HomeMy WebLinkAbout11-12500 CITY OF ZEPHYRHILLS
5335 - 8TH STREET �
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ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12500 Address: 38233 DAUGHTERY RD
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: 35-25-21-0010-12300-0000
Improv. Cost:
Date Issued: 11 /01 /2011 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILL FL 33541
Date Paid: 11/01/2011 Phone: (813)783-6189
Work Desc: FPM- SPRINKLER QUARTERLY- ADVENTIST HEALTH
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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
wsts 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
GOMMENCEMNT 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
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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
, � Permit Application
Date Received / Z(/�'/ Phone Contact for Permit ��{� s� d 73S
Owner's Name /"�,Lsi(/�iQ j i�T4G z� �+ �"� j C�,�' Owner's Phone Number �� �
Owner's Address � � � 3� �/�-!t '� � �O� �� � � � `� t- i1
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Fee Simple Titleholder Name Titleholder Phone Number ��� C�
Fee Simple Titleholder Address
Job Address Lot # �
Sub Division Parcel #
� Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent
a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Instatlation
� Emergency Generator> 30 kw � LP1Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places ofi Assembly-ANNUAL
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Sprinkler � ❑ ❑� � Recreational Burn 2 S�(�
Fire Alarm � ❑ ❑ ❑ �
� ❑ Sparklers
Hood Cteaning � ❑ ❑ ❑ � Sprinkler System Instailations
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Spnnkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL Valuation of Project
Fuel Tanks
� Other�
Contractor �
- Company ji°►t ���f/ij�
Signature Registered Y/ N Fee Current Y/ N
Address License #
ELECTRICIAN Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
PLUMBER Company
Signature Registered Y/ N Fee Current Y/ N
Address
License #
MECHANICAL Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
OTHER
Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
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)
Supply 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)