HomeMy WebLinkAbout09-9550 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9550
ANNUAL FIRE PROTECTION MAINTENANCE
3 . 0 2 7
Permit Number: 9550 Address: 7838 GALL BL
Permit Type: FIRE PROTECTION MAINTENANCE 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: 35- 25 -21- 0010 - 00700 -0000
Im rov. Cost: O .. €'
Date Issued: 9/16/2009 Name: PRIMERICA GROUP ONE
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Total Fees: 25.00 Address: 3629 MADACA LN
Amount Paid: 25.00 TAMPA FL 33618
Date Paid: 9/16/2009 Phone: (813)933 -0629
Work Desc: FPM -SEMI HOOD CLEANING FOR PUBLIX
SO H A - N PR.TE T • ERVI FIRE RMIT FEES 25.00
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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."
1■401,
P 111 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 OfZephyrFil1 Fax-813-780-0021
Pemvt App lcalon
Date Received 1 I - Phone Contact Permit 1 1 1 _ 1 1,--...
Ownees Name WI I is Phan Number 1 O I3 r 1 1.(4 <! .
Owners Address (1 ?F r ' '' i 0 L , / - - hire /
Fee Simple Titleholder Name I J ! TiMshaider Phone Number WE ! _ ' 1
Fee Simple ?ltleholderAddress 1 1
t„ti n.rA.sar - .4 4
- — - 1 t_at#
Sub Division Pared # 11111111W4
2 _
s ry u t D Bio41azard Waste Storage - ANNUAL n Fumigation Tent
! 1-1 !- =^a_� Malarial Mar n _; nn F—Tsi � men 11ee
I t o "ir Exhaust iGtdten ii0od€tYurw L _ t _
0 Controlled Bun - I Hood Yptaieion
_ Emergency Generabr <30lore 1 i _ tE'INatrrarUes staltemon
Q F_nrergerxy Generator> 30 kw EJ LPAlaksal Gas - ANNUAL Sala / t
u Fire Protection Maintenance - ANNUAL y� 1 Macau or f
® r--■ Cot I r
SprdnId . t ? M t MS J Rer rionet Burn ✓
l=rre Alarm D Alarm ❑ z
Hood Clearing 0 ® 0 1 t 1 Spereer slims= tem.ations
Hood Suppaeston El 0 ❑ 0 ) ` El SlwdPiPes (SpWJ.t Sys)
I Fire Alarm instrdlatlorr = Tomb liooiirgi'Tar Kettle
Fire Pumps 1 Way lie Storage ANNUAL
Fee Works
-
Flarrerrable Appicabon. ANNUAL J i fjotr of Project
Fuel Tanks
ED Other- i
Contractor Company- signature 1CXI�l/�r/ k i 4/0 l (�!/ P o d- I Y/ 1 Fee Current 1 Y / N
Address — . .1/ '' : -"" . - . se . License it 1 , 76 Sig � 0/ - Company
i!f Registered YIN 1 Fee curren 1 YI I
Address 1 - License* 1
PLUMBER Company
Signature Registered I Y/ N 1 Fee c a ent 1 Y/ N J
Address I Lam* i
MECHANICAL w
Signature Registered I Y/ N 1 Fee Current I Y/ N 1
Address I I License if I
OTHER Company
Signature Registered Y/ N 1 Fee Current 1 Y/ N 1
Address License #
Directions.
Fit out application compteteiy.
Owner & Contractor sign back of applicdion. notarized (Or. copy of signed contract with owner)
if over $2500, a Notice of Conimencarnant is required (Mechanicat work over $5000)
Supply two (2) sets of drawings vii► applicable documentarian
Allow 10-14 days for review after submittal dale. Parcel # - obtained from Property Tax Notice
NOTICE OF DEED : The undersigned understands t hat this permit maybe° subject ,to
which may be more restrictive than County regulations. The .undersigned assumes responsibility for -compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND `CONTRACTOR : if the owner has - hired - :a - -contractor or
contractors to undertake work, they may be required to be licensed in accordwice 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 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 con ractors, he is advised to have the contractor(s) sign
portions of the `contractor Block' of this application for which they will be responsmfe. If you, as - the owner 'sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled - permitting .privileges in Pasco
County.
CONSTRUCTION.tJEN LAW #Chapter7l3, Florida Staldttss,asam.iided): if valuation of work is $2;500.00 or more,
certify that 1, the applicant, have been provided with a copy of - the `Florida Construction Lien Law — Homeowner's
Protections Guide" prepared by Florida Department of Agricxcse and Consumer Affaks. if the applicant is someone
other than the 'owner', 1 certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the `comer prior to commencement.
__ - - - - - -- _ --
COPERIAMORIVOWNERM-AFFIDAVIT: I certify _that an ,
and
that all work will be done in compliance with all applicable leas regulating construction, zoning and land
development. Application is hereby made to obtain a permit to do work and instanation as indicated. I certify
that no work or won has commenced prior to issuanoe of a permit and all work will be performed to
meet standards of ail laws regulating construction, County and City codes, .zoning regulations, and land
development regulations in the jwisdiction. I also certify that t understand that the regulations of other
. government agencies may apply to the intended work, and that it is my responsibility to identify what actions 1
must take to be in compliance.
If tam the AGENT FOR THE OWNER, 1 promise in good fails to informs 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 condftioning, gas, or other insffions not specificaly inched in the application. A
permit issued shall be construed to be a tense to proceed with the work and not as authority hority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shad issuance of a hermit prevent the Building Office 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 perm 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 writ ig, from the Bullring 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 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 CONTRACTOR
-- Subscribed ibed Ibis - - - - - -- -- - - -__ _ _ _Subs called sworn bloseNneed) befo►e' this
Who islare personally limier to me or hasrfiaee produced Who is & personally (mown to me or hasihare produced
as idenrlicaian. as ikon.
Norery Pubbc Notary Public
Commission No. Commission No.
Name of Notary typed; Printed or stamped Name of Notary typed. pdr*ed or stamped