HomeMy WebLinkAbout09-9114 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9114
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9114 Address: 7446 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:
Improv. Cost:
Date Issued: 5/08/2009 Name: SYBEA,INC.(ARBY'S)
Total Fees: 25.00 Address: 7446 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/08/2009 Phone:
Work Desc: FPM- SUPPRESSION SEMI- ARBY'S
FIREMASTER FIRE PERMIT FEES 25.00 a....
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FIRE ACC EACE Final qvt
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."
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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 Zephyrhills Fire. Fax- 813-780 -0021
Permit Application
Date Received 0 j S^ 7-ezi �J Phone Contact for Permit fp / 3 ii 75 6
Owner's Name
1 Owner's Phone Number I 1 11
Owner's Address
Fee Simple Titleholder Name Titleholder Phone Number 1 1 1 1
Fee Simple Titleholder Address
�-7 . _, °. Mrr.�a: tr��5';s;z=.*'�
Job Address / 4 / 4 1 & 6,-.2.1/ 13 ". A r"b `3 Lot # 1
Sub Division Parcel # I
',r xrs - ::- �,;,:.•s.�srs �.a:::;.: :ra:,mu =r ,* s ° *,� •>.:•:a w: .Fa,: s a,. =. r_s_ a: xaa� „{.�... w- . < -: I
I Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent
El Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL
ni Controlled Bum ( Hood Installation
pi Emergency Generator < 30 kw I] LP /Natural Gas - Installation
El Emergency Generator> 30 kw I1 LP /Natural Gas - ANNUAL Sale
I Fire Protection Maintenance - ANNUAL Ii Places of Assembly- ANNUAL
IUtnyl'Semmi r ""' 1 Other
Sprinkler r1 ❑ ❑ ❑ n Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I I l Sparklers
Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations
Hood Suppression 1 --- ❑ 3d ❑ 1 ( I I Standpipes (Sprinkler Sys)
n Fire Alarm Installation (` I Torch Roofing/Tar Kettle
I Fire Pumps Ii Waste Tire Storage ANNUAL
I] Fire Works
F-7 Flammable Application- ANNUAL I 79/OQ I Valuation of Project
rI Fuel Tanks
ri Other: I
W
Contractor '-�� " _ •sue `e , . . >
Signature I ✓
S I Company m/�/G � /� - F, /'Ylc. 5 ✓ r-
Registered Y/ N I Fee Current I Y / N I
Address I r f c I !sG L Pict r 4.5 lvL -7-a„,./a____ I License # ( - 7/5/f d( a C.X , I
ELECTRICIAN!
I Company I
Signature Registered Y/ N I Fee Current I Y / N I
Address I I License # I I
PLUMBER I I Company
Signature 1 Registered Y/ N I Fee Current I Y/ N I
Address I I License # I
MECHANICAL I Company I
Signature I Registered Y/ N j Fee Current I Y/ N I
Address I I License # I
OTHER f I Company
Signature I 1 Registered Y/ N . 1 Fee Current I Y/ N I
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 may .DEED "RESTRICTIONS: The undersigned ula
g d ons. The undersigned assumes responsibility for:c mpl ace with any
which any
which may y be more restrictive than County
applicable deed restrictions.
UNLICENSED CONTRA`C CONTRACTOR ged to be E ce nO sed S!B ac i co E dance with state and local regulationsc If
contractors to of li en s they
co
der t is not lic the owner n r or intended contractor are uncertain contractor may be cited - for a
what licensing r qui misdemeanor
may violaion
under state law. If the owner o they intended
0 0 9. k, m o r are e, if t he oow t ne r has hi edea contractor County
or o tors, hel�s Division—Licensing
dvsed to ha e he cost actor(s) sign
809. emrhe wr
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 properly licensed and is not entitled to permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, ,a a a d If Const on r i $ ,500.00 or more, I
certify that I, the applicant, have been provided with a copy o
is someone
Protection Guide" prepared by the Florida Department of Agriculture above described document and prompse faith th to
other than the "owner", I certify that I have obtained a copy of the
deliver it to the "owner" prior to commencement.
and
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the iinformation
regulating this ap r pl cti d o is rag u aa t l and
that all work will be done in compliance with all applicable
that o no work or installation t ha e commenced pr issuance of a permit and' that t all t work will indicated.
be performed certify
to
that wok instio
meet standards of all laws regulating construction, County and City codes, zoning regulations, and land
developmen a g e e n c ie tions i s may a tppp i jurisdiction. othe tended work, and that it is my understand
responsibility to ident
ify t what actions I
government gnie Y
must take to be in compliance.
If i AGENT FOR THE OWNER, ru l inform
separat permit may be requiired for conditions
t a electr cal work,
this affidaida vit prior to commencing construction. I understand that a
plumbing, ed shall sis, wells, on air o b ' e a lice se to p other
the work and not as authority to d violatee cancel, alter, or
se a s i a a any rov is io construed to
fter
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the
t issued shall become loyal d
requiring a correction of errors in plans, construction or violations of any codes. Every p
unless m it work it is suspended o or authorid
a b such
andone d f f ais period od of six (6) within six months of
after the time e the t work is commenced. An authorized
xtension
the permpended r bd
may be requested, in writing, from the Building
eOfo (90) days, thejob is deed ab will
andoned demonstrate
justifiable cause for the extension. If work RESULT
WARNING OWNER: FAILURE TY.TIF ICE OF COMMENCEMENT YOU INTEND D TO OBTA N NANC NG CONSULT
PAYING TWICE FOR IMPROVE TO YOUR PROPER
MENTS • MENCEMENT.
WITH YOUR LENDER OR AN ' TT 01 RNEY BEFORE RECORDING YOUR NOTICE OF
FLORIDA JURAT (F.S. 117.0 ' / Alle .
,'� CONTRACTOR
OWNER OR AGENT Subscribed and swom to (� affirmed) before me this
Subscribed and swom to (or a " ed) before m his by
by Who is/are personally known to me or has/have produced
Who is /are personally known to me or has/have produced as identification.
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped