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HomeMy WebLinkAbout07-7173 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7173 Permit Number: 7173 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv, Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 4330 20 ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: N/A Parcel Number: 13-26-21-0070-07400-0000 11/06/2007 25.00 25.00 11/06/2007 QTRL Y MAINTENANCE - SPRINKLER ZEPHYRHILLS CORP. Address: 777 W. PUTNAM AVE GREENWICH, CT 068305091 Phone: ~(Jldd) ~ r'S8 l'/(~/o7 T . FIRE LIGHT TEST-Final FIRE SYSTEM ACCEPTANCE Fina 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." -.... CONTRACTOR SIGNATURE P IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application m~~~~'IM@1fA1L_#.~Ltfl- ~,,,.._,,,~,LJ.,,"__,,,,,...U,,,,~,,,,,,,,,,,,,","J Owner's Name Owner's Address ~frill.J ~~/ I Owner's Phone Number S-fI'..Lek I "2 ~/,kVfh,'lIS f r/' I Titleholder Phone Number I 2 J S 117 g :g II /? 5"'1 33SC/Z I II II I Z t:t'A'I rh I tis I '1330 Jo ~ I I ,Y33o I Fee Simple Titleholder Name Fee Simple Titleholder Address Job Address Sub Division d2>-j;. S.bwf I Lot# Parcel # \ Uti I AII'llt:U rKUlV1 t"KUt"t:K I T I tv. I'IIU 11L.t:) D D D D D ~ ~ D D D Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen HoodlDuct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL Sprinkler ~ Fire Alarm D Hood Clean/Suppression D Fire Alarm Installation Fire Pumps Fire Works (JrtlL Y D Fumigation Tent D Hazardous Material D Hood Installation D LP/Natural Gas-Installation D LP/Natural Gas-ANNUAL Sale D Places of Assembly-ANNUAL D Recreational Bum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage Other: Contractor Signature Address Flammable Application- ANNUAL Fuel Tanks OTHER Signature Address Directions: Company Registered License # Y/N ELECTRICIAN Signature Address I I PLUMBER Signature Address I MECHANICA~ Signature Address I Y/N Fee Current Company Registered License # Y/N Y I N Fee Current Company Registered Y I N I Fee Current Y/N License # Company Registered Y I N I Fee Current Y/N License # Company Registered License # Y I N I Fee Current Y/N 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. __ "..__"_....~._...."'_-""~___"~...__._,......__.__~___.......__.~__._,._.h...~,..,,_..,' _,."_~.. ,.....,... _ _ .."e...-_' n._ ""','.".._. ,....".. NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or 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 owner 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 apply 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 "contractor 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 entitled to permitting privileges in Pasco County. CONSTRUCTION LIEN LAW (Chapter713, 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 "owner" 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 withd all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I musttake to be in compliance. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance 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 within six months of permit issuance, or if work authorized by theperrriUis suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension maybe 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 ninety (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 X9lJ It"lJTI;,ND. TO. 9BT AINFINANCING, CONSULT WITH YOUR;LENDEROR,AN_ARORNE:V1BEFORE.:REcnmDING'YOURNOTICE OF COMMENCEMENT. ..... UF-lieRla~:deFm'r,I(E:sJ!117t03) ,.' .. ..... .~................. OWNER OR AGENT . ~"'f:rn,aOO -- to (0< ~ m>ed) _,e \Ie .." e> . by 0 "".c:l -r- '\ (? l 0', "-, ~ n <.~ TI Who is/areJersonallv known to me or has/have produced A / - as identification. ~ Name of Notary typed, printed or stamped '- . ~ -X ~ ---C) '----\ ~ "\ Commission No. "S) '\) L-\ l..-\ 5 85.:3 ~ 0.... '('e. l'- 'D _ \-\~ \' \' 'f'Y> 0... r-.. r--- Name of Notary typed, printed or stamped Notary Public NIt MICHELE HOGE . MY COMMISSION' 00 389241 EXPIRES: F8b1\l8lY 26, 2009 Bonded Thru NolIIy PubIc \JndIlWIIIIIS CD KAREN D. HERRMANN Notary Public, State of Florida My comm. expires July 13, 2009 Comm. No. DO 445853