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Home My WebLink About11-12592 CITY OF ZEPHYRHILLS 5335 - 8TH STREEf ✓� � (813) 780-0020 12592 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12592 Address: 6712 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: 02-26-21-0010-03800-0000 Improv. Cost: Date Issued: 12/05/2011 Name: LUSARE INVESTMENT HOLDINGS LLC Total Fees: 50.00 Address: 28804 FALLING LEAVES WAY Amount Paid: 50.00 WESLEY CHAPEL, FL 335435761 Date Paid: 12/05/2011 Phone: (813)679-1883 Work Desc: FPM- SPRINKLER /FIRE ALARM ANNUAL- PEDIATRIC PARTNERS ., �� ( � /�( \ . �/ � r � ,_ � ina Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fire prevention and prote�tion 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. Ali 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 813-780-0020 City of Zephyrhills Fire Fax-813-780-002 - Permit Application � 9y Q �943 Date Received t� � �� Phone Contact for Permit �,Q Z ._ ,�.,_ ._•:.. ----,,:�:__,__=- _k.�=�_,;-: = _`;:::_ _ -.•- --.r._�.. . .�.- :__._ ..<-. _:,�.�=��.rm.===-�:. =:�.r�_ t �..- .-._..-- -- _ _ '° _. � � - - .. . . .;�.. ..... . - . . . .... ._ .... ... Owner's Name /r�� r /L eT�+l��S Owner'S Phone Number �7 7d ,� jQV� Owner's Address (Q ��/+ �7�y n �y� /T�L` ' �(. 3� � y i– Fee S�mple Titleholder Name Titlehoider Phone Number C� C] � Fee S�mpie Titleholtler Address _.__.. ._.__. -.-,:- �.w}u-,x - ._ _ . �: -:_. - - - • --- ' ° -- - - -- ,..:.._ -_. ��_...:< =`'='r?_,�=F�ra�.= ` ';;�„ '_ ��;�- - •�' - ;, .;... . ._;..t Job Address C./ �J � �/� y � �'��l.G � /�(� �f S � Lot # �� Sub Division Parcel # .. .,. _ ..� ._-_ _-.:�_:_:- - - - - _ -_ - =-- =- -- - ' - - - - _:-.. ' :x - .�.::-,.,...• s ._. R :- J �_ , .-,��....:.;_.F... _...:..: -.".�_. -�,�:;�_._� �.:�=�o��--�----=�� _ ,- _ .__�.__. �.��_�,M1._ .�.,_ ,..�._.� - -.__..__,.._ ---- -- � Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier il or RQ Facility) ANNUAL � Comm Exhaust Kitchen Hood/Dud a Hood Instaliation � Controlled Bum � LP/Naturai Gas-Instaliation � Emergenq Generator < 30 kw a LP/Natural Gas-ANNUAL Sale � Emergency Generator> 30 kw � Places of Assembly-AI�NUAL � Fire Protection Maintenance - ANNUAL a Recreational Burn tr emi �n t er Sprinkler � ❑ ❑ � � � Sparkiers Fire Alarm �❑ ❑ �� Sprinkler System Instailations Hood Cleaning � O O �� Standpipes (Spnnkler Sys) Hood Suppression �❑ ❑ O� � Torch RoofinglT'ar Kettle � Fire Alarm installatlon a Waste Tire Storage ANNUA� � Fre F�mps Fire Works � Flammable Application- ANNUAI Valuation of Project � fuel Tanks � Other� - - -. . , .. .,,. __ . ;,_.:::..,..::;::=��=;_� - _ _....-__.� -_ _ -_._.. .-_�.- -�� - ==_ - _ - .� . : - _.��.__a�_� .--- -- ' _ ��-w ... ._. .., __. _�_ ..._.. _. _..�._, .,.. ._.._ ___.�.�._-...... - �..�,..„.�.. ,z _ -- - - - 4 ,._- ,-..-� ...;. . �... ....._. �.. . �,�; _ �s._. � _x:_. , .. .� :---.�.,,:�:a �;� Contractor COmpany ""T' .}, � (u �•D nG. I Signature Registered Y/ N Fee Current Y I N Address 3531 1�e ��anQ. Ra�. License# E,FOOOO ELECTRICIAN Company � _ Signature RegiStered Y/ N Fee Current Y/ N Address License # PLUMBER Company S�gnature Registered L Y/ N Fee Current Y/ N adaress License # MECHANICAL COmpany — � Signature Registered Y/ N Fee Currznt Y/ N Address License # OTHER Company —� Signature Registered Y/ N Fee Current Y! N Address �— --- _..� '�.�._:_,. °__�,:a= - . _ _ - _ - ._ - ._ . : -.t__.:__.., .` - ,. - - - - ' � -- - - � - License # _. . .. ,. ,. .. _�:., _ .. . ,-:-_�._�:...... -.._..�,.-.�.:.�,_� :-; Di rect�ons: ' , _.-_..... ..___ �:-:: _._... ., Fill out application completey Owner 8 ConVactor 5ign back of applicaUon, notarized (Or, copy of signed contract with owner) if over S2500, a Notice of Commencement is required (MeChanical work over 55000) Supply lwo (2) sets of drawings with appiicabte documentation Allow t 0-14 days for review after submittal date. Parcel #- obtained from Propsrty Tax Notice (http:Uappraiser pasCOgov com) � 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application DateReceived �(B l/ Pnone_Contactfor�ermit },q�. qt-�,2 ��}�3 Owner's Name £i(�/� �j 1 C, � /�rZT��,a � Owner's Phone Number �� b� Owner's Address EY / ��. � /� /� r � � ��/(�� L � 3S�y i I Fee Simple Titleholder Name � �� Titleholder Phone Number Fee Simple Titleholder Address JobAddress f�7/� /,�,g,�y � �/7 !'Z Y�J�,{/'--c -_ - -_ � Lot # C] Sub Divisio� Parcel # � Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier II or RQ ANNUAL � Comm Exhaust Kitchen Hood/Duct � Hood Installation a Controlled Burn a LP/Natural Gas-Installation � Emergency Generator < 3o kw � LP/Natural Gas-ANNUAL Sale � Emergency Generator> 30 kw � Places ofAssembly-ANNUAL � Fire Prc,ectic�� A�iair�tenar�cz - ANNUAL � Recreational Burn t y emi � er Sprinkler � ❑ p �' � � Sparklers ��, !� Fire Alarm � p ❑ ❑� � Sprinkler System Installations �� Hood Cleaning � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) Hood Suppression � ❑ ❑ ❑�� Torch RoofinglTar Kettle � Fire Alarm Installation � Waste Tire Storage ANNUAL � Fire Pumps � Fire Works � Flammable Application- ANNUAL � Valuation of Project Fuel Tanks Q Other _. „ .. -: __. _.�:-., -_:. .-._: - ,:. - :•...:_:_.::;z Contractor " --- � - . , S�gnature Company -T-- � Registered Y/ N Fee Current Y/ N Aadress 3531 � �or► Q$ g 1 � License # Z ELECTRICtAN Signature Company Registered Y/ N Fee Current Y/ N Address � License # PLUMBER � Signature Company Regisi�red Y/"d Fee Current �' / y Address License # MECNANICAL Signature Company �—' Registered Y/ N Fee Current Y/ N Address License # � vTHER Sigr,ature Company � Registered Y/ N Fee Current Y/ N Address ;,_,., License # � DirecUons: - - - , ,, --- _ Fill out application completely Owner & Contractor sign back of application, notarized (Or, copy of signed contract with o�Nner) 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)