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Home My WebLink About11-11757 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (sis) �so-oo20 11757 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 11757 Address: 5950 12TH ST Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book: Proposed Use: NOT APPLICABLE tot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-2 6-21-0010-01800-0010 Improv. Cost: Date Issued: 4/08/2011 Name: ZEPHYRHILLS MASONIC LODGE Total Fees: 25.00 Address: 5950 12TH ST Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/08/2011 Phone: Work Desc: FPM-SEMI ANNUAL HOOD SUPPRESSION FOR ZHILLS MASONIC LODGE Y � 5. � ' �1�� .,2 2' �� . J; , 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 activi without an a inspection shall be charged double permit fee per day of operation or a minimum of $100. 0, whichever i sgreater� 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." �.. PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSP �pN OFFICER CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED 2EPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 r's-�so-oo2o City of Zephyrhills Fire Permit Application Fax-813-780-Op21 Date Received . t Phone Contact for Pertnit �� Owners Name �� Owners Phone Number Owners Address Fee Simple Titleholder Name � � � Fee Simple Titleholder Address Titleholder Phone Number Job Address � 1 — j� �"7D� � � Sub Division Lot # � Parcel # � Bio-Hazard Vyaste Storage - ANNUAL � ' � Fumigation Tent Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Bum � Hood Installation Emergency Generator < 30 kw � � Emergency Generator> 30 kw �P/Natural Gas-Installation � Fire Protection Maintenance - ANNUAL � �P�Natural Gas-ANNUAL Sale � Places of Assembly-ANNUA ��l� � ❑ rTy emi � er ' / � • I Sprinkler � � � ❑ � ❑ Recreational Bum Fire Alartn � � � ❑ �� Sparklers Hood Cleaning p � � �� ❑ � �� Sprinkler System Installations Hood Suppressian � � Standpipes (Sp�nkler Sys) Fire Alarm Installation � � Torch Roofing/Tar Kettle Fire Pumps � � Waste Tire Storege ANNUAL Fire Works � Flammable Application- ANNUAL � Fuel Tanks Valuation of Project Q Other: Contractor Signature Company ` j�o� U �, 7 �� , � GG � Address Registered Y/ N Fee Current Y/ N ELECTRICIAN License# Z�G,�y�p�G—�—I Signature Company Address Registered Y/ N Fee Current Y/ N PLUMBER License # r 3ignature Company Address Registered Y/ N Fee Current Y/ N �AECHANICAL License # iignature Company Address Registered Y/ N Fee Current Y/ N )THER License # ignature Company Address Registered Y/ N Fee Current Y/ N irections: License # Fill out application completely Owner & Contractor sign back of application, notarized (Or, copy of signed contrect with owner) If over $2500, a NoGce 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 h //a raiser.pascogov.com) � ttP� PP NOTICE OF DEED RESTRICTIONS: The �e ula ons. The undersig ed a umes esponsibilbty for compl ance w'th any which may be more restrictive than County g applicable deed restrictions. UNLICENSED CONTRACTORS AN bON q� o be Ecen !Bac th s ate and ocae egulati sc If contractors to undertake work, they y contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor under state law. If the own sed to the Pasco C unty Buading D v s onr c s ng Section at 27-847- intended work, they are advi 8009. Furthermore, if the owner has hiredlicationtfortwhch theyrwill�be esponsableelf the owneasign as the portions of the "contractor Block" of this app contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in asco County. Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I CONSTRUCTION LIEN LAW (Chapter 713, of the "Florida Construction Lien Law—Homeowner's certify that I, the applicant, have been provided with a copy Protection Guide" prepared by the Florida Department of A�gf �{he above descr bed document nd prompsean fa th to other than the "owner", I ce�tify that I have obtained a copy deliver it to the "owner" prior to commencement. _ CONTRACTOR'SIOWNER'S A om��ance . with al applicalbleeawsr egu'latingtconstuaton� zon ng and land that all work will be done P development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has cu a nenconstrluctions County�a d Cry g regulat'ons, andeand meet standards of all laws reg 9 development regulations in thi to�t workcand thaai s my eespons bi ty to t what act ons I government agencies may app y must take to be in compliance If I am the AGENT FOR THE OWNER, �u tion1 de�stan that a�separat permit may be req u ed for I electrecal work, this affidavit prior to commencing const plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. permit issued shall be construed to be al codesenor shalee sua a pe mit�prevent the ding Officeal from thereafter set aside any provisions of the technic requiring a correction of errors in plans, cons 5 r commen e within s z onths of perm t p sua o aif wo authorized by un less t he w o r k a u t h o r i z e d b y s u c h p e r m i t the permit is suspended or abandonhe Bui d n al fosa per'o oeto h xc t n nety r (90) days and will demonstrate may be requested, in writing, from t 9 justifiable cause for the extension. If work ceases for ninery (90) consecutive days, the job is considered abandone . WARNING TO OWNER: YOUR FAILURE T OUR PROP RTY TIF YOU INT�END TO OBTAIN F NANC NGTCONSULT PAYING TWICE FOR IMPROVEMENTS TO Y 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 knovm to me or has/have produced Who isjare 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