HomeMy WebLinkAbout11-12498 CITY OF ZEPHYRHILLS
5335 - 8TH STREET �"'�
(sis) �so-oozo 12498
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12498 Address: 38250 A AVE
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: 14-26-21-0010-01300-0010
Improv. Cost:
Date Issued: 11/01/2011 Name: ZEPHYR HAVEN NURSING HOME
Total Fees: 25.00 Address: 38250 A AVE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 11/01/2011 Phone: (407)975-3000
Work Desc: FPM- SPRINKLER QUARTERLY- ZEPHYR HAVEN NURSING HOME
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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 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 acrnrdance 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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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
a�a-�so;oo2o City of Zephyrhills Fire
. Fax-813-780-0021
Permit Application
Date Recewed �/ /� t3/'/� Phone Contact for Permit 9�/ �i S�Q' �f 73s"'
Owner's Name ZC � LiC �(,�/t ' � Owner's Phone Number �� C� ��
Owner's Address 3���`j � �.-�/ �/L c� GGs �'�� 3�� 7 G-
Fee Simple Titleholder Name Titleholder Phone Number ��� ��
Fee Simple Titleholder Address
Job Address �
Lot #
Sub Division
Parcel #
� Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Burn � Hood Instal�ation
� Emergency Generator < 30 kw a LP/Natural Gas-Installation
� Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
t y emi �n t er �y �
Sprinkler '� ❑ ❑ B � Recreational Burn f /
Fire Alarm � ❑ ❑ ❑ �i
C � � Sparklers
Hood Cleaning � ❑ ❑ ❑ � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ C� � Standpipes (Sprinkler Sys)
� Fire Alarm Installation � Torch Roofinglfar Kettie
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL
� Valuation of Project
Fuel Tanks
Q Other
Contractor
Signature Company �y�
Registered Y/ N Fee Current Y/ N
Address
License #
ELECTRICIAN
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
License #
Directions:
Fill out application completely
Owner 8 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)
Supply rivo (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)