HomeMy WebLinkAbout11-11674 - CITY OF ZEPHYRHILLS !
5335 - 8TH STREET
(sis� �so-oozo 11674
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11674 Address: 6816 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0010-02400-0020
Improv. Cost:
Date Issued: 3/22/2011 Name: PIN CHASERS BOWLING
Total Fees: 25.00 Address: 6816 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/22/2011 Phone: (813)782-5511
Work Desc: FPM- HOOD QUARTERLY- PIN CHASERS
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Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fre
prevention and protection related activities such as inspections, pian 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 pertormed 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
FEB/20/20�7/TUF 11:10 AM ZEPHYPHILLS BUILDI(dG FAX No.813 P.002
`813�80'0020 Ciry of Zephyrhills�iC� Fax-813-780-0021 - • ��i�'
� - Permit Application �-•-• .. • �a:ic
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_Date R�ceivad . — �Pliorie Contact for pormlt -
• ,,.. � . �
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owna�sNama -- - — � Z 3�Q�' _..._
pwnar'sAddress a2 Io .�% .J .0 7 ` .3�2 �lv
Fee Slmple�'illeholder Name Titleholder Phone Number ���
Fee SlmpleTitloholderAddrase
Job Address � i.� l..-�'L-�S C � S ��lV . ` " 1 ' / " � Lot #i �
Subbivlslon ' Parcel #
� Bio-Hazard iNaste Storege -•ANNUAL a �umlga6onTent " ,
� Comm �ch�u9t Kitchen Hoodlbuct ' � Hezardoua Matedal (Tier II or RQ �aclUty) ANNUAL
� Con►rolled Bum � Hood InateilatJon
� Emergency Oenerator < 30 kw . � LP/Newrai Gas-Installation
�'�mergency Generator ��0 kw a LPINatural Gas-ANNUAL 3ale
� Flre ProtacGon Malntananca-ANNUAL � Places of.4ssemblY-ANNUAL � J .�� �
� �c em� � `� (1 �
Sprinkler a p ❑ ❑� � Recreational6um, � �
Fre Afartn '� D ❑ D�� � SparK�Brs -
Hood Claening � �� ❑ ❑ � � Sprinkler Syatem InstaOaiions .
• Hood Suppression �• Q CJ ❑� � Standpipaa (Sprinkler5ys)
' � Fire Alartn InatallatSon � � Torch Rooftng/Tar Kettle
F�re Pumpa ' � � Waeie'(1re StorageANNUAI..
Fire Warks
Flammabla Appllcaaorr ANNUAL ' Valua�ioll of projeCt '
� Fuef Tanks
� Other:
Contractor . Company
gfgnsture, Registered / N Fee Currant Y/ N �
AddreSe • License # .
ELECTRICIAN Compsny �
Signature Reglstered Y E N Fee Cumerct Y! N
Addres6 ucense # �
PLUMBER - Company �— �
Signature Regiater�d Y� N Fea Current Y/ N
Address � � Llcense #
MECHANICA� Company
Signature Reglstered Y! N Fee Current Y! N
Addreea -Llcanee # - �
OTHER Company • R ��
Slgnature Reese��md Y/ N �sa Current Y/ h)
Addraes • LlCenae #
blrecUons: � �
Flf out appllcaUon completaly.
Owner & CohtretloT e18n hack of appllCadon, notar¢ed (Of, copy of Slgned contraot whh owner)
1P over 52500, a Notlte of Cammencement Is requ�red.(Meeha�tcal work ovar $5000) •
Supply two (2} 9ete of drawings whh applicable documeMation �
Aliow 1 o-14 dHys for rovlew sftar aubmittal date. Parcel it - obtainad �Prom Property Tax fVo6ce (httpJ/appreiser.pascogov.com)
FEB/?_�/206�/TUE 11:10 AM ZEPHYAHILLS BUILDIPJG FAX No,813 P,003
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=�'���QTI:�E+C)'F:D�ED;R�STRICTlaNS: ?he.underslgned. may.be:subject;to�°de�d":r,estr.ictlo�t,��tr1
�. �:::� :. � �-: , - . Y : p� -- .'�'_'t�a
�,=z '�,vc;h;�h�err,ay°be•more•restricfive than County�regu(ations:_7he;�und�r.signed�assumes-re�ponsibiiit �or�om �ar���with�n r��+
�— :appllcable�deed restrictlons. " -�� `'�`�"�'���^�
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�17N1:IC•ENSED -CONTRlaCT.DRS �AND �CONTRpCTOR-=R�SF3C?NS1Bt�1�tE�S:=' ;If�the �owner has ' w ._� f: W^F'
.:contractors undertake work,�they may�be requlred'to be ilcensed in�accordance with state and local hf.the =
contractor is not }icensed as requlred .by law, 'both �the owner ;and contractor 'may .be cited'for :a �misdem�anvr ,violation.. - �
�.under�state law. If�the owner or intended�cantractor.are uncerfaln:as�to what licensing�requirements may:apply�for�the ��� -
infended •work,'the,y are�advlsed�to contact the •l�asco County:Building:inspection .Dlvision—Licenstng Sectlon:at 727=847
-.8009. =F.urfhermore, .if ttie owner has hired -a contractor or contractors, :he Is advised �to •have �the Contractor(s) �{gn
portlons of the "contractor Black" of thls applfcaiionfor which•xhe�y will be responsible. lf you, as•the owner�.slgn:as.the
�• �;coniractor,'that �may be an indlcation :that he is �not licensed.and is not ent3tled�to:perm�f��n9 �Arivileges in�:P.asaa =�� �,
.
-Gounty. �
=CONSTRUCT{ON _LI�N-LAW �(Chapter713,'�lorlc�a`Statutes, �s:amended): lf valuatlon�of work is'$2;500.D0 .or'mpre, :)
aertlfy �that l, "the appllcent, have been provided - with a copy .of �the °Florida Construction Llen Law-^Homeowner's
�F'rateckion Guide" prepared by'the Florida Department af Agriculture:and Consumer Affalrs. 1f the appflcant is �som�one .
other�than the'"owner",1 oertify that l have obtained.a copy of the-above desaribed document and promise in goqd falth�to I
deliver lt to the "owner" prior:ta commBncement.
GONTRACTOFt'.SI�WN�R'S �AFFlDAVIT: I certify that aii the informatlon In this applicafion Is accurate and ,
Y that all work will .be done in complian.ce with �ll applicable ►aws r�gulating constrvcifon, zoning and land
development. Application ls hereby made to obfaln a permit to do work and Installatlon as lndicated. 1 certify
thaf no work or installation has commenced prior to Issuance of a permlt� and�that �all work wlll be perFormed to
meet standards of all laws regulating consfruction, County and City codes, .zaning regulations, and lan8
development �ragulations in �the jurisdictlon. I.afso ce�Ify �that I understand that the regulafions of other
_ government agencies may apAly�to the lntsnded work, and that It is my responsibillty to identify what action5 I
must take'to tie in compllanca.
If i am�tha.AG�NT F0l2TH� OWNER, l p�omise in good faith to inform the owner of�the permftting conditions setforth in
thls afFidavit prlor�to�commancing �onstruction. l understand fhat a separate permit may.be required for efectrical work,
plumbing, slgns, wells, poa}s, air conditioning, gas, or other installations nof speclflcalty Included In tha applicatlon. A
permit issued shaA be construed to be a lic�nse to proceed with the work and not as authority to vialate, cancel, after, or
set aside any provislons of the�technical codas, nor shall fssuance of a permit prevent the �ullding Official from thereafter
requiring a correcklon of errors ln plans, construction or violations of any codes. �very permt� Issued shall become invalid
unless the work auttiorized'by such perm)t is commenced within six months of perrnit issuance, or if work aufhorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commanced. Ar� extension
may be requested, in wrlting, from the Sullding Official far a period no# to exceed nlnety (90) days and wlli demonstrate
justifiable cause for the extension: tf work ceases for ninety (90) consecutive days, the job is considered abandon�d.
''WARNINGT�'DWN�R: 'YOUR"�AILURETO RECORD A'NOTIC�'OF;COMM�NGEM�NT M;4Y=�REStJLT=lN�YOUR = - •
PAYINC TW10E �aR IMPROV�MENTS TO YQUR PRI�PERTY NTENDTO OBTAIN FINANCING, CONSULT
WITH Y UR L ND�R OR. N ATTORN Y B��OR� RECOR NG YOUR TIGE OF C) NCE NT.
FLORIPA JURAT (F.S. 917.03) � . � � ,.
�'`
DWN@3t GR AGHN'f CON7RAC �' ,
Subsc,Ylbad and swom to (or affirmed) before me thfs Subscdbad and swom tr� (or afflrmed i re e s
by — _bY
Whp islare ersorally known tc me or ha produced
Who is/are persohalty known to me or hasTha�e produced � ' a' ntificetion.
as identificstion_ •
NotHry Publia •
tJOtary Publ�c
Gommiesian No. Commission No.
Name of Notnry typed; printed or'stamped Name of Na�rY typed, pnnted ar s�mped