HomeMy WebLinkAbout10-10752 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10752
•ANNUAL FIRE PROTECTION MAINTENANCE
PREMV:TE: :=72:7777:717 fi r ,17,17 `: % s
Permit Number: 10752 Address: 7838 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN.E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 3 5 - 25 -21- 0010 - 00700 -0000
Improv. Cost: 7 ; � 7-7777—IT
Date Issued: 7/22/2010 Name: PRIMERICA GROUP ONE
Total Fees: 25.00 Address: 3629 MADACA LN
Amount Paid: 25.00 TAMPA FL 33618
Date Paid: 7/22/2010 Phone: (813)933 -0629
Work Desc: FPM- FIRE ALARM QUARTERLY- PUBLIX
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AD S R Y I � I N
F I R P RMI S 25.00
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Chapter 633, Florida Statutes, authorizes the City to L c 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."
t ■
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. -ts'C / 0/ S Z' Fax- 813 - 780 -0021
Permit Application
4.-
Date Received " � Phone Contact for Permit ,
Owner's Name I P45( i C ju cam, .4� t fig a --- Owner's Phone Number 1 1 1 1 1
kner'sAddress - 7 A'3s- G-etu j10 ZG ?,/4, i0 F e
Fee Simple Titleholder Name I Titleholder Phone Number I
Fee Simple Titleholder Address I
Job Address 7 /r3 fr LT if u Nub 2/1r1 f I , .
Lot*
Sub Division Parcel #
El Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Controlled Bum n Hood Installation
I Emergency Generator < 30 kw f ] LP /Natural Gas - Installation
n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
(;j j semi' ujj Uther
Sprinkler D • ❑ ❑ I I Recreational Bum
Fire Alarm De ❑ IS. f I ri Sparklers
Hood Cleaning ■ • ❑ ❑ f I n Sprinkler System Installations
Hood Suppression JJ ❑ ❑ ❑ f I [ ] Standpipes (Sprinkler Sys)
n Fire Alarm Installation n Torch Roofing/Tar Kettle
n Fire Pumps n Waste Tire Storage ANNUAL
n Fire Works
F-7 Flammable Application- ANNUAL I I Valuation of Project
n Fuel Tanks
In Other: I
Contractor Company �i �j s �'t C zr CI r
Signature Registered Y / N Fee Current Y / N
Address 3 Z �'1/
1/.- Arc iI W 0 4 I License # !s'F ( 623 I
ELECTRICIAN Company
Signature Registered Y/ N I Fee Current I Y/ N
Address I I License # I
PLUMBER Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address i I License # I
MECHANICAL Company
Signature
Registered Y/ N J Fee Current I Y/ N j
Address I I License # I I
OTHER I Company
Signature I Registered Y/ N _I Fee Current I Y/ N I
Address I I
I License # I
Directions: l
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 (httpJ /appraiser.pascogov.com)
'NOTICE OF 'DEED RESTRICTIONS: The undersigned understands that this permit maybe subjectto "deed "Testrictidns"
which may be more restrictive than County regulations. The undersigned assumes responsibility forrcompliarrcemith 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 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 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 S ame d e ): I valuation
Construction work
ei $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy
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 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 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 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 E FOR IMPROV OWNER: YOU MENTS TO YOUR PROPERTY.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT
PAYING TWICE
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 1 7.03)
OWNER OR AGENT a CONTRACTOR
and swom to (or affirmed) before me this
Subscribed and swum to (or affirmed) before me this by
by Who is/are personally known to me or has/have produced
Who is/are personally known to me
i dentifi on. produced as identification.
as icati
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed rinted or stamped Name of Notary typed, printed or stamped