HomeMy WebLinkAbout14-15019 ° CITY OF ZEPHYRHILLS
5335-STH STREET
(813)780-0020 15019
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 15019 Address: 5048 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0000-01400-0000
Improv. Cost:
Date Issued: 2/27/2014 Name: CUMBERLAND FARMS (NAK MOM)
Total Fees: 25.00 Address: 777 DEHAM ST
Amount Paid: 25.00 CANTON, MASS
Date Paid: 2/27/2014 Phone:
Work Desc: FPM-SEMI ANNUAL HOOD CLEANING FOR HOLE IN ONE DONUTS
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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
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 shali be performed in aaordance 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 OFFICER ''
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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' ' � Permit Application
Date Received � �Ul�. �� I.Z-7��� Phone Contact for Permit g��� .s�{� �{3S�
Owner's Name L��J z (/' Owner's Phone Number �.3 S�.S �3 S
Owner'sAddress ��.p�/� //J� /�/"/�� �� �JC7�1f'
Fee Simple Titleholder Name Titleholder Phone Number C� � �
Fee Simple Titleholder Address
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Job Address � / ���/N V!V� /V(,j� J� �//J G��C� 2�/,�4'�� Lot# �
Sub Division Parcel#
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� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
aControlled Bum � 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 / )
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Sprinkler � ❑ ❑ ❑ � � Recreational Bum �
Fire Alarm � O ❑ ❑ � � Sparklers �
Hood Cleaning ❑ � ❑ � � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
aFire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL Valuation of Project
� Fuel Tanks
Q Othef:
Contractor ' / Company / s�� S' yQ /G�
Signature �"�-�' Registered Y/N Fee Current Y/N
Address Lice�se#
ELECTRICIAN Company
Signature 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#
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Directions
Fill out application completely.
Owner 8 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 Property Tax Notice(http://appraiser.pascogov.com)