HomeMy WebLinkAbout09-8805 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8805
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 8805 Address: 5317 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENANC E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-13300-0090
Improv. Cost: . .
Date Issued: 2/12/2009 Name: CLOCK FAMILY RESTAURANT
Total Fees: 50.00 Address: 5317 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/12/2009 Phone: (813)788-2511
Work Desc: FPM-HOOD CLEAN QUARTERLY-SEMI SUPPRESSION- CLOCK RESTUARANT
SOUTHEASTERN PROTECTION SERVICE FIRE PERMIT FEES
50.00
uu
FIRE ACCEPTANCE Final rii €
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? r (�,i1 tom, Fax-813-780-0021
Permit Application �+ 12
Date Received
... ..... Phone Contact for Permit
Owner's Name Ownner's Phone Number J ._.I o '
Owner's Address , 32≤
9/
Fee Sampeholder Name l7tlehdder Phone Number C1 1 ��
Sample Titl
Fee Simple Titleholder Address FT
Job AddressL4J3Ii
Sub Division Parcel#
Bio+lazard Waste Storage-ANNUAL a �
Fvrnigatlon Tent
Comm Fa ust MIchen Hoodn)ur a Hazardous Material(Tier II or RQ Facaty)ANNUAL
Controlled Bum D Hood Instalatiorr
Emergency Generator<30 kw [ J LPMapral Gas-krs�abon
R Emergency Generator>30 kw LPMatrral Gays-ANNUAL sale
Fire Protection Ma rce-ANNUAL ED Places of ,,c��
®® U.Sprinkler D o ❑ ❑ L El Reae36orral Bun . �
Fire Alarm El O O ❑ LJ EJ spate 1" 5i)
Hood Suppression ❑ ifd' ❑ L a ( Sys
ln�i�a� ) l!
Fire Alarm Installation a Torch Rowinorra Kettle
Fre Pumps weals Tim storage ANNUAL
Fire Works
Flammable Application-ANNUAL Valuation of Project
Fuel Tanks
cJ Other.
contractor 'Y
Signature
Registered Y/N I Y/N
Address Licer�e#
ELECTRIC
Signature
YIN I FeeQnent -Y/N'
Address License#
PLUMBER Company
Signature
Registered YIN I Fee Current L Y/N
Address
License#
MECHANICAL
nature
Company
Sig
Registered L Y/N Fee Current L Y/N
Address
License#
OTHER
Signature Company
Registered Y/N Fee Current L Y/N
Address
License#
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-J/appraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS: The undersigned understands.that this permit may be-subject:to"deeid"..cestrictions
which may be more restrictive than County regulations. The undersigned-assumes responsibility-for.compliarace,with any
_applicable deed restrictions.
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 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--Lloensing 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 whichI� responis not sible.
If yopsr as-the
ing owner
ww a rgesgn Pasco
n as the
contractor, that may be an Indication that he is rot properly
County. ae valuation of work is$2;5!00.00 or more, I
CONSTRUCTION.LIEN-LAW(Chapter713,Florida amended)'
certify that 1, 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.
__—�IMAC;TDMGMAMW-S-A GAYIT: 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. 1 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 Budding 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)mores 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'COMIIENCEMENT 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)
OWNER OR AGENT CONiRACTOR
---_Subsaided --_ _Subbed and. n bsor a Mnue0 before me his
Who isIamerSOnaIy known 6D me or tcaslhave produced Who is/me persOrieMY knalM to me or hasihave produced
as idenhficahOn. ass iderrtlfiCation
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed;printed or stamped Name of Notary typed,printed or stamped