HomeMy WebLinkAbout12-13617 CITY OF ZEPHYRHILLS �,,.--
5335-8TH STREET
(sis)�so-oo20 13617
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13617 Address: 38250 A AVE
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: 14-26-21-0010-01300-0010
Improv. Cost:
Date Issued: 11/16/2012 Name: ZEPHYR HAVEN NURSING HOME
Total Fees: 25.00 Address: 38250 A AVE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 11/16/2012 Phone: (407)975-3000
Work Desc: FPM-SPRINKLER QUARTLERY ZEPHYR HAVEN NURSING HOME
5.
�' ��,'`� 'Z
� ,���� �
.�_ I �
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
costs related to the aforemenaoned.
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 I!ZL.� (�s'� B�3'
Owner's Name � �� (/''/ %� ' Il?'L Owner's Phone Number � � �
Owner's Address � � � �
Fee Simple Titleholder Name Titlehoider Phone Number C� � �
Fee Simple Titleholder Address
Job Address Lot# �
Sub Drvision Parcel#
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
a Comm Exhaust Kitchen Hood/Duct � Hazardous Matenal(Tier II or RQ Facility)ANNUAL
� Controlled Burn Hood Installation �
� Emergency Generator<30 kw � LP/Naturaf Gas-Installation �!A I�'
o � �e
Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenarice-ANNUAL � Places of Assembly-ANNUAL
y em; a.n Utner
Sprinkler � �7 � � Recreational Burn
Fire Alarm � ❑ ❑ � � � Sparklers
Hood Cleaning � ❑ � � � � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkter Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � �Naste Tire Storage ANNUAL
� Fire Works
� Flammable Appiication-ANNUAL Valuation of Project
� Fuel Tanks
� Other
Contractor Company i� �C%r�l
S:gnature Registered Y/N Fee Current Y/N
Address License#
ELECTRICIAN Company
Signature I Registered Y/N Fee Current Y/N
Address License#
PLUMBER Company
Signature Registered Y J N Fee Current Y/N
Address �_ I ❑cense# I �
MECHANICAL Company
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
Directions
Fill out application completely
Owner 8 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)
Supply two(2)sets of drawings with applicabie documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappraiser.pascogov com)