HomeMy WebLinkAbout10-10100 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10100
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 10100 Address: 6118 8T
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: 02 -26- 0080 -00A00 -0123
Improv. Cost: 5� . � ; : , - -4 � .;v
Date Issued: 2/08/2010 Name: CITY OF ZEPH DEPT)
Total Fees: 25.O0 t d lam A ddress: 6118 8TH ST
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/08/2010 Phone:
Work Desc: FPM - SPRINKLER ANNUAL- POLICE DEPARTMENT FEE WAIVED
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1- A E 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." O!
- r 1 63J
P II " 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 Zephyrhills`Fire. /0 ( Fax- 813 -780 -0021
Permit Application
Date Received
Phone Contact for Permit
Owner's Name , S TMPLFXGR T NNELL Owners Phone Number 813 6 2 6 5482
Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 .
Fee Simple . Titleholder Name • Titleholder Phone Number
Fee SimpleTitleholder Address
1�.Aa £ - s , - ' %' aW"" E. —_ - - :: ' °: _x -a .O,.— . " . ��za-�°" a e w- ''s�°" " x
Job Address
COt R Sw.e.eti 2eR,'\(h CA. 33 5(42 Lot#
Sub Division Parcel
.mss. - -. .. - ". u , , - . v ,,,, ,. .k:_ . ... r.. �-a°� .: , . _
1 •1 Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent
1 Comm Exhaust Kitchen Hood /Duct 1 Hazardous Material (Tier II or RQ Facility) ANNUAL
1 . 1 Controlled Burn I Hood Installation
1 Emergency Generator < 30 kw I LP /Natural Gas - Installation
- • 1 1 'Emergency Generator > 30 kw 1 LP /Natural Gas - ANNUAL Sale
1 1' Fire Protection Maintenance - A NUAL 1 Places of Assembly - ANNUAL
Utrlyl'Semil Ani =igm
Sprinkler ❑ ❑ )1. I I Recreational Burn
, Fire Alarm I 1 ❑ ❑ ❑ 1 1 1 ( Sparklers
Hood Cleaning , ❑ ❑ ❑ I , , I Sprinkler' System Installations
• Hood Suppression , ❑ . _ I _ , . ,17 I 1 -_ 1 1 Standpipes (Sprinkler Sys)
1 Fire Alarm Installation I 1 Torch Roofing/Tar Kettle
1 Fire Pumps 1 • 1 _ Waste Tire Storage ANNUAL
1 1 Fire Works ‘"
Flammable Application- ANNUAL I Valuation of Project
1 : 1' Fuel Tanks •
1 1 . Other 1 rijct,c t - sl ov...) •
Contractor o r Company D CYi"'/ Kfi+w,.LC
Signature Registered _ Y / N Fee Current • Y / N
Address . License # ( .
-•
ELECTRICIAN Company .
Signature Registered Y / N I Fee Current 1. . Y / N I,.
Address 1 .. . . 1 License # ( 1
PLUMBER Company
Signature Registered Y / N 1 Fee Current 1 Y 1. N i
Address 1 1 License # . 1 '
MECHANICAL Company
Signature Registered Y / N I Fee Current I Y/ N,
. Address 1, , 1 License # 1
OTHER • Company •
Signature Registered Y / N I Fee Current 1 Y / NI
Address 1 License #
Directions:
Fill out application compfetely. -
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 maybe subjectao ":restrictions"
which may be more restrictive than County regulations. 'The undersigned assumes responsibility for-:compliance with 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 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 which 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 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 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::.:.0 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 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
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
;..' WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBI' N FINANCING, CONSULT
WiTH YOUR LENDER OR AN ATTO' • BEFORE RECORDING YOUR NOTICE r,' Cc ENCEMENT.
FLORIDA„ RAT(F.117.o-
OWNER OR AGENT / CONTRACTOR Al
Subscribed and sworn • (or - • ed) before me this Subscribed and s • m to or - - irmed) before me this
by by
Who is /are personally known to me dr has /have produced Who is /are personally known to me or has /have produced
as idenfification. as identification.
Notary Public Notary Public
Commission No. Commission No. -
Name of Notary typed; printed or stamped Name of Notary typed; printed or stamped