HomeMy WebLinkAbout11-11871 , CITY OF ZEPHYRHILLS L /
• 5335 - STH STREET
(si3)�so-oo20 11871
LP/NATURAL GAS PERMIT
Permit Number: 11871/11739 Address: 7952 7954 GALL BLVD
Permit Type: LP/NATURAL GAS ZEPHYRHILLS, FL.
Class of Work: FIRE-LP/NATURAL GAS Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ZEPHYR COMMONS
Est. Value: Parcel Number: 35-25-21-0010-00700-0000
Improv. Cost: 1,800.00
Date Issued: 5/16/2011 Name: ZEPHYR COMMONS LLC
Total Fees: 125.00 Address: 3629 MADACA LANE
Amount Paid: 125.00 TAMPA FL 33618
Date Paid: 5/16/2011 Phone: (813)927-0011
Work Desc: INSTALLATION GAS LINE FIVE GUYS
5 . 5 .00
FIRE INSPECTION FEES 25.00
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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
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT W TH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YO OT E OF MENCEMENT."
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CONT A URE I IC R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
� a�3��so-oo2o City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received � Z� Phone Contact for Permit � �7 b�
Owner's Name � Owner's Phone Number �� �
Owner's Address
Fee Simple Titleholder Name Titleholder Phone Number �� �
Fee Simple Titleholder Address
✓ � Job Address L / / Lot #
Sub Division Parcel #
� Bio-Hazard Waste 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 � LP/Natural Gas-Installation
� Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale ��/
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL i //
r y emi �n t er y� �
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Sprinkler � ❑ ❑ ❑ � Recreational Bum '
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
� Fire Alarm Installation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� FlammableApplication-ANNUAL Valuation of Project
� Fuei Tanks
� Other•
Contractor Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
ELECTRICIAN Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
PLUMBER � � �. _ / ,,. y- Company (� f
Signature .�� �� Registered Y/ Fee Current Y/
Address � j — j�7'f'j � License # '�y �
MECHANICAL Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
OTHER Company
Signature Registered Y/ N Fee Current Y/ N
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 10-14 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 contractor 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 (Chapter 713, 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)
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OWNER OR AGENT CONTRACTOR -/GC�
Subscribed and sworn to (or affirmed) before me this Subscribed and n to (or affirmed) before me this /� yfJ y
by by
Who is/are personalfy known to me or has/have produced Who js/are personally known to me or s/have produced
as identification. / ryti�� ���3t�tJp�ntification.
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Notary Public �• � '�' � • Notary Public
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Commission No. Comm'ssion No �: ��� :*=
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Name of Notary typed, printed or stamped Name of Notary typed, prinT � '��t,,�
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. �`��1C%ll e p s! 111�6�\i
° McNatt Plumbing Co., Inc.
CFCO 45185
5800 E. Broadway Avenue
Tampa, Florida 33619
(813) 971-6100 (800) 601-9759
Fax (813) 975-0410
LETTER OF AUTHORIZATION
Effective Date: �/��� �
Company or Municipality � �e � � `
Address
This is verification that the individuals listed below are duly authorized agents of our
firm and are hereby authorized to execute SECURING LICENSES AND/OR PERMITS
on behalf of JOEL MCNATT OF MCNATT PLUMBING CO., INC.
Agent's Printed Full Name
� �y� G/��l%
License Holder's Signature ' " -������� �'�`''
License Holder's Printed Name ��L ���'�� � 7 / `' �'� � S'
State of /"L G' �'"�iC! �
County of �i������� � �
The foregoing instrument was acknowledged before ine this , day of
_. _ � __-__ -2011, by �OeL- ?i���y��''�r �who is
� '�� ' �• •� • �0 �ir
� personally known to m�}�or (w o has produced �` : p �,M�SS�p,y •., � as
Identification) and y�o (did ' not) take an oath. +=* ;%.��0'°`u ,�,� �:. ;
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Notary Public �� � � � `,� �� � � � aQ�
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Printed Notary Name �� y' faJv/� �� ��� ��� �e°��
Lephyrhills Fire Rescue
6�)O7 Dairy Road, Lephyi•hi(]s, F1_� 335�42
I�ire Marshal F3us (813) 780-0041
Kerrv 13arnetl Fax (�31 �) 780-U0�4
y E-mail: kbarnett(a).fire.Lephyrhills.tLus
Plan Review #: 1 1-052
Project: Natural Gas
Number of Pages: 1
May 13, 2011
t have received and reviewed the plan for the installation of natural gas located at 7954 Gall Blvd
and will allow the project to move forward. Paying for permit, contractor acknowledges
complying with the comments listed below. Should anyone have any questions, please do not
hesitate to contact the Fire Marshal's office.
1. Ensure gas is installed in accordance to all applicable codes and/or standards.
2. Install bollards if gas meter is in a location subject to damage from any type of
motorized vehicle, including riding mowers.
3. Label all exposed pipe as natural gas either by color code or placarding. Labeling
shall be every 10 feet.
4. Automatic gas valve for cooking equipment shall not be located above ceiling.
Inspections Required:
1. Rough in pressure test
2. Final
KERRY BAR TT, F1RE MARSHAL
***Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance with applicable fire safety codes. This review is not intended to be a final approval of the
submitted plans. It is tl�e contractor's sole responsibility to ensure that the plans are in complete compliance
with all applicable NFPA codes and local ordinances. In the event that further examination or site
inspection reveals areas of non-compliance, it shall be the contractor's sole responsibility, at their sole
expense to bring tliose areas in compliance. The City assumes no responsibility for the contractor's failure
to be in compliance with all applicable NFPA codes and locat ordinances.
ZE��YRHILLS FIRE DEPARTMENT
69Q7 Dairy Road, Zephyrhills, FL 33542
Fire Chief Ke��h Witliams Bus {813)780-0041 Fax (813)780-OOd4
FIRE SERVICE USER FEES
Occupancy No.:
Plan No.: Contractor: A-_
Business Name: '�✓t � Billing Address: % c��-- /�-
Business Address: � � �''� �'� �'
Business Phone No.� Billing Phone No.:
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
8 Site Plan N!C Annual N/C Sprinkler $50 1stAlarm N/C
Multi-Family/Commercial 06 sf 1 st Re-inSpeCtion N!C Standpipes $50 2nd Ale�m N/C
(Minimum Charge $25.00 2nd Re-inspection $100 Fire Pump �50 3rd Alarm N/C
� Plan Revisions OBL 3rd Re-inspection $250 Hoods 350 4th Alarm $100
4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150
SPRINKLER SYSTEMS (Business closed uMil LP Gas 350 6th Atarm E200
8 0- 25 Heads � VIOIatWI1s COREC�2d� Natural Gas �;� NON COMPLIANCE $150
26 plus Heads $100 SPRtNKLER SYSTEMS Fuel Tanks- �r m�k
STANDPIPE SYSTEM Hydro Undergrounds 345 Sparklers $100
� Per Riser 350 Hydrostatic Test a65 Persyscem Fire Works $500
FIRE PUMP Acceptance Test S45 �rgrstem Camp Fire 325
� Per Pump 3100 Hydrant Flow $75 Controlled Burn 3100
FIRE ALARM SYSTEM Hood/Duct S50
8 0- 25 Devices S50 FIRE ALARM SYSTEM Place of Assembly SSO Annual
26 plus Devices $100 System Acceptance 350 Fire Protection $25
SUPPRESSION SYSTEMS Recall ACCepta�ce 350 Flammable Application 350 Anaual
W $50 OTHER Waste Tire Storage S50 n��Wi
pry $50 Fire WalUSmoke Wall $15 per wau Generator < KW $100
CO2 $50 LP Gas $25 Per Wnk Generator >30 KV1/ 150
Other $50 Naturat Gas 25 �� Sy�m Bio-Hazard Waste $100 Annual
KITCHEN EXHAUST Fumigation Tenting 350
� Haod/Ducts $50 Terd 10'x10' or greater E1 S per tent Torch PoVApplied $50
OTHER Fire Pump $45 Haz. Materials $100 a���si
LP Installation per tank b50 Fire Suppression 330
Fuel Tank Installation $50 System Acceptance
(Per Tank} $50 8 Exhaust Hood/Duct 330
atural Gas Installation $ Re-inspection DBL
(PerSystem) � (otherthanannua�)
Sprey Booth $50 � Inspection scheduled DBL 8
and cancelled less than
24 hours
Construction Insp. N/C
Emergency Vehicle Ac FALSE ALARM
PLANS TOTAL� INSPECTION TdTAL� PERMIT TOTAL TOTAL�__ _�
GRAND TOTAL �
Comments:
Date: J I' L
Insq��ctor: � d �