HomeMy WebLinkAbout09-9283 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9283
€ ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9283 Address: 6937 MEDICAL VIEW LN
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:
Improv. Cost: „: i . 9 ._ e ,:3,;',';•
l � � �;, ��° � ate.. 4,
Date Issued: 6/24/2009 Name: RYMAN, KEVIN
Total Fees: 25.00 Address: 6937 MEDICAL VIEW LN
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/24/2009 Phone:
Work Desc: FPM- SPRINKLER QUARTERLY- JG HOUSING SOLUTION- SCH WK 22ND JUNE
A TOTAL SOLUTION, 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.” .,!!
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P . " 4 " 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
'- G ` ,- ' (-, , n' ,. _ " Li :i. ZEPHYRHILLS BUILDING 'an L. N -- .i
513- 78o -0020
City of.ZephyrhillS Firre • •• 9- �" 3 Fax - 813 - 78o - 0o2i ,if
Permit Application I r
P hone Contact for Pemdt i L'f!% V,tle:ti •
Date Received • ....: .. .....:... . .. .:: , ..... —,_ .,. • -
/./ • /
Owner's Phone Number VLF *57
Owners Name �L7 • . 1
/ w A , / , S . 3 .353 1 Z
Owners Address n 1 1 1 1
• Titleholder Phone Number
Fee Simple Titleholder Name
Fee Simple Titleholder Address
/� m � r O Ze I i hi f 3 s- L • I 1
`
Job Address .. tQ Q� / � ,c4 _. ! 1
1 Parcel # I
Sub Division T— .
Sic- Hazard Waste Storage - ANNUAL F Fumigation Tent
n
Comm Exhaust Kitchen Hood/Duct 71 Hazardous Material (Tier II or RQ Facility) ANNUAL •
EJ Controlled Bum El. Hood installation
Emergency Generator < 30 kw n LP/Natural Gas - Installation . "
Emergency Generator > 30 kw • • El LP/Natural Gas-ANNUAL Sale
L Fire Protection Maintenance - ANNUAL El Places of Assembly-ANNUAL
ra yt 'Semi] MUT" lutner
Sprinkler ./o� ID El I Recreational Bum
Fire Alarm E ID ❑ ❑ i 1' n Sparklers
Hood Cleaning = ❑ ❑ ❑ L. j 1 j i Sprinkler 'System Installations.
Hood Suppression D ❑ . ❑ . ❑ 1 1 EJ Standpipes.(Sprinkler Sys)
•
Li Fire Alarm Installation ' ED Torch Roofing/Tar Kettle •
f 1 Fire Pumps n Waste Tire Storage ANNUAL .
Fire Works 1
Flammable Application- ANNUAL ValUa6on of Project
Fuel Tanks
El Other. 7
- ..:.... Company mil'!.! .r�
Contractor � —de , Registered [vI Fee Current . IIME
Signature�� -
Address 'L'f I" ,/rime Z . / License # •
� " Company
EL � — Registered Y / N .Fee Current Y / N 1
• Signnature sture 1AN •
Address � . License #
—
CvmPanY
PL re Registered Y./N' Fee current _ Y/ N
Signatunature _.. ,
Address Ucenae #. 1
MECHANICAL I Cony
Signature Registered Y/ N j Fee Current 1 N J •
Address __ - License #
OTHER j Company
Registered Y/ N Fee Current 1 Y/ N
Signature
License # ,.
Address •
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.(Meohanical work over $5000)
Supply two (2) sets of drawings with applicable documentation l/a rai asC
Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property T ax Notice (h ttp' pp ser .p ov,cam •)
.
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_„ - -._ i. _ .. L: P.M LET1711III1LLw 1, _ nn , .,, ,,._ __,. - - -
'NOTICE OF DEED 'RESTRICTIONS: The .undersigned understands that this permit may be•subjectit " dedd :restrictions " - ' •
which may be more restrictive than County regulations, The,undersigned:assumes responsibility foricompliance any
applicable deed restrictions.
:UNLICENSED CONTRAC O D be g be ll e S i 9 ae l eo dance with tats and Dori rgul the
contractors so o undertake Y Y •
co
der t is not ( � eh e owner opriiintendedc the uncerta n .as 'to what licensing quiirements may apply
under s taw.
intended work, they are advised contact the-Pasco County Building Inspection Division—Licensing $eotion_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 Biock" of this application for which - they will be responsible. if you, as 'the owner sign n as the
contractor, that may be an indication that he is not properly licensed and is not entitled'to' permitting p
County. 500.00 or more, I
CONSTRUCTION LIEN LAW (Chapter 713, Flori Statutes,.as.amended): if valuation of work is $2,
owner's
certify that I, the applicant, have .been, provided with ; a copy of the "Florida Construction Lien La H os sownens
Protection Guide" prepared by Department of A ibed document. nd •promPse in good faith to
other than the "owner", l certify that I have obtained a copy of the above descr
deliver It to the "owner prior to commencement:
and
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that a information n this app il cats zoning accuate
land
that all work will be done In compliance. with all app regulating
y
development. Application is comma ced prior to ssuance of a permit and that all will performedito
that no work or installation h uVations, and land
• meet standards of all laws regulating construction, • County and City codes, .zoning reg
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 1 .
must take . to be in compliance. conditions set forth In
If I am the AGENT 'FORTHE OWNER, I promise in good faith to inform the owner of the permitting
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical
plumbing, signs, wells, o nsttrued r t be aconditioning,
license to p oceed with the installations
work and o w as au h City o�violatee cancel, alter, or
serms ide issued shall be con
fter
set aside any provisions of the technical codes, nor shall issuance of a permit prevent Buildi
issued Hall (become inrom.
requiring a correction of errors in plans, construction.or violations of any codes. Every permit
unless m it work w ended o b by n doned e or a period of six (6) months after the t m the work is commenced. An extension
may pbe requested, is suspended in d or aban
may be equested, in writing, from the Building Official for a period days the job 1s ns tlered. ba
justifiable cause for the extension. If work ceases for ninety (90) consecutive
WARNING TO OWNER: YOUR FAILURE TO ' RECORD A NOT IF YOU ' C OMMEN MENT M IN RE SU L CON
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER
WITH YOU - LEND R O AN A ORN . Y BEFORE • ECO - DING YOU NOTICE OF COM MENCEMENT.
FLORIDA JURA7 (FS. 117.03)
- CONTRACTOR •
Q d AGENT a this Subscribed and swum to Or affirmed) > re :- y .
` Subscnped and ywo to (or a N •) - . • - , .,e� (,,- Y) o by • to me _, has/haYe Produced
h e persona by
Who is/are personally as id�tfication
W is/are persona known to me or has/have pro • sari — •
as identification.
' Notary Public
Notary Public' .
Cammisslon No.
Commisslan No. t _ g •
N ot r—� p'�� t , . Name of Notary typed, printed or stamped
Name of Notary typed; printed or stamped
o § Florida , j'3it
s o; ;639
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