HomeMy WebLinkAbout11-11462 CITY OF ZEPHYRHILLS '/
5335 - 8TH STREET 11462
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11462 Address: 6907 DAIRY RD
Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02 26 - 0010 - 01000 - 0000
Improv. Cost:
Date Issued: 1/28/2011 Name: CITY OF ZEPHYRHILLS
Total Fees: i - Address: 6907 DAIRY RD
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: Phone:
Work Desc: FPM - ANNUAL FIRE SPRINKLER FOR ZEPHYRHILLS FIRE STATION #1
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- , inal
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." "VP
Ai
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 =r 80-0020 City of Zephyrhiffs'Fire:
Fix- 313 -7a0 -0021
Permit Application
Date Received
Phone Contact Permit t
Owner's Name S TMPT,FXGR TNNFT,T, 1 Owner's Phone Number 1 81 3 1 1 626 1 5482
`
Owner's Address 1 4701. Oak Fair Blvd TAMPA FL 33610
•
Fee Simple Titleholder Name I • - I Titleholder Phone Number 1 J
Fee SimpleTitleholderAddress I
-
Job Address
Ili IP, le .` g•('€. I .; ME Let I
Sub Division
Parcel
. I ,I Bio- Hazard Waste Storage- ANNUAL Ii Fumigation Tent
Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier If or RQ Facility) ANNUAL •
I . • Controlled Burn I I Hood Installation
' I ` ` I' Emergency Generator < 30 kw I I LP /Natural Gas- lnsfallation
Emergency Generator> 30 kw ' I I LP /Natural Gas - ANNUAL Sale
•
Fire Protection Maintenance - ANNUAL - I I Places of Assembly- ANNUAL ..
. lCftriyl isemi( g
Sprinkler, ❑ ❑ ►,. I I Recreational Bum
Fire Atarrii • ' . I 1 ❑ ❑ ❑- I , 1 : 1 1 Sparklers 1
' - Hood Cleaning I 1 ❑ ❑ ' ❑ I I 1 "1 Sprinkler System Installations •
' �
Hood Suppression O � - -
H ❑
- I I .. .1 . es (Sprinkler Sys)
f • Fire Alarm Installation -
T rch Roofin g(i`ar Ketfle` `
�, Fire Pumps • • I 1 - Waste The Storage ANNUAL
j , ...1: 'I' Fire Works •
I . I. Flammable Application- ANNUAL
I ( Valuation o ject
f Pro
F uel Tanks
I Other .. . ..
Contractor
Company -<, - -, .,,� >,.., . R;P` 4�,.�` �:.:>x -, a€
Signature I 3 cell- i �, 'S c. C
I Registered Y / N • Fee .Current • Y / N
Address I
License #
ELECTRICIAN • . „ ` Company
Signature ( Registered ' Y / N Fee C
un-ent Y / N I
Address I I :
. r
. License # I I
PLUMBER Company • Signature - Registered Y / N : F
I F e Current Y / N;' I: •
Address I I License # . I ' I
MECHANICAL - Company
Signature Registered I Y / N j Fee Current
• i
. Address .. . License #. I I
Y / N
f, f
OTHER I Company
Signature ! Registered Y / N J Fee Current 1 Y / N
Address I
Di " � «: _ License
rections: . -.. -� ,,,,-. - =, -•� ,.: = s
x,
Fill out application completely. '
_ __ _ Owner & Contractor 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 -
AI[oJ 10 -14 days for review after submittal date. Parcel 4- obtaind from Proper y Tax Nofica h f /(a
( p: ppraiser.pascogov.com)
•
'NOTICE OFIDEED RESTRICTIONS : i he -t re (a(igons -Chunderstands and signed ssumes r , spans�.b responsibility for�:comp!
which may be more restrictive than Coun nc� with any -
County g
.applicable deed restrictions.
UNLICENSED `CONTRA�ooR��AmDyC a be licensed in If
accordance with state ate and (ocaliegu{ationact�tr�oQ -
contractors is undertake Y
contractor (s licensed as required ded or are uncertain as to whatrlcenbsi cited-for
- requirements s may apply for
under state law. If the owner or _
intended work, they are advised to contact has hired _a the-Pasco B
contractor orco torsF ne Ps Ddvised 'to i havenrghe c o actar(s} g�gn
portions Furthermore, if the owner n
portions of the "contractor Block" of
this that Pe is not pr licensed d be is not entitled-to Pasco
contractor, that may be an tndtcatt
County.
CONSTRUCTION - LIEN LAW (Chapter71 Florida Statutes, - a amen
me d e o i f C anon of
on Lien Law is or o,
certify that 1, • the applicant, have been provided with a copy of
is someone
Protection Guide" prepared by Florida Department of Agriculture tneabove d s�r(bed docum and prOmrs. If the faith to
other than the owner , 1 certify that I have obtained a copy of
deliver it to the "oNmer" prior to commencement. ..
• CONTRACTOR'SIOWNER'S- AFFIDAVIT :• ( certify that all the information in this application' is accurate and
that all work w((1 li done in co cation is hereby plmade with all
a permit to laws do Work and 9 Construction, n dicat d..1 certify development. Appli
that no work or installation has commenced prior to issuance of a and p mit and d zo work will be performed rfo d land • meet standards of all laws regulating construction, County City
development regulations in the jurisdiction. 1 also certify that I understand that the regulations of other •
. government agencies may apply the intended work, arid that it is my responsibility to identify what actions 1
must take to be in compliance. ons set (fl ;am the AGENT FOR THE OWNER I promise- in good faith
that past permlti r ma p be__re t g ed for l e(ectr cai work ;, _,_ _ -_
- .. -tE �ls °affidavit -- prior -to commencln coristrucf(on_,...[.un e.rs. n
plumbing, signs, wells, pools, air conditioning,• gas, or other installations not specifically included in the application. A
pe, cancel, alter, or
rmit issued shall 6e to be a license to proceed
with
a permi�p prevent the Official from thereafter
set aside any provisions of the technical codes, nor shall
requiring a correction errors s plans; m i t violations any codes. Every
months of permit permit
issuance, u or d if w autho by
unless y
m work authorized
t nded r by such d fm
May pbe e is esspenn writing; or aba om the Buildi peridd cif t (6) months pfter the time
Offic al fora period not to the
nety days and will demonstrate
niay ab re le c au s o; i h e _ from
justifiabause 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
IF YOU INTEND TO ME N F IN =
WAR .....
P A Y t.. . . C= FOI2 [MPROVEMENTSTO YOUR PROPERTY. • BEFORE RECORDING YOUR NOTIGE !' C!1 11: ENGEMENT, .
1iV[TH YOUR (:ENDER. OR' AN ATtO' '
FLORIDAJURAT(FS.117. ' ar- a .
CONTRACTOR te .
bW Subscribed and om
to or timed) before me the g rid sy ern (or - r . ed) before me this — _ -
by Who is /are personally known to me or hasthave produced
Who is/are P personally known to nia i enfic has/have produced - as identification.
as identifica5on.
_ Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed; Printed or stamped
Name of Notary typed; printed or stamped .