HomeMy WebLinkAbout07-7275
.CITYOF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
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7275
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
7275
FIRE PROTECTION MAINTENANC
FIRE-PROTECTION MAINTENAN E
COMMERCIAL
Address: 38300 11TH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-06600-0011
133.75
25.00
25.00
12/07/2007 Phone:
FPM-HOOD CLEANING - SCHEDULED 12/19
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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."
~
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPEcnON
CALL FOR INSPEcnON - 8 HOUR NOnCE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marsha. Office - 813-780-0041
Date Received
City of.Zephyrhills Fire
Permit Application
Phone Contact for Permit
813-780-0020
Owner's Name
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Owner's Address
Fee Simple Titleholder Name
Fee Simple Titleholder Address
Fax-813-780-0021
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Owner's Phone Number
I J
Titleholder Phone Number
II
Parcel #
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Contractor ... ~J:.3~
Signature ~ ~ C-c:::.
Address I f' /~ 1- /3<< /l UVtn '- f< /) .
ELECTRICIAN
Signature I
Address I
Fire Alarm Installation
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Fuel Tanks
D
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Job Address
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Lot#
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Fumigation Tent
Hazardous Material (Tier II or RQ Facility) ANNUAL
Hood Installation
S~d-
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LP/Natural Gas-Installation
LP/Natural Gas-ANNUAL Sale
Places of Assembly-ANNUAL
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
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Recreational Bum
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch Roofing
Waste Tire Storage ANNUAL
Valuation of Project
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Sub Division
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D BiD-Hazard Waste Storage - ANNUAL
D Comm Exhaust Kitchen Hood/Duct
D Controlled Bum
D Emergency Generator < 30 kw
D Emergency Generator> 30 kw
D Fire Protection Maintenance - ANNUAL
Sprinkler D
Fire Alarm D
Hood Clean/Suppression gj
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PLUMBER
Signature
Address I
MECHANICALI
Signature .
Address I
OTHER
Signature
Address I
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Directions:
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Y I N Fee Current Y I N
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I Y IN
Fee Current
Y/N
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
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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.
...----..--.....-......-....-....-..-...-...- ...-.... ..-.....
" .
.NOT,ICE~QFaEED;RESTRICTIONS: The undersignedunderstandsthatthis permit m~ybe subject to ~deed'" restrictions"
.Whic.hmaybe.more ~es.trictive than County regulations. The.undersignedassumes Tesponslbillty'for compliance with any
appllcabledeedrestriciJ(ilns. . . . . .
. UNLICENSED CONTRACTORS AND .CONTRAC'f;OR RESPONSIBIL:.:mES: If the owner has hired a contractor or
contractors. to und.ertake work, they may be required to be licensed in accordance with 'stateand local regLIlations. If the
contractor IS -not licensed as required by law, both the owner and contractor may be .cited fora ..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 Pasc~ .County Building Inspection Division-Licensing Section at 727-847-
800~. .Further,!,ore,if the own;r has. hired.a ~ontractor .orcontra~tors, he is advised to have the contractor(s) sign
porllons.ofthe contractor Block OUhlS 'appllcation for which they wllLbe responsible. If you, as the owner sign as the
contractor, that may be an .indication that he is not properly Iicensed.and is not entitled to permitting privileges in Pasco
County .
CONSTRUCTION.UEN'LAW (Chapter713, Florida statutes, as amended): If valuation of work is $2,500.00 or more;"
certify that I, the applicant, have been provided with a copy of the. "Florida Construction Lien Law--Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than' the "owner", I.certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to .commencement. .
. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application .is accurate and
... __.. .., "that. all.work . will. be <lone in. compliance..with.,all..applicable..laws .regl:llatiAg.,cOAstruction,-..zoning.:and..land........._-
development. Applic~tion is hereby made to obtain a permit to do work and installation as indicated. I certify
that no work. or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of all laws regulating .construction, County and City codes, zoning regulations, and .Iand
developm~nt regulations in. the jurisdiction. I also certify .that I understand that the regUlations of other
government agencies may apply to the intended work, and that it is my responsibility to. i~entify what actions I
must,take to be in compliance. .
If I .am the AGENT fO~ THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth:in
this affidavit prior ~o. comf:l1E!ncli:lg construction. I understand that a separate permit may be required for. electrical work,
plumbing, signs; wells, :pools, air conditioning, gas, or other installations not specifically. included in the application. A
~rmit":is$Ued .S:h~II:p~ construed to be a .\icense to proceed with the work and not as authority to violate, cancel, alter, or
setaside aniprOvisions of the technical codes, nor shall issuance of a permit prevent the Building .Official from thereafter
. requirirng.a:.correction of errors in pl~ns, construction or violations o! any codes. Eve'r permit issued shall become invalid
. ,i.inl~ssi:tie:jiVorK.;autnl;)rized'.bY such 'permitiscommen~ed Within SIX month~ o.f permltlssm~nce, or if work authorized by
.. -tlie;peiJiifi..issu~p~rid~d or abandoned for.a period ~ SIX (6) mo~ths after the time th~ work IS commenced: An extension
may"~ requested, tn .writing, from the BUlldmg Officla~ .for a penod not t~ exceed mn~ty ~90) .da~s and.wllI demonstrate
, j~le cause for the extension. ff woll< ceases for nmely (90) conseculiVe days. the Job IS consIdered abandoned.
WARNiNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR _ROVEMENTS T.() YPII~~!~91!Ef1.!X,.IF :!eIl!~.;!P.BN1\IJ!I,gINAt<lCING. CONSULT
WI+hI :v..owR4bBIlIIDER"'(!)RJ.\.NA:Q'_NS\~)se~RE- ~:y.o~.t~,.'WTlCE OF COMMENCEMENT.
:::':~:!:r~":':.":._.:-_....-~.--c:OfiiRAcro"~~' ,"' . ..... ..' .. .... .",
s_ and sworn lD{or_ ......methls s_ and~sf\IDned b ..me'"
. ~. ~.
Wh~ is/are personally knoWn to me or has/have produced Who is/are personally to me or h . rodu::e
. ~-Nomy~:~:j~~vj~9{1~ -~p-
.Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
.......... . Bobbie Swetland
:.~.:':I" r~:. M'( CoMM1SS.\otH. 00268763 EX~RES
. ;', : ~ febrUary 22. 2008
:':"',. . . .' is,: \lONDED T"RlJ TllOV f~1N INSUR~CE, INC
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GREASE CUTTERS
4107 BURWELL ROAD
WEBSTER, FLORIDA 33597
352-206-1997
Company: Four Bears (63 C~Lj ~-\C\I;L\,"\
Address: 38300 11th Ave. ~
City, State, Zip: Zephyrhills, FI. 33540
Customer No. 0013
Frequency: 12 Weeks
HOOD CLEANING:
Fans: 1
Backsplash: 1
Hoods: I
Filters: 3
Shafts: 1
FILTER TYPES:
Quantity:-L
Material: Galvanized
FILTER SIZES:
15x15
15x20
15x26
20x15
20x20 3
20x26
26x15
26x20
26x26
ImSTAlJiRANT CLEANING:
Floors: Bathrooms:
Game Machines: Wood paneling & Trim:
Bars & Counter Tops: Tables & Chairs:
Windows & Mirrors:
Stainless Steal:
Sidewalks:
Amount: $125.00
Sales Tax:$ 8.75
Total:$133.75
COMMENTS:
DATE OF CONTRACT: 20 December 2000