HomeMy WebLinkAbout12-13168 CITY OF ZEPHYRHILLS ,
5335-8TH STREET 13168
(813)780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
Perrr�it Number: 13168 Address: 7810 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35-25-21-0010-00700-0000
Improv. Cost: Name: PRIMERICA GROUP ONE
Date Issued: 6/13/2012
Total Fees: 25.00 Address: 3629 MADACA LANE
Amount Paid: 25.00 TAMPA FL 33618
Date Paid: 6/13J2012 Phone: (813)933-0629
Work Desc: FPM- SPRINKLER ANNUAL- UPS /ZEPHYR COMMONS
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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
sisaeo-oozo Ciry of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received Phone Contact for Permit � �S 83�
Owner's Name Owner's Phone Number �� �V3 Q�Z
Z9 �A �. �" A �
Owner's Address � � ��
Fee Simpie Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
Job Address
�� 1..� � � --{"�—,— Lot# �
Sub Division
Parcel#
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or R�Facility)ANNUAL
� Controlled Bum � Hood Installation
� Emergency Generator<30 kw � LPINatural Gas-Installation
� Emergency Generator>30 kw � LP/Natural GasANNUAL Sale
�x� Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL
tif•� y emi n er � � �
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Sprinkler � ❑ ❑ � � Recreational Bum � ( 3
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
aFuel Tanks
Q Other
Contractor �_ � Company a�1 � T �.le S
Signature Registered Y!N Fee Current Y/N
Address � 'ZZ � �c.. a r �� 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 Curcent Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Curtent Y/N
Address License#
Directions:
Fill out application completely
Owner&Contractor sign back of application,notarized(Or,copy of signed contrad 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. P2rcel#-obtained from Property Tax Notice(http:!/appraiser.pascoaov.com)