HomeMy WebLinkAbout10-11082 CITY OF ZEPHYRHILLS
5335 - 811 STREET
(813) 780 -0020 11082
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11082 Address: 7306 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: 3 5 - 25 - 21 - 0010 - 08800 - 0000
Improv. Cost:
Issued: 10/25/2010 °� ° " "'Name: - �- ����,,�
TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN STATE RD
Amount Paid: 25.00 BALA CYNWYD, PA 190042102
Date Paid: 10/25/2010 Phone:
Work Desc: FPM- SPRINKLER QUARTERLY TOWNVIEW RETAIL LLC
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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 $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
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/SAY
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041
813 -780 -0020 City ofZephyrhills Fire-
r61,- rex- oi riov -��ci
Permit Application
Dat+A'Received
• for Permit s7
Phone Contact y (� ` 1
Owner's Phone
1700 v41EtJ itenNlt (....4.4. I --
Owner's Name
Number I I 1 I l
Owner's Address 1 12 j •OvitS).f011.0cC7 S T7}ygttS PAZA G4 4 4.34a pp I4DD92.. 1o Z
Fee Simple Titleholder Name Titleholder Phone Number 1 l
Fee Simple Titleholder Address
Job Address / 10(9 G Pte-C.- ra...V.D Z tEh1r02641u. Pt- Lot #
Sub Division e rTh tiC ma c,. Parcel # 3S ZJ 7 1 ' Oib i O ' Q$,rpo • ape,
ED Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent
n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
Ej Controlled Bum n Hood Installation
Emergency Generator < 30 kw n LP /Natural Gas - Installation
H n Emergency Generator> 30 kw
LP /Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
(LIf !Semi] Da' Uther
Sprinkler I ] o ❑ ❑ n Recreational Bum
Fire Alarm ❑ ❑ ❑ I 1 n Sparklers
I I
Hood Cleaning ❑ ❑ ❑ I I n Sprinkler System Installations
Hood Suppression Ej ❑ ❑ ❑ ( I n Standpipes (Sprinkler Sys)
n Fire Alarm Installation n Torch Roofing/Tar Kettle
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL
' .00 Valuation of Project
Fuel Tanks
0 Other: I
WINNISIffifillin /
Contractor S T - r
", Company laoppy. r-AttS 'SP2>,A 1I1L • I
Signature 14111112 Registered Y/ N j Fee Current Y/ N J
Address 1 License # I4 a ea bz.04,30119S'
ELECTRICIAN Company
Signature Registered Y/ N j Fee Current I Y / N I
Address I I License # I
PLUMBER Company
Signature Registered Y/ N I Fee Current Y/ N J
Address I I License # I
MECHANICAL Company
Signature Registered Y/ N 1 Fee Current I Y/ N J
Address I I License # I
OTHER
Company
Signature Registered Y/ N j 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 (httpJlappraiser.pascogov.com)
DEE
D RESTRICTIONS: The undersigned understands that this ssumes responsibility for:compl a
which may any
which may y be more restrictive than County regulations. "The undersigned
applicable deed restrictions.
UNLICENSED CONTRACTORS .AND °CONTRAe��o be RESPONSIBILITIES:
licensed i6 ac i co E dance whth state and local-regulations. meanorriolation
contractors so undertake wo tquy may be,requi
apply
for the
contractor state is not licensed o n r or intended cone the owner and contractor
uncerta n as to what licensing r quiremen may :
unenr d w law. If the owner or I
Buildin Inspection Division — Licensing Section at 7.27-847 -
intended work, they are advised to contact the Pasco County 9
Furthermore, if the owner has hired .a contractor oh co tract be responsible. e is advised i e the co owner r sign sign
p009. application whl Y
portions of the "may be Block" of this that he licensed and is not entitled permitting privileges in Pasco
contractor, that may be an indication that he is not properly
County.
CONSTRUCTION LIEN LAW (Chapter713, Florida Stat _a of the amended): If valuation
Constouctlon work is
en $ 5 or more, I
CON applicant, have been provided with copy applicant is me omeone
Protection that I, the app' promise in good someone
to
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the app
other than the "owner ", I certify that I have obtained a copy of the above described document and p
deliver it to the "owner" prior to commencement.
llcation is accurate and
CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this app
that all work will be done in compliance with all app
licable laws regulating construction, zoning and land
development. Application is hereby made to obtain issuance of a do work and permit t and l all t work will performedto
that no work or installation has commenced prior to and City codes, zoning regulations, and
la
meet standards of all laws regulating construction, County and
I under zo at the regu of other
development regulations in the jurisdiction. I also certify
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.
the A GENT FORTHE OWNER, I promise in good faith
t iform the owner of the
permit may be permitting required conditions set forth in cal work,
t i am construction. I understand llcation. A
this affidavit prior to commencing as, or other installations not specifically included in the app'
plumbing, signs, wells, pools, air to be a conditioning, g
' issued shall be construed to be a license to proceed h of a pemi�-preventthehBtt{ ding Offic - -from thereafter
permit a any -- — —
set aside any provisions oath exec ticaTco— nides, "nor st�att issuance
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
work authorized by such permit is commenced within six
after the time the work is commenced. An extension
s
unless mew (90) days and will demonstrate n
the permit is suspended or abandoned for a period. of six (6) months
may be requested, in writing, from the Building Official for aperiod secutive days, the job is considered abandoned.
justifiable cause for the extension. If work ceases for ninety ( ) 'OF'COMMENCEMENT MAY RESULT IN YOUR
WARNING OWNER: YOUR FAILURE TO RECORD A NOTICE G YOUR NOTICE OF COMMENC
PAYING TWICE FOR IMPROVEMENTS T TO YOUR PROPERTY. IF YOU I TO OBTAIN FINANCING, CONSUL T
WITHD , OUR LENDER o OR AN ATTORNEY BEFORE RECORD
FLORI
CONTRACTOR
OWNER OR AGENT before me this Subscribed and sworn to (or affirmed) before me this
Subscribed and sworn to (or affirmed) by
by Who is/are Wally known to me or has/have as identification.
Who i _personally known to m as dentification
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, Printed or stamped
Name of Notary typed, Printed or stamped