HomeMy WebLinkAbout14-15084 CITY OF ZEPHYRHILLS
5335-8TH STREET
� "' (813)780-0020 1508�
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 15084 � Address: 6855 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: 03-26-21-0010-01600-0020
Improv. Cost: °� § �
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Date Issued: 3/13/2014 Name: GOLDEN CORRAL
Total Fees: 25.00 Address: 6855 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/13/2014 Phone: (813)783-8969
Work Desc: FPM- SUPPRESSION SEMI- GOLDEN CORRAL
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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 OFFICER `'
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
aisaso-oa2o City of Zephyrhills Fire
Fax-813-780-0021
Permit Application -
Date Received '? -4' . _ti� Phone Contact for Permit '
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Owner's Name �o\�o�-. LoC l�-� Owner's Phone Number ` � 783 p�
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Owner's Address 9 S� �y\l �` J � �� L—
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Fee Simple Titleholder Name �� �� �
Titleholder Phone Number
Fee Simple Titleholder Address �J
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Job Address �
Lot#
Sub Division
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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 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
❑�y emi �n er ❑
Sprinkler ❑ ❑ ❑ Recreational Bum
Fire Alarm � r—, ❑ / ���
❑ ❑ ❑ �_� Sparklers � �j /
Hood Cleaning � ❑ p � r� ❑ �� ��
L Sprinkler System Installations
Hood Suppression � ❑ �[ ❑ � � Standpipes(Sprinkler Sys)
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Fire Alarm Installation a Torch RoofingRar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
aFire Works
� Flammable Application-ANNUAL
� Valuation of Project
Fuel Tanks
QOther:
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Contractor `` �
Signature Company ,•�.G _ � `
Registered Y/N Fe Current Y/1�I
Address P c�� /j� $ (� 3 License#
ELECTRICIAN
Company
Signature Registered Y/N Fee Current Y/N
Address
License#
PLUMBER
Signature
Company
Registered Y/N Fee Current Y!N
Address
License#
MECHANICAL
Company
Signature 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 submittal date. Parcei#-obtained from Property Tax Notice htt //a
( p: ppraiser.pascogov.com)