HomeMy WebLinkAbout09-9505 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9505
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9505 Address: 6151 12TH ST
Permit Type: FIRE PROTECTION MAINTENANCE 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:
Improv. Cost: IVA _ a : °< ...........
Date Issued: Name: CHURCH O F THE NAZAR
Total Fees: 25.00 Address: 6151 12TH ST
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/01/2009 Phone:
Work Desc: FPM - SUPPRESSION ANNUAL- CHURCH OF NAZARENE
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HERNAND• 1 & AF • IPMENT FI 'ERM T FE 25.00
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IR A EPTANGE Final a
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."
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P 'T 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
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813- 780-0020 City of Zephyfipls fhldtl+? • Fax 780 -0021
Permit Application
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Owner's Name .. _ E . _ el ' y _ . Al ..- _ . Donee& Phone Number I 1
Owner's Address 6 5/ / / � , - " f '� , 4 !
Fee Simple Titleholder Name Titleholder Phone Number ( I I I
Fee SirapiellisholdsrAddress1 I
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Job Address Lot*
Sub Division Parcel it 1 .
Elio-Hazard Waste Storage - ANNUAL Q Fu nipatlon Tent •
a Comm E,d,aust 1(kh.n Hood/Duct El MRardous Material (Tier II or RO Facility) ANNUAL
ED ControNed Sum o Hood installation
Emergency Generator < 30 kw LP/Nib/al Gas-Installation
ktion l!!!5] IMI 2E3 mx-AN B ji. Emergency Generator > 30 kw
LP/Natural G.*- 4NHUAL Sale
Fire p Maintenance - ANNUAL a Places of Asssrnbly- ANNUAL
Spits** L__ o 0 o _ Ram Bun
Floe Alarm 0 0 0 _ Sparklers
Hood ClwrYrg 0 0 0 Sprinkler System instablims '
Hood Suppression o o Standpipes (Sprkider Sys)
Re Alarm knteratlon - _ _ Torch *i
Roofing/Tar g/Tar Ket le '
F. p . — - . Waste lire Storage ANNUAL ' umps
Fin work: Valuation of Project
Flenanabla Apprcatlon- ANNUAL ) '
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ID, All ?areel d - obtained from Property Tax Nolte (M pllspprabsr peaoopoV.axn)
'NOTICE OF:DEED RESTRICTIONSIPlitiftbdersigned understands that this permit may.besubjq er dl'Inastrictions"
which may be more •restrictive lhan''OotinWWregulations. The:underaignod .assumes responsibIlity mopmpiiaoce'with any
applicable deed restrictions.
' , UNUCENSED , CONTRACTORS ►'ND CDNTRACTOR :RESP.ONSIBIUTIES: • •if - the owner .hipsthavontractor or •
contractors to undertake work, they may be required to be licensed in accordance with state and local if the
contractor Is not licensed as required by law, both the owner and contractor may be cited for misdemeanor violation
under state law. .1f 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 .entltled •to permitting : privileges In Pasco
County.
CONSTRUCTION LIEN LAW (Chapter713, Florida Statutes 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 applyto the intended work, and that It is my responsibility to identify what actions I
must take 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 Istuancs 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 sbi (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
juiltif914114 cause for the extension. nif work ceases for ninety(90) consecutive days, the Job is considered abandoned.
WARNING TO' 'OWNER 'YO`UR F ►ILURE TO RECORD A NOTICE 'OF 'COMMENCEMENT MAY RESULT IN YOUR
PAYINOTIft9GE *MOM TO YOUR FROPE*TY. IF YOB 4 TO * FINANCING, CONSULT
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Who "" y kno*n to me or hatAtavo lOd
as Identification. > • as Identification.
AO • Notary Public �S - 1® /Art 4 Notary Public
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Commission No. J'
Name of ; FirfdmPad Name of Notary typed, printed or stamped
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MY COMMISSION # DD844782
EXPIRES: tobcanl xr'12, 2012
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