HomeMy WebLinkAbout07-7276
CITY OFZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
7276
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:
7276
FIRE PROTECTION MAINTENANC
FIRE-PROTECTION MAINTENAN E
COMMERCIAL
Address: 5327 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-13300-0010
197.95
25.00
25.00
12/07/2007 Phone:
FPM-HOOD CLEANING - SCHEDULED 12/30/07
Name: THE COUNTRY KITCHEN ON 301
Address: 5327 GALL BLVD
ZEPHYRHILLS, FL. 33542
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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 NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
B13-780-0020
Date Received
Owner's Name
Owner's Address
Fax-813-780-0021
City of.Zephyrhi/ls Fire
.Permit Application
Phone Contact for Pennit
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Fee Simplel Titleholder Name
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Owner's Phone Number
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I Titleholder Phone Number I
Fee Simplel Titleholder Address
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Sub Division
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Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen HoodlDuct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
Sprinkler D
Fire Alann D
Hood Clean/Suppression ~
Fire Alann Installation
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Fuel Tanks
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Fumigation Tent
Hazardous Material (Tier II or RQ Facility) ANNUAL
Hood Installation
LP/Natural Gas-Installation
LP/Natural Gas-ANNUAL Sale
Places of Assembly-ANNUAL
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\ 2--(30(07
Recreational Bum
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch Roofing
Waste Tire Storage ANNUAL
Other:
Valuation of Project
Contractor
Signature
Address I 1.\ \ Di
ELECTRICIAN
Signature I
Address I
PLUMBER
Signature
Address I
~ECHANICALI
Signature .
Address I
OTHER
Signature
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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.
Company
Registered
License #
IbCP:f-a ()~
Y I N Fee Current Y I N
Company
Registered
License #
Y/N
Y/N
Fee Current
Company
Registered
Y/N
Y/N
Fee Current
License #
Company
Registered
License #
Y/N
Y/N
Fee Current
Company
Registered
Y/N
Fee Current
Y I N I
License # J
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.NO'T,ICE~OFDEiiD;RESTRICTIONS: Ihe undersigned understands that this permit m~y be subject to ~deed" restrictions"
-whien may be.. more restrictive.than County regulations. Tne.undersignedassumes-responsibility'for compliance With any
applicable deed restrictions. . . ..
.UNLlCENSED CONTRACTORS ANO.CONTRAC-r.OR RESPONSIBILmES: If the owner has hired a contractor or
contractors. to und.ertake work, they may be required to be licensed in .accordance wlth'state and local reglllations. If the
con~ctor IS 'not hcensed as requIred by law, both the owner and contractor may be,cited fora.misdemeanor violation
under state law. IHhe 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~. .Furthe"!,ore,if the own;r has. hired. a c::ontractor .or contra~tors, he is advised to have the contractor{s) sign
portions .0Uhe contractor Block of thIs .apphcation 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 .
CONSTRUCTIONUEN'LAW (Chapter713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more;'1
certifY that I, ihe applicant, have been provided with a copy of the' "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than- the "owner", I. certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to .commencement.
. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
... _.. .., "that. all.work -will. be -done in. compliance. with..aU.-applicable--laws .regl:llatiRg.-constnlction....zoning.:and-.land.. -.. ...--.
development. Applic~tion is hereby made to obtain a permit to do work and installation as indicated. I certify
that no work. or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of all laws regulating .construction, County and City codes, zoning regulations, and land
developm~nt regulations in the jurisdiction. I also certify .that I understand that the regulations of other
government agencies may apply to the intended work, and that it is my responsibility to. i~entify what actions I
must take to be in compliance.
If I.am the AGENT fO~ THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior .to comT;l1f!ncing construction. I understand that a separate permit may be required for. electrical work,
plumbing, signs; wells, :pools, air conditioning, gas, or other installations not l?pecifically included in the application. A
~rmitis$u~d.S:hlall:b~ construed to be a.license toproc~d with the work and not as aLithori~ ~o violate, cancel, alter, or
setaside any.provisions of the technical codes, nor shall Issuance of a permit prevent the BUlldmg .official from thereafter
. requiFirng.acorrection of errors in pl~ns, construction or violations of any codes. Every permit issued shall become invalid
. ,unle~s:ilie:Work;authqrjzed.by such permit is commenced within six month~ ~f permit. issuance, or if work authorized by
. .tfie;:peITii1(is-su~p~rid~d or abandoned for.a period o~ six. (6) mo~ths after the tIme th~ work is commenced: An extension
may.-~e requested, ~n writing, from the BUlldmg Officla~ .for a pened not t~ exceed mn~ty ~90) .da~s and.wllI demonstrate
, j#~~le c~use for the extension. If work ceases for mnety (90) consecutive days, the Job IS conSIdered abandoned.
WARNiNG 1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROveMENTS T~ yp~~.f.~9.P.E.~TX":.I~~J1If.~,I9.9~J~lf'1I.gINANCU...G,. CONSULT
. WInd ~..(J)Y . _ENDER.,.(l)R,.AN,.A:r,:rSRNS~)se~RE-'Re~' . .!"OTlCE OF COMMENCEMENT.
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._ .. ..._.._...........-..-...--....-............---.-..---.....--.___n________._.________._._.... . ..... ..... ..... ............-......-.-.
.OWNER OR AGENT CONTRACTO
Subscribed and sworn to {or afllnned) beforerne this Subscribed and sworn
by
Wh~ .islar:e per:;nallY known to me or has/have produced Who is/are persona~ known to me or h e
. ~1_ ~p_ {~~ ~/j3S;~~p-
Commission No. .Commlsslon No.__ .
Name of Notary typ', pre~ or stam~bie Swetland
. . l.f!:;jj~..\ MY COMMISSION # 00268763 EXPIRES
~. } j February 22. 2008 .
.~ ..' 80NCEDiHRUTI'OYFI\IN INSURI\NCE.INC
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Name of Notary typed. printed or stamped
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GREASE CUTTERS
4107 BURWELL ROAD
WEBSTER, FLORIDA 33597
352-206-1997
Company: RJ.' s Country Kitchen
Address: 5327 Gall Blvd.
City, State, Zip: Zephyrhills. FI. 33540
Customer No. 0029
Frequency: 12 Weeks
HOOD CLEANING:
Fans: 1
Backsplash: 1
Hoods: 1
Filters: 7
Shafts: 1
FILTER TYPES:
Quantity: 7
Material: Galvanized
FILTER SIZES:
15x15
15x20
15x26
20x15
20x20 7
20x26
26x15
26x20
26x26
RESTAURANT CLEANING:
Floors: Bathrooms:
Game Machines: Wood paneling & Trim:
Bars & Counter Tops: Tables & Chairs:
Windows & Mirrors:
Stainless Steal:
Sidewalks:
COMMENTS:
Alarm Code: 5555-2
Amount: $185.00
Sales Tax:$ 12.95
Total:$197.95
DATE OF CONTRACT: 08 October 2004