HomeMy WebLinkAbout13-13853 CITY OF ZEPHYRHILLS
5335-8TH SIREET
(sis)�so-oozo 13853
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13853 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 Number: 35-25-21-0010-12300-0000
Improv. Cost:
Date Issued: 2/08/2013 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILL FL 33541
Date Paid: 2/08/2013 Phone: (813 783-6189
Work Desc: FPM- SPRINKLER QUARTERLY FL HOSPT WOUND CENTER
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Chapter 633, Florida Statutes,authorizes the City to charge and oollect user fees to pay for the costs of fire
prevention and protection related activities such as inspections,plan review,administrative fees,and other
oosts 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
ai3-7ao-oo2o City of Zephyrhills Fire
T Permit Appliwtion Fax-813-780-0021
Date Received 2/6/2013 Phone Contact for Pertnit 813 313 1611
Owner's Name FL Hos ital Ze h rhills-Ctr Wound Care&H erbar Owner's Phone Number ��� �
Owner's Address 38233 DAUGHTERY RI ZEPHYRHILL FL 33540-1485
Fee Simple Titleholder Name Titleholder Phone Number �� �
Fee Simple Titleholdef Address
Job Address �
Sub Division Lot#
Parcel#
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
❑ Controlled Burn Hood Installation
❑ Emergency Generator<30 kw � LP/Natural Gas-Installation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL ���
Sprinkler ���m� y�/ �
Fire Alarm � X � ° � 0 Recreational Burn �"r I
❑ � ° � � 0 Sparklers �
Hood Cleaning ❑ ❑ ❑ � � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps
Fire Works 0 Waste Tire Storage ANNUAL
� Flammable Application-ANNUAL
Fuel Tanks
Valuation of Project
❑ Other
Contractor Wanda Paradis Comp Sim lex Grinnell
Signature
Regist Y/N Fee Cu Y!N
Address 4701 Oak Fair Blvd,Tam a FL 33610 License#
ELECTRICIAN
Signature � Company
Regist� Y/N Fee Cu Y/N
Address
License#
PLUMBER
Signature Compa�
Regista Y/N Fee Cw Y/N
Address —
MECHANICAL License#
Signature � Compay
Regist Y/N Fee Cu Y/N
Address
License#
OTHER
Signature Company
Regist�Y/N J Fee Cu Y/N
Address
Directions: License#
Fill out application completely
Ow�er$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 applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Pro e Tax Notice htt //a
P rtY ( p: ppraiser.pascogov com)