HomeMy WebLinkAbout10-11259 CITY OF ZEPHYRHILLS �/
• - 5335 - 8TH STREET
(813) 780 -0020 11259
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 11259 Address: 3751 LAUREL VALLEY BLVD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: RV PARK Lot(s): Block: Section:
Square Feet: Subdivision: MAJESTIC OAKS
Est. Value: Parcel Number: 24- 26 -21- 0030 - 00000 -0000
Improv. Cost:
Date Issued: 12/06/2010 Name: MAJESTIC OAKS LLC
Total Fees: 25.00 Address: 3751 LAUREL VALLEY BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/06/2010 Phone:
Work Desc: FPM- SPRINKLER QUARTERLY- MAJESTIC OAKS
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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."
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
' 313 =780 -0020 City of Zepnyrhilis`Fire ./�f' ; if 2,S 1 Fax- 313 -780 -0021
Permit Application
Date Received Phone Contact for Permit I
Owner's Name STMPT,FXCSR TNNFLL Owner's Phone Number 813 ( 626 1 15 4 8 2
Owners Address 4701. Oak Fair Blvd TAMPA FL 33610
Fee Simple Titleholder Name • ' Titleholder Phone Number
Fee SimpieTit[eholderAddress 1
; ,, K
Job Address X75) LAJ e.t \Jctttp,q �iVcL - zok,lyh•1RiS 4L U citz.. s
Lot
Sub Division Parcel 4
-, 7- "`:':a ..._.."rte . cam :. =ue r. mow, ..,-_ "
,�a- .v;,_�- ...�.,...�.z.. ,.,..... � ..... .e..- .... ...a,- _�.s��,.�.._.� �. - �.:.........���� �.�,^�`:�- _._:_tom:. . � , .. ,;��.:.:�=�-."'..- �Ta„`
Bio- Hzard Waste Storage - ANNUAL I Fumigation Tent
I Comm Exhaust Kitchen Hood /Duct 1 Hazardous Material (Tier If or RQ Facility) ANNUAL
Controlled Bum I Hood installation
F . Ernergency Generator < 30 kw 1 I . LP /Natural Gas - Installation
Emergency 30 -kw LP /Natural Gas- ANNUALSale a. 1 1
I. Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL ..
win giim IAnI j Other
Sprinkler, V .. ❑ O. - i ( Recreational Bum -
Fire Alarm - 1 ❑ ❑ ❑- [ , I Sparklers
•
' • ' Hood Cleaning 0 ❑ - ❑ I Sprinkler System instailations •
_: Hood Suppression - - .F7 0 0 -0 i ( .. .. I I ., Standpipes (Sprinkler Sys);. •
Are Alarm installation " " - Torch Roofing/Tar Kettle
1 , i • Frre Pumps 1� . Waste Tire Storage ANNUAL
I I Fire Works • , • '
I '• I F[amrnable Application- ANNUAL f I Valuation of Project
I I . Fuel Tanks
I.....i Other: 1 •
E•za � = mkt– . , • . w. - � :- � : ss• - - ., -- -. .. rz _ . -.� _. -: t _� =:°rte- --n• •
Contractor —` / Company A � <Ya"' � Kfn.v�- t( �- .k
Signature l Registered Y / N Fee Current • Y / N I •
• Address 1 - . •• . _ I, License # i •
ELECTRI-;':Y Company . - .
• Signature - Registered • .Y 1N : "Fee Current Y / N I r
1 1 . (
Address I License # i E
.PLUMBER• :. Company
Signature Registered Y / N m 1 Fee Current Y /14.'i I" -
Address 1 . - - • License # - • -
MECHANICAL • Company -
Signature Registered Y/ N I Fee Current Y / N
. Address I,:...; . ' - 1 License # I 1
OTHER - Company .
Signature Registered Y / N - I Fee Current 1 Y / N
Address - License # 1
- ,.: . _ - =:-...--, ,.. _ -.. =1710_ __.,R. - u.. . ..,-• - -,- -
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 4- obtained from Property Tax Notice (hftp: / /appraiser.pascogov.com)
•
'NOTICE OF -DEED RESTRICTIONS: 'The undersigned understands.that this permit may_be•subject to `deed" estrictions"
which may be mare restrictive than County regulations. i he- undersigned assumes responsibility for:compliance with any
_applicable deed restrictions.
UNLICENSED 'CONTRACTORS AND - CONTRACTOR RESPONSIBILI T [ES: 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 :a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as what licensing requirements may :apply for the
intended work, they are advised to contact the-Pasco County Building [nspection 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 which will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not property 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 bythe 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: • 1 certify that all the information in this application' is accurate and
that-all work will be done in coripfiance 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. -1 certify
that no work or installation has commenced prior to issuance of a permit and all work will be performed to
meet standards of all laws' regulating construction, County and City codes, ..zoning regulations, and and
development regulations in the jurisdiction. 1 also certify that I understand that the regulations of other
. government agencies may appl•to the intended work, and that it is my responsibility to identify what actions 1
must take to be in compliance. .
'if I °am the AGENT FOR THE OWNER, 1 promise in good faith to inform the owner of the permitting _conditions set forth in
- this poor to co min encing- construction...:: IT_ understand thai';_aseparate 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 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 shalt.becorde invalid. . ,
uhless 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 "Or COMMENCEMENT MAY: RESULT IN, YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBT• N FINANCING, CONSULT
WiTH YOUR LENDER OR'AN ATTO BEFORE RECORDING YOUR NOTICE " Cc e ENCEMENT.
FLOR(DAJURATS O 117.x• `
AV WNE OR A
/ CONTRACTOR s/_
Subscribed and sworn . (or . • r• ed) before me this Subscribed and s om to or - ''imed) before me this'
by- by
Who is /are personally known to n'ie 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