HomeMy WebLinkAbout08-8040
..
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
8040
Permit Number: 8040
Permit Type: FIRE PROTECTION MAINTENANC
Class of Work: FIRE-PROTECTION MAINTENAN E
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 6329 GALL BL
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot{s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 03-26-21-0020-00000-0010
7/02/2008
25.00
25.00
7/02/2008 Phone:
FPM-ANNUAL FIRE ALARM -KAUFMAN EYE-SCHEDULED FOR 7/3/08
Name: KAUFMAN GROUP ENTERPRISES
Address: 6329 GALL BLVD
ZEPHYRHILLS, FL. 33542
6~
9 ~.if8
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 $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
-..
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
813-780-0020 City of.Zephyrhills Fire . vf_ 001 (; Fax-813-780-0021
Permit Application I..f'
.. . . I
~~"!},~i~~_!E:,,,J21Jl~~,_~..~~._~1Jf,_.-!~~~~~~~~""~-lJr1ELJJ,:2~~,
Owner's Name Owner's Phone Number I q,.,.3> 117 ~ ~ Illlol (0
Owner's Address
Fee Simple Titleholder Name
I
I
~$""'=~~f-_'~I~
I ~a.m~
I
I Titleholder Phone Number I
II
II
Fee Simple Titleholder Address
tV~"
- ~'M
'-~~""""'-&1!~:.~i~"
I Lot#
Job Address
Sub Division
Parcel #
tVtll AII'olt::U rKVIVI t"'KVt"'t::K I Y I f\A I'\IV Ilvt::)
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
Fire Alarm ~
Hood Clean/Suppression D
Fire Alarm Installation
D
D Fire Pumps
D Fire Works
o Flammable Application- ANNUAL
D Fuel Tanks
D Other:
~~:~i'mJ~''''< - ':''W''''':r,',,,~-,,~~n
~~~:~~::r I ~ ~i
Add~, :'~ '11\ C) N.eQ,..lh..Q..\Z- PI -0 Odt Ohl
ELECTRICIAN =tf
Signature
Address I
D
D
D
D
D
D
D
D
D
D
D
D
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
Valuation of Project
--.
filii'
I
FL4
PLUMBER
Signature
Address I
MECHANICALI
Signature
Address I
OTHER
Signature
~,,~~,;;.J.....,.~,
Directions:
Company
Registered
License #
~ll1l'Irmi':.....,,~~i~~~
~CJQH.1{ 'Lletiro;l~wn<,
K:5?l N J U Fee Current ~
I f:.F . OCOlt1..f( 0 I
I Y I N Fee Current Y I N I
I
~-~~ ,r.~!;1I"...
""~.
Company
Registered
License #
Company
Registered
License #
Y/N
Y/N
Fee Current
Company
Registered
License #
Y/N
Y/N
Fee Current
Company
Registered
I License # I
~;;w--",,";;O'~~_<~i=<""'}.;::%,.:;;i<-:'~"'x-i~.~_,.,,~~~t~~~~"~__-_'v:'
....;,.:;.w.,:/~_.__."..,:"...."~',""'::;_.::..'~i""o.it.;:..i:'"""""";:':-:,iili:..:'.:,.,.::"i>i'h'~'-..:~::';"",,-:,-:~.,,~,..,
Y/N
Y/N
Fee Current
I
'-...,;f-j\i;v:.,:.;.i..~i.~.~ii.~iii;{<.":\~:,.:._'''<<.-'l<~~"'.....,,~...:.;<.-_.,,::~~;&~~:~';;;,~~.~,;;<..~~&m
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.
-_._.....__._-,.._-_..----"'..._..-...--..~.- ..--..........-...-- .-
HNOT,ICE.OFDEEO..RESTRICTIONS: The undersigned understands that this permit maybe subject to ~deed" restrictions"
.which may be. more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restricticms. . . ..
. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to. be licensed in accordance with state and localregtllations. 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 Pasc~ .County Building Inspection Division-Licensing Section at 727M847-
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.LlEN.LAW (Chapter713, Florida Statutes, as amended): Ifvaluation of work is $2,500.00 or more,.1
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
.. . H .. ... ..that. all. work -will be-done in. compliance. with.. all-applicable..laws . regl:JlatiRg.-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. 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 coriunencing 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
permit~issued .shall:be construed to be a .license to proceed with the work and not as authority to violate, cancel, alter, or
setasic:ls' aniprovisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
. requirirng.acorrection of errors in pl~ns, construction or violations of any codes. Every permit issued shall become invalid
. .unl~sidhe~~o,"k'authorized.by such permit is commenced within six month~ ~f permit issuance, or if work authorized by
. .tlie(pel1iili:.:is'.sus.pE;,rided or abandoned for a period of six (6) months after the time the work is commenced. An extension
ma)rbe requested, -in writing, from the Building Official.for a period not t~ exceed nin~ty ~90)da~s and will demonstrate
. j~~~if!~ble ca.i.Jse 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 COM~ENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVENiENT~ -r:~. Y9-LJ~.p'~q.PE~!.X~Jf~raY1t.1T.E.flJP.IP,9~JAlf'LF:I~ANCING,. CONSULT
Wl+H :y..(llllR:"~bEND6R_(I)RAN-A+r(:)RN.s.v.IBSpmRE-REOfjRDING'Y.OtJR,i(()TICE OF COMMENCEMENT.
i::..~1:f~fi~D~1t1:11t03)"" .:....,.,' ..
_~... .. - -.. . .._ _~. .___. .0' ._..._. ________._______________ ---------. ----. -----.-. ------- ...- -.. "..'P .... ---... ..... ---- .
_ _. _ "._.~~' or .....,.., _0' ".,.. -- '.,'" .... -~, . -. ." P" -- ,- .. .. ........ -."
.OWNER O.R 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 sworn to (or affirmed) before me this
. by
Who is/are personally known to me or has/have produced
as identification.
Notary Public
Notary Public
Commission No.
.Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped