HomeMy WebLinkAbout11-11995 CITY OF ZEPHYRHILLS
" 5335 - 8TH STREET
(si3) �so-oo20 11995
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11995 Address: 7813 7833 GALL BLVD
Permit Type: FiRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 34-25-21-0150-0000-0010
Improv. Cost:
Date Issued: 7/18/2011 Name: KOB PROPERTIES LLC
Total Fees: 25.00 Address: 38068 DAUGHTERY RD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540
Date Paid: 7/18/2011 Phone: (813)782-5600
Work Desc: FPM- SPRINKLER QUARTERLY- 1 RISER - CONCIRE
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Chapter 633, Florida Statutes, authorizes the City to charge and wllect 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 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
a�s-�8o-002o City of Zephyrhills Fire
Permit Application Fax-813-780-0021
Date Received
� ��s . ,, _ , W _ ^ , , Phone Contact for Permit
Owner's Name � �� - � � ,t.,. -. ;�- ,�.._�..K. �.,... - . , ...,.. . _ $ - � - . ..
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� �n T'�'n- Owner's Phone Number
Owner's Address � p l /
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Fee Simple Titleholder Name � � ��
Fee Simple Titleholder Address Titleholder Phone Number
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+�"R. a �tE' 3
Job Address
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Sub Division
Lot # C�
� F..� , .,:..:�,-� ,�_, ,�,�, _ , Parcel #
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Bio-Hazard Waste Storage - ANNUAL � �����:*x�t
� Fumigation Tent
Comm Exhaust Kitchen Hood/Duct � Hazardous Matenal (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-ANNUAL �� � `�
►ry emi � er
Sprinkler � �/ � � � ❑ � i
❑ Recreational Bum 1r �� �! J 9G�
Fire Alarm � � � �� ❑ - ��� � � �
❑ Sparklers
Hood Cleaning � � � � ❑
❑ � Sprinkler System Installation �
Hood Suppression p � � ❑
� Standpipes (Sprinkler Sys)
Fire Alarm Installation �
� Torch Roofing/Tar Kettle
Fire Pumps
� '� Waste Tire Storage ANNUAL
Fire Works
� Flammable Application- ANNUAL � ��Iy �
� Fuel Tanks Valuation of Project
Q Other. . .. ._ _. .. .�..
' -�'Sx`wah'.. ,.: v3?nx.;s': y .rFa» d�,�%. � .vG�.'�-;":ti:fi+�'d.sg't4t`�: M , -.^- -... °� -,
R 7�Ti'.�d'S•.0 , .y�A�.a�s.:+wS^ n «: •`l+ir#'.,.Y,.yzY.:a<_:.• .x,`a �
ontractor � �.-�-:�:.�� *�.��,��c:�a�.,,�,.-.,�.
i � �^�.���. �,<-�--,:� - �
ignature � , �`�, '7 � Co pany /�4 �
gistered / N Y / N
Address Fee,iC�f`rent
_ECTRICIAN icense #
gnature ��
Address Registered Y/ N Fee Current Y/ N
.UMBER
License # �
�nature Company
Address Registered Y/ N Fee Current Y/ N
:CHANICAL License #
�nature Company
Address Registered Y/ N Fee Current Y/ N
HER License #
nature Company
Address Registered Y/ N Fee Current Y/ N
�ctions: License #
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 htt //a
� P� ppraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS. The undersigned The undersigned a spons bilty for compl a e t w th any
which may be more restrictive than County regulations
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONe�►ed t be Ecen iBac th s ate a d locaeregulati If
contractors to undertake work, they may b q I for the
contractor is not licensed as required by law, bot�h�ohare uncerta n as what licenseng qu� emen may app y�olation
under state law. If the owner or intended contra
intended work, they are advised to contact the Pas n�ractor t org ontrac to s�he ad sed to ave he contractor(s) $�he
8009. Furthermore, if the owner has hired a co
portions of the "contractor Block" of t�na� he p�operly licensed is not entbtled t y permitting pr v egesgn Pasco
contractor, that may be an indication
County. If valuation of work is $2,500.00 or more, I
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, a of a F o 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 � g f�the t above descr bed document nd prompsean fa th to
other than the "owner", I certify that I have obtained a copy
deliver it to the "owner" prior to commencement. lication is accurate and
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this app '
that all work will be done in compliance w � it obtain a per to do wo k g stallation indicateda I certfy
development. Application is hereby made
that no work or installation has commen constructionS County a d City odesh g regula ons, and
meet standards of all laws regulating
development regulations in the jurisdiction. I also certify that I underessao s bilit to fy act ons I
government agencies may apply to the intended work, and that it is my p Y
must take to be in compliance.
If I am the AGENT FOR THE OWNER, I promise �understan thatna�separat permit may be�r q u d for I work�,
this affidavit prior to commencing construction lication
plumbing, signs, wells, pools, air co�ne a nse to p oceed the work and not as au or ty to violatee ancel, alter, or
permit issued shall be construed to
set aside any provisions of the technical codes, t on oa of any codesp ery t iss ed shall be ome �ed b
requiring a correction of errors in plans, construc
unless the work authorized by such per�m� a�S e od of six (6) m after the t meethetworkas ommenced An
the permit is suspended or abandoned f p
may be requested, in writing, from the Building �o��ninety (90)rconsecutive days, the job is de ed bandonedstra e
justifiable cause for the extension. If work cease
WARNING TO OWNER: YOUR FAILURE TO RE PROPERTY TIF YOU NT TO OBTAIN F NANCING CONSULT
PAYING T W I C E F O R I M P R O V E M E N T S T O Y O U R
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N O T I C E O F C O M M E N C E M E N T.
FLORIDA JURAT (F.S. 117 03)
CONTRACTOR
OWNER OR AGENT Subscribed and swom to (or affirtned) before me this
Subscribed and sworn to (or affirtned) before me this bY
bY Who is nally known to me or has/have produced
Who i s/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. Pnnted or stamped
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