HomeMy WebLinkAbout09-9786 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9786
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9786 Address: 7306 GALL 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: 35 25 - 0010 - 08800 - 0000
Improv. Cost: __ W _ t °# *
Date Issued: 11/20/2009 Name: TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN STATE RD
Amount Paid: 25.00 BALA CYNWYD, PA 190042102
Date Paid: 11/20/2009 Phone:
Work Desc: FPM- SPRINKLER QUARTERLY- TOWNVIEW RETAIL
R•DAN I- -' _ , INC. - - = E 25.00
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FIRE AC 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." apPIP
IOW
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
813- 780 -0020 City of ZephyrhiUs Fax - 813-780 -0021 it
Permit Application . _ _
Date Received Phone Contact for Permit 1 (.a Zl J 135'7
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,� {'FE 'T*w n.: -. a �� .. r , c-...v .., , -,t, W a: _ _ -'. - •-, c - - . r ::r«mn a�*t¢ ,
Owners Name t.b1(,leV-) <Fje5 t.-4. I Owners Phone Number ( 1
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Owner's Address ( us C...-VNie5L4Ol4OC b lam -5r, gb,
Fee Simple Titleholder Name Titleholder Phone Number ,
Fee Simple Titleholder Address I I
Pi
Job Address ' ' O( , (9 PAtr> , u�tt Lot#
Sub Division 1 OP Z C'l0 kt"ig- -thU.s Parcel # ZS • Z,1 to AymW 0006
El Bio- Hazard Waste Storage - ANNUAL ED Fumigation Tent
n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
Controlled Bum n Hood Installation
LJ Emergency Generator < 30 kw n LP /Natural Gas - Installation
n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
(7 Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
�
71301 'semi' raj Uther
Sprinkler E 4 ❑ ❑ n Recreational Bum
Fire Alarm El ❑ ❑ ❑ I 1 n Sparklers
Hood Cleaning 0 ❑ ❑ ❑ I I n Sprinkler System Installations
Hood Suppression Ej ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys)
a Fire Alarm Installation = Torch Roofing/Tar Kettle
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL I 44 .7-..V. 00 ( Valuation of Project
Fuel Tanks
Q Other: I
Aro or maw
Contractor ' - f' R
. bti►) Company AMAIN F12 5Ati 'KL7t l s . / I
Signature r/ - Registered Y / N I Fee Current Y / N
Address I IF License # S a 0L4,),rx711 41 1S CI.
ELECTRICIAN Company I
Signature Registered Y / N 1 Fee Current I Y / N
Address I License # I
{
PLUMBER Company I
Signature *. Registered Y/ N I Fee Current 1 Y / N I
Address I I License # I I
MECHANICAL Company I
Signature Registered Y/ N I Fee Current I Y / N 1
Address I I License #
OTHER Company I
Signature Registered Y/ N 1 Fee Current I Y/ N 1
Address License #
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
If over $2500, a Notice of Commencement is required (Mechanical work over $5000)
Supply two (2) sets of drawings with applicable documentation
Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
NOTICE OF'DEEDRESTRICTIONS: The undersigned understands that this permit may be subject :to - "deed "restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for:compliantewith: 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 regulations. 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 contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for e is not enfitled you, as privileges Pasco
contractor, that may be an indication that he is not properly p Y
County.
CONSTRUCTION LIEN LAW (Chapter713, Florida Statutes, a s ame d e o ): If valuation of Construction Lien $2,500.00 or more, ' I
certify that I, the applicant, have been provided with a copy
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 apply to the intended work, and that it is my responsibility to identify what actions I
must take to be in compliance. forth in
tion affidavit prior to commencing c
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application.
set aside an y p i io be ns of the construe technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
set asde any provisions
shall become invalid
unless a correction of errors plans, violations of
six months months of permit p s ermit ance, work authorized by
unless the work authorized such p ermit
An extension
the permit is suspended or abandoned andoned for a period of six (6) months after the time the worWoms and will demonstrate
may be requested, in writing, from the Building Official for a ppriod,not to exceed nin onsrdered abandoned.
cause for the extension. If work ceases for ninety (90) consecutive d s RESULT
WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE F YOU INTEND TO I F NANO NG CONSUL IN
PAY TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR OMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) � = 111111111 CONTRACTOR
OWNER OR AGENT S sc • d a swom t• or • - .) bef9 - me this
Subscribed and sworn to (or affirmed) before me this b • G r • S -
bY stare ersonall down to a or has /have produced
Who is /are personally known to me or has /have produced .�J P ----- as identification.
as identification.
4 ..r l O otary Public
Notary Public 1 ` �� ' 4111 �
Commission No.
Commission No. < ,HERYL A. DUFFEL
typed, printed or stamped Name of Notary typed, printed or sta.," EXPIRES: November 12, 2011
Name of Notary typ P ,rF,a° goaded Thu Budget Notary Services
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