HomeMy WebLinkAbout08-8224
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
v
8224
Permit Number: 8224
Permit Type: FIRE PROTECTION MAINTENANC
Class of Work: FIRE-PROTECTION MAINTENAN E
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 8/15/2008
Total Fees: 25.00
Amount Paid: 25.00
Date Paid: 8/15/2008 Phone:
Work Desc: HOOD CLEANING QUARTERLY FOR MCDONALDS-DONE 8/13/08
Address: 6042 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MCDONALDS USA, LLC
Address: 6042 GALL BLVD
ZEPHYRHILLS, FL. 33542
C)D~
g / Z'Yuf)
Cp
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-
Permit Application
Fax-813-780-0021
Phone Contact for Permit
Owner's Name
Igt ~
II ;5"0 II q;ro
Date Received
Owner's Address
N OV,4 C.u:.fHJ J MG ~e({))Jc...e: Ie. Owner's Phone Number
p. O. &0 X TAmPA 1=1, 33677
Fee Simple Titleholder Name
Fee Simple Titleholder Address
Titleholder Phone Number I
II
II
Job Address
1 Lot#
me DONALD 'S GOLl<). GALL g[jtJ) .;lePltytp.IlJ.,S, 33540
/ I Parcel # I
Sub Division
Contractor
Si9nature
Md~1
ELECTRICIAN
Signature
Address I
PLUMBER
Signature
Address I
MECHANICALI
Signature
Address I
OTHER
Signature
Address
Directions:
D
D
D
D
D
D
D
D
D
D
D
D
D
D
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
Do ooc=J
~~ooc=J
Doooc=J
Fire Alarm
Hood Cleaning
Hood Suppression
D
B
B
D
I
Fire Alarm Installation
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Fuel Tanks C
Other: I UOOf) UfiNI/JG ill/a
DEL A { e:.t..e..N c..;z..t .
p.o. BOX, 4Qvv rAfYlPA. fl. 33G 77
,
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
0:2
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch RoofingfTar Kettle
Waste Tire Storage ANNUAL
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Valuation of Project
~ I
BE bolJe ON AU6tfSTj /J. ! OJ
Y/N I Fee Current Y/N
Y/N I Fee Current Y/N
Y/N I Fee Current Y/N
Y/N I Fee Current Y/N
Fee Current
Y/N
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 )
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may.besubjectto."deed"fJ"estrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner hashired:acontractor or
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. If 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 COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
CONTRACTOR
Subscribed and swom to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
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
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
v
8228
ermit Num er: 8228
Permit Type: FIRE PROTECTION MAINTENANC
Class of Work: FIRE-STANDPIPES
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 8/20/2008
Total Fees: 25.00
Amount Paid: 25.00
Date Paid: 8/20/2008 Phone:
Work Desc: FPM-SUPPRESSION SEMI ANNUAL-DOMINIOS PIZZA
Address: 5050 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0000-01400-0000
Name: DOMINOS PIZZA
Address: 5050 GALL BLVD
ZEPHYRHILLS, FL. 33542
('\ I (Y>J
Vq,~5D~
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
COMMENCEMNTMAY 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
Permit Application
~~.~~.~~.\,.~:r:;;:J..",,<"......."-_._.._~- .=-'===r..;..-;:;;.":,:;?;:<,o-""-,,""~-==.~~.....=....~=~~,~Permit~_...L,."..~.....,...,,U-_.,,~. ..1J._,.__
1. Od/J1 w'rJ" ~r?2 z/7 .".,........... -] ~I Z7'Y I I 77rlLl
. jC) $'6 f?rJL'- 6LtJ D :
'ee Simple Titleholder Name I I TItleh0Ider Phone Number I II II
~;.~~:=:'~~d:=~,"""",.l."~J:""''''''~'''~01&""",,~~\:;~~!.:'O"-c.''~;r-'!'':''?i..::l;;l'is:;,p::"';';:'"';;;;...~~~~:L.::::,,-'".~' ;.':""z'.-:' ..."
I I Lot # I
,ub ~!~...="''''..i;;j.;;z:"::;r"~,."",,,,~''''''''''''''':''\..''Q..,r-~~-=.,,,,~,,l.,..>=,=~::3;;'""""~"""'''':;u,.:.;;;;;.,-".:.".~...:;.!l:;';.;'''=~::='''''",~:;z.~,.>.;..';",,,-.:::;;....",:::'.:iZ.';;;;.
D Fire Alarm Installation
~ Fire P\.mps
RreWorIcs
. Flammable ApplicatiOn- ANNUAL
Fuel Tanks
,.:.;;;.C.::r=e:.::::l;;:;kJ~~~;..:...~,~=~:"""""""".=""""".,.","",~.",~.;,.,,,...;::4:~~~'~;:;~~""""''''''"'':'"'''''''';''~~L-'''''''--'''''''''''''''''"4.'~~"'''''-'
~:=r I = Y; N I Fee Cunern I ~:;--_._=--
Address I Ucense # I
~CTRICIANj Company
,lQnature I Reglsteted Y I N I Fee CUrrent I Y I N I
Address I license # I
'lUMBER I Company
iignature Registered Y I N I Fee Current I Y I N I
Address I License # I
~ECHANICALI Company
'Ignature . Registered Y I N I Fee Current I Y I N I
Address I LIcense # I
~:HER I /r' ~/A//.t--vL.. Company S~'<!'/ry" r;;<e C:o"',Oju:.,-"rr-
>Ignature . . y L-. ":'/ ~ . Registered cY:'bN I Fee Current I Y I N _
=~J~t~~- ,_:i~~~~:<_;~__!1g _._~~--<:!:6_=-.....~~,L=,m"~~:!<MJ.i'2~S::'S:?,':9.'e.. ~lr~,~,""~I,"",~_",",~,.~,'a;
Fill out application c:ornpIelBIy.
Owner & Contractor: sign back of appIlcatlon. notarized (Or. copy of signed conlract with owner)
If over $2500, a Notice of COmmellC:ei'l8Ilt is required (MechanIcal work over $50(0)
Supply two (2) sets of drawings with applicable cfocumentation
Allow 10-14 days for review after submitlal date. Parcel # - obIained from Property Tax Notice (http://appraiser.pascogov.com)
>wner's Name
>wner's Address
ob Address
o
D
o
D
D
D
Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kl1chen HoodIOuct
C0ntr0lIed Bum
Emergency Generator < 30 kw
Emergency Genera1Dr> 30 kw
Rre Protection Malrdenanc:e - ANNUAL
"0 ~ (!!!!!] I!!!J ~
o ooL-J
OOOOc=J
Ooooc=J
0" 0 ~O c=J
Sprinkler
Fire Alarm
Hood CleanIng
Hood Suppression
D
D
o
D
o
o
o
o
o
o
o
o
~
Ftm1lgaIIon Tent
Hazardous MatIIlrIal (Tier II or RQ Facility) ANNUAL
Hood InsIaIIation
LPJNaturaI Gas-InstaI/aIiO
LP/NaluraI Gas-ANNUAL Sale
Places of AssembIy-ANNUAL
Recreational Bum
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch RoofingITar Kettle
Waste Tire SlDrage ANNUAL
~ Valuation of Project
IOTICE OF'DEED RESTRICTIONS: The undersigned understands that this permit may .be'subjectto-"deEB:r.'rrestrictions"
ffiich may be more restrictive than County regulations. The""undersigned assumes responsibUity for~mpliaRCe'with any
Ipplicable deed restrictions.
JNLlCENSED CONTRACTORS AND CONTRACTOR RESPONSIBIU11ES: If.the owner has -hired-:a'contractor or -
:ontractors to undertake work, they may be required 10 be licensed in accordance with state and local-regulations. If the
:ontractor is not licensed as required by law, both the owner and contractor may be clted"ior a misdemeanor violation
Inder state laW. If the owner or intended. contractor are uncertain as to what licensing -requirements may :apply for the
ntended work, they are advised to contact the.Pasco County Building Inspec60n Division--Licensing Section.at 727-847-
K)()9. Furthermore, if the owner has hired a contractor or contractors. he is advised to have the contractor(s} sign
)Qrtions of the "contractor stock" of this application -for which 1hey will be responsible. If you, as "the owner sign as the
Xlntractor, that may be an indication that he is not property licensed and Is not entIUed"to permitting privileges in Pasco
::;ounty .
:ONSTRUC110N-UEN LAW (Chapter713, Florida Statutes,..as.amended): IfvaJuation of work is $2."500.00 or more, I
31ify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Jrotection Guide- prepared by 1he Rorida. Department of Agriculture and Consumer Affairs. If the applicant is someone
)ther than the "owner", I certify that I have obtainE!d a copy of the above desaibed document and promise in good faith to
jeliver it to the "owner" prior to commencement.
CONTRACTOR's/OWNER'SAFFIDA VIT: 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 unders1and 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 PfOITlise 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 elecbical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically inauded in the application. A
pennit 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. If work ceases for ninety (90) conseartive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAlLlIU: TO RECORD A "NOTICE 'OF -COIIIENCEIIENT 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 RECORDIlIG YOUR N011CE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
CONTRACTOR
Subscribed and sworn to (or aftirmed) before me this
py
Who lsIare .,e.fIOll8lly kncMn to me or haslhave produced
as idenIificatlon.
OWNER OR AGENT
Subsaibed and sworn to (or affirmed) tlefore me this
py
Who islare personally kncMn to me or haslhave pnxluced
as identlIIca1Ion.
NoIary Public:
Notary Public
CommissIoI. No.
Commission No.
Name of Nolary typed;1i1nled or stamped
Name of Notary typed; printed or stamped