HomeMy WebLinkAbout10-10190 CITY OF ZEPHYRHILLS `X
5335 - 8TH STREET
(813) 780 -0020 10190
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 10190 Address: 7643 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: 34- 25 -21- 0010 - 03100 -0000
Improv. Cost: . ,:. E ° .: as �_: rq k;,,.
Date Issued: 3/03/2010 Name: CHILI'S BAR & GRILL
Total Fees: -------25-00- _.--.
Address: 7643 GALL BLVD
Amount P : . 25.00 _— ZEPHYRHILLS, FL. 33542
Date Paid: 3/00720t10 -- Phone:
Work Desc: FPM - QUARTERLY SPRINKLER FOR CHILI'S
I M-L X RI L LP IR - ER IT ES 25.00
1
inal i t .. .. �. ...
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 � 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- 313- 780-0021
�} Permit Application
Date Received d / Phone Contact for Permit I
Owner's Name S TMPLEXG13 TNNELL Owner's Phone Number - 813 1626 1 5482
Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610
Fee Simple Titleholder Name - ' Titleholder Phone Number I
Fee Simple Titleholder Address
i= a. . "'r "'� �.,,, Wit•.:: -_. 7 -;-4' ,a-; 'K:.,M2 r ` .. r- .1. Z' -.,E -r - - :�.� � o ' -
Job Address 7 -11 Ci.c , it ZI vz . Ze Pn y r h ', i IS VI- " - I 1 Lot #
Sub Division Parcel #
—.», _.: •-• `.-r-: '-. .. :'=' .�- z:4.c «.; . . ' - F ,": .. ,..........` " _...: =.,y^:- ; . -,,.3 : .,. --.. ..-. a .'. - y ' a.
I • I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent
Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier If or RQ Facility) ANNUAL
I I Controlled Bum I Hood Installation
,.
I Emergency Generator < 30 kw I LP /Natural Gas - Installation
• I I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Safe , I q
0
I. I Fire Protection Maintenance - ANNUAL • I Places of Assembly - ANNUAL - 4r / D V
t !Anil Other (
Sprinkler • f cu". ❑ ❑ , I I Recreational Bum
D U
Fire Alarm I I ❑ ❑ 0- I [ I I Sparklers 1
Hood Cleaning I 10 0 0 I I I Sprinkler System Installations
- Hood Suppression 1 1 0 0 0 I I I I Standpipes (Sprinkler Sys)
Fire Alarm Installation
1 I Torch Roofing/Tar Kettle
. ( I Fire Pumps Waste Tire Storage ANNUAL
I I , Fire Works
•
Flammable Application- ANNUAL
I I' 1 j Valuation of Project
k Fuel Tanks
•
I I Other: . I .
•
F. - . _ : s''"'" ,:s'z? - - r ` ; -� xi .s.:s a s' -- ^ii 4' '' _ s s - :.4- a : - ; r - ire - -&— w . -:4 .. .,a r:. : . , .: ', ,xs€ c -;r,.:
Contractor / Company -- cyr-- Ks.- ..--c. C(
Signature Registered Y / N Fee Current I' Y / N j
Address I L License* •
ELECTRICIAN
• _ Company _ .
Signature
- - Registered • Y / N j Fee Current I : :Y / N l
Address I I License # I I
PLUMBER _ Company _
Signature I - Registered Y / N A Fee Current' I Y / N I •
Address I •
I License # . I •
MECHANICAL Company
Signature Registered Y/ N J Fee Current 1 Y/ N j
. Address I.
I License #
OTHER Company - .
Signature Registered Y / N I Fee Current I Y / Ni
Address I L' #
License
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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 maybe subject to `deed':restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for.complianoewith any
- applicable deed restrictions.
UNLICENSED . CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has -hired 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 727 -847-
80 "09. 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, -a amended): If Construction of Lien Law is or e, I
more,
that I, the applicant, have been provided with a copy of me
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 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 l 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.
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 permif 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
by
unless the work authorized by such permit is commenced w m h onths after the time the work as commenced. An extension
the permit is suspended or abandoned for a period of s ( )
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 'COMMENCEMENT MAY'RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBT • E N INANCING, CONSULT
WiTH YOUR LENDER OR AN ATTO' - BEFORE RECORDING YOUR NOTICE a' C �
FLORIDA JURAT (Fs. 117.1
/
/ /
T CONTRACTOR
% i ce
OWNER OR ADEN Subscribed and s om to or - ' imied) before me this
Subscri and sworn • • (or . i • ed) before me this by
by Who is(are personally known to me or has/have produced
Who is /are personally known to ma i identification. produced as identification.
as ificati
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed; printed rinted or stamped Name of Notary typed,- printed or stamped