HomeMy WebLinkAbout09-8951 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 8951
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 8951 Address: 6610 S TADIUM DR
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02 -26 -21 -001 B- 00000 -0010
Improv. Cost: t" S'i ; a a . ' , . £ oil
Date Issued: 3/23/2009 Name: PICKERING, MICHAEL
Total Fees: 664)6 254/ Address: 6610 STADIUM DR
Amount Paid: 25,50 254 ZEPHYRHILLS, FL. 33542
Date Paid: 3/23/2009 Phone: (813)873 -7479
Work Desc: FPM -FIRE ALARM ANNUAL - DAVITA INC- SCH 3/23/09
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PATTIE ELEC. & REFRIGERATION - - �.z OQ FIRE PERMIT 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."
Orr'
Ai ICJ
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
R13a80 =0020 City of.Zephyrhills l ( Fax - 813 -780 -0021
Permit Application
Date Received Phone Contact for Permit R /.3 -,ea-- 33/ .
Owner's Name D fc-U ;h9 .TNC , Owner's Phone Number �/3 we 7
,S-
Owner's Address 6.( /Q 4Gtd ;u� A I' f/- 2 /1i / /l�' ff. 33 v2
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address I
rtrt;ttttYY e e ..
' { r ss�s ':. SF .�X�.i�:�a^�.k ? {.�:'.wd §J�dMtl'�&W��`�'.a.'' s��`..`4.J1 �.;. ...EI.Si� . . € . . . »... .. ..,... . ... m .,.'x4,ra.n... w. . . .. .... .:. . .. ...
n
Jo Add . ...,. Sym Lot#
Job Address
Sub Division Parcel*
T >... .ti.. ,. ` :....:.�- re... .:l Ca.�t '.
^ Fed': a i ttt^. .. -. _ ..
7 - 1 Bio -Hazard Waste Storage - ANNUAL I I Fumigation Tent
I 1 Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
Controlled Bum I Hood Installation
I Emergency Generator < 30 kw I LP /Natural Gas - Installation
Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale
X Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
ILitrlyl )bemil uther
Sprinkler n ❑ ❑ ❑ Recreational Bum
Fire Alann i I ❑ ❑ ❑ I I I Sparklers
Hood Cleaning ❑ ❑ ❑ I Sprinkler System Installations
Hood Suppression n ❑ ❑ ❑ 1 Standpipes (Sprinkler Sys)
n Fire Alarm Installation I' Torch Roofing/Tar Kettle
I Fire Pumps Waste Tire Storage ANNUAL
n Fire Works
I Flammable Application- ANNUAL
r'' 1 Valuation of Project
I I Fuel Tanks
Other: 1� .— -- - � ��r — ,.a ,
- .'..�.... - 3 «. � , pangr ,ms'; ,, tfe .,�,,.,,■,, 'sk' t? ` ro"` , ,1 " s li:ii4Mita.. i51 - 2. :', Miaird�.._G, MOtt <.r ;,a aii t.,,: E
Contractor Company
Signature • Registered Y / N Fee Current Y / N
Address 1 I License #
ELECTRICIAN � � Company • /
Signature i 1 �� Registered UP / N Fee Current I Y / N
7 I License # I OC GDO / Zb
Address 13g „/ �Ge,�ies � Z ��,A�� � 1 c� 3
PLUMBER Company
Signature Registered Y / N 1 Fee Current Y/ N
Address I I License # I
MECHANICAL Company
Signature Registered Y / N Fee Current Y / N
Address' I License # I I
OTHER Company I
Signature Registered Y / N Fee Current I Y / N
Address 1_ License*
_ ....:::�::"''u
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 OFDEED RESTRICTIONS 'The undersigned
The undersigned a sponsib lby for:compliase vvith any
which may be more restrictive than County regulations.
.applicable deed restrictions.
UNLICENSED CONTRe 1 C o TOR he y m b eN eg R u red o be licensed RESPONSIBILITIES:
OS i Bac w the owner has - hird - :a ith state and localeregulations -contractor Ifthe
contractors is undertake
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemyanpop Y to anon for the
under state 00 law. If the owner or intended the Pasco County Building Inspection D v s on r L censing 727-847-
intended work, they are advised contact to
ign
8009. . d Furthermore, if the owner has hired
li contractor
for which -the contractors, elftyou have
as the own as (s) s the
portions of the "contractor Block" of this application y will be responsible
contractor, that may be an indication that he is not properly licensed and is not entitled permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW (Chapter71 Florida Statutes, -a oamended): e "Florida Construction r i $2,500.00 Law—Homeowner's
certify that I, the applicant, have been provided with a copy llcant is so
Protection Guide" prepared by the Florida Department of Agricure and Consumer Affairs. If the
above described document and prompse in good fa to
other than the "owner ", I certify that I have obtained a copy of th
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
o
that no work or installation has commenced prior to issuance of a d permit and
d that tall zoning work r wil lattons, and rmed to
m standards of all laws regulating construction, County City
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 FOR OWN, t ��prom�ise in faith to
inform
at permit may brequired for conditions
electr cal work,
this affidavit prior to commencing
p m i t issued id shall wells, on air o be a license to p oceed with installations not specifically
and not s authority to violated anc or
se i a any ro v i s io construed to
fter
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Bui
issued sha l become inl from d
requiring a correction of errors in plans, construction or violations of any codes. Every permit
unless m it work is suspended o or a b ndo andon h e P fa is period of six (6) within six months of
after the-time permit thework issuance,
s commenced. authorized by extension
the permit pended r bn
may be requested, in writing, from the Building Official for ap consecutive not o days, ni n job t9 considered will demonstrate
justifiable cause for the extension. If work ceases for ninety (9 0) ICE 'OF
WARNING OWNER: YOUR FAI TS TO YOUR PROPERTY. r IF YOU INT TO OBTAIN FINANCING CONSULT
PAYI TWICE FOR IMPROVEMEN
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117. ) )3-7 �� CONTRACTOR . ))7 t ), " -Pe---- � 7
OWNER OR AGENTf e me this Subscribed and sworn to (orfaffirmed) before me this
Subscribed and sworn to (or affirmed) before by
by Who is /are personally known to me or has /have produced
Who is/are personally known to me
identification. avi on. produced as identification.
as ientificti
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
2009 -03 -23 08:49 PATTIE ELECTRIC 8137884904 » 813 780 0021 P 1/1
ACORD CERTIFICATE OF - LIABILITY INSURANCE /2 AIMNIOD/YYY1')
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Lanier iipsnrw, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
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