HomeMy WebLinkAbout09-9440 CITY OF ZEPHYRHILLS
• • 5335 - 8TH STREET
(813) 780 -0020 9440
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 9440 Address: 7340 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ZEPHYRHILLS COLONY
Est. Value: Parcel Number: 35- 25 -21- 0010 - 08800 -0000
Improv. Cost:
Date Issued: 8/18/2009 Name: TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN SR
Amount Paid: 25.00 BALA CYNWYD PA 19004 -2102
Date Paid: 8/18/2009 Phone:
Work Desc: FPM- SPRINKLER QU A RTERLY- TOWNVIEW RETAIL- SCHEDULE 7/27/09
R• .A IR ` - , IN . I PER 1 25.00
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FIRE A P A 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." 11!
1i
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
813780 -0020 City of:Zephyrhltls Fire a ra < -o i o -r ov
Permit Application 49(1(( G
• Phone Contactfor Permit
Date Receved.,
Owner's Name I hL r h 11' S �c-�" 1`-q \ I Owners Phone Number I 1 I 1 1
_ I
Owners Address 1 `170 C-,c(II 601 , _ 41 (� _� i 17( Name I Titleholder Phone Number I I 1 1 1 I
Fee Simple Titleholder I I
Fee Simple Titleholder Address
��- O.. c I) . ?Ad - Z t4
i' I 3 , -L 1 Lot # I
Job Address I l �I
�-l1. �� 1 I
Sub Division I I Parcel # I
0 Bio- Hazard Waste Storage - ANNUAL = Fumigation Tent
Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
a Controlled Bum I Hood Installation
Emergency Generator < 30 kw El LP /Natural Gas - Installation
Emergency Generator > 30 kw ED LP /Natural Gas - ANNUAL Sale
a Fire Protection Maintenance - ANNUAL E Places of Assembly- ANNUAL
r Iemi Lail Uther
Sprinkler i 0 ❑ E] Recreational Bum
Fire Alarm ED ❑ ❑ ❑ I I = Sparklers
Hood Cleaning Ej ❑ ❑ ❑ I 1 Sprinkler System Installations
Hood Suppression 0 ❑ ❑ ❑ I I = Standpipes (Sprinkler Sys)
ED Fire Alarm Installation a Torch Roofing/Tar Kettle
Fire Pumps Waste Tire Storage ANNUAL
Fire Works I
Flammable Application- ANNUAL Valuation of Project
Fuel Tanks I
Q Other: 1
Contractor ompany [ 1 T-.),;(0 rr tf -. C.CtrS
Signature � ∎r egistered I Y N Fee Current - Y 1 N
���t�� .��
Address � i ir i . License # I ll k Ug7(X Y; I Icri c / 1
ELECTRICIAN Company
Signature m" Registered Y/ N I Fee Current I Y/ N
e License # I
Address ( �
PLUMBER + 111k -mod.. Company
Signature
` 'r Registered Y/ N I Fee Current I Y/ N I
Address I I License #
MECHANICAL Company
Signature Registered Y/ N I Fee Current I Y / N
Address I I License #
OTHER Company
Signature Registered Y/ N I Fee Current 1 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 OF 'DEED RESTRICTIONS: The undersigned understands that this permit may basubject'ao "deed` trestric, ►ions
which may be more restrictive than County regulations. The undersigned assumes responsibility .for rcompliancawith any
.applicable deed restrictions.
UNLICENSED CONTRACTORS AND °'CONTRACTOR RESPONSIBILITIES: 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
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 7.27 -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 to permitting privileges in Pasco
County.
CONSTRUCTION .LIEN LAW (Chapter713, Florida Statutes,.as amended): If valuation of work is $2,500.00 or more, I
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: I 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
meet standards of all laws regulating construction, County and City codes, zoning regulations, and land
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 I
must take to be in compliance.
If 1 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 o theTechnical codes; "nor their of permit prevent 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 e tirjae the werk is commenced. An extension
may be requested, in writing, from the Building Official for a perio 'x ed ninety (911), days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) c utaye 'is,Ititf j9b is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A'NOTICE OF COt/IMLICEMENT 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 3' F OMMENCEMENT.
FLORIDAJURAT (F.S. i 17.03) ffillimok
OWNER OR AGENT p , ' b
C (� i) k v I O CONTRACTOR , I - 1
•1
s , • - • d swopq or �v� s e e,r affi - s t` -
' 1 l.E by ( � V L byd swo - P,i�lr ` r
1 o ' are personally�to me or has/have produced Who is/are personally nown to Die or has/have produced
as identification. as Identification.
if j r / � � C am ., _ . r�!__.i► Notary Public
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( .Q 4�.1, - . _ 1 AO . - ry Publ AL A -'J .t
i
Commission No. Commission No.
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
2- PftY.P.ue <, CHERYL A. DUFFELL
,�� ::°"<,, CHERYL A. DUFFELL
s s . MY COMMISSION # DD 730956 - * MY COMMISSION # DD 730956
r 1 tit e EXPIRES: November 12, 2011 ,in,, °, EXPIRES: November 12, 2011
, Bonded Thru Budget Nota Services NqT ' ° ^ c Bonded Thru Budget Notary Services
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