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Home My WebLink About09-8772 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8772 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 8772 Address: 5950 12TH ST Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-01800-0010 Improv. Cost: Date Issued: 1/28/2009 Name: ZEPHYRHILLS MASONIC LODGE Total Fees: 25.00 Address: 5950 12TH ST Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 1/28/2009 Phone: Work Desc: FPM-SUPPRESSION SEMI- MASONIC LODGE SECURITY FIRE EQUIPMENT LLC FIRE PERMIT FEES 25.00 (o4 z�z 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 813-780-0020 City of ZephyrhillS Fire /1 Fax-813-780-0021 Permit Application f // fate Received Phone Contact for Permit )nines Name Hi/ off Owners Phone Number t13 omI L_L0 £2 )wnees Address Jsvi2 :ea Simple Titleholder Name Titleholder Phone Number 'ee Simple Titleholder Address ob Address Lot# ≥ub Division Parcel# Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RD Facility)ANNUAL Controlled Bum [ J Hood Installation Emergency Generator<30 kw LP/Natural Gas-Installation Emergency Generator>30 kw Q LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL Places of Assembly ANNUAL ®® uaer Sprinkler ❑ ❑ ❑ Recreational Bum Fire Alarm 0 0 O JI Sparklers Hood Cleaning O O O I Sprinkler System Installations Hood Suppression ❑ ❑ LI Standpipes(Sprinkler Sys) Fire Alarm Installation Torch Roofing/Tar Kettle Fire Pumps Waste Tire Storage ANNUAL Fire Works Flammable Application-ANNUAL , Valuation of Project Fuel Tanks Other: Contractor Company Signature Registered Y IN Fee Current Y/N Address License# ELECTRICIAN[ Company Signature Registered YIN Fee Current t Y I N Address License# PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License# OTHERpany signature J / — Registered /N Fee arrant N Address Q License# 6 2 Directions: ._.. — 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$5000) Supply two(2)sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http l/appraiser.pascogov.com) IOTICE OF-DEED RESTRICTIONS: The undersigned understands is permit r es m Pica Y* �hlch may be more r than County APP deed restrictions. JNLICEPED CONTRACTORS AND.CONTRACTOR lithe owner has i*edaaxdractor or or tractors to undertake work,they may be required to be licensed in accordance with stale and Ioca1-reilstIons. If the dractor Is not licensed as required by law, both the owner and comaaotor may be ciled-lor a misdemeanor violation ender state taw.. If the owner or intended.contractor are uncerlain as to what loerreing r+equtrernents may apply for the mended work,they are advised to coal Od the-Pasco County t3dld ng Inspection Sectionat 727-847- 3009. Furthermore.if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign cortiorts of the=cordractur Block'of this application-for which-they vA be responsible. If you, as-the owner-sign as the ortractor,that may be an indication that he is not properly licensed and is not enti1ed Io permitting privileges In Pasco ounty' if valuation of work is$Z500 00 or more, I :ONSTRUCTION.LEN LAW(Chspbsr713,Florida St bulss,as-amandodx mortify that I, the applicant, have been provided with a copy of the 'Florida Cansi uclion Lien s Drotedlon Guide' prepared bythe Florida Deparbnent of Agricuibre and Consumer AIllrirs. If the appQcarrt is someone tther than the"owner,I certIfy that I have obtained a copy of the above described document and promise in goodish to iehver It to the"owner"prior to commeflcemenl CONTRA AFFVAVIT I certify that all the kdNm tion In this application Is accurate and that all work will be done in compliance with all applicableletirsregiatkig construction, zoning and land development. Application is hereby made to obtain a penult to do work and irrefallelion as itdicaded. I certify that no work or won has commenced prior to issuance of a permit andthat ail work wiN be performed to meet standards of ail laws regulating construction, County and City codes, =cuing reguaIaw, and land development regulatloop in the jurisdiction. I also certify that I u dersfacnd that the regulations of other government agencies may apply to the intended work,and that It its my responsibility y to Identify what actions I must take to be in compliance. If I am the AGEIIT FOR`f'ME OWNER, I promise in good faith to kIbM the Owner Of the permitiirg conditions set forth in this-dfldavit prior to commencing construction. I s,-or find that a separate permit egi*ed for the electrical appM a Lion. A plumbing, s , pools, air tom, or other edions not sped�lly ircl ded permit issued shah be construed to be a license to proceed with the work and not as authority to vioiat ,cwnoel,alter, or set aside any provisions of the technical cedes,nor strati lance of a permit pr's the Building Ol& s!from thereafter requiring a conection of errors in piers,construction or violations of any codes. Every permit issued shall become invalid unless the work autnri�ed by such pond is corrMnenoed witty six morits of permit issturrre. or M work authorized by the permit is suspended or abandoned for a period of sbc(6)morrtirs attar the brae the work Is commenced. An extension may be requested. In wring,from the Brsildirg Official for a period not to an eed rusty(90)days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutiVe mss,the job is considered abandoned. WARNING TO OYll1 R= YOUR FAILURE TO RECORD A NOTICE.OF MAY RESULT IN YOUR PAYING TWICE FOR S TO YOUR PROTY. F YOU NTEIID TO OBTAMri FINANCING,CONSULT WITH YOUR LBW OR AN ATIORIEY BEORE RECORDING YOUR NOTICE OF COI ,ICFIaw1T. FLORIDA JURAT(F.S.117.03) GVJNM OR/1BrT ccInascTo __ Steed and await b(or a-mad)befoae ma this SubscrInd and senora io(ar armed}batons me#ft Wt ro!stare psmorrry Im i to me or ireeAnaus Produced Vitro Islas Persorra�y bnowwr iQ me ar ors rdenafcafon. Notary PU NG Notary Public Caanlsefon N _____________ Lbrrmdeebn No. Name of Noay typed:PI md Name of Notary typed.phi or aran