HomeMy WebLinkAbout12-13032 CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oo20 13032
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13032 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: 5/10/2012 Name: FLORIDA MEDICAL CLINIC
Total Fees: 25.00 Address: 38135 MARKET SQUARE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540
Date Paid: 5/03/2012 Phone: (813)780-8440
Work Desc: FPM-QUARTERLY FIRE SPRINKLER FOR 38135 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-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received Phone Contact for Permit 813 621 1357
owner's tvame FLORIDA MEDICAL CLINIC Owner's Phone Number 813 780 8440
owner'sAddress 38135 MARKET SQUARE OR., ZEPHYRHILLS, FL 33540
Fee Simple Titleholder Name Titleholder Phone Number � � �
Fee Simple Titlehotder Address
JobAddress 38135 MARKET SQUARE DR., ZEPHYRHILLS, FL 33540 �ot# �
sub�ivision CITY OF ZEPHYRHILLS Parcel tt 02-26-21-0010-03900-0030
� Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Instailation
� Emergency Generator<30 kw � LP/Natural Gas-Instaliation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
aFire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �� �
ry emi �n er � � l) ,
Sprinkler � � p ❑ � � Recreationai Burn i ;
` r
Fire Alarm � ❑ ❑ ❑ � � Sparklers ��—��f
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
Hood Suppression � � ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Instailation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL $25.QQ VaNuation of Project
Fuel Tanks
Q Other�
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 RODAN FIRE SPRINKLERS, INC.
Signature /�—� Registered Y/N Fee Current Y/N
Address H T. A �icense# 1 1
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)
Suppiy 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)