HomeMy WebLinkAbout09-8981 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 8981
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 8981 Address: 6855 GALL BLVD
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: 03-26-21-0010-01600-0020 ¢
I mprov. Cost: '`� �`�'r.. 'L. tr 7
g £ &$ t, ''. ';;724E-;
Date Issued: 4/02/2009 Name: GOLDE CORRAL
Total Fees: 25.00 Address: 6855 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/02/2009 Phone: (813)783 -8969
Work Desc: FPM- SEMI HOOD SUPPRESSION- GOLDEN CORRAL- SCH WK 13TH APRIL
FIRE FIGHTER, INC. FIRE PERMIT FEES 25.00
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FIRE ACCEPTANCE Final d `�
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."
Ir
r. 1 0 1 2Y
P -41 "• 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
i i k N 8 1
813 -780 -0020 City ofZephyrhilisFire• Fax- 813 - 780 -0021
Permit Application
Date Received 4- p? Q q Phone Contact for Permit 996 J by t
Owner's Name 4i:Sde,11 (nr/-ie Owner's Phone Number , 8)3 183 796Q _
Owner's Address Co SS S G -\ ` Bl J c. 3 3 Sal 2
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address } m� s
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y. "'q's����p' „ w , ., °: .ru -..., :.: '.•*,..:! «a ,':'-:,, . «a. . z "�''�'k:�ir�:...... .... ... ,:. .. .,.....,. w....._ .. ..,... ,..., .,
Job Address ‘ t-5-15- G 60 2e,"ylh, /+f 335 2 - , Lot#
Sub Division
Parcel
r I Bio-Hazard Waste Storage - ANNUAL J I Fumigation Tent
Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL
n - Controlled Bum I I Hood Installation
n Emergency Generator < 30 kw I LP /Natural Gas - Installation
Emergency Generator> 30 kw J I LP /Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL J I Places of Assembly- ANNUAL
_ IutriyI 'I berm] Fri iUtner 1
Sprinkler ID ❑ I Recreational Bum
Fire Alarm I ❑ ❑ ❑ I I Sparklers
Hood Cleaning E ❑ ❑ ❑ I J I Sprinkler System installations
Hood Suppression C ❑ >0 ❑ I 1 Standpipes (Sprinkler Sys)
n Fire Alarm Installation I Torch Roofing/Tar Kettle • H Fire Pumps Waste The Storage ANNUAL
Fire Works
Flammable Application- ANNUAL { I Valuation of Project
Fuel Tanks
n Other: I
Contractor f/ Company
Signature / - `'r�� S '! / Registered Y / N Fee Current Y / N -
Address I License* 1
ELECTRICIAN Company
Signature • Registered _ Y / N - Fee Current Y / N
Address 1 License*
PLUMBER Company
Signature Registered ` Y / N Fee Current I Y / N
Address I License #
MECHANICAL Company
Signature Registered Y / N _ Fee Current I Y / N
Address • License # J
OTHER Company
Signature Registered Y / N Fee Current I Y / N
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)
w OTICE OF DEED The undersigned underst at a permit m y.b sibuby f O 'de
which arse with any
hich may be more restrictive than County regulations. The 9
_applicable deed restrictions.
or -
UNLICENSED CONTRACTORS AND - CONTRACTO be E P NS IB ac ITI S If with o and loca regulc c or the If
con so undertake work, they may be required I ola the
contractor is not licensed as
as required by law, both the p as to what licens ng r qu� emen may app y iolation
under state law. If the owner or intended contra are uncertain
Inspection Division — Licensing Section:at 7.Z7 -847-
intended work, they are advised to contact the Pasco County
p0 e the
h
09. Furthermore, if the owner has hired .a contractor or contractors, he is advised to have the contractor(s) Pa sign
cot the "contractor Block „ of this application for which they will be responsible. If you, as the owner •sign a
conntrac ractorr, , that may ay be be an indication that he is not properly licensed and is not entitled permitting .privileges
County.
CONSTRUCTION -LIEN LAW ( Chapter793, Florida Statutes, -as: amended): If valuation of work is $2;500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Ilcant is someone
Protection Guide” prepared by Florida Department o A of the described document and promure and Consumer Affairs. If the in good faith to
other than the "owner ", I certify that I have obtained copy
deliver it'.to the "owner" prior to commencement.
that all the information in this application is accurate and
CONTRAC will be done in AFFIDAVIT: I certify that laws regulating construction, zoning and land
that all work will li done in y mcompliance with t i a permit and all ion as is performed f y
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 is County and City codes, .zoning regulations, and land
meet standards of all laws regulating construction, that I understand that the regulations of other
development regulations in the jurisdiction. I also certify
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.
the AGENT FORTHE OWNER, I promise in good faith t inform thet owner of the permit may permitting required for electrical set
r cal forth in
t f I am th construction. I undertsta tio
this affidavit prior to commencing
plumbing, signs, wells, pools, air conditioning, e toss roceed other
with the work and not as authority to violateecancel, after, or
k an not a tue ority tog Ofai e, a n c 1, a fter, or
se a s a a p rov io construed c o i s a license P er issued shall become invalid af ter
set aside any provisions of the technical codes, nor shall issuance of a permit
requiring a correction of errors in plans, construction or violations of any codes. Every p
the work authorized by such permit is commenced wlithin, six
after the of
eermiit issuance, commenced. Ap horized extension
unless th g0 days e n c will demonstrate
may be is suspended ed, in or g, abandoned ld
from the BuingloOfficial for a period not to exceed ninety (90) may be requested, in writing, 90 consecutive days, the job is considered abandoned.
justifiable cause for the extension. If work ceases for ninety ( 'NOTICE 'OF "COMMENCEMENT MAY RESULT IN YOUR
WARNING TWICE OWNER: YOUR FAILURE TO YOUR PROPER-N. O A YOUR NOTICE OF COMMENNA
PAYING TW
ICE FOR IMPROVEMENTS TO YOUR RECORDING YO YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECD
FLORIDAJURAT (F.S. 117.03)
OWNER OR AGENT CDNTRACTDR
Subscribed and sworn to (or affirmed) before me this
Subscribed and sworn to (or affirmed) before me this b
by - i ce— re personally known to me or has
av
sidentification. produced
d
Who isle personally known to me
as identification
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped