HomeMy WebLinkAbout08-7430
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
7430
Permit Number: 7430
Permit Type: FIRE HOOD SUPPRESSION SYS
Class of Work: FIRE-PROTECTION MAINTENAN
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 5130 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-07000-0012
25.00
25.00
1/28/2008 Phone:
LUPTON- SUPPRESSION MAINTENANCE WORK IS DONE
Name: LUPTON
Address: 5130 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 INSPECTION
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
Date Received
~/Owner's Name!
Owner's Address
813.,780-002Q.
City of zJphyrhills Fire
Permit \A.pplication
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Fee Simple Titleholder Name
Fax-813-780-0021
Phone Contact for Permit
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! I Owner's Phone Number I
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I Titleholder Phone Number I
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Fee Simple Titleholder Address
Job Address
Sub Division
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Parcel #
I Lot#
(uts I AINt:U I-KUM t-'KUt-'t:K I Y I AX NU 11l,;t:)
Jl Contractor
- '-signature
Address I
ELECTRICIANI
Signature .
Address I
PLUMBER
Signature
Address I
MECHANICALI
Signature
Address I
OTHER
Signature
Addres:s
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Bio-Hazard Waste Storage - ANNUAL
D
D
D
D
D
D
D
D
D
D
D
D
Comm Exhaust Kitchen Hood/Duct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
Sprinkler
Fire Alarm
Hood Clean/s~n
Fire Alarm Installation
Fire Pumps
D
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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
Recreational Bum
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch Roofing
Waste Tire Storage ANNUAL
~pany
~gistered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Valuation of Project
Other:
1~~(~3ei~~ -
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Fire Works
Flammable Application- ANNUAL
Fuel Tanks
Fee Current
Y/N
Fee Current
Y/N
Fee Current
Fee Current
Y/N
Directions:
Fill out application completely. I
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 I
Allow 10-14 days for review after submittal date.
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NOTICE OF DEED :RESTRICTIONS: The undersigned under~tands 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. i
UNLICENSED CONTRACTORS AND CONTRACTOR RE~PONSIBILlTIES:lf the owner has hired a contractor or
contractors to undertake work, they may be required to be IicEjmsed 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 unc;ertain 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 orl contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for whichJ 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. I
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statute~, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a cqpy 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~t he above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
_ CONTRACTOR'S/OWNER'S AFFIDAVIT: I cert, that all the information in this application is accurate and
that all work will be done in compliance with all applicable laws regulating construction, zoning and land
development. Application is hereby made to obt~in 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 constructi!on, County and City codes, zoning regulations, and land
development regulations in the jurisdiction. I also certify that I understand that the regulations of other
I government agencies may apply to the intended Work, and that it is my responsibility to identify what actions I
must take to be in compliance. :
If I am the AGENT FOR THE OWNER, I promise in good fait~ to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understandil that a separate permit may be required for electrical work,
plumbing, ~igns, 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 violatibns 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
the permit i~ suspended or abandoned for a period of six (6) rronths after 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 ninety (90) consecutive days, the job is considered abandoned.
WARNINdTO OWNER: YOUR FAILURE TO RECORD Ai NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE~TY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) I
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CONTRACTOR
Subsqribed and sworn to (or affirmed) before me this
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Who is/are personally known to me or has/have produced
i as identification.
OWNER OR AGENT
Subscribed and sworn to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as identification.
Notary Public
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omr~lIsslon o.
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Name of Notary typed, printed or stamped
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Notary Public
Commission No.
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Name of Notary typed, printed or stamped
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