � Recreational Burn � � 1' �. � ef � Sprinkter Sparklers Fire F,larm � O ❑ ❑� � Sprinkler System Installations Hood Cleaning � p ❑ ❑ C] � Standpipes (Sprinkler Sys) Hood Suppression � ❑ ❑ ❑�� Torch Roofing/Tar Kettle � Fire Alarm Installation � Waste Tire Storage ANNUAL � Rre Pumps � Fire Works � Flammable Application- ANNUAL "�� Valuation of Project Fuel Tanks Q Other• ContraCtor �. . � - ._ _.._ . - __,_ �,. _. _ _._. _ _ . .— - - Company -�—� Sgnature � Registered Y/ N Fee Current Y/ N �adress 353{ {h �or� q'18538000�Apo,Z, � License # ELECTRfCIAN Signature Campany Registered Y/ N Fee Current Y/ N Address License # PLUMBER Signature Company Registered Y/ PJ J Fee Current y/� Address � license # MECHANICAL Signature Company Registered Y/ N Fee Current Y/ N Address � License # vTHER Company Sigra:ure � Registered Y/ N Fee Current Y/ N Address _ , License # _._.:_. Directions: - : , - _ _ _ _ ,. Fill out application Completely Owner & Contractor sign back of application, notarized (Or, copy of s�9ned contract with owner) if over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicabte documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov com) sisaso-oo2o City of Zephyrhills Fire Fax ' . Permit Application Date Received � Phone Contact for Permit �,� �l Q�) :t � 9 q 3 ,.._........ _: - -x:}.=::=-.-. - - � - - - - __ _ :.-. . . - - ----- - -.,-.-_:_:..__ _ :.._ .,... _a,-- . ..... . ,/ . - - - - ^ � •-- � -- - �iL a � --� Owner's Phone Nu --- - —. ...._.r. -- Owner's Name mber �� Owner'sAddress �� /L ✓ � �'P � � pl Fee S�mple Titteholder Name Titleholder Phone Number �� Fee S�mple TdlehoiqerAddress _. _. __ _, . -- ;u� - - - - - .. _ . �. -__:_,.. .>. , _.;n>.t.-- -- - - - - . . _ ,.. _,.,. .. _ . .._ .:.-s r .... _ _ _, _._:... ..' -'za...-v:r.-..:�: _ s:L�='_'a.'�'±:__� X]�=.�:eSZ3ar'.a��-T�'� '�.�.: -..�:.._ �._: � �'= _ Job Address tot � � Sub Division Parcel # . _ _.,.. __ _- - -- - - - - ;. . . .._-. ..- r��,._—•,:a__:_.��s �a...,.;r`,r;� - - -. _... _ z�;�:_. - =:�4�._.:�:,��:= --_-.-= — - � Bio-Hazard Waste Storage - ANNUAL a Hazardous Material �er il or RQ Facility) ANNUAL � Comm Exhaust Kitchen Hood/Duct � Nood Instaliation � Controlled Bum � LPlNatural Gas-Instatia6on � Emergenq GeneraTor < 30 kw a LP/Natural Gas-ANNUAL Sale � Emergency Generator > 30 kw � Pla:xs of AsSembly-ANNUAL a Fire Protection Maintenance - ANNUAL a ReCreational Burrt t y emi � er � � Spnnkler � ❑ ❑ ❑ B � Sparklers TI� I�� 3 ��( ( Fire Alarm �❑ � ❑� � Sprinkler System Installations Hood Cieanin9 �� Standpipes (Sprinkler Sys) Hood Suppression �❑ ❑ ❑� � Torch Roofing/Tar Kettie � Fire Alarrn Installation a Waste Tire Storage ANNUAL n Fire Pumps U Fire works � Flammable ApplicaGon- ANNUAL �_ � Valuation af Project Fuei Tanks � Other: - , _ ,. _ . ..... _ _ . .��..:. ,::..:.-. . - - - _ __�,<�.>,::.,,. . - :..___.<.. _. _- .�.�.�,r.,,:.,:_�_.��=�. .,, . . _ _ - �� w - - - - - = - - - _ ._ � _.-�.�, -�_.:�,, =�:_-- - _- -_��_�- __--- � _ . ... _ _ _.� L-�=.�.::__._ :.:....,._ _...: ��..:� . _�:=.�_...a::_: - - ----_ ---- -=�_ � ---- __..._.._---__- =_. �.:.:..,.��:_. . . . -- �.��.� . Contractor Company '""�"' .}, � �u .4.�'O n Signature Registered Y/ N Fee Current Y 1 N Address 3531 l�+e ,�1,one Ra1 License# E.F0000�141 ELECTRICIAN Company � Signature RegiStered Y/ 1�) Fee Current Y/ N Address License # PLUMBER Company -� S�gnawre � Registered Y!(�" Fee Curcent Y/ N AdOress License # MECHANICAL COmpany Sgnature Registered Y/ N Fee Currant Y/ N Address License # OTHER Company Signature Registered Y/ n) Fee Current Y/ N Address License # -._._ . . _ _. _.-•_-_____:-.,.. _ . .._ -- __. _�r=__ - - _- - - - --- •i-- - ._-_�, � ,- - .�.-.... - - - - - :.- � DirecUOns. - -- -.�-_,.�:,�_sa::_.. ...:.:.........,....:-- Fill out applfcation completely Owner & ConVactor sfgn back of appllcation, notarized (Or, copy of signed conVact with owner} If over 52500, 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 Propsrty Tax Notice (http:/lappraiser pascogov com) � � A Ttl�'A1� �t��l.�'"�'��, ��. �� Pr�o�dl� ��vi�p �I+��ida €��s 9 �!�8 Total System Integration, Design, /nstallation, Service, Monitoring & /nspection � /�/LANT '� � BOSCH n��` -� -- ��.,� September 19, 2011 RE: Inspection Permits City of Zephyrhills 5335 8�' Street Zephyrhills, FL 33542 To Whom It May Concern: Enclosed is a check for $50 for permits. Please break it up as follows: $25 — Semi-Annual Fire Sprinkler Inspection $25 — Semi-Annual Fire Sprinkler inspection Sincerel Amanda Stephan � A Total Solution, Inc. m�� .��l��i��i��,�� Phone: 727-942-1993 Fax:727-943-5919 STATE FIRE SPRINKLER LICENSE #92353800012002 STATE FIRE ALARM LICENSE #EF0000441 3487 Keystone Road, Tarpon Springs, Florida 34688-7815 Local (727) 942-1993 Central Florida 1-888-ATS-FIRE Fax (727) 943-5919 www.atotalsolution.com