HomeMy WebLinkAbout09-8792 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8792
ANNUAL FIRE PROTECTION MAINTENANCE
d .3 ? '.:.`T r.
Permit Number: 8792 Address: 5316 11TH ST
Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: CHURCH Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0100-17100-0100
Improv. Cost: „ _ ..`
Date Issued: 2/05/2009 Name: SAINT JOSEPH CATHOLIC CHURCH
Total Fees: Address: 5316 11TH ST
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: Phone: (813)782-2813
Work Desc: FPM-SUPPRESSION ANNUAL-ST JOSEPH CHURCH-SCH 2/09 CREDIT PRMT8697
CONTRAtTORSE, .: ...3 , � ',�e.a fie::. ,
HERNANDO FIRE&SAFETY EQUIPMENT
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^?^ Fax-813-780-0021
Permit Application -
Date Received I PtlOneConthCt for Permit
Owners Name .b/ !,/ Ownser Phone Nunber ti ��
Addr
ess dress P I
Fee Simple Titleholder Name1O Nunber I I
Fee Simple Titleholder Address
Lot#
Job Address
Sub Division Parcel#
Bio-Hazard Waste Storage-ANNUAL [ ] Fumigation Tent
a Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL
El Controlled Bum [ J Hood Installation
aEmergency Generator<30 kw [ J LP/Natal Gas-Installation
Emergency Generator>30 kw LP/Natural Gas-4NNUAL Sale
R Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL
® _ uuwr
Sprinider O O O a Recreational Bun
Fire Alarm ❑ ❑ ❑ u El Sparklers
Hood Cleaning O ❑ O II El Sprinkler System k lations
Hood Suppression O ❑ II El Standpipes(Spy Sys)
a
Fire Alerts ir Mation
Q Torch Roofing/Tar Kettle
uta
Are Pumps - Q Waste Tire Storage ANNUAL
Fie Works
Flammable Application-ANNUAL I Valuation of Project
Fuel Tanks
El Other
Contractor
Signature I Registered N Fee N
Address License#
ELECTRICIA Company
Signature I Registered Y/N Fee Current I Y/N
Address License#
PLUMBER Company
Signature Registered Y/N II Y/N
Address License#
MECHANICAL Company
Signature Registered Y/N I Fee Current I Y/N
Address License#
OTHER Company
Signature Registered Y/N . Fee Current I Y/N
Address Lkanse#
Directions:
Fi out application completely.
Owner&Contractor sign back of application.notarizad{t0r,copy of signed contract with owner)
If over$2500,a Notice of Commsneerfsnt is required PAScbenical work over$5000)
Supply two(2).sets of drawings with applicable documentation
Allow 10-14 days for review after sobm ttel date.. Parcel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com)
'NOTICE OF DEED RESTRICTIONS flkThderSigfled understands that this permit may.be:su8c Ag0deeid ;restrictions"
which may be more•restrictive'than*Oount regulations. The.undersigned.assumes responsibilityipiii mpliarace'with any
.applicable deed restrictions.
UNLICENSED CONTRACTORS ND :RESPONSIBILITIES: -if the owner ham h ed-a'aaDntractor 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. 9f 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 I ND TOO N FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU N T10E OF O MENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACT
OR
Subscribed and sworn to(or affirmed)before me this Subs b d and swum
Who Is/are personally known to me or has/have produced 11iiitiiIi knthw'to pr ye prod
as identification.
as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
FRANCIS SPERLAZZA
MY COMMISSION N 00844752
EXPIRES:Deamba I2,2012
,' ,3;NARY Pt.Nary Olzwr Aron CO..