HomeMy WebLinkAbout11-12577 CITY OF ZEPHYRHILLS
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(sis) �so-oo20 12577
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12577 Address: 7350 DAIRY 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: 35-25-21-0010-06900-0020
Improv. Cost:
Date Issued: 12/02/2011 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/02/2011 Phone: (407)975-3000
Work Desc: FPM- SPRINKLER QUARTERLY- ZEPHYRHILL HEALTH 8� REHAB
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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 activides such as inspections, plan review, administrative fees, and other
aosts 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 pertormed 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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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
813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Receiv��' �� Phone Contact for Permit y� �ts� Q�,3,5
Owner's Name zG h,2 �CL (/�«�l 1' /�-� /1A� Owner's Phone Number �� �
Owner's Address ��� !� /�/�/� �D� � ry Q/ti �C� �L � 3syp
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) a{VNUAL
� Controlled Burn � Hood Instaliation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
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Sprinkler � ❑ ❑ � � Recreational Burn
Fire Alarm � ❑ ❑ ❑ � � Sparklers �� /
Hood Cleaning � ❑ ❑ ❑� � Sprinkier System Installations �' r
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
� Fire Alarm installation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL Valuation of Project
Fuel Tanks
Q Other
Contractor
Company ��rs ,cinnc'1L
Signature Registered Y J 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 reqwred (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:/lappraiser.pascogov.com)