HomeMy WebLinkAbout09-9535 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9535
CONTROLLED BURN PERMIT
Permit Number: 9535 Address: 39735 CHANCEY RD
Permit Type: FIRE CONTROLLED BURN ZEPHYRHILLS, FL.
Class of Work: FIRE - CONTROLLED BURN Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 24- 26 -21- 0000 - 00100 -0050
mprov. Cost r s : i. °
BAPTIST CHURCH
Total Fees: 100.00 Address: PO BOX 1505
Amount Paid: 100.00 ZEPHYRHILLS, FL. 33539
Date Paid: 9/10/2009 Phone: (813)788 -0283
Work Desc: CONTROLLED BURN- AGAPE CHURCH
FI-E PERMIT 1 0 .
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F - E SITE INSIDE TION -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.
Per Ordinance 652, the controlled burn shall not be ignited before 9:00 a.m. and shall be out one (1) hour
before sunset. Zephyrhills Fire Rescue Communications shall be contacted at 813- 780 -0038 prior to the fire
being ' • ited and after it has been extinguished each and every day.
1111: -
9.-(2_,Ze
ip ON RACTOR SIGNATURE P � IT OFFICER
PERMIT EXPIRES IN 15 DAYS FROM DATE OF ISSUANCE.
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813 - 780 -0041
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Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus (813) 780 -0041
Kerry Barnett Fax (813) 780 -0044
E -mail: kbarnett@fire.zephyrhills.fl.us
Plan Review #: n/a
Project: Open Burning
Number of Pages: Permit Application
June 12, 2009
I have received and reviewed the permit request to conduct open burning (burning of yard
trash) at 39735 Chancey Road. The Assistant Fire Marshal reviewed the site however the
guide lines for burning (City Ordinance 652) have been listed below. By paying for
permit, applicant acknowledges complying with the following items below.
Should anyone have any questions, please do not hesitate to contact the Fire Marshal's
office.
1. An air curtain is not required because this is not a land clearing situation.
2. Open burning shall be 300' away from any other occupied building.
3. Open burning shall be 100' from any public road.
4. Open burning shall be initiated after 9:00 a.m. and extinguished 1 hour before
sunset. Fire shall be attended at all times.
5. Fire shall be located in a pit with the ground being cleared around the pit. Pit
size shall not exceed 8' x 8'x 8'.
6. There shall be a water source at the site to adequately extinguish the fire.
7. Fire Rescue Dispatch shall be notified once the fire is started and once the fire
is extinguished. A contact number shall be left with dispatch. Should dispatch
receive any complaints due to smoke the fire shall be extinguished.
Inspections Required:
1. Site i .pe conducted already by Asst. FM Noyas)
,4
KERR ' B TT, FIRE MARSHAL
** *Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance with applicable fire safety codes. This review is not intended to be a final approval of the
submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance
with all applicable NFPA codes and local ordinances. In the event that further examination or site
inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole
expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure
to be in compliance with all applicable NFPA codes and local ordinances.
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City ofZephyrhilleFire• Fax - 313 - 780 - 0021
81813-78D-002 00
P Application
Phone Contact for Permit
yam �::�s�_�.. ..,._..,M. ... bats Received
Owner's Name
A G Fl t E 1 3 A f r 1 S r Owner's Phone Number
Owner's Address
Y417 35 C. I W /SAD
Titleholder Phone Number
Fee Simple Titleholder Name J
Fee Simple Titleholder Address °"
.... �. ":.:..: ' ., r�"x�.u 'Txur�'hWj�' . "���. %'wn°xa"'�.r+ira ^ °u •
4 35
C) -anic oPitD Lot#
Jab Address
Parcel # 1
Sub Division
Bio- Hazard Waste Storage - ANNUAL
( � Fumigation Tent
1 I I Hazardous Material (Tier II or RQ Facility) ANNUAL
I 1 Comm Exhaust Kitchen Hood/Duct
,r I
_ ;]/ Hood Installation
- Controlled Burn I 1
LP /Natural Gas- tnstaliation
1 Emergency Generator < 30 kw � LP/Natural Gas - ANNUAL Sale
Emergency Generetor> 30 kw I I Places of Assembly - ANNUAL
]ut q
n Fire Protection Maintenance - ANNUAL finer !I � / 1
ny� ' }semi] f�1 1 � L.� ( - � �-•
CI I Recreational Bum Sprinkler
1 1 o 0 01 I Sparklers
Fire Alarm
0 ❑ 0 I I Sprinkler System Installations
Hood Cleaning
❑ 0 0 ❑ I 1 Standpipes (Sprinkler Sys) 1
Hood Suppression 1
11 I Fire Alarm Installation 1 1 Torch Roofing/Tar Kettle
1 I 1 Waste Tire Storage ANNUAL
Fire Pumps
1 i Fire Works Valuation of Project
1 Flammable Application - ANNUAL
:.1 1 Fuel Tanks
1 1 1 Other: 1
Company
Contractor l ,/ L N I . a Q C. I� Registered [ Y/ N I Fee Current 1 Y/ N
Signature I - V !i
Address 1 I License #
• 1 Company
ELECTRICIAN Registered Y / N Fee Current L Y / N
• •
Signature
Address 1 1 License #
PLUMBER Company
Registered Y / N Fee Current I Y / N
Signature
Address 1 I License # 1 I
MECHANICAL, Company
Signature
MECHANICAL' Registered 1 L Y / N I Fee Current 1 Y/ N
Address 1 l • License # 1
OTHER Company
•
Signature I Registered Y / N 1 Fee Current 1 Y/ NI
Address License#
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Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
If over 52500, a Notice of Commencement is required .(Mechanical work over $5000)
Supply two (2) sets of drawings with applicable documentation •
Allow 1D days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /app raiser. asco ov.com
p 9 )
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'NOTICE;OF :DEED RESTRICTIONS: The undersigned understands that this permit maybe subject to "deed ":restrictions"
which may be more restrictive than County regulations. Tha.undersigned _assumes responsibility .forrcompliartte'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 If the
contractor is not licensed as required by law, both the owner .and contractor may be cited - for a misdemeanor Y iolation
under state law. If the owner or intended contractor are uncertain .as - to what licensing requirements may :apply for the
intendedwork, they are advised to contact the Pasco County Building Inspection Division — Licensing Section:at 727 -847-
8009. Furthermore, if the owner has hired o �which - they will be responsible. If you, as the owner contractor(s)
portions -of the "contractor Block" of this application
contractor, that may be an indication that he is not properly licensed and is not entitled permitting .privileges in Pasco
County.
2;500.00 or more, I
CONSTRUCTION .LIEN LAW (Chapter713, Florida Statutes, the :amended): If C luation o f f en $ Law— Homeowner's
certify that I, the applicant, have .been provided with a copy of
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 itfo 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'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 u understand or tht a atio ar sp al may
y be req ir en fo e r lest ica n work,
plumbing, signs, wells, pools, air conditioning, g
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 perrnit 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 Lo ve days, ni n job i9 o days n abawill demonstrate
justifiable cause for the extension. If work ceases for ninety (90)
WARNING TO OWNER: YOUR FAILURE TO RECORD A 'NOTICE OU INTEND TO OBTAIN F�INANC NGTCO IN S
PAYI TWICE FOR IMPROVEMENTS TO YOUR P O
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to (or affirmed) before me this
Subscribed and swom to (or afFtrmed).before me this by
by Who is/are personalty known to me or has/have produced
Who islare personally known to me
identification. on. produced as identification.
as iti
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed. printed or stamped
Name of Notary typed, printed or stamped
ZEPHYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrhills, FL 33542
Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044
FIRE SERVICE USER FEES
Occupancy No_ �
Plan No.: Contractor.
Business Name: V " C Ae �s.< /J - *' - Billing Address:
Business Address: / - S GhArl ce r i Rd
Business Phone No.: • Billing Phone No.:
Business Fax No.:, Billing Fax No.:
Contact: Contact: /,Al 1/4" /is'D C_,&.---
_ PLAN REVIEW FEES INSPECTION FEES _ PERMIT FEE _ FALSE ALARM FEE
_ Site Plan N/C _ Annual N/C _ Sprinkler $50 — 1st Alarm N/C
_ Mufli- Family /Commercial .06 sf _ 1st Re- inspection N/C _ Standpipes $50 _ 2nd Alarm N/C
(Minimum Charge $25.00 _ 2nd Re- inspection 5100 _ Fire Pump $50 _ 3rd Alarm N/C
0 Plan Revisions DBL ` 3rd Re- inspection $250 _ Hoods $50 _ 4th Alarm $100
_ 4th Re- Inspection 5500 _ Fire Alarm $50 — 5th Alarm $150
_ SPRINKLER SYSTEMS (Business closed until — LP Gas $50 _ 6th Alarm $200
_ 0 - 25 Heads $50 violations corrected) _ Natural Gas $50 _ NON COMPLIANCE $150
_ 26 plus Heads $100 SPRINKLER SYSTEMS _ Fuel Tanks - per tank $50
STANDPIPE SYSTEM Hydro Undergrounds $45 _ Sparklers $100
0 Per Riser $50 Hydrostatic Test 565 Per system _ Fire Works $500
FIRE PUMP Acceptance Test $45 per system _ Camp Fire $25
fl Per Pump $100 Hydrant Flow $75 ) A( Controlled Bum $100
FIRE ALARM SYSTEM _ Hood/Duct $50
r— _ 0 - 25 Devices $50 FIRE ALARM SYSTEM ` Place of Assembly $50 Annual
_ 26 plus Devices $100 System Acceptance $50 — Fire Protection $25
_ SUPPRESSION SYSTEMS Recall Acceptance 550 Flammable Application $50 Annual
_ Wet $50 — OTHER r Waste Tire Storage $50 Annual
Dry Fire $50 _ F Wall/Smoke Wall $15 p er wan Generator < KW $100
_ CO2 $50 _ LP Gas $25 per tank _ Generator >30 KW 150
_ Other $50 — Natural Gas $25 per system _ Bio-Hazard Waste 5100 Annual
KITCHEN EXHAUST _ _ Fumigation Tenting $50
0 Hood/Ducts $50 _ Tent 10•x10' or greater $15 per tent — Torch Pot/Applied $50
— OTHER — Fire Pump $45 _ Haz. Materials $100 Annual
_ LP Installation per tank $50 _ Fire Suppression $30
_ Fuel Tank Installation $50 _ System Acceptance
(Per Tank) $50 _ Exhaust Hood/Duct $30
0 Natural Gas Installation $50 _ Re - inspection DBL
(Per System) (other than annual)
D Spray Booth $50 [] Inspection scheduled DBL
and cancelled less than _
24 hours
R Construction Insp. N/C
Emergency Vehicle Ac' $50 FALSE ALARM
PLANS TOTAL INSPECTION TOTAL PERMIT TOTAL / ad TOTAL
GRAND TOTAL I l',0 - I
Comments:
Date: p /2�
I nerigcto r. = C?"1"7 �