HomeMy WebLinkAbout13-14804 - CITY OF ZEPHYRHILLS
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ANNUAL FIRE PROTECTION MAINTENANCE �
Permit Number: 14804 Address: 5009 GALL BLVD
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: 11-26-21-0010-2088-0060
Improv. Cost:
Date Issued: 12/09/2013 ' Name: BRUNS, DAN 8 MARY E
Total Fees: 25.00 Address: 5820 CYPRESS ST
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/09/2013 Phone: (813)780-2005
Work Desc: FPM- HOOD CLEAN SEMI- 301 CORNER GRILLE
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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 RECORDING YOUR NOTICE
OF COMMENCEMENT."
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PERMIT OFFICE `
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
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P rmit Application
Date Rece�d�ed � .• �� � /�0�,3 Phone Contact for Permit p�3 ,j�fs" �'f 3s�
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Owner's Name �-S��C� Owner s Phone Number ��3 �Lfs q 3 S/
Owner's Address • Q. ��/C 1 7 d �f�M�� �� `�6 7�
Fee Simple Titleholder Name Titleholder Phone Number �� U ��
Fee Simple Titleholder Address �--����
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JobAddress J�' �R�� �j�,l`� �aQg G�C/ T7IIfD. �
L ���'B Lot#
Sub Division
R Parcel#
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Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Bum � Hood Installation
� Emergency Generator<30 kw � LP/Natural Gas-Instalfation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
❑ r y emi � er ❑
Sprinkler ❑ ❑ ❑ Recreational Bum ,f�� ! >
Fire Alarm �r
� � � �� � Sparklers � �
Hood Cleaning (� ❑ � � �
� � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ C� � Standpipes(Sprinkler Sys)
� Fire Alarm Instaliation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� FlammableApplication-ANNUAL
� Valuation of Project
Fuel Tanks
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Q Other:
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Contractor � � .� ...._:_ ,� ..-�� _ .,:�.�:,:��.__.4 _, -
Signature
Company � s
Registered Y/N Fee Current Y/N
Address
License#
ELECTRICIAN
Signature
Company
Registered Y/N Fee Current Y/N
Address
License#
PLUMBER
Signature
Company
Registered Y/N Fee Current Y/N
Address � �
License#
MECHANICAL
Signature
Company
Registered Y/N Fee Current Y/N
Address
License#
OTHER
Signature
Company
Registered Y/N Fee Current Y/N
Address
License#
Directions.
Fill out application completely
Owner&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 submittai date. Parcel#-obtained from Property Tax Notice(http:!/appraiser.pascogov.com)