HomeMy WebLinkAbout08-8577 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8577
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 8577
Address: 39602 AMETHYST WAY LOT 5
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: EMERALD POINTE RV RESORT
Est. Value: Parcel Number: 24-26-21-0020-00000-0050
Improv. Cost:
Date Issued: 12/01/2008 Name: EMERALD POINT R
Total Fees: 25.00 Address: 39602 AMETHYST WAY LOT 5
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/01/2008 Phone:
Work Desc: FPM-SPRINKLER BACK FLOW-CLUBHOUSE - DONE 12/1/08
A TOTAL SOLUTION,INC FIRE PERMIT FEES 25.00
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FIRE ACCEPTANCE Final
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$100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041
U I UL Luu r i u> 11 :Z1 AM L;YHYKHILLS BUILDING FAX _'1Ts, ?-78fl-r 2� P, 00• 1
913-780-0020 City ofZeptiyrhills Firs 44 .(1 J Fax-813-780-0021
Permit Application
Date Received Phone Contact for•Permit Z 9�/2 (c,
Owner's Name E T I?,V Owner's Phone Number I2 t°° J 2 Z
Owner's Address jzZ FL 35 /O
Fee Simple Titleholder Name L. 0 Titleholder Phone Number I
Fee.Simple Ttleholder Address
Job Address .. 39 6'O Q ) . Lot# L__-_�
Sub Division Parcel# A y 2g. ' 2 1 v p
a B10-He and Waste Storage ANNUAL [ Fumigation Tent
. Comm Exhaust Kitchen HoodfDuct Ei: Hazardous Material(Tier II or RQ Facility)ANNUAL
Controlled Bum �. Hood inatallaton
Emergency Generator t 30 kw LP/Natural Gas-Installation
Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
• Fire.Protection Maintenance-ANNUAL PlacesofAssembty-ANNUAL
e; R er
Sprinkler ❑ ❑ ❑ uw Recreational Burn
Fire Alarm ❑ O ❑ L I Sparlders
Hood Cleaning ❑ 0 O L I EJ SpdnklerSystem Installations.
Hood Suppression ❑ .o O Q 8tandplpee.($Pdnkier Sys)
• Fire Alarm Installation Torch Rooting/Tar Kettle i2 '.
Fire Pumps Q Waste Tire Storage ANNUAL
FIre Works c
Flammable Application-ANNUAL Valuation of Project
Fuel TanKs
• Q Other:
Contractor • S. Company T to l 50-I t C n /ZiG��I
5,g"ature Ragisbeted V I NJ roe Current . /N
Address L53 Jeae Q License#
ELECTRICIAN Company •
Signature Registered LTh'/NJ Fee Currant L Y IN
• Address ucanse#
PLUMBER Company
Signature Registered Y/N' Fee Current N
Address License#.
MECHANICAL Company
Signature Registered [_V'NI , Fee Current Y/N �
Address License#OTHER , . . • Company
$ignatUn Registered YIN Fee Current Y/N
Address . • License# .
Directions: .
Fill out application oompletety_
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$5000)'
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http llappraiaer pascogov,com) .
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'NOTICE OF:DEED'RESTRIGTION8: The undersigned understands that this permit maybe•subject'to'dead"restrictions"• -•.
which may-be more restrictive than County regulations, The--undersigned.assumes responsibility:for:complian a+with any
• .applicable deed restrictions.. '•
.;UNLICENSED CONTRACTORS AND'CONTRACTOR RESPiDNSIBILITIES: if:the owner has-hired-;a-contractor'or' -
contractors'to undertake work,they may be required:to be licensed in accordance with state and local-regulations. If the
contractor is not licensed as required by law, both the owner and contractor may,be cited'for.a-misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing•requirements may apply for the
intended work,they are advised-to contact the-Pasco County Building Inspection.Division---Licensing Sectlon_at 727-847-
8009. Furthermore, if the owner'has hired-a contractor or contractors, he Is advised'to. have-the contractor(E) sign
portions of the"contractor Block" of this application'for which-they'will be responsible. If you, as-the owner-sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled-to'permitting.privileges in Pasco '
County. •
CONSTRUCTION LIEN-LAW(Chapter713,Florida Statute$,.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 Affair& 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 commencements
- CONTRACTOR'S/OWNER'S-AFFIDAVIT: (certify that all the information In this application Is accurate and
that all work will be done Ili 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'FORTHE 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,construcction.or violations of any codes. Every permit issued shall become invalid
• unless the work authorized by such permit is cdrnmenced 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 LENd R ORAN ATTORNEY BEFORE RECD DING YOUR,,NOTICE,OF COMMENCEMENT
FLORIDA JURAT(F_S.117,03)
OWNER OR AGENT • • CO
Subscribed and,swer to(or of rirmed this Suf>scribed�d swornafirmed rem
Who is/are persona known to me or has have produced Who is/are personally known to me or has/have produced
as identification. as identlrtcafon.•
2� (.� {J NoteEI
ry Public' . 'Z� Notary Public
Commission N 7/ 0 Commission NoTb 3 9/c)
Name of Notary typed;printed or stamped . . Name of Notary typed,printed or stamped
r°�e Y Acaw 'u. �c a e o or a r P�:' Ncta y public orate of Florida
r ,ibeth De Jesus :° �� i=ii abett)Da Jesus
"� vy Commission D0639910 t�y ,ornmission DD639910
�oF °� Eresil�;t3/2011 ''tor ° rpirts0?t13/2011