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HomeMy WebLinkAbout10-11022 CITY OF ZEPHYRHILLS " 5335 - 8TH STREET 11022 (813) 780-0020 ANNUAL FIRE PROTECTION 'MAINTENANCE ° 7:,:,;fS.Z'ZVjfarSiiirifPrrll, 77' " ` � - Address: 4330 20TH ST Permit Number: 11022 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: N/A Est. Value: Parcel Number: 13-26-21-0070-07400-0000 Improv. Cost: . A Date Issued: 10/06/2010 Name: ZEPHYRHILLS CORP. Total Fees: 25.00 Address: 777 W. PUTNAM AVE Amount Paid: 25.00 GREENWICH, CT 068305091 Date Paid 10/06/2010 Phone: Work Desc: FPM SUPPRESSION SEMI- ZEPHYRHILLS WATER w .�, ,� - . _ a; ��;�� 1 . , �E;-4 ' I 5.10 ° rte C l2 l A - A anal 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." /i 11 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 530u 813-780-0020 City of.Zephyrhills Fire 0 /' b ZZ Fax - 813-780 -0021 Permit Application Date Received P one Contact for Perm �.:•,��a .. :.Y .: a. Owner's Name Z Pi-ri hI-4( LL S (A ) pa r Owner's Phone Number ) I I Owner's Address I Fee Simple Titleholder Name Titleholder Phone Number l I Fee Simple Titleholder Address Job Address LI 3 3 0 D 7-11 S i R f ■ Pei `f R ("k I -k. ,s 1^ L _ 3 3 53' . Lot # Sub Division Parcel # Bio -Hazard Waste Storage - ANNUAL I I Fumigation Tent n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL I Controlled Bum n Hood Installation I - 1 Emergency Generator < 30 kw n LP /Natural Gas - Installation I Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL iUtrlyI !Semi"' (ai Uther Sprinkler ❑ ❑ ❑ 17 Recreational Bum Fire Alarm n ❑ ❑ ❑ 1 1 Sparklers Hood Cleaning 17 ❑ ❑ ❑ 1 I 1 Sprinkler System Installations Hood Suppression I Standpipes (Sprinkler Sys) FT Fire Alarm Installation n Torch Roofing/Tar Kettle , n Fire Pumps I I Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL ) •I Valuation of Project Fuel Tanks Other: I Contractor 7/Y / - -- Company 54 f `( f fQ)h/ A/ Af Signature � S� t7 ✓S Registered Y/ N _ Fee Current I Y / N N Address I 1 License # ELECTRICIAN Company Signature Registered Y/ N I Fee Current I Y/ N j Address I I License* PLUMBER Company Signature Registered Y/-1\1 j Fee Current I Y/ N Address 1 1 License # MECHANICAL Company Signature Registered Y/ N Fee Current I Y/ N j Address License # I OTHER Company Signature Registered Y/ N Fee Current I Y/ N j 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 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 subject:to "deed ":restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for:compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has - hired :a or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. 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 to 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 2010 -2011 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9-30 -2011 FOLIO NO FACILITIES OR MACHINES ROOMS SEATS EM PLOYEES 0 0 0 20 RENEWAL 179817.0000 • H. WASTE TAX OCC. CODE BUSINESS TYPE SURCHARGE 280.065 FIRE EXTINGUISHER SERVICE /SAFETY INSPECTION /DATA PROCESSING 40.00 112.00 340.000 TRAINING I ; , y °q 40.00 30.00 • BUSINESS 3338 PORTER RD LOCATION LITHIA 33547 NAME STC INC DBA SAFETY TRAINING & CONSULTING MAILING PO BOX 5770 ADDRESS LAKELAND FL 33807 -5770 • BUSINESS TAX RECEIPT DOUG BELQEN, PAID - 7292 - 85 H13- 635 -5200 TAX COLLECTOR HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 07/16/2010 *** 182.00 IN BUSINESS, PROFESSION, OR OCCUPATION SPECIFIED HEREON. THIS BECOMES A TAX RECEIPT WHEN VALIDATED, POLIO COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT Na 25447 et ASS: A EXPIRES: 9/30/2011 OWNER 'NAME RICE, BENNtE R LOCATION. 2361 CHESTERFIELD CIR BUSINESS NAME AND MAILING ADDRESS LAKELAND CODE S T C INC ; ACTIVITY TYPE SAFETY TRAINING & CONSULTING 540000 LTD PROFESSIONAL TECHNICAL v,,,,,-1...0 c P O BOX 5770 LAKELAND, FL 3 3807 -5770 ,` , PROFESSIONAL LICENSE (IF APPLICABLE) • OFFICE OF JOE G. r / 'a /� * ��( /� * �KfiH COUNTY LOCAL F `DQER� { F{� T^it COLLECTOR TONSPOCUOSLY D SPLAYED AT THE BUSINESS TAX RECEIPT MUST BE BUSINESS LOCATION PAID- 4097531•0001 -0001 09/17/2010 09 f17/2010 PJN 412 3 SAFETY TRAINING AND CONSULTING