HomeMy WebLinkAbout09-8985 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 8985
ANNUAL FIRE PROTECTION MAINTENANCE
mka. � 4 tg
.�.t k^
m �v+�o- r � �� a+& a»� �ea �• Yv �� i ..
Permit Number: 8985
Address: 6848 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN.E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02- 26 -21- 0010 - 00900 -0020
Improv. Cost: �
Date Issued: 4/06/2009 Name: ZEPHYRHILLS CINEMA 10
Total Fees: 25.00 Address: 6848 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/06/2009 Phone:
Work Desc: FPM- ANNUAL FIRE ALARM- ZEPHYRHILLS CINEMA 10 - SCH 4/6/09
THE HARTLINE ALARM CO.,INC. FIRE PERMIT FEES 25.00
V
':12;77r: rw
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."
�
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 -78O -0020 City ofZephyrhillsFire- Fax - 813-780 -0021
Permit Application
Date Received
Permit
Owner's Name ZC /) y e I.: `!S OA t•• eb Owner's Phone Number
8V115 -J j t }-
Owner's Address b � / �'r Q � V �/ Z,e�� y r ;AM S I r C
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address I
:T „.e 1' A LX }7J' PVkwk ate i
...: �.. �,... '�re. "?' t.mzwb�u; ' w «.,.. ' ' �f .� ,.. »:..,: :.0 .., i. _ ..:,.. . ”. rNN„ I':% �'. �t�. �Ffi%:. Sr .°i,.u'�':r .,. ,.,�,a ..n.�w...,. v.,........F�r . ..a.,: .�. u.-..r .,...,...«.� ,,. .. ,.
Lot*
Job Address
Sub Division -
Parcel
IT Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent
Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL
n - Controlled Burn 1 Hood installation
Emergency Generator < 30 kw n LP /Natural Gas - Installation
I Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL
J L.ttrlyl JSemi I pZ71 'Littler : 6 Z
Sprinkler n ❑ ❑ ID Recreational Bum 1
Fire Alarm ---7 ❑ ❑ 2(J Sparklers
Hood Cleaning n ❑ ❑ ❑ J Sprinkler System Installations
Hood Suppression I ❑ ❑ ❑ J J Standpipes (Sprinkler Sys)
f] Fire Alarm Installation I' Torch Roofing/Tar Kettle
Fire Pumps I Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL Valuation of Project
Fuel Tanks
n Other: I
Contractor i t Company
Signature
jt ( Registered _ Y / N Fee Current I Y / N
Address 1 1 License* 1
ELECTRICIAN Company
Signature Registered _ Y / N Fee Current Y / N -
Address I License #
PLUMBER Company
Signature Registered Y / N Fee Current Y / N I
Address I I License* 1
MECHANICAL Company
Signature Registered - Y / N Fee Current 1 Y / N
Address 1 • License # I
OTHER, Company
Signature Registered Y / N Fee Current 1 Y / N
Address License # I
, e s,,, ..,am.. - ..... Dam
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 ft- obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
‘NOTICE OF 'DEED RESTRICTIONS: The undersigned understands i at this permit may .be su i elianee r
w h any
which may be more restrictive than County regulations. - The�.un 9
.applicable deed restrictions.
UNLICENSED CONTRACTORS AND - CONTRAea O RRE RESPONSIBILITIES: Bac with ate and local ea
contractor or violation
contractors to und w as tquy may be r q
I for the
under a is not lie t owner n r or intended by law,
the owner certain as t a what licensing quirements may :apply under state law. If the owner or inter Inspection Division — Licensing Section_at 727-847 -
intendedi�work, they are advised to contact the Pasco County Building Insp
which co y will contractors, responsible. If you, have
the owner sign as the
Furthermore, if the owner has hired .a contractor or contractors, he is advised to have the coiteraecs° (s pasco in p009. lication
co to r , the "contractor that may b Block" of this app licensed and is not entitled permitting .pri i 9
contractor, ay be an indication that he is not properly
County.
CONSTRUCTION .LIEN LAW ( Chapter713, Florida Statutes,as:amended): If valuation of work is $2;500.00 or more, I
certify that 1, - the applicant, have been provided with a copy of the "Florida Construction Lien Law— Homeowner's
Ilcant is someone and Consumer
Protection Guide" prepared by'the Florida Department of A of the described Affairs.
and promIf the in good faith to
other than the "owner ", I certify that I have obtained a copy
deliver it'to the `owner" prior to commencement. that all the information in this application is accurate and
that CONTRACTOR'S/OWNE will be don in AFFIDAVIT: I certify licable laws regulating construction, zoning and land
that all work will li done in compliance with t i app permit and that all work will be performed to
development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify
met ee t standards rd s of inofa la laws regulating has gummen construction, County p City codes, .zoning regulations, and land e d prior to issuance
meet adrd all la
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
g° conditions set forth in
must take to be in compliance promise in good faith to inform the owner of the permitting
this i affidavit the AGENT commencing HE OWNER, I p application. A
vit rior to commencing construction. I understand that specifically be for electrical work,
this plumbing, prior gas, or other d d violate, n cancel, alter, A
plumbing, d shall wells, pools, air to be conditioning, 9
se a s issued an ro i io construed c o i s a l odes, nor shall issuance of a permits not as event the Building halt become invalid
requiring aside any provisions errors in plans, construction or violations of any the technical codes, codes. Every permit issued requiring a correction of er
work authorized by such permit is commenced within six
after the of permit t issua n commenced. authorized extension
unless the (90) days e nd will demonstrate by
m a p r is suspended ed, in or g, from the a period for period not to exceed ninety ( G a )
may be requested, in writing, from the Building gp
justifiable cause for the extension. If work ceases for ninety (90) ) consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A'NOTI YOU INTEND *COMMENCEMENT M I RE U TCONSULR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDAJURAT (F.S. 117.03) CO��y -FOR
pWNHR DR AGENT Subscribed and sworn to (or affirmed) before me this
Subscribed and swum to (or affirmed) before me this b
by Who i' s/are personally known to me or hasaSade identification.
Who i s/�personally known to m as dentification
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped