HomeMy WebLinkAbout09-9232 • - CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9232
ANNUAL FLAMMABLE APPLICATION PERMIT
Permit Number: 9232 Address: 3951 COPELAND DR
Permit Type: FIRE FLAMMABLE APPLICATION ZEPHYRHILLS, FL.
Class of Work: FIRE - FLAMMABLE APPLICATION Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 24- 26 -21- 0000 - 00100 -0080
Improv. Cost:
Date Issued: 6/11/2009 Name: WHEEL BLAST
Total Fees: 50.00 Address: 3951 COPELAND DR
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/11/2009 Phone: (813)715 -7117
Work Desc: FLAMMABLE PERMIT- WHEELBLAST - 25- 30,000 GAL OF PAINT
FIRE PERMIT FEES 50.00
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FIRE JOINT INSP(APPL/SITE)
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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.
frIP
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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
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813- 780 -0020 City ofZephyrhillsFire• Fax -813 -780 -0071
Permit Application
(n 1 `- /J 9 I - Phone Contact for Permit
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Owner's l 4y e e ti ps 7 la c-- /Al ke ��c-� J Owner's Phone Number m / 3 9f 7 / 3 .
Owner's Name Gj /' "�- , o,,,:0_,.... / / ? g
Owner's Address 3 / fJ L o � �G,a /1. /N FL .. J S-
Sej Titleholder Phone Number I 1
Fee Simple Titleholder Name -
Fee Simple rttiehoider Address r „ „.
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Lot r
Job Address S a
Sub Division
1 I Parcel # , r
J
Bio-Hazard Waste Storage - ANNUAL 71 Fumigation Tent
I Comm Exhaust Kitchen Hood /Duct 1 Hazardous Material (Tier II or RQ Facility) ANNUAL
- Controlled Bum I Hood Installation
1 1 Emergency Generator < 30 kw I LP /Natural Gas - installation
Emergency Generator> 30 kw
LP /Natural Gas - ANNUAL Sale
I Fire Protection Maintenance - ANNUAL • I Places of Assembly- ANNUAL
1C,ttnyi •1 semi � . � i
` Spinkler ❑ ❑ ❑ Recreational Bum ,,11 l//t�l]Ji�U)
Are Alarm I I ❑ ❑ ❑ I 1 I Sparklers 2
i v/
Hood Cleaning n ❑ ❑ ❑ I I I Sprinkler System installations 2 4
j I Standpipes (Sprinkler Sys) 1
lJ
Hood Suppression ❑ ❑ ❑ J • Fire Alarm Installation I Torch Roofing/Tar Kettle
I I Fire Pumps 1 Waste Tire Storage ANNUAL
I I Fire Works J
I Flammable Application- ANNUAL Valuation of Project
d I Fuel Tanks
I 1 Other: 1
Contractor / Company
Signature p it& IlV Registered L Y/ N Fee Current Y / N
Address . License #
ELECTRICIAN Company
Sionature . • Registered Y / N Fee Current Y / N I
Address License #
PLUMBER Company
Signature Registered Y / N Fee Current .. Y / N
Address 1 License #
MECHANICAL Company
Signature Registered Y N f F ee Current Y/ N
Address I License #
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)
•
N
OTICEI;OF:DEED RESTRICTIONS: The undersigned The undersigned ais permit
r ay.be su b ty.for:c mpl lotions
any
which may be more restrictive than County regulations.
. appiicable deed restrictions.
UNLICENSED 'CONTRACTORS AND ''CONTRACTOR RESRONSIBILmES: 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 If the
u t a is not l If the owner as requ me nde bed contractorhare uncertain .as -to contractor at licensing requirements may :apply for the
under state law. I the owner or intended
o
8 009. a Further the rmore, if the are he advised owner has hired .a contractor Building he is advised to 1 have the contractor(s) sign p009. furthehe wer hash
as the
portions of the " contra application-for which will be responsible. If you, as-the or sig Pasco
contractor, that may be e an a Block" of this ahp .privileges
n indication that he is not properly licensed and is not entitled
County.
CONSTRUCTION LIEN LAW ( ChapterTl3, Florida StaEutes, 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
Protection Guide" prepared bylhe Florida Department s �Agriculture e above described document and prom Psean faith to
I
other than the "owner certify that I have obtained
deliver it'to the `owner prior to commencement.
CONTRACTOR'S/OWNER'S at all the information in this application is accurate and
�5 •AFFIDAVIT: I certify applicable laws regulating construction, zoning and land
that all work will be done in compliance with all app
t op
work installation Application is her ommenced pri
or to issuance of a permit and -that installation as indicated. I certify will be performed to
that meet work rd installation has c and City codes, .zoning regulations, and land
meet standards of all laws regulating construction, County that I understand that the regulations and
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.
set forth in
If 1 am the AGENT'FDRTHE OWNER, I promise in u de faith that a s orm the owner of the permitting eparate permit may be required for electrical work,
this affidavit prior to commencing construction. I
si ns, wells, pools, air conditioning, gas, or other installations not specifically included in the application.
plumbing, 9
permit issued shall be construed to be a license to shal��ssuancehof a permitp not as event authority to
ding violate,
Official from thereafter
p permit issued shall become invalid
requiring aside any provisions of
r rors in plans, construction or violations of any the technical codes, nor codes. Every
requiring a correction of errors
rized by
unless the work authorized by such permit is commenced �o�hs months timeetheitworkais commence,
ommenced. An extension
the pe is suspended or abandoned for period ( )
may b
y be ;requesteded, , fi in writing, from the Building Official, for a9 erc �secutive days, the job i9 c os considered ed aba
justifiable cause for the extension. If work ceases for ninety ( )
WARNING TO OWNER: YOUR FAILURE TO 'OF ' N MEN M INANC NGTCONS
PAYI TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 1
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA!JURAT (F.S.117.03)
cONTRACT'OR
DINNER OR AGENT Subscribed and sworn to (or firmed) before me this
Subscribed and swam to (or affirmed) .before me this by
by ve roduc ed Who Is/are personally known to me or has/have identification.
Who is/are personally known to m an identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, Printed or stamped
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WHEELBLAST, INC. 44293
City of Zephyrhills 6/5/2009
25.00
Bank of America Chec Permits 25.00