HomeMy WebLinkAbout12-12799 CITY OF ZEPHYRHILLS
� 5335-8TH STREET
�si3��so-oozo 12799
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12799 Address: 38135 MARKET SQUARE DR
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: 02-26-21-0010-03900-0030
Improv. Cost:
Date Issued: 2/16/2012 Name: FLORIDA MEDICAL CLINIC
Total Fees: 25.00 Address: 38135 MARKET SQUARE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540
Date Paid: 2/16/2012 Phone: (813)780-8440
Work Desc: FON-ANNUAL FIRE SPRINKLER FOR FLORIDA MEDICAL
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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 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 OfFce- 813-780-0041
813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
' Permit Application
�ate Received Phone Contact for Permit 813 621 1357
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Owner's Name FLORIDA MEDICAL CLINIC Owners Phone Number 813 780 8440
owner's Address 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540
Fee Simple Titleholder Name Titleholder Phone Number � � �
Fee Simple Titleholder Address
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JobAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540 �ot# �
Sub Diwsion CITY OF ZEPHYRHILLS Parce�# 02- - - - -
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a Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Installation
� 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
r y emi �n er
Sprinkler � ❑ ❑ � � � Recreational Bum f���
Fire Alarm � O ❑ ❑ � � Sparklers ,�I � I
Hood Cleaning � � ❑ ❑ � � Sprinkler System Installa ons �
Hood Suppression � ❑ ❑ � � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle �_,
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Fiammable Application-ANNUAL $25.�� Valuation of Project
� Fuel Tanks
0 Other
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Contractor Company
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 JEFFERY D. BURNHAM /� company R N FIRE SPRINKL S, INC.
Signature �'^ �-1 Registered Y N Fee CuRent !N
Address 25 1 N. 70TH T. AM A FL 61 �icense tt 1 10 012
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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:/lappraissr.pascogov.com)