HomeMy WebLinkAbout10-10136 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10136
ANNUAL FIRE PROTECTION MAINTENANCE
LIINVISTairal
Permit Number: 10136 Address: 5506 GALL BLVD 71:7117
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 - 0010 - 05700 - 0256
Improv. Cost:
Date Issued: 2/17/2010 Name: PHIL MOOK ENT.INC
Total Fees: 25.00 Address: 1108 W BRANDON BLVD
Amount Paid: 25.00 BRANDON FL 33511
Date Paid: 2/17/2010 Phone:
Work Desc: FPM -SEMI SUPPRESSION KFC -SCH FEB 2010
p
I P 25.00
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I ` A E - AN 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." 7r
.r102Y
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
'80 -0020 City of Zephyrhills "Fire Fax- 813-780 -0021
Permit Application
Date a -,:en 10 Phone Contact for Permit
Owner's Name I Owner's Phone Number I 1 I 1 I
Owner's Address I
Fee Simple Titleholder Name Titleholder Phone Number
1 1 1 I
Fee Simple Titleholder Address I
� -)(� C- (7 3 it} Lot #
Job Address �� 1r
Sub Division Parcel #
1 1 Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent
n ry
Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL
n Controlled Bum I I Hood Installation
n Emergency Generator < 30 kw I I LP /Natural Gas - Installation
n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
n Fire Protection Maintenance - ANNUAL r I Places of Assembly- ANNUAL
Itttriy� ) Semi ) Uther
Sprinkler n ❑ • ❑ ❑ n Recreational Bum
Fire Alarm n ❑ • ❑ ❑ I I I I Sparklers
Hood Cleaning n ❑ • ❑ ❑ I I I I Sprinkler System Installations
Hood Suppression Fro ❑ ,r te/ ❑ I I I Standpipes (Sprinkler Sys)
I
n Fire Alarm Installation n Torch Roofing/Tar Kettle
n Fire Pumps n Waste Tire Storage ANNUAL
n Fire Works
ri Flammable Application- ANNUAL I ( Valuation of Project
Fuel Tanks
In Other: I
Contractor ,777/ Company /U� po4 p, , r... , eri." t r :.. 1
Signature /
Registered Y/ N I Fee Current 1 Y/ N I
Address '17" �iG 1 ,c. 4r r 6/0-d_.--
-r&.,...,,,- r( I License # r /1632 tl C96,0 racb
ELECTRICIAN Company 7
Signature Registered Y / N I Fee Current I Y/ N I
Address I License # I
PLUMBER Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License # I
MECHANICAL Company I
Signature Registered Y / N I Fee Current 1 Y' / N i _
Address I I License # I
of OTHER
Company I
Signature Registered Y/ N I Fee Current I Y / N
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 (httpf /appraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS: The undersigned The undersigned a esp nsibilbty fortcompl a �e t witl +ny
which may be more restrictive than County regulations.
applicable deed restrictions. or
AND
b eN eg R u red to be RESPONSIBILITIES:
ens B ac i co E dance with state and local egulation If
contractors to not li ens they
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemyan violation for the
under state law. If the owner or intended onact the Pasco County Building Division— e l_ice s ng at 727-847 -
intended t work, they y advised advvised
n
8009. Furthermore, if the owner er has hired 11Cation contractor
for which they contractors, tbleelftyou have
as the own as
portions of the "contractor Block" of this app y will be espons
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 (Chapter 713, _Florida Statutes,-a of m e d e ): If valuation of work
e $ 0 50 0.00 or more, Homeowner's
certify that I, the applicant, have been provided with a copy
other than thei an the " owner", , I c ce by rt fy the
hat I obtained a copy of Agriculture and Consumer
described docum and promise in faith to
other tho, I e
deliver it to the "owner" prior to commencement.
CONTRAS/OWNER'S
don e in compliance with all ppli able laws information this application is
on, zoning accurate
and land
that all work be done
development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify
met ee t no wrk
st annd a rd s in alt la w sa egO 9 regulating construction, of a zoning regulations, performed
nd and
m at
adrd o all laws
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 AGENT FOR THE OWNER, r in good faith to permit may be required ed for conditions
electrc
this affidavit al work,
this affidaida vit prior to commencing construction. I understand that a
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application.
, cancel, alter, or
permit issued shall construed technical license
codes, nor shall ssuance o a pe mitprevent the Building ding Offii to dal from thereafter
set t aside any provisions ns of the to permit issued shall become invalid
requiring a correction of errors in plans, construction or violations of any codes. Every p
unless m e work suspended or permit
b ndch d is
period of six (6) within onths after of is commenced. authorized by extension
may permit is es ed, in d or abandoned P
may be requested, in writing, from the o k Building
ases Official
ninety (90) days, the job i od not to exceed ninety de ed aba l ndoned demonstrate
justifiable cause for the extension. If `
WARNING TO OWNER: YOUR FAILURE TO YOUR RECORD A PROPERTY. IF YOU COMMENCEMENT
TO OBTAIN n FINANCSNGTCONSULT
PAYING TWICE FOR IMPROVEMENTS TO YO • MENCEMENT.
WITH YOUR LENDER OR AN ' TT' RNEY BEFORE RECORDING YOUR NOTICE OF
FLORIDA JURAT (F.S. 117.0 , /
CONTRACTOR or__
OWNER OR AGENT A �� Subscribed and swum to (� affirmed) before me this
Subscribed and swom to (or a" ed) before m - his - -by
______py Who is/are personally known to me or has/have produced
Who is/are personally known to me or has/have produced as identification.
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
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