HomeMy WebLinkAbout12-13699 ' CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis)�so-oo20 13699
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13699 Address: 38357 CR 54 E
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Ciass 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: 02-26-21-001A-00000-0110
Improv. Cost:
Date Issued: 12/11/2012 Name: BLESSING LELAND B TRUST
Total Fees: 25.00 Address: 35420 BASELINE DR
Amount Paid: 25.00 DADE CITY FL 33525
Date Paid: 12/11/2012 Phone: (813)788-5554
Work Desc: FPM-ANNUAL FIRE ALARM FOR STATE FARM
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the aosts 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
s�s-�ao-oozo Cifij of Zephyrhills'Fire� Fax-813-780-0021
Permit Application
)ate Received �— �_ - Phone Contact for Permit
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hvners Name SS cti � � S Ovmer's Phone Number o ( ?j � <"5�
)wners Address � � y \. � " � �O�`�
=ee Simple Titleholder Name TiHeholder Phone Number � � �
=ee Simple Titleholder Address
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Job Addr=ss � ,'�j..7 � � � 'e `� 1r� Lot# �
Sub Division � Y Parcel# (� �1-a(p ��� — f)U� � "�oU� -D rJ �
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� BiaHazard Wast�Storege-ANNUAL � Fumigailon Tent
� Comm Exhaust 1Ctchen HoodlDuct Q Hazarclous Material(Tier II or RQ Facility)ANNUAL
� Controlled 8um � Hood Instailatlon
� Emergenny Generator<30 kw � LP!Naturel Gas-Instaliation �"
Emergeney Generator>30 kw � LPINatural Gas-ANNUAL Sala �
Fire Protection Mairttenance-ANNUAL � Places of Assembly-ANNUAL y � � �j
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Sprinkler � ❑ ❑ ❑ � � Recreational Bum /J/�� �'' '
L% ��%
Fire Alarm � � ❑ �! � � Sparklers
Hood Cleaning ❑ O /❑ � a SprinklerSystem Installatlons "`---------~
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys}
aFire Afarm InstallaUon � Torcfi RoofinglTar Kettle
Fire Pumps � Waste Tfre Storage ANNUAL
Fire Works '
Flammabla Applicatlon-ANNUAL Valuation of Project
Fue{Tanks
Q Other;
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ConVactvr Comparry � ',• + � •� � ':�r�-' - 6.
Signature ' Registered Y N Fee CuRent N
Address a 1� �], - � � '- f'' License# �t�, i c:3
ELECTRIC�AN Company
5ignature Registered Y/N Fee Current L Y/N
Address �icense#
PLUMBER Company
Signature RegiStered Y/nl Fse Curtent �(/N
Address Licensa#
MECHANICAL Company
Signature Registered Y/N Fee Current Y/N
Address �— License#
OTHER � Company
5ignature Registerad Y/N Fee Current �'/N
Address �— L1Cense#
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Directions: � �� J � ��
Fill aut application completely.
Owner 8 Contractor sign back of applicatior�,notarized(Or,copy of slgned cvntraet with owner)
If over�2500,a Notice of Commencement is required(Mechanical work over a5000)
SuppYy two(2)sets of drewings with appiicable documentation
Allow 10-14 days for review aiter submittal date. Parcel#-obtained from Property Tax Notice(http:llappraiser.pascogov.com)
SPECIALTY ELECTRONIC SYSTEMS, �n,c. 019757
� CI'�Y OF ZEPHYRHILLS/ PERMITS 12/7/2012
25 00
Welis Fargo 25.00