HomeMy WebLinkAbout09-9275 •
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9275
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 9275 Address: 5217 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11- 26 -21- 0010 - 16600 -0010
Improv. Cost:
Date Issued: 6/23/2009 Name: PEEPLES FAMILY CORP INC
Total Fees: 25.00 Address: PO BOX 1058
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/23/2009 Phone: (813)782 -2989
Work Desc: FPM -FIRE SPRINKLER ANNUAL FOR HYNES SUPPLY SCHEDULED 6/23/09
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AAA FIRE PROTECTION SVGS INC FIRE PERMIT FEES 25.00
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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."
/r
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 l I Phone ntact for Permit • Owners Name - - - Owner's Phone Number 1 ') T 117 al 2- ( 9 G
Owners Address ` I I
Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 1 1
Fee Simple Titleholder Address I I
_ .,... ;� „ �e; a;�.s+v., ..., " -" .. ,„ `w:r� °�,� ' >��.:s�r:�'�rr rr�,�:;as= t�,'. ,� =e > . �,r� .:c.._a,.- ,. -..:�,. .� �,'.v =:� u.�,.. . ^.',:°r ., .�s...::., - a w - ' -.... �. i�,: �.- :, �:; ,: ,.
:b Address .5--- 1 7 G 4-1 / t111744. Lot #
Sub Division I Parcel # I
;ter A te ; >• .., ;..�..,' �� �. �:,��._ .'.c. < ;� �_- . >, u
n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent
n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier 11 or RO Facility) ANNUAL
•
n Controlled Bum n Hood Installation
n Emergency Generator < 30 kw n LP/Natura �
I Gas - Installation ,-
r - i Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Salee
IZ Fire Protection Maintenance - ANNUAL n Places of Assembly - ANNUAL
f l !Semi ® =AZ. j � 9, ,
Sprinkler ❑ ❑ y Q,' n Recreational Bum f
Fire Alarm 0 ❑ ❑ ❑ 1 1 n / Sparklers /
Hood Cleaning El ❑ ❑ ❑ I I n Sprinkler System Installations
Hood Suppression El ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys)
n Fire Alarm Installation n Torch Roofing/Tar Kettle
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application ANNUAL I I Valuation of Project
El Fuel Tanks
• Other:
"aY '&;xtiNY.".v5. +?`s�lk3!<]:,;k!£?Nty x+*"af '.e - . e:a.m. zh' -r "- iv Y.h,;Y CLS . 1,. 'arc - as. .. �+a:4! f..::i.. e:;'. 'tc.?.. w ry '''.:T ..`-' ,. >:s*y3tYP:i en . :• -'4tk *il P'\.a1?'.fl, . ,43 +5;.;vc, s?:.v:, 4' ..:a:.; ,ssiL :::.
Contractor (J V , I'. „/ V / , Company -� F Fe f' teal ✓vs-2
Signature Registered Y / N I Fee Current I Y / N
Add - Ii ♦ _ _ , qb " - • - License # I ' S 4 I) &-7 a 0 o 0l ,tic.
•
ELECTRIC • N Company
Signature Registered Y / N i Fee Current I Y/ N
Address 1 I License # I
PLUMBER Company
Signature Registered Y/ N J Fee Current I Y/ N J
Address I I License # I I
MECHANICAL Company
Signature Registered Y/ N J Fee Current I Y/ N I
Address I - ( License # I wt. I
•
OTHER N l • Company �: zgr !• �[= .„4.1 1M _
Signatu - 1 Registered Y / N Fee Current Y / N
Ad ress Mgr /_illW mam /j , License # •
Direction- _
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 OF 'DEED RESTRICTIONS: The undersigned understands that this permit may be subject,to ":restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for: compliance any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND -CONTRACTOR RESPONSIBILITIES: If the owner has rhired :a =contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing - requirements may :apply for the
intended work, they are advised to contact the Pasco County°Building Inspection Division — Licensing Section at 727 -847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
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 permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW (Chapter713, Florida Statutes, -as amended): If valuation of work is $2,500.00 or more,
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S /OWNER'S AFFIDAVIT: 1 certify that all the information in this application is accurate and
that all work will be done in compliance with all applicable laws regulating construction, zoning and land
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 issuance of a permit and that all work will be performed to
land
meet standards of all laws regulating construction, County fa understand codes, t zoning g regulations, and
other
development regulations in the jurisdiction. I also certify
regulations
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.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
job is considered abandoned.
justifiable cause for the extension. tf work ceases for ninety (90) consecutive days, the j
WARNING TO OWNER: YOUR FAILURE TO RECORD A' NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS OR AN ATTORN TO BEFORE RECORDING Y YOU R NOTICE O F FINANCING, CONSULT
WITH YOUR LENDER COMMENCEMENT.
FLORIDA JURAT (F.S. 7.03) /t , _ AL
OWNER OR AGENT i,_ l _at!" 41 .. •• w.— CONTRA
; to (or affirmed) before me this
S bs« • and sworn ,t (or affirmed) b t ) + S _ 7 � by 'i A t .
�� �: by I O n i own to me SS 1 v y i personaly kno3.to me or ha -ve produced -
. s/are personally kn i has/have produced / �2 as identification.
AA A ` as identification. jJ y
�.( �/,y Notary Public
Notary Public C � K t 41- 11L241461k2112rA2-
Co J 478#2
ission No. Commission No.
,t�,Q� A. t Al 0 /r. se !�S
Nam AA / eit Name of Notary typed, pn or stamped
of Notary typed; printed or stamped
UN RICHARD -r ' UNDA
:.: Comrmission DD 808528 4 Commis 00
Expires July 24, 2012 ',_ .: , � 28l eo63es7ma
-�'�' 8063
Baidadll�nT
AAA Fire Protection Services, Inc.
8502 Sunstate Street — Tampa, FL. 33634 -1312 —(813) 886 -8869 — Fax: (813) 882 -3703
Automatic Fire Sprinkler Inspection ti Y1
Proposal/Contract
Items noted in the inspection report that are outside the scope of NFPA 25 do not imply that a full engineering evaluation or any other
type of analysis has been completed. Owner is responsible to correct deficiencies in a timely manner.
Date of Proposal: June -2 -09 (4 1 �J
Attn: Mr. Ernest Peeples
Bill To: Peeples Family Group
Address: P.O. Box 1058
City, State & Zip: Zephyrhills, Fl. 33539
Phone and Fax: P: (813)782 -2989 Lsji
Property Location: 5217 Gall Blvd. Zephyrhills, Fl.
Number of Systems (Risers . ONE (1)
AAA FIRE PROTECTION agrees to inspect said location on an Annual basis in accordance with
N.F.P.A. 25 for a contract price of $ 235.00 per inspection. This proposal does not include
inspection or testing of underground fire mains, backflow preventers, special hazard systems, fire
alarm or kitchen hood systems. This is an inspection contract only. If additional work needs to be
done, a separate contract for the additional work will be prepared for your consideration.
AAA FIRE PROTECTION to be held harmless for any damages that may arise from performing
this inspection. AAA Fire Protection is not responsible for the requirements of owners as
indicated in N.F.P.A. 25.
The report and recommendation(s) will be forward :d to the owner along with our invoice. One
copy should be filed and the other should be forwt •ded to your Insurance Agent for his/her use.
This contract is for a total of One (1) inspection. If applicable, any past due invoices shall be J
paid before this inspection will be performed. Fees are due and payable upon inspection. Check`
Master Card, Discover or Visa.
Yes . / No V add $ 98.00 per quarter for 3 quarters to inspect components of system that
require quarterly inspections per N.F.P.A. 25
Authorized Acceptance for AAA FIRE PROTECTION
r
Authorized Acceptance for the owner
V, if 6 --A®.- 62 7
Title Date
Sprinkler Systems Repairs Installations Design Inspection