HomeMy WebLinkAbout09-9246 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9246
ANNUAL WASTE TIRE STORAGE PERMIT
Permit Number: 9246 Address: 37911 SR 54 WEST
Permit Type: FIRE WASTE TIRE STORAGE ZEPHYRHILLS, FL.
Class of Work: FIRE -WASTE TIRE STORAGE Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 10- 26 -21- 0030 - 00000 -0050
Improv. Cost: :,: OW: . r ' , A
Date Issued: 6/15/2009 Name: MCRAE, T. D.
Total Fees: 50.00 Address: 2508 N 50TH ST
Amount Paid: 50.00 TAMPA FL 33619
Date Paid: 6/15/2009 Phone:
Work Desc: WASTE TIRE STORAGE- WASTE TIRE RECYCLE INC- ONCE A MONTH
FIRE PERMIT FEES 50.00
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FIRE SITE INSPECTION -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.
TIRE REMOVAL COMPANY:
PHONE NUMBER: FREQ OF REMOVAL:
ICY
P IT OFFICER
PERMIT EXPIRES IN ONE (1) YEAR FROM DATE OF ISSUANCE
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041
• - T 1 50 a) 0 Dna_ le
813-780-0020 City of Zephyrhills Fire yJ! 9 7-4-
% ` Fax- 813 -780 -0021
Permit Application
Date Received Phone Contact for Permit
aOwner's Name M'4 ,1! I .-.. ,•Im tit A y t a > %e Owner's Phone Number I $t7 / 113 7"7 1 1 / . (9 1
Owner's Address 1 3 1 52 5l ` z e� ><y r-14 r` l5 i rt 3 3 S T �-
' Fee Simple Titleholder Name I 1 Titleholder Phone Number 1 p / 1377 113 8 3
Fee Simple Titleholder Address I I
� . ` / ✓evV.
Job Address °l I '3
7 9 I 1 5P '5 `1 Ze,. y 4i (5, f/ Lot #
Sub Division I I Parcel # I I
'.' N"'$,.. ? ", <e..:.in#46.i"ra +a Pn 3: 5d.`.'+ ;3F•,$m'F•`. ->'.s .`*s;..,::3'.. ,.,,_ >.°.$ n: A& ^;,>.�ux4'22`aa.3.,a_:::,' r3 ..v.,;:: ...ask*xxx. Tai( „/.d9 nab` L' i' u'. x1. R"f` wwn% '✓k#'da�_Sv':�k'x"R"fdsXi:mgr.k iNt:t#,Fd ..�.ar:>.. �'.`.a`r es^a -�.f'
Il Bio-Hazard Waste Storage - ANNUAL = Hazardous Material (Tier II or RQ Facility) ANNUAL
El Comm Exhaust Kitchen Hood /Duct El Hood Installation
El Controlled Bum = LP /Natural Gas - Installation
Emergency Generator < 30 kw E=I LP /Natural Gas - ANNUAL Sale
Emergency Generator > 30 kw I-1 Places of Assembly- ANNUAL
El Fire Protection Maintenance - ANNUAL n Recreational Bum
[jjj'j Elaill (y11 tit)` 7 '
Sprinkler D ❑ ❑ ❑ 'Other E Sparklers Et
Fire Alarm El ❑ ❑ ❑ I I E Sprinkler System Installations Z, , / / 1 i 1
Hood Cleaning El ❑ ❑ ❑ I I = Standpipes (Sprinkler Sys) t5 3 —
Hood Suppression 0 ❑ ❑ ❑ I I El Tor oofmgfiarKettle 1 „ .1 L gfh 4/4-
El Fire Alarm Installation T
I I 1 Tire Storage ANNUAL - ek i � L,
-- 6I l Y�
Q
Fire Pumps
Fire Works
Flammable Application- ANNUAL I I Valuation of Project
Fuel Tanks
n Other: I
W tV. ,': . Ar"::. * .'1 ? S "•SfYe,' 'r',:, °. :'e "£Y b ' • ' im"s^,?:,) ,,,, "W'''' , �"'',' '°'' ''' '' `' „4 1. .. .
ter. Z. .. x .... A . . .. M
Contractor r '/ Company
r Signature e - 8 , 1 i, ( r= -..- Registered Y / N J Fee Current I Y / N I
Address ( I License # I
ELECTRICIAN Company
Signature Registered Y/ N I Fee Current I Y / N I
Address I I License # I
PLUMBER Company
Signature Registered Y/ N I Fee Current I Y / N I
Address I I License # I I
MECHANICAL Company I
Signature Registered Y/ N I Fee Current 1 Y/ N J
Address I I License # I I
OTHER Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address License #
, a�,r- sr: >:>x. xk..� .... z.:.>.. �;» :....;•a,:.»a;';.';•,.....:...: PK.. ..< •.::-. a:s.:;cs. s ,�,stu,w,....s,,A....,. ..•�,:xir:;A,.w�..�:
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 - days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
hiTICEPF :DEED RESTRICTIONS: The undersigned understands undrsigned .assumes permit
responsibility.for:comp arse wtt
.which any
hich may be more restrictive than County regulations. Th
_applicable deed restrictions. CTOR RESPONSIBILITIES: If the owner has -hired or
UNLICENSED 'CONTRACTORS AND 'CONTRACTOR
cotrtractom"to• undertake work, they may be required - to be licensed in accordance with state and local If the
f
contractor is •not licensed. as required by law, b -the ate uncertair► .as to wa r m cens'tng men may :app y for the violation
under state law. If the owner or intended contra Building Inspection Division — Licensing Section_at 727-847 -
8 009. a Furthermore, ore, if the ow owner has hirtd .a County will be responsible. advised
If you, have the co n racto si gn
pO
Og: Furthermore, if the owner has hired .a c nn� � •
chtheYmctors' pes advised to have the riv le es�in
portions •
r, the "contractor ay be n Biopic" of this application-for properly licensed and is not entitled -permitting .p g
contractor, that may be an indication that he is •not °.prop y � valuation of work is or more, I
County. Chapter.gndsd):
CONSTRUCTION rtify that 1, -the tip LIEN LAW ( 7K3, Florida Statutes,•as provided ,with a copy of the 'Florida Construction Lien Law — Homeowner's
certify ttiat 1, the applicant, have .been p
Protection Guide" prepared by Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
I certify that -I have obtained a copy of the above described document and promise in good faith to
other than the "owner,
deliver itlto the "owner" that prior to commencement. I certify that all the information in this application' is accurate and
• t
CONTRACTOR'S/OWNER
t alt work wil l be done in compliance omp liance with all applicable laws regulating construction, zoning and land
- devv all development. will done n cation is hereby made to obtain
issuance of a permit and•that will be performed to
construction, County and City codes, _zoning regulations, and Land
that no work or installation has commence prior
meet standards of all laws regulating
development regulations in the jurisdiction. I also certify that I understand that the regulations of other
govemment agencies may apply to the: intended work, and that it is my responsibility to identify what actions 1
govern conditions set forth m
must take to be in compliance..
If 1 am the AGENT•FORTHE OWNER, I promise in good faith to inform e owner o the
ey be required for electrical s cal whr
gas, .or other installations not specifically included in the application. A
this affidavit prior to commas air con I s, understand
her that a separate d o in violate, cancel, ti A
plumbing, e i issued w ins, wells, on air to be conditioning, 9 the work and not as authority
se a s a a ny p i io be construed c o i s l lo to shall with permit issued shall become invalid
visions of the technical codes, nor shall issuance ns of any codes. prevent
Every Pe Building Official from thereafter or
requiring any pro
unless t a correction of errors y in plans, permit is cction or e dl w io o s after months of
e.r work i commenced. ut extension
by
work authorized by such permit is commenced wmhin, six months of permit issuance, or if work authorized by
the unless the w period of six ( (90) days e n c will demonstrate
map be is suspended ed, in or g, from the a p )
may be requested, to writing, from the Building Of>'ictal, for a9eriod not to exceed ninety ( 0 consecutive days, the job is considered abandoned.
justifiable cause for the extension. if work ceases for ninety ( )
WARNING TO OWNER: YOUR FAILURE TO RECORD A'N CE - C OMMEN M FA INANC N LT NNSULR
PAYIN TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF Y OU
WITH YOUR LENDER OR AN ATTORNEY.BEFORE RECORDING YOUR NOTICE OF COMM NCEMENT.
FLORIDA JURAT (F.S.117.
Subscribed and sworn to (or affirmed) before me this
OWNER DR ACsENT (or afftmied).befere me this by
Subscribed and •sworn tD ( Who � personally known to me or has/have Produced
by as identification.
Who isfare personally known is w as de has/have i onroduc
Notary Public
Notary Public
Commission No. •
Commission No.
Name of Notary typed, printed or stamped
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•
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Name of Notary typed; pfd or stamped