HomeMy WebLinkAbout15-16600 -
CITY OF ZEPHYRHILLS
5335-8TH STREET
,, (sis)�so-oozo 16600
FIRE SPRINKLER SYSTEM PERMIT
�. PERMIT INFORMATION - i LOCATION INFORMATION
Permit Number: 16600 Address: 6429 GALL BLVD
Permit Type: FIRE SPRINKLER SYSTEM ZEPHYRHILLS, FL.
Class of Work: FIRE-SPRINKLER SYS Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03-26-21-0020-00000-0030
Improv. Cost: 1,930.00 E- . � OWNER INFORMATION
Date Issued: ��, �a7/t�is Name: WALGREENS
Total Fees: 150.0.0 Address: 6429 GALL BLVD
Amount Paid: 150.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/07/2015 Phone: (847)315-4717
Work Desc: INSTALL 2 ADDITIONAL SPRINKLER HEADS
CONTRACTOR S � ( APPLICATION fEES - � '
FIRE ALARM A D SPRINKL RS FIRE SPRINKLER SY 50.00 F RE P REVIEW FEES 25.00
� FIRE INSPECTION FEES 45.00 CONTRACTOR CERTIFICATE 30.00
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FIRE-PRESSURE TEST
FIRE ACCEPTANCE Final
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 tlie 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 accord�nce with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
�
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAI�!
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMEN ENT."
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CONTRACTOR SIGNATURE PERMIT OFFICE
PERMIT EXPERES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
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City of Zephyrhills
BUILDIIVG PLAN REVIEW COMMENTS
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Co��tractor/Homeowner: ��� �
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Date Received: — l�J' �
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Site: (� � Z1� `(�.r14-`` ��v.J
Permit Type: �'i �� '�'�u��G_
Approved w/no cominents:� Approved w/the below comments: ❑ Denied w/the below comments: �
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This comment eet shall be kept with tt�e permit andlor lans.
Or► �
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Bill Burgess—Buil ' Official Date Contractor andJor Homeowner
(Required when comments aze present)
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� s��-�so-oozo City of Zephyrhills Permit Application '1 Fau-813-780-0027
M - Building Department ���•}� n�t l���� '��r{/J
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Date Received phone Cantact for Pertnitting �� Z 3 3 � I?�
Ownels Name �/" 1�`Qi�.S-� Owner Phone Number
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Owners Address Owner Phone Number
Fee Simple Titleholder Name � Owner Phone Number
Fee Simple Titleholder Address I
JOB ADDRESS a� 1 �� I LOT# � �I
SUBDIVISION PARCEL ID#I
I (OBTpINED FROM PROPERTYTAX NOTCE)
WORK PROPOSED e NEW CoNSTR e ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK v i ��I(,��J" � +
BUILDING SIZE S�FOOTAGE� HEIGHT �
�BUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ �f � ���n-�
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION U U
QGAS Q ROOFING Q SPECIALTY ID OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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BUILDER COMPAr1Y
SIGNATURE aECisTERED Y/ N �cuRREn Y/N
Address I License#
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ELECTRICIAN COMPANY
SIGNATURE �cisTe�� Y/ N �Cu�n Y/N
Address License�
PLUMBER COMPAINY
SIGNATURE r�clsrE�o Y/ N �cuw�n Y/N
Address License�
MECHANICAL COMPA�NY
SIGNATURE �cis��o Y/ N r�cuwx�n Y/N
Address License#
OTHER '�� COMPANY ��'�- T't��1�' ss�-�- � ►�n�,9�,�3
SIGNATURE �c�s�n Y/ N �cuwt�n Y/
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Address ( �� " /� � � �Y�^t r�1 �.I License# � I Zu����j� �
1 1 1 1 I 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 �1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of E�ergy Fortns;R-O-W Pertnit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Sitt Fence installed,
Sanitary Facilities 8 1 dumpster;Site Woric Pertnit for subdi�isions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Lffe Safet�Page;(1)set of Energy Fortns.R-O-W Pertnit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construdion Plans,Stormwater Plans w/Siit Fence installed,
Sanitary Facilities 8 1 dumpster.Site Work Permit for all n i projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW constructiorl: .
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Directions:• • • • • • • • • • • • • • • • • • • • • • I
Fill out application completely
Owner 8 Contrador sign back of application,notarized
If over�2500,a Notice of Commencement is required. (A/C upgradesI over$7500)
" Agent(for the contractar)or Power of Ariomey(for the owner)would be sdmeone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITf1NG (copy of conUact required)
Reroofs if shingles Sewers Service Upgrades A!C Fences(PIOUSurvey/Faotage)
Driveways-Not over Counter rf on public roadways..needs ROW
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� � NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restricti�e than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions. I
UNLICENSED CONTRACTORS AND CONTRACTOR RES�ONSIBILITIES: If the owner has hired a contractor or
y contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owne�and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may appiy for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"conVactor Block"of this application for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entiUed to permitting privileges in Pasco
County I
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
, that Transportation Impact Fees and Recourse Recovery Fee�s may apply to the consVuction of new buildings,change of
use in existing buildings, or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,tha{such fees, as may be due,will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final power release. Ilf the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore,if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner�,I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owne�'prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulatin�constri�ction,zoning and land development. Application is
hereby made to obtain a permit to do work and installati n as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work�will be pertormed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, a�d land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govemment agencies may apply to the intended work,and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management DisVict-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers�eawalls,Docks,Navigable Waterways.
- Department of Health 8� Rehabilitative Service§/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida. I
- If the fill material is to be used in Flood Zone�"A° in connection with a permitted building using stem wall
construction,I certify that fiIl will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I ce�tiTy that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application,for lots less than one(1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good fa�th to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understantl that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or othe�r installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the woric and not as authority to violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall iss ance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced v�ithin six months of permit issuance,or if work authorized by
the permit is suspended or abandoned for a period of six(6)�months aft@r the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninetyl(90)consecutive days,the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCtNG,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03) (`�—�v`���n, �
OWNER OR AGENT CO TRACTOR
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Subscribed and swom to(or aifirmed)before me this Su s ' ed and swom to aifirtned)be(o�me t is
by by 1 P/7� C/
Who islare personally known to me or has/have produced o islare, o ly 4 o�pm to me ar hasJhave produced
as identification. � ( �v+L��a�identifica6on.
Nota Public I Nota Public
ry ry
Commission No. Co on No. l`-� � ,,_ _� .� ,. _
� � � zi�"'�� TINA FERNANDEZ i'
Name of Notary lyped,printed or stamped Nafne of Notary typed,pnn ed or stamped :2 s •�; �
= � . _ Notary Public-State af Flori�� ���
�,` o�;My Comm.Explres Aug 14,2018
'%;FO����`;�'� Commission#FF 151087
. ZEPHYRHILLS FIRE DEPARTMENT
38410 6th Ave Zephyrhills, FL 33542
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FIRE SERVICE USER FEES
Occupancy No.: �� p ��� � t -',` �,,_
Plan No.: Contractor-�[(�, ��!'�u'�-� � �yi��M��
Business Name: � Billing Address:
Business Address: (o��2.-� � � �
Business Phone No.: Billing Phone No.:
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
Site Plan N/C Annual N/C ` prinkler $50 1stAlarm N/C
-Multi-Family/Commerc' O6 sf 1st Re-inspection N/C Standpipes $50 2nd Alarm N/C
(Minimum Char e$25.00 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C
� Plan Revisions DBL 3rd Re-inspection $250 Hoods $50 4th Alarm $100
, 4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150
SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Alarm $200
0-25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150
26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- pertank $50
STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100
� Per Riser $50 Hydrostatic Test 65 per system Fire Works $500
FIRE PUMP cceptance Test 45 ersystem Camp Fire $25
� Per Pump $100 Hydrant Flow $75 Controlled Burn $100
FIRE ALARM SYSTEM Hood/Duct $50
� 0-25 Devices $50 FIRE ALARM SYSTEM �lace of Assembly $50 Mnual
26 plus Devices $100 System Acceptance $50 Fire Protection $25
SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $50 Annual
Wet $50 OTHER Waste Tire Storage $50 Annual
Dry $50 Fire Wall/Smoke Wall $15 perwall Generator<KW $100
CO2 $50 LP Gas $25 per tan Generator>30 KW 150
Other $50 Natural Gas $25 persyst�m Bio-Hazard Waste $100 nnnuai
KITCHEN EXHAUST Fumigation Tenting $50
� Hood/Ducts $50 Tent 10'x10'or greater $15 per fent Torch PoUApplied $50
OTHER Fire Pump $45 Haz.Materials $100 Mnual
LP Installation per tank $50 Fire Suppression $30
Fuel Tank Installation $50 System Acceptance
❑ (Per Tank) $50 � Exhaust Hood/Duct $30
Natural Gas Installation $50 Re-inspeCtion DBL
(Per System) (other than annual)
� Spray Booth $50 � Inspection scheduled DBL B
and cancelled less than
y� 24 hours
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� � Construction Insp. � N/C ��
�� Emergency Vehicl� $50 �' FALSE ALARM
PLAMS TOTAL� INSPECTION TOTAL� PERMIT TOTAL TOTAL�
GRAND TOTAL ��
Comments: ���
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Date:
Inspector:
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