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13-14425
� � CITY OF ZEPHYRHILLS 5335-STH STREET (si3)�so-oo20 14 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 14425 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: 8/08/2013 Name: ADVENTIST HEALTH SYSTEM Total Fees: 50.00 Address: 7050 GALL BLVD Amount Paid: 50.00 ZEPHYRHILL FL 33541 Date Paid: 8/08/2013 Phone: (813)783-6189 Work Desc: FPM- SPRINKLER & FIRE ALARM ANNUAL -ADVENTIST HEALTH SYSTEM 5 . SIMPLEX GRINNELL AKOS ' ���- � � � 2�� � . 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 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 pertormed 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 RECORDING YOUR NOTICE OF COMMENCEMENT." _-., �, , , I � � '''�Jj�..'�.�,-� C J ' �_>'' PERMIT OFFICE PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 ..... ........._.. ,...� .,.�....r...�......... . - Perm(t Applicafion V Daie Received Phone Contact for Permlt L•i��e-ipar,�..:ts;--.p•:.w.s:_.._. ,_ . _.......-..,..,s .,_. ,..__7,.Fxa�TR.:.tP%:.-,-.C'...:3:�.. '-".i--._ .� ="._r,. : . ,. -..-. � '.��iP .=t"s'"�.: .�� _�.-.1�-,_-_�c-.s.-, �. w� 7`=�� Owners Name Owners Phone IJumber � ��� [� Owner's Address � � Fee Simple Titieholder t�ame TiUehoider Phone iJumbsr C� � � fea Slmple Tdeholder Address ' �- -- - ._._,_... v-=,,-�-, - -- -- �.;�:��:-,., - `:�-c3?;'4iF;�o .,t. _..�-i:r- _ '.,E.:.__1`s.s.,?a:F:'-- - '•�•:..,rs�"c p:°>;:': ' __ ' __ '_ __ - - -q�;,-'__ - :a�:-.� 1 �:tid�..q•.�.�. ,. �...... �. .. .�k - : � . -,.�._..�.,�__�::.nr_eSs�G�ru�.�.:.�_� ..:>.,:�:x� �:. _c r•.... ._..._ �.»�<:.- - - -- - -- � =:.a,�tY . �-�_... �-�.:...r... ---- _ _..�—_._��. ._..�-�, ... _.��:r='=_-_:.-"`='-'-:-='—z��:'-"L� . .='re==a"-*_�f - �s t `'—�= -- ��'� � Job Addtess (.�t{� Sub Division Pa►cel# — ��._„�::--�...,__.._.F� - -- - - - - - - ,_�:�c�"::�_��_.:.•�-�<:r.w....__.,.�_. -.,:r -,.::c��. .-,.;..-�:r:.�-- _---= r _ , , _� ---- ' -_—= r-*.a�iti�s,_t- . .rs �o-�:,._.. ,. '�'i-7;;^`:,..-i, ...._:,.,.- .-���..t.�;..,:.;: — - - � -•'+`-•^sti•..'.:y:ro.,... -F.�—a .:.1.. .,_.. .T.�_ .r.,.,�,-,_-,.. ---- -,._.s•-....._._.. ..... . •. :�. .:. fi�� �L �y,..._.. --- - - s� �. . __ '':` E. � Blaliezard Waste Storage-AIQNUAL Q Fumigafion Tent Q Comm Lxhaust Kitchen HoodlDuct � HazaMous Mate�ial(Tfer!I or RQ F�cil{ty)ANNUAL � � ConUolled Burn Q Hood Installation � Emargency Generefor<30 kw � LP/Nalural Gas-lnsiallafton , � Emergency Qenerator>30!cw Q LP1Natural Gas-ANNUAL Sale � Fire Prot enance- , � Places of Assembly-ANNUAL � �- em �. e�- - ------ -- - � —-- ---- Sprinklar � ❑ ❑ - `� � Recreailonai Bum ;��Z� F(re Narm �� ❑ � Spaticlers — . a � Fiood Cleaning � � � � � Sprinkier Syatem[nslalialfons ood Suppreasion � ❑ Q ❑ � � Standpipes(Sptinkler Sys) , aFire/Verm InsfailaUon � 1'orch Roofing/i"ar Kattle Q Flre Pumps a Waste Tire Sforage/WNUAL Q �ire Works � Flammabie Applfcatlon-ANNUAL Valuatian of Project � Fuel Ta�ks [� Other: ti�::,,�:,��,aY�w:::�r-.;�...>=:�.�__-_.�. - -- - - - - ..n.�y'?F,...-.x.y >.:i?,.."a_:. -Y-1 ,�•' "':y'a tF . ,Y..<-1-5+���:�?�k_.�:'rsr....;f.,..�...u:�.LS:i_.3:.-�ti?�3_,:c.:e,:..:�°._':l?�'.�r�?:"_:-'�.�:t�'?<`�=s:e:i�i:r;:z:-.- �._.-. .....�, ii's:SJ��iR1F�i�i::Y.-,us`�.*&'.�.1�=-'?i"'�'k:'::r:::,i�✓�,{c.�:acii�.�"r+'.Ct1{fi:sF2:�3�'.�'aS Cor�iractor Company ' Signature Registered Y/(d Fee Current Y/ Address ��{� Ltcense# ELECTRICIAN Company Stgnature Reetstered Y/N Fea Current Y/N Address Ltcense# PLIJMBER Company Slgnalure Registered Y/N Fee Current Y 1 N Address License� MECHANICAI Company � Signature Registered Y/N Fee Curcent Y/(V Addreas (��n�� � 0T1iEi2 Company u� Signature Registered Y/N Fee Current Y/N Addresa llcense# � �� �. - ' _-i=- ;p s �t c [�4v '�q 1 5�a::+;:�3ir'r:.�.'-.ris.iH,:!i � Dlrections: -- - ---- ----.____�__.___._�__�...___ .._----�-- . --. .._____.� �^-. , �.._� ,..?1�.R____ Flil auf applleaUon completely. O�mer&Contractor sign 6eck of appUcat(on,notarized(Or,copy o€slgned contract with owner) if over 52600,a Noi(ce of Commsncement Is required(Mechanical work over$5080} 5upply dvo(2)sets of drawings wilfi appNcebfe documentatlon /Ulow 1U-14 days for review after submittal date. - Patcel#-obtained irom Property 7ax Notice(http:l/appralser.pascogov.com) ....- .,-_____ -"y -' --r � -.. _ . .-- , - Permlt Application Data Recelved Phone Contect tor Permlt t� � 3� Y ,, 11�.&�..:fs:xd:s:�1tT.=.s�,;.a.e],s. ..�;s-i:_;c:S:.ihT.'-.^.:s?,'7li: -. ..r_-.=..:.:-.—_ _ _ ...--- . ..,.. -.-i ' . -�:�.. - .<.-eE� . ,- .. ._.; r - �u._. _-.'.a::. Owners Name Owne�s Phone Number t� � � Owners Address � Fee Simple Titleholder Nama Titleholder Phone Number C� � � Fee Stmpte T(@eholder Address .,.:� ...;:. _ - �- - .zq,.�s: �-r:�„ _ - -- - -�..t..-:x t - ---- - - - - - ,�.:���� - - - r:r�- �::,i�.��<..,_.,. ..-.��`r.�izi`.::i r='�`�-3t"�+. - - ..`�..-`-�•:.` I�.o.s3?�i�: ,'i'"�.,'—`Z'= -" _- - --{�'ti<3� - -- - -- .,..-,',;-';�;,xx:;:,wx+s.'�.":.[fi:.�.....rtr''� _ ....... ..'.'�i.�=i... o.�- ' - ' — _ -. .-� ._�..._.. . . � ,... .v... .�.: .+a . ., �,,.,-, x s.r. i-.�:..,.:�..._:<�..�:� Job Address ~� �..• � Lot# � Sub O(vislon Parcel�l � h�^�'..'s.`:'�"t7S=.�€.rn.x�i:J.[';Xak-:e+,*.---.rr;-'�T's.z't�:sn3�=�tE.�r^"^-s,..�y�-t=`s:u F3C`au,"8�.''�_''"•�:-_:..-�— ' - - _.-�..,...�,:, � 'T" r�.�S'�Y'=:i i '-�:�_._-.,-.-.-':�=4'=�+_�:, -_ d3�Ci�_- .�r�.s .;,t� �:c:d.}':'�irle=atYiai<� Q BiaHazard Waste Siorage-ANNUAI. Q Fumlgallon Ten[ � Comm Exhauet iQtchen HoodlDuct a Hazarc3ous Material(Tfar II or RQ Facilily)APlNUA� � a Conirolled Burn � Hood insiella[lon Q �mergency Generator<30 kw � tPlNatural Gas-Insfaflation � Emergen�y Oenerator>30 kw � LPlNatural Gas-ANNUAi.Ssle � � F(ra Protectlon Maintenence-AtJNUAL � Places of AssembSy-ANNUAL . - ---- em �_ �� — _ � . .- -- ---- Spdn [] ❑ � RecreaUonal Bum 2 F(reAlarm ❑ 'f�Q, � Spar[cfers r � . � HoocE C3eaning Cl [] O � Sprinkler Syatam Instaliadons Hood Suppress(on � O ❑ � Standpfpes(Sprinkler Sys} , a Fire !nslallatEan. Q Torch RoofinglTar Kettle ffre Pumps � Waste l7re Storage ANNUAL Fire Worlcs Flammable Appllcatfon-MlNUAL Vatuafion of Project • Fuel Tenks � Q Other: ' � • -...,, _- : - . {4`.'.SP�s�,�-�_.t-: a:,:.�, . �,.:.:-i.�.. . :.��._ ._,,.-. :. . .M:...� �.wx:���,s:�;,,�_;��.._=�-- �. ,�� . .-- - - '.�.:a:t.-53kh.._..._" .,.:., t....., �37��=:!`-eia•i=�'4;�tr;t:=^ ',r:�. ... t;ir�• . . � <.,_y`4:=�?; ..�, �..�. ..�._...,,. r �„. . _,..., ;�•.,.r�.rs�+'j•v.-,•�xass:. _ ' -'�;F;f:`.ia�i:i.J?w.::tRi:�.Y3:�7'Sv�.3:I�yA eL._.�.E :--__-�'{-n?t:, .«.�e�..._r.,a;k&.'• 't . . ..... .. ___ Contractor �""'4^ Company � Signature Registered Y/N Fee Currenf Y/N Address Lfcense# --� ELECTRICIAN Compeny Signeture Registered L Y/N Fes Current Y/�I Addrass Ucense# � PLUMBER Company �� Signature Regisiered Y!N Fea Current Y 1 f� � Address LEcense# MECHANICAL Company � Signature Registered L Y/N Fee Curcent Y!N Atidress License# —� OTFEER Company " � Sl�nature Regiatered Y/N Fea Carrent Y!iN Address License# �- —� . . ..�d?� ""�-� r »c i - - -=,3--.:.. _�i?i'—:��s t.......-. s .�,. .... 7Q S[7�c t +:ii:�� Direc@ona: - - - , -- %:�.�,5:�->� Ftli out applfceUon completely_ Owner&Contractor stgn beck of appiicetion,noterized(Or,copy of slgned conUsci wllh ownerj If over S2b00,a NoUce ot Commencement ts required(MechanEcal work•over$5000) Supply two(2)asts of draw3ngs►viih appllcabfa documentalian A11rn�10-14 days for rsvlew after sabmtQat deie. Parcel#-obieined irom Property i"ax Notice(httg://appralser.pascogov.com)