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Home My WebLink About12-12752 CITY OF ZEPHYRHILLS � 5335-8TH STREET (si3)�so-oo20 12752 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12752 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: 2/01/2012 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 2/01/2012 Phone: (407 975-3000 Work Desc: FPM- SPRINKLER QUARTERLY-ZEPHYR HAVEN NURSING HOME � �,� 2 -� " ( � � , __, ina Chapter 633, Florida Statutes,authorizes tl�e City to charge and aollect user fees to pay for the costs of fire prevendon 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 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." �.. 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�s-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date ReY�eived � 1/30/2012 Phone Contact for Permit 813 313 1637 Owner's Name Zephyr Haven Nursing Home Owner's Phone Number � 813 782 5508 Owner's Address 38250 A AVE, ZEPHYRHILLS, FL 33542 Fee Simple Titleholder Name Titleholder Phone Number [� �� Fee Simpte Titleholder Address Job Address 38250 A AVE ZEPHYRHILLS FL 33542 � �ot# � 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 Installation � Emergency Generator<30 kw � LP/Natural Gas-Installation � Emergency Generator>30 kw � LP/Natural Gas-Ai�RUAL 5ale .� / � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � �s�/ tr y emi �n t er ❑ � Sprinkler X� X ❑ ❑ � Recreational Burn Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL Valuation of Project Fuel Tanks X� Other Also (1)Annual Backflow inspection Contractor �� Company SimplexGrinnell Signature Registered Y/N Fee Current Y/N Address 4701 Oak Fair Blvd.,Tampa, FL. 33610 �icense# 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��urrent Y/N Address License# OTHER Company Signature Registered Y/N Fee rurrent Y/N Address License# Directions: T- 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)