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� CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oo20 13394
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13394 Address: 5216 7TH ST HISTORIC
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: 11-26-21-0010-16700-0180
Improv. Cost:
Date Issued: 8/30/2012 Name: ZEPHYRHILLS TOURIST CLUB
Total Fees: 25.00 Address: 5216 7TH ST. HISTORIC
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/30/2012 Phone:
Work Desc: FPM-ANNUAL FIRE ALARM FOR ZEPHYRHILLS TOURIST CLUB
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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
wsts 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
s��-7aa-ao2o �� City of Zephyrhills'Fire� Fax-8t3-78o-o021
� , /,. Permit Application
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)ate Received ��{..:.LL.� - r � Phone Contact for Permit ����C.—]T�
v�,ws:..,-<e�.,..;i�:�� �-�a�c�.��::�����-ass��.•-'�.—.�.—� -
hvner's Name �, `i V Owne�5 Phone Number C� C� �
)wners Address � "'� '�-� ; S � �
=ee Simpl=Titleholder Name TiHeholder Phone Number � � �
=ee SimpleTitleholderAddress
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JobAddress � • {' j ` � �-�� Lot# C
Sub Division Q Parcei# � L ..� 0 - ���U
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� Bio-Hazard Waste 5torage-ANNUAL � Fumigation Tent
� Comm 6chaust Iqtchen Hood/Duct a Hazardous Material{Tler li or RQ Feciliiy)ANNUAL
� Conirolled Bum � Hood Installatlon
� Emergency Generator<30 kw � LP/Naturel Gas-Instaflation
Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale
Fire Protection Mairrtenance-APiNUAL � Places of Assembly-ANNUAL
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Sprinkler � ❑ p O � � Recreational Bum � � ` �
Fire Alartn ❑ ❑ S�h � � Sparklers J�
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Hood Cleaning ❑ p ,O � a Sprinkler System Instailatlons �_
Hood Suppression � p ❑ O �� o Standpipes(Sprinkler Sys)
aFirc�Alartn installation � Torch RaofingfCar Kettle
' Fire Pumps � Waste Tire Storage ANNUAL
Fire Works
Flammable Applicatlon-ANNUAL � Valuation of Project
Fuef Tanks
� Other:
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Contractor " �
ComParry ' � :�- > �' n.� 'ir�'���'►ts,
Signature �, _ ' Registered Y N Fee C:utTent Y �
Address � �c � _ "'3 �-
� r'° License'� F F �J J c: �i3 H �
ELECTRICIAN Company �
5ignature Registered Y!N Fee C;urrent Y/N
Address --y
License# �
PLUMBER Company
5ignature Registered Y/N Fee Gurrent Y/N
Address
License# �—
MECHANICAL Company
Signature Registered Y/N Fee c:urrent Y/N
Address —� License# �— ��
OTHER
Compeny
Signature Registerad Y/N Fee(:urrent Y/N
Address
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Fill aut appllcation completely.
Owner 8 Contractor sign back of applicatior�,notarized(Or,copy of signad contract with owner}
If over$250D,a Notice of Commencement is required(Mechanica!work over a5000)
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:!/appr�isar.pascogov.cam)