HomeMy WebLinkAbout08-7493
CITY OFZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL 'FIRE PROTECTION 'MAINTENANCE
7493
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:
7493
FIRE PROTECTION MAINTENANC
FIRE-PROTECTION MAINTENAN E
COMMERCIAL
RMAiI
Address: 6701 DAIRY RD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot{s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 02-26-21-0010-03900-0060
2/13/2008
25,00
25.00
2/13/2008 Phone:
FPM-WESTBROOKE MANOR - QUARTERLY-SUPPRESSION
Name: ALLEGIANCE SENIOR CARE
Address: 6701 DAIRY RD
ZEPHYRHILLS, FL 33542
~111~,~t w!-.- jXk,-____,-,,,., ,~, -^ ,- ; ~!:{~
FIRE ACCEPTANCE Final
r;nJ
3r ) 1~()€3
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 NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
City of Zephyrhills Fir.e'
Permit Application
t~=;i;!il~\~c:~~:,c;.~_mJ''''0i'':_'~,"~''0i..@",,-L--_w;__~~o~;Co~t~ct for!ermit m,ly___Ll"'0i,","i0iM"JJ''''m~_",~~,,1
I II II I
oS /- 5~/
I II
, , . <t1 :1->80-0020
Owner's Name
Owner's Address
Fee Simple Titleholder Name
Fax-813-780-0021
Fee Simple Titleholder Address
D Fire Alarm Installation
D
B
D Fuel Tanks
D~I I
ELECTRICIANI Company
Signature . Registered Y I N Fee Current Y I N
Address I License #
PLUMBER Company
Signature Registered
Address I License #
MECHANICAl_I Company
Signature Registered
Address I License #
OTHER Company
Signature Registered
Address License #
Directions:
Job Address
Sub Division
D
D
D
D
@
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 0 0 0 L-J
Doooc=J
~ ~ ~ ~B
Fire Alarm
Hood Cleaning
Hood Suppression
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Lot#
I
Parcel #
o
o
o
o
o
o
D
D
D
D
o
o
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 RoofingfTar Kettle
Waste Tire Storage ANNUAL
Valuation of Project
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
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. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com)
;,"~ INGT4CE'OF DEED 'RESTRICTIONS: The undersigned under:staqds,;that :this -permit may ,besubjectto'''deed''rrestrictions!lmtl'1nds:7
.c..iNhich'may'be<more restrictive than County regulations. TheclJndersigned..assumes responsibilityfor:compliance'with any,:,-,(+'r,..,,,_
,applicable deed restrictions, c. c .
unUNl2ICENSED CONTRACTORS AND-CONTRACTOR RESP,ONSIBIL:lTIES: --If-the -owner has -hired'~a--contractor -or-- ____n
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 with 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
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 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
the permit is suspended or abandoned for a period of six (6) months 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, tf 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 YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO NCEME T,
FLORIDA JURAT (F,S, 117,03)
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,
CONTRACTOR
Subscribed and swo ~
by -
Who is/are personally known to m
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped