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Home My WebLink About10-11017 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 1 '017 ANNUAL FIRE PROTECTION MAINTENANCE mintmilti ;TT 4- Permit Number: 11017 Address: 5017 GALL BLVD 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: 11 26 - 0010 - 20800 - 001 . 0 Improv. Cost: " `` ° `� : �� '��- Date Issued: 10/05/2010 Name: HUFFMAN CARLYLE & BARBARA Total Fees: 25.00 Address: PO BOX 251 Amount Paid: 25.00 CRYSTAL SPRINGS, FL 33524 Date Paid: 10/05/2010 Phone: (813)783 -8098 Work Desc: FPM - SUPPRESSION SEMI- BARBS RESTUARANT x s tom. - i 25.00 1711S'Q— / 0 A - 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." 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 813a80-0020 City of.Zephyrhills Fire Permit Application Fax- 813 - 780 -0021 Date Received " ... ,w,, -, Contact for Phone orPerrrnt � „.;,� Owners } .R.?OS ILiStsy. Zr lfc� S�r'N _ ,... .A.,.,.. Name T Owners Phone Number 1 /3 112P I7 I ?O zp I Owner's Address Sa/ 7 Goo - Lc- '3L Vb ,Z,e // AL. I Fee Simple Titleholder Name I I 1 I I Titleholder Phone Number Fee Simple Titleholder Address I :;, 5 ai, a E ,. GE M a : 5 . k C a w. I ` 1�9.'.” �k ,..,e.:iY:'aa,&;*�...x :a.;. ,�.,s".3..,,:..3i; Job Address I I Lot # Sub Division I Parcel # I m Bio- Hazard Waste Storage - ANNUAL h f I Fumigation Tent Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL n Controlled Bum Hood Installation n Emergency Generator < 30 kw LP /Natural Gas - Installation Emergency Generator > 30 kw = LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL 1 ' Places of Assembly- ANNUAL IQtrly� emi �iR l Other Sprinkler ❑ ❑ ❑ n Recreational Bum Fire Alarm n ❑ ❑ ❑ I I Sparklers Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations Suppression Hood Su �, I pp EZ ❑ X ❑ I I n Standpipes (Sprinkler Sys ) Fire Alarm Installation Torch Roofing/Tar Kettle n F Fire Pumps = Waste Tire Storage ANNUAL n Fire Works n Flammable Application- ANNUAL I 1 F Valuation of Project Fuel Tanks 0 Other: I w. � ?c ex's MITM "S€x:? ATZMAZE T EMLIMMIZZEMSa3 a�.4 > -;. -. ' ' - NMA..'D ,., . - t,. �"` ',. ...".: ..��:> °.;' ' •::< z':: zraT { Contractor ._��.:_; Signature I Company I Registered I Y/ N I Fee Current 1 Y N Address I License # I ELECTRICIAN Signature I I Company Registered Y/ N I Fee Current I Y/ N J Address I PLUMBER License # I I Signature Company I Registered Y/ N I Fee Current I Y/ N I Address MECHANICAL 1 License # I Signature Company I Registered Y/ N . 1 Fee Current 1 Y/ N Address OTHER I License # Signature I Company -Seeurrr ,C E me LZe I Registered Cy/ N I Fee Current I ('i N I Address .. k�... ,tea ..�.. , License # j: /99. e Directions �. ca � , a">1. :, > aar.&eva�.u�, :�a: s €�' per ,. -.=�Ea ., 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) which NOTICE m OF more re st STRIeTt a C unty regulations. The undersigned assumes - esponsib assumes-responsibility-for-compliance ance w th any may be more renctiv applicable deed restrictions. UNLICENSED CON a RA WO OR he y m a y b required to be RESPONSIBILITIES: c acodance with state and hired a egulations contractor or Ifthe contractors to and contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanorvi under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply intended work, they are he o to r has hi ed contractor County he is Division—Licensing d advised to have he cunt actors) sign 8 Furthermore, if the o co of tha "contractor that may be an indication that he is not properly licensed will ands not entitled to permitting privileges gn Pasco contractor, e l County. CONS that I, the e LIEN LAW ha h e p b een provided wh Statutes, py of amended): "Florida Construction ction Len $2,500.00 Law—Homeowner's owner's certify ect ion Guide" p I, the rep a r ent, is someone Protection prepared by the Florida Department of Agriculture e above described Affairs. and promIf the faith h to other than the "owner ", I certify that I have obtained a copy of 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 the AGENT FOR THE OWNER, construction. understand that a forth in promise in good faith to permit may be required ed for conditions electr ca this affidavit l work, this affidavit prior to commencing plumbing, issued shall be con wells, onstr air ued to be a license to proceed ewith installations not and not as authority hority to violate, can application. l, lter, or permit issue sstr set aside any p of r the in plans, technical on or violations of any codes. Every t perm t issued Official hall become invalid requiring a correctioh of errors in unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by m a permit is es ted, in d or g, from abandoned he Building io Offi Official for 0 a period not to exceed t n ninety days and will demonstrate may be requested, i the ea te n from justifiable cause for th extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE IF YOU INT TO OBTAIN F NANC NGTCON PAY TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) CONTRACTOR OWNER OR AGENT Subscribed and swom to (or affirmed) before me this Subscribed and swom to (or affirmed) before me this by by Who is/are personally known to me or has/have produced Who islare personally known to me or has/have produced as identi fication. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped