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Home My WebLink About10-10892 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 10892 CONTROLLED BURN PERMIT %R",a ,N azn >� -a� ,.,.. f £ ..x.. x ....:. f'i .,.r ' . .:k � .> 5� F_. $' z...o..e,,.. .� ;..,.a..,.,.,.,�q c' , . • Permit Number: 10892 Address: 39735 CHANCEY RD Permit Type: FIRE CONTROLLED BURN ZEPHYRHILLS, FL. Class of Work: FIRE - CONTROLLED BURN Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 24- 26 -21- 0000 -00100 -0050 Improv. Cost: Date Issued: • 9/08/2010 Name: AGAPE BAPTIST CHURCH Total Fees: 100.00 Address: PO BOX 1505 Amount Paid: 100.00 . ZEPHYRHILLS, FL. 33539 Date Paid: 9/08/2010 Phone: (813)788 -0283 Work Desc: CONTROL BURN AGAPE CHURCH , ; .:e�,.��.a�,,.a m 100.,s / „ / -/0 • 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. Per Ordinance 652, the controlled burn shall not be ignited before 9:00 a.m. and shall be out one (1) hour before sunset. Zephyrhills Fire Rescue Communications shall be contacted at 813 - 780 -0038 prior to the fire being ignited and after it has been extinguished each and every day. iti CO RACTOR SIGNATURE P IT OFFICER PERMIT EXPIRES IN 15 DAYS FROM DATE OF ISSUANCE. CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041 • gu,e�% PAR a / ��. 813aso 0020 City of.Zephyrhills Fire / Fax•- 813- 750 -0021 $ ii I o Permit Application Date Received Phone Contact for Permit 9i Owner's Name 04 V E gp cm A ,-C,.4PF Ql`}P Owner's Phone Number - f / '3 7 S1 / , 2 s 8 Owner's Address 3 9 7.35 e_>9 nAlee g laX}-] Fee Simple Titleholder Name I Titleholder Phone Number Fee Simple Titleholder Address . q .. :.wt+rY.r.MSC'rc:�?�t , r.;. ».'ax e w 4k= .. -r�:. r r-,,,,,,s:.r.. < _ ,. ,,.._ ::;:E`.,..t .ti;,;r t _^� xs h «'i> &'§ #•'_...,. C'aidm. da" ...., a'"... Job Address 99 73 5 - OMN O 9J' Z- N /LLS' 335 `/a..... Lot # Sub Division Parcel # Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL al Controlled Bum n Hood Installation FT Emergency Generator < 30 kw I I LP /Natural Gas - Installation I I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL • n Places of Assembly- ANNUAL ILttrlyl 'berm' UM tither Sprinkler n ❑ ❑ ❑ n Recreational Bum Fire Alarm n ❑ ❑ ❑ I ( n Sparklers Hood Cleaning n ❑ ❑ ❑ l I n Sprinkler System Installations Hood Suppression Ei ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) n Fire Alarm Installation n Torch Roofing/Tar Kettle H Fire Pumps I Waste Tire Storage ANNUAL Fire Works n lammable Application- ANNUAL I /V V. 00 I Valuation of Project n 1/uel Tanks P1 Other: I r Contractor v Company - (61 6 - Signature .. I - , � Registered Y / N I Fee Current I Y / N I Address NOP' �� I License # I ELECTRICIAN Company Signature Registered Y/ N I Fee Current I Y/ N 1 Address 1 I License* I 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 I Fee Current I Y/ N I Address I I License # OTHER Company Signature Registered Y/ N I Fee Current 1 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 (http: / /appraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may- be °:restrictions which may be more restrictive than County regulations. The .assumes responsibility for:compiiarte 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 - 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, -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 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 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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. FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and sworn to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by b y 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 • ZEPdYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)7800044 FIRE SERVICE USER FEES Occupancy No.: , Plan No.: I (7 01 Contractor: c Business Name: ALA ''t4 - Billing Address: Business Address: . 3 7 S' tc . Business Phone No: Billing Phone No.: Business Fax No.: Billing Fax No.: Contact: Contact: ^ PLAN REVIEW FEES _ INSPECTION FEES PERMIT FEE FALSE ALARM FEE Site Plan N/C _Annual N/C Sprinkler $50 ^ _ 1st Alarm N/C Multi Family /Commercial .06 sf — 1st Re- inspection N/C Standpipes $50 2nd Alarm N/C (Minimum Charge $25.00 _ 2nd Re- inspection $100 Fire Pump $50 _ 3rd Alarm N/C 0 Plan Revisions DBL _ 3rd Re- inspection $250 Hoods $50 4th Alarm $100 _ 4th Re- Inspection $500 Fire Alarm $50 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until LP Gas $50 _ 6th Alarm $200 — 0 - 25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150 26 plus Heads $100 _ SPRINKLER SYSTEMS Fuel Tanks- per tank $50 STANDPIPE SYSTEM _ Hydro Undergrounds $45 Sparklers $100 Per Riser $50 _ Hydrostatic Test $65 per system Fire Works $500 FIRE PUMP _ Acceptance Test $45 per system Camp Fire $25 0 Per Pump $100 _ Hydrant Flow $75 ontrolled Burn ) FIRE ALARM SYSTEM Hood /Duct 0 - 25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $50 Annual 26 plus Devices $100 _ System Acceptance $50 Fire Protection $25 SUPPRESSION SYSTEMS _ Recall Acceptance $50 Flammable Application $50 Annual Wet $50 _ OTHER Waste Tire Storage $50 Annual Dry $50 _ Fire Wall /Smoke Wall $15 per wan Generator < KW $100 _ CO2 $50 _ LP Gas $25 per tank Generator >30 KW 150 — Other $50 _ Natural Gas $25 per system Bio-Hazard Waste $100 Annual KITCHEN EXHAUST _ Fumigation Tenting $50 El Hood /Ducts $50 ^ Tent 10'x10' or greater $15 per tent Torch Pot/Applied $50 OTHER _ Fire Pump $45 Haz. Materials $100 Annual LP Installation per tank $50 — Fire Suppression $30 Fuel Tank Installation $50 _ System Acceptance (Per Tank) $50 _ Exhaust Hood /Duct $30 0 Natural Gas Installation $50 Re - inspection DBL (Per System) (other than annual) ❑ 0 Spray Booth $50 Inspection scheduled DBL and cancelled less than _ 24 hours _ Construction Insp. N/C Emergency Vehicle Acs $50 — FALSE ALARM PLANS TOTAL r _ INSPECTION TOTAL I I PERMIT TOTAL 72=4•P TOTAL [ GRAND TOTAL I yG I Comments: Date: / , Insg ,` 1. J` - ` ' ' * . / ti it il a i ii ___________ ;1,1,3,,, :;:f.i.:,,11- ii ---. -I : LI : : I '1.111 l''''':::-: • 5 0 :1 \ 7 4 ( ?( 1 iiii ill o;J; fill:, ;.) 'e, 1 1 i IR. 1. II - h ! 11,4 I . A \ t":<II '4 8 K st : :• ;i it : i .?„ , 8 2. ) M" - x MN i m 11=1' i SUWON 54. 10113141P 3315_ 10115 12 1.