HomeMy WebLinkAbout09-9615 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9615
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9615 Address: 6251 FORT KING RD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN •E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03- 26 -21- 0010 - 09500 -0000
Improv. Cost:
Date Issued: 10/07/2009 Name: ALLIANCE CHURCH OF ZEPHRYHILLS
Total Fees: 80.00 Address: 6251 FORT KING RD
Amount Paid: 80.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/07/2009 Phone:
Work Desc: FPM- SUPPRESSION /HOOD CLEAN- ALLIANCE CHURCH -SCH 10/13/09
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FIRE EM IN F RE PE' MIT 50.00 •NTRA To ERTIFICATE 30.00
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FIRE A - TAN E 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."
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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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_ (.;ity or zepnymine Fire
Permit Application dr 13 F _ • • 13-780-0021
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Owner's Name 2' lk (5-(7.pplivrh,11 . . "(
7eLyj s- Owner's Phan _ umber 1 'P k / 31 4 4..,4 - 1 S ZD.51
Owners Address 1 621s / II Rad- '1,T)A. • - Oa) Zez c, I'? ,..? S" R. I
Fee Simple Titleholder Name // Titleholder Ph• = Number 1 r[ - 3 11 ig 1 2,g-es1
Fee Simple Titleholder Address r,:,FlrgallrAnre:„ZrrtltjPi tillararif
Job Address 6 t. r 4? APEZWIREMEMICii • ..,/..c J #
Sub Division 1 Parcel $ r..)- t -00 La -; -, o0 00
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El Bio-Halird Wa • Storage - ANNUAL El Fumipation T - •
7 Comm i.xtleust &hen Hood/Duct 1=1 Hazardous Ma! 'al (Tier 0 pr RC' FaCility) ANN
7 Controlld Bum • E:1 Hood Install -- J.1
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0 Emergecy G ' r < 30 kw = LP/Natural 0
7 EmergeImy Gentiator , 30 kw El LP/Natural G- NNUAL Sale
I liel Fire Protection Intenance • ANNUAL = maces of Anti • ly-ANNUAL
1 .-- 1 MI E=i IM 221 . .
Sprinklir Li 0 . 0 0 = Recreational B
Fire Alain I:=1 0 0 0 1 ------ 1 L] Spenders ! I
Hood Cisaning 0 0 i I 1 ri Sprinkler Sy ._..- Installations
Hood Sippressh LJ b of 0 1 1
1 Li Standpipes (S. kier Sys) I
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Fire Ala Install/lion Torch Rodin! • r Kettle ,.
= Fire Pu ps f Waste Tire S■• • a ANNUAL
= Fire Wake •
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fl] Flammal)le Aeon on- ANNUAL I 4 niill Valuation of P i '-ject
= Fuel Ta ks
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Signature k•e..■-•••--- (4...../ Registered ir J17. Fee Current rzcs
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Address A .jge, 1 1W 7 ■74 - "LialgolY1:7171EINEECOgaitfr - ' ucense * I:. • ..rrya.0 (90/ A.e7 1 i
ELECTRICIAN Company I 1
Signature I Registered ' / N 1 Fee Current 1 IV 1 N 1
Address 1
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PLUMBER Co _I
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Company Signature 1
Signature Registered • / N 1 Fee Current / N
Address I 1 License # !
MECHANICA Company I
Sign . ature I Registered /N 1 Fee Current 1 FiN I
Address f License* J i I
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Signature Registered 1 zir i=miLt3rE. .
Address 1 1 Licensn* •
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Directions:
Fill out applicatf comp! ly. •
Owner S. Contra r sign of oppllootlen, notarized (Or, Dopy of signed contract virth awner) •
if over $2500, a 1 tree Of mmencement is required (Mechanical work over $5000)
Supply ONO (2) s of d with applicable documentation
Ailow 10.14 dy Dr revict after submittal date. Parcel* obtained from 'petty Tex ........ • ;oe (http://appraiser,p .1111 m)
NOTICE OF DEED EST 1 CTIONS: The undersigned understands that this per may be subject to "d •" restrictions"
which may be more restri: e than County regulations. The undersigned assum i responsibility for corn lance with any
applicable deed res iction=
UNLICENSED CO TRA ORS AND CONTRACTOR RESPONSIBILITIES: I the owner has hired I contractor or
contractors to uncle ake , rk, they may required to be licensed in accordanc: ' state and local r- • lations. If the
contractor is not lic nsed ',. s required by law, both the owner and contractor ma be cited for a misde _nor violation
under state law. If the o ', er or intended contractor are uncertain as to what li: nsing requirements m I apply for the
intended work, they are a• 'sed to contact the Pasco County Building Inspection ' vision -- Licensing Se n • n at 727 -847-
8009. •Furthermore, if th owner has hired a contractor or contractors, he is - •vised to have the co tractor(s) sign
portions of the "con_racto ' :lock" of this application for which they will be respon ble. If you, as the o er sign as the
contractor, that may be a indication that he is not properly licensed and Is riot 'tied to permitting privi - ges in Pasco
County. j 1
CONSTRUCTION UEN (Chapter 713, Florida Statutes, as amended): If luation of work is $2,5' 1 .00 or more, I
certify that I, the applica - have been provided with a copy of the "Florida onstruction Lien Le Homeowner's
Protection Guide" pr pare r by the Florida Department of Agriculture and Consu r Affairs. If the appli nt is someone
other than the "own r", I = ify that I have obtained a copy of the above described • ocument and promise : n good faith to
deliver it to the "own r" pri to commencement.
- CONT CT• 'SIOWNER'S AFFIDAVIT: I certify that all the inform ion in this application accurate and
that all rk ill be done in compliance with all applicable laws lating construction, z• ing and land
develop ent. ' . pplication is hereby made to obtain a permit to do wo . and installation as ind. ted. I certify
that no ork o installation has commenced prior to issuance of a pe , and that all work will performed to
meet s nda of all laws regulating construction, County and C' codes, zoning n�ul ns, and land
develop ent . gulations in the jurisdiction. I also certify that 1 u - rstand that the regul tons of other
govem ent a • -ncies may apply to the intended work, and that it is m' responsibility to iden ' what actions 1
must to a to b= in compliance.
If I am the AGENT OR T - E OWNER, I promise in good faith to inform the owne .1 the permitting cond' ' ns set forth in
this affidavit prior to com , • ncing construction. I understand that a separate pe it may be required for lectrical work, :- plumbing, signs, w I s, p• , Is, air conditioning, gas, or other installations not s • ' cally included in the pplication. A
permit issued shall a con : ed to be a license to proceed with the work and not .s authority to violate, ncel, alter, or
set aside any provis • ns o - e technical codes, nor shall issuance of a permit pre nt the Building Official m thereafter
requiring a correctio of e •rs in plans, construction or violations of any codes. E =ry permit issued shall ecome invalid
unless the work aut , orize •. by such permit is commenced within six months of • = it issuance, or if wo ; authorized by
the permit is suspen • ed o , bandoned for a period of six (6) months after the time e work is commenced i An extension
may be requested, i writi e , from the Building Official for a period not to exceed inety (90) days and 1'1 demonstrate
justifiable cause for . e e - nsion. If work ceases for ninety (90) consecutive days, ' e job is considered a • = ndoned.
WARNING TO OW ER: • OUR FAILURE TO RECORD A NOTICE OF COM NCEMENT MAY RE ` LT IN YOUR
PAYING TWICE FO - IMP OVEMENTS TO YOUR PROPERTY. IF YOU INTEN TO OBTAIN FINANCI; G. CONSULT
WITH YOUR LEND: R 0 N ATTORNEY BEFORE RECORDING YOUR NOTI e. OF COMMENC ME " .
FLORIDA JURAT (F.S. 1 7.03)
OWNER OR AGENT CONTRACTOR r ,�, s,
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Subscribed and sworn to •) before me this Subscribed and swom to (or of l ed) before me this
by by
Who is/are personally kn- or has/have produced Who Is/are personally known to or has/have produced I
s identification. as identification.
II Notary Public Notary Public
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t:ommisslon No. Mr commission N0,
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Name of Notary typed, pri ed or mped Namo Of Notary typed, printed 0 ramped •
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