HomeMy WebLinkAbout12-12933 CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oo20 12933
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12933 Address: 38220 HENRY 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: 02-26-21-0080-OOA00-0122
Improv. Cost:
Date Issued: 3/28/2012 Name: HCRA PROPERTIES I LLC
Total Fees: 25.00 Address: 333 N SUMMIT ST
Amount Paid: 25.00 TOLEDO OH 43604
Date Paid: 3/28/2012 Phone: (813)788-7114
Work Desc: FPM- SPRINKLER 5YR- HEARTLAND MANOR CARE
��,��-- �2--
� �
�-
ina
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 Pians, 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 RECO IN Y R NOTICE
OF COMMENCEMENT." '
PERMIT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
sis-�ao-oo2o City of 7_ephyrhilis Fire Fax-B13-780-0021
Permit Application
Date RP��rved '_ �--1 Phone_ContactfOr�ermd �,?�} 9"i Q (q Q3
Owner's Name /f� � � � �C,e, /yJ/}WGILC/�'�C�i Owner's Phone Number C� � �
Owner's Address �� �Q y �/!�/ i
Fee S�mpie Titiehoider Name Titleholder Phone Number C� � �
Fee S�mple Titleholder Address
Job Address b,�aj� _ �AI,�Y �/'�/ - - - -_ - ��
� Lot#
Sub Division Parcel# T I
� Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Comm Exhaust Kitchen Hood/Duct � Hood Instailation
� Controlled Burn Q LP/Natural Gas-Installation ��( ����
� Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale
� Emergency Generator>30 kw � Places ofAssembly-ANNUAL
� �ire Profection Maintenance-ANNUAL � Recreational Burn
try emi � er
Sprinkler � ❑ p ❑ 5y� � Sparklers
Fire Alarm � O ❑ ❑ � � Sprinkler System Installations
Hood Cleaning � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys)
Hood Suppression � ❑ O ❑ C� � Torch Roofing/Tar Kettle
QFire Alarm Installation � Waste Tire Storage ANNUAL
� Fire Pumps
� Ffre Works
� Flammable Application-ANNUAL �� Valuation of Project
� Fuel Tanks
� Other
- -�
Gontractor - - -- .,-�_.,_ _. . _._. ; _ _
Company —�-- �
S�gnature Registered Y/N Fee Current Y/N
aaaress 3�j,3� � }on �icense# Q � g �� z
ELECTRICIAN
Company
Signature Registered Y/N Fee Current Y/N
Address License# C �
P�UMBER Company �
S�gnature Kegistered Y/P� Fee Current Y/N
Address License# �
MECHANICAL Company � �
S�gnature Registered Y/N Fee Current Y/N
Address license# �— �
vTHER � � Company
_igr,a'.ur�
Registered Y/(�J Fee Currerit Y/N
Address _ ' � ` _ �
License#
Cirec;ions: - -
Fill out application completety
Owner&COntractor sign back of appiication,notarized(Or,copy of signetl contract with uwner)
If over 32500,a Notice of Commencement is required(Mechanical work over$SOOU)
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 comj