HomeMy WebLinkAbout12-13031 CITY OF ZEPHYRHILLS
5335-8TH STREET
�sis��so-oo20 13031
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13031 Address: 38107 MARKET SQUARE DR
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost:
Date Issued: 5/03/2012 Name: FLORIDA MEDICAL CLINIC
Total Fees: 25.00 Address: 38107 MARKET SQUARE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/03/2012 Phone:
Work Desc: FPM-QUARTERLY FIRE SPRINKLER FOR 38107 MARKET SQ
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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 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
a�3-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received Phone Contact for Permit 813 621 1357
Owner's Name FLORIDA MEDICAL CLINIC Owner's Phone Number � � �
owner's,4ddress 38107 MARKET SQUARE DR., ZEPHYRHILLS, FL 33542
Fee Simple Titleholder Name Titleholder Phone Number C� � �
Fee Simple Titleholder Address
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JobAddress 38107 MARKET SQUARE DR., ZEPHYRHILLS, FL 33542 �ot# ��
Sub Division CITY OF ZEPHYRHILLS Parcel#
a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
a 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-ANNUAL Sale �
a Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNURi � / �
ry emi �n er j /j� � Q � /
Sprinkler � � ❑ ❑ � � Recreational Burn 1 �
� ✓.. . �
Fire Alarm � ❑ ❑ ❑ � � Sparklers �� ` �
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations `�
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofinglfar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL $25.QQ Valuation of Project
Fuel Tanks
Q Other
Contractor Company e �` �� y 14 l
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 �EFFERY D. BURNHAM Company RODAN FIRE SPRINKLERS, INC.
Signature � Registered Y/N Fee Current Y/N
Address � 7 F 1 License# � 1
Directions. ' '
Filt out application completely
Owner&Contractor sign back of application,notanzed(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
Ailow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov com)