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HomeMy WebLinkAbout07-7188 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7188 Permit Number: 7188 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv, Cost: Date Issued: 11/13/2007 Total Fees: 25.00 Amount Paid: 25.00 Date Paid: 11/13/2007 Work Desc: FPM-SUPPRESSION - SEMI ANNUAL Address: 7643 GALL BLVD ZEPHYRHILLS, FL. Township: Range: Book: Lot{s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 35-25-21-0110-00000-0040 Name: CHILI'S BAR & GRILL Address: 7643 GALL BLVD ZEPHYRHILLS, FL. 33542 Phone: Q,~~ ~ r)6 td27 (07 ~ 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 CO ENT." -.. 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 8113-780-0020 Date Received Owner's Name Owner's Address City of.Zephyrhills Fire Permit Application - (3 - .;;J.oo, IChr /,. ~ !3lJl, j 6-1' ttl A0-;~ I G;\\("OCNl I I I 7~ it3 I Fee Simple Titleholder Name Fax-813-780-0021 ~&,6.l <6 fc"::, II dPI'4 IA 555 Phone Contact for Permit Owner's Phone Number I Titleholder Phone Number I II II -- iWlIr~ - -~. l::a:li.ilI Fee Simple Titleholder Address Job Address Sub Division ~~~~1iII t< ......-nltbt!~- D D D D D D D D D D D D D Fumigation Tent D Hazardous Material (Tier II or RQ Facility) ANNUAL 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 ANNUAL ~J/ f3/v ! Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL Sprinkler D Fire Alarm D HoodClea~ Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Parcel # I Lot# ~Ub IAII'lt:U r-I"(UIVI t"'KUt"'t:1"( I Y I A^ I'lU 111",t:) nlill 1T~ T!I ~rtlllf Ii !!~. J1~~ ., Valuation of Project Other: Contractor Signature Address ELECTRICIAN Signature I Address I PLUMBER Signature Address I MECHANiCAL! Signature I Address I OTHER Signature Address I ld_~' -. W""'''''\;j."""",,,,..,.=,~,,,...:.,=-..,,,,,-- ;'''''''''''''''''''''-'''''--'''-'-''''',''="V'.~'~"",.^",_,=='",,_,-,,=._...~. _~'__.~. 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. =""".''''''-' ~ ,~_,.,-.,.I Company Registered License # Company Registered License # Company Registered License # Company Registered License # Company Registered License # I ~(1"YlSL,kv b-t.n"'"'- " Y I ~ I Fee Current I Y I N I I Y I N I Fee Current I I Y IN I r Y IN' I I Y I N I Fee Current L Y/N '-'-"'.~. ."",-.~ Y I N I I Y IN I I Y I N I . wy.", . ,,,,,,... '.... ..~,_'"_,...="', '. .! Fee Current Fee Current ~ __...._..._....a_~.._..__...._"..._a....._...._ ..__........_...-~ . ~ .NOTtICE.OF.~DEED.RESTRICTIONS: The undersigned understands that this .permit maybe subject to ~deed" restrictions" 'which may be. more restrictive than County regulations. The undersigned assumesresponsibility'for compJiance with any applicable deed restrictions. . . . UNLICENSED CONTRACTORS AND 'CONTRACTOR RESPONSIBILmES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with'state and localregtilations. 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'L1EN'LAW (Chapter713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more;.' 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 '<ione in. compliance . with-.all.applicable..laws .regulatiRg..constructioR;..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. i~entify what actions I must.take 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. corill:nencing construction. I understand that a separate permit may be required for. electrical work, plumbing, signs; wells,llools, air conditioning, gas, or other installations not specifically included in the application. A p~rmit~issued .sncdl:be construed to be a license to. proceed with the work and not as authority to violate, cancel, alter, or seiaside- anY'provisions of the technical codes, nor shall issuance of a permit prevent the Building .Official from thereafter . requiring.acorrection of errors in pl~ns, construction or violations of any codes. Every permit issued shall become invalid . .unless.itie:;worK'8uthorized.by such permit is commenced Within six months of permit issuance, or if work authorized by tfiE;:peITriJt."is'.sus.p~rided or abandoned for a period of six (6) months after the time the work is commenced. An extension mayJJe requested, -in writing, from the Building Official.for a J'leriod not to exceed ninety (90) days and will demonstrate . j#~~lJble 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 MA YRESUL T IN YOUR PAYING TWICE FOR IMPRoVENiENT~ -':9 Yt!U~_ r~-'?~~:!X~ Jf..!Rl!!~J.E.~P.;t:fU:~~J~lt1I_EINANC.ING, CONSULT i~\~~~~~~~:~:::::_~~C~:~~:~NCEMENT- ~.__ .. :OWNER OR AGI: CONTRACTOR b:'rl .-eVf Subpcri~ and swom {or eel afore me this Subpcrib~ and sworn (or affirm~) befQre me this IZ .. " J..1.U'3jQ:z by ~..('. \\1\3Ju, bYf'^lc.hClL~ tiD~ ,;:)n~~ \IYbP is/are personally knoWn to me or haslhave produ Wh? is/are personally.known to me or haslhave produ~d ~ \'f20<2 LI c.. as idenUfication. <;;7~ "'bQ-.} {2 \.-l <L. as identification. ~.tt-~A~ Notary Public ~.~ . d-~ Notary Public .commission No. ~W~ K _ '~ aren L. Miller -<<: .C1!:: ~ rD . -.. .: nm talQR 11 00689664 Name of Notary typ~ ...,. ~ctober 29 2010 ,SMI\ BondodT F. . . my .In ~ Insurance, Ine e00-38S.7019 Commission No. ,"'''t.' . .:"~~"~~. NameOf'~ ":;'fi.'~l(rf, Expires October 29., 2010 Bond... Troy Fern .I......ne.. Ine eoo.385-i019