HomeMy WebLinkAbout12-13618 - CITY OF ZEPHYRHILLS
5335-8TH STREET
�s13)�so-oozo 13618
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13618 Address: 38233 DAUGHTERY RD
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 Numbe�: 35-25-21-0010-12300-0000
Improv. Cost:
Date Issued: 11/16/2012 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILL FL 33541
Date Paid: 11/16/2012 Phone: (813)783-6189
Work Desc: FPM- SPRINKLER QUARTERLY FLORIDA HOSPITAL ZP WOUND CENTR
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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�s-�ao-oozo City of Zephyrhilis Fire Fax-813-780-0021
Permit Application
Date Received' [ � � Phone Contact for Permit 7� �� dT3 '
Owner's Name �(j' QS � L jj � �s (�C.p� ��aMone Number � � ��
Owner's Address � o�3 3 p�.r B�
Fee Simple Titleholder Name Titleholder Phone Number � � �
Fee Simple Titleholder Address
Job Address Lot# ��
Sub Division Parcet#
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Installation
aEmergency Generator<30 kw � LP/Natural Gas-Installation
� Emergency Generator>30 kw ' � LP1Natural Gas-ANNUAL Sale � � /�
� �}
Fire Protection Maintenarice-ANNUAL � Piaces of Assembly-ANNUA� � �� (/
tny �ni ',i �n i ti-�Cr
Sprinkler �r ❑ ❑ � � Recreational Burn
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
Hood Suppression � O ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL Valuation of Project
� Fuel Tanks
� Other
Contractor Company i7«ri /)yt`
Signature Registered Y/ Fee Current Y/N
Address License#
ELECTRICIAN Company
Signature I 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 Company
Signature Registered Y/N Fee Current Y/N
Address License#
Directions
Fill out application completely
Owner 8 Contractor sign back of appiication,no;arized(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
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http//appraiser.pascogov com)