HomeMy WebLinkAbout09-9626 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9626
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9626 Address: 37411 EILAND BLVD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03- 26 -21- 0010 - 05300 -0000
Improv. Cost: $ . ° " `
Date Issued: 10/07/2009 Name: GOLDEN HEALTH SERVICES INC
Total Fees: 25.00 Address: 2424 CURLEW RD
Amount Paid: 25.00 PALM HARBOUR, FL 34683
Date Paid: 10/07/2009 Phone: (727)781 -5885
Work Desc: FPM -HOOD CLEAN SEMI- WEST WINDS- SCH 10/15/09
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VI IL IN 1 INC FIE - RMI 25.00
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FIRE A CE A ina
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." �r
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
.^H,r 00i r, ' RHILLS PI,1ILDINC FAX ,to. 313-730-0021 F. 001
813480 -0020 City ofZephyrhil(s'FIro: • 196 Fax- 813.780.0021
. Permit Application .
Date Rix etvad Phone ContscYfor Permit rr
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Owners Nat'l!: , • LOST W //1 SI T e- ■ Own Ph Number , I 8 • .. _ 1 7 8 3 1 ' 'TM-en
, :v:nere Ad 3 / a • d A. ' r 'il - F2. 3 a Q .
• Fee S:mple 71tleholdsr Name Titleholder Phone Number ` 1 1
Fee Simple Titleholder Address L . • —
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Job Adaless
e C W/ e / / , ✓id Lot #
Sub Divisior, Parcel #
,kura -per 6ia }IeYa
rd Waste Storage - ANNUAL ED Fumigation Tent
Comm Exhaust Kitchen Hood/Duct El Hazardous Material (Tier II or RQ Facility) ANNUAL
0 Controlled Bum Hood installation
ergency Generator < 30 kw ,. LP/Naturai Gas - Installation
Emergency Generator > 30 kw LP /Natural Gas- ANNUAL Sale .
i 1= m Fire Protection Maintenance - ANNUAL Pieces of Assembly- ANNUAL •
' f aJ EE1 `Other .
S Gh Jlf.4 Sprinkler' ❑ D D Recreational Bum
OCT
1 Fire Alarm . ❑ ❑ ❑ T Sparklers
J 1
Hood Cleaning O a Sprinkler System Installations
I . Hood Suppression 0 0 0 Standpipe, (Sprinkler Sya) ,
Fire Alarm Installation Torch Roofing/Tar Kettle
Fire Pumps Tire Storage ANNUAL
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Fire Works
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j Flammable Application- ANNUAL 1....;. , Valuation of Project
Feet Tanks
EJ Other: -- •
i 96 c n actor L./.. / ._1_1,11.
Company •
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Si;irieture L - • • Registered Y / N [ Fee Current f Y / N J
Adlre W, * G,/07/P/Agfl,1/1W A. License , .
Li.,C::`r R rCIA NI Company
g1g, utu e L Registered Y/ N J Fee Current L Y! N
Address C • ----1 License #. i 1
PLUMBER Company
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:::�,na ere r �_
( - Registered Y/ N I Fee Current I Y/ N
Address � License # L
MECHANICAL Company •
Signature Registered Y / ,N1 Fee Current pi/ N
Address 7 I License 0 1
C HE>l Company _
s +p lure Registered MEM Fee Currant ! N
aEtiss imeame #
A ! r do aahcns: •
F111 out application completely.
Owner & Contractor sign back of application. notarized (Or, copy of signed contract with owner)
i+ over 52300, a Notice of Commencement kr required- (Mechanical work over $6000) • .
Supply two (2) set; of drawings with applloable documentation ,
Allow 10 -14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:/ /apprelser,pascogov.com)
VIGIL INC Sic..
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Head & Cleaning
P.U. Beet 273 T . VOW. Ft 3 •
P: 113 - 41* F: iii - 1133-10
gaterai aye -ceta .
.... `7.Y2i:'07 'r,U 09 :22 A11 ZEPHYFHILLS BUILDING FAX No. 819 - 780 - 0021 ?. 002
'NOTICE OF DEED RESTRICTIONS: The undersigned understands. that this permit may.be!subject ;'tor "deed"irestrictions •
.which may be more restrictive than County'regulations. The'.undersigned.assumes responsibility; forreompliancelwith any . .
applicable deed restrictions. '
UNLiCENSEb CONTRACTORS AND 'CONTRACTOR RESPONSIBILITIES: if the owner has 'hlred•:a-contractor or '
contractors to undertake work, they may be required lo be licensed in.accordance with state and Local• regulations. If the
contractor is not licensed as required by law, both the owner end 'contractor may be cited for a :misdemeanor vioiatior+
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 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 property licensed and is not entitled'to'permitting .privileges to .Pasco
County.
CONSTRUCTION .LIEN LAW (Chapter .Florida Statutes, :amended): 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
Protection Guide". prepared by . the Florida Department of Agriculture and. Consumer Affairs. 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 "owner" prior to commencement.
CONTRACTOR'S /OWNER'S•AFFIDAViT: l 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 perrnit to do work and installation as Indicated. 1 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 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.
Ii I yam the AGENT •FOR'THE OWNER, 1 promise in good faith to inform the owner of the permitting conditions setforth in
this affidavit priorto commencing construction.: I understand that a separate permit may be required for electrical work.
plumbing, signs, wells, pools, alr 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 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 six (8) 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
Justifiable cause for the extension. if work ceases for ninety (90) consecutive days, the job is considered abandoned.
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WARNING TO OWNER: YOUR FAILURE TO RECORD A 'OF - COMMENCEMENT MAY 'RESULT IN YOUR • ..
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YQUR N' ' • R TTO.. Y - _ • • • IN c • ; N • T C 0 • , ,, _ MENT
FLORIDA JURAT (F.S. 117.03)
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OWNER OR AGENT
;subscribed and sworn to•(or affirmed) before ore this , Subscribed and swum to (or mied) be • re a this
by .._ by_
is /are personally known to me or has/have produced • Who Ls/are parsons known to me or has/have produced
as Identification. as idendticatlon.
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Notary Public . Notary Public
• C'n'missinn No. . _ Commission No._
Flame of N otary typed; printed or stamped • Name of Notary typed, printed or stamped 0
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