HomeMy WebLinkAbout11-12142 CITY OF ZEPHYRHILLS
^ 5335 - 8TH STREET �
(si3) �so-oo20 12'�42
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12142 Address: 5214 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: 11-26-21-0010-16600-0250
Improv. Cost:
Date Issued: 7/18/2011 Name: VICHRIS INC
Total Fees: 25.00 Address: 5214 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/18/2011 Phone: (813)782-9556
Work Desc: FPM-HOOD CLEAN QUARTERLY- VILLAGE INN
5.
��
�
�
� ��'
�
��
�
ina
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 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/20/2007/TL�E 11:10 AM ZEPHYPHILLS BUILDIhJG FAX No.813-780-0021 P,002
� �a�a- Ciry of.Zephyrhills�:i���,_�• ��ax-aia-rao�ooz� . .:�:;�
� - PermitApplicafivn �-�-� ° ��-;`
.M ��
_Date Received .. — 'Plione Contact�for Parmh =
,...� . - -
Own�r's Name -- � -' ^' ' — _ Owners Phone Number ,� �� �Q( � .
Owner's Address � � �% .J .0 ` 7 ` � .� � lv
Fee Simple l'IUeholdar Name Titlaholder Phone Number ���
Fee S1mpIa7litaholderAddrase '
.lob Address � �, � t # ��
5 ub bivlslon ' ' Parcel #
� �Bio-Hazard iNaste Storege -•ANNUAL � �umlgationTent ' ,
� Comm �xhau9t Kitchen Hoad/buct ' � Hezardous �laterlal (Tier N or R4 �aclllq+) ANNUAL
� Conlrolled eum � Wood Inatallatlon
� Emergeney peneratior c 80 kw � LP/Netural Gas-Installativn
� '�mergency Generator? �0 Kw � l.PlNatural Gas-ANNUAL 9ale
�Iro Protec6oi, Malntenanc� - ANNUAL � Places of AssemblY-ANNUAL
' LL�fl� 6m� � e
Sprinkler a p ❑ ❑� � itecreational Bum, /��'�
Frs Alartn '� D ❑ D� � Sparlt�ers �
Hood Cleenin9 ��' D O� � Sprinkler Syatem Installations
' Hood suppressfon � Q 17 p� � 5tarxipipea (5prinkler sys)
' � Fire Alertil Ir�etallatlon ' � Torch Rooftng/Tar Kettle
Fire Pumps ' � Waete'flre Storege ANNUAL
Fire Works '
Flammable AppllcaUorr ANNUAL ' Valuafion of proJect
� Fuel Tanks
� other:
Gontracror , _ Company
$� Registsred / N Fee Current Y/ N
Addre9e License #
ELECTRICIAN Compeny '
signature - RegisterBd Y/ N fse Cimerrt Y/ N
Addrees LJcgnsC # �
PLUMBER ' Compar�y �+'—
SEgnature Registsred Y/ N Fea Current Y/ N
Address ' ' Llcense #
M�CHANICAL Company
Signature RegEstered Y/ N Fee Current Y� / N
Addreae - #
OTHER . Compsny • '
Slgnature Regiatermd Y/ f�! Kea Current Y/ N
Address Ucenes #
blrecUons: .
F!( out appllcaUon complet0ly.
Owner & Cohtratto► elgn heck of appllcadon, noter�ed (Or, cnpy aF slqnad contraot wlth owner)
if over 52500, a NoUct of Commencemenf Is raquired.(MechantCat work over S5o0o) •
Suppy two (2) seta of drawings whh appficable documantatian �
Allow 14-14 dsys for rovlew after aubmittal data. Parael �- obtained finm Properiy Tax No6ce (httpJlappre;ser.pascogov.com}
FEB/20/2007/TLE 11:10 AM ZEPHYRHILLS BUILDING FAX No,813-780-0021 P,003
- �.��_-'- :.:��:..�,,,.
.�•:, � - � _ --r.� ,��?�'- . _�,M. . �,i.,
�J���� °-F - . . - ��'�- '__ ___' � I
ca�iara .•^:,; �tior��:� :;_?. _ -,::�.�nn�=`._i
�. �;��f'O;�Ii�E+D'F:D�ED R�STRICTlONS: - f he.underslgned. may.be�subject;to�"de�d"��.estr.i�tjp���tr
-'r�viaiChYrrrayybemore•restrictivethanCountY°re,gulatfons:`The.�ur�d�r.si-ned�assumes:regponsibllE �for�om iaric�4wlEh�, �
�— -8; �Y; PI� ... !�,i�a[��
.applloab1e�deed restrictlons. - -'. ';.�G��iicaT ,-.:;- - ' ''�;"
�'.G(VL:tC�ENSED �GONTRACT.ORS �i4ND ;CONTRACTOR °If�he - ownEr has �,_ f .
:contractors to undartake wo�k, �they may be requir�d'to be licensed in��accordance with state.and local If xhe =- :-� • I
contractor is not licetlsed 8s requlred �.by law, 'bot� •the owner ;and .cont�actor •may .be cited'for :a �misdemeanor , violatior�. - �
�.under�state law. If�the owner or intended�cantractor..are uncerfaln=as'fo what llcensiny'I'equirements may:apply'for -.
intended work,'they are advised�to contact the•Pasco CauntyiBuilding;frtspaotion Dlvision—Licenstng Sectlon_at727=847
-.8009. =F.urfhermore, .if the owner has hired :a cantractor or contractors, �he Is advised �to -have - the contractor(s) �fgn
portlons af tfie "confractor Slock" of thls appllcation#or which�Shey will be responsible, lfi you, as•the awner�.slgn:as�.fhe
�� �contractor,'that�may bean indlcation�thst�he is�not�pr.operly licensed•and is nof entitled in�=P.asao -� ��.,
-County. ;
•CONSTRUCTEON.LI�lJ•LAW�(Chapter713,'�{arlda`Statutes,�s:amended): Ifvaluatlan�afwork is'$2;500.�O.or'mor$,:I '
aertify �that 'I, the applfcant, have beerl provided 'with a copy .ofi � the °Florida Construction Llen Law-^Homeowners
pratection �Guide" prepared by�the �lorida Department af Agricultura.and Consumer Affialrs. If the applicant is �som�one
other than the"`ownsr", I oertify that ( have obtained.a copy of.the�abov� desaribed document �nd promise in good falth�to
deliver It to the ° owner" prior�ta commencement.
- CC�NT�RACTaR'.SI�WN�R'S-AFF)DAVIT: l cer�ify that all the infarmatlon in this application Is acGUrate and
'that al{ work will .be done in ccmpfiarice v:�'�� ali aFpli�ble (aws re�ulating constrvcflon, zoning and land �
development. Application ls hereby made to obfaln a permit to do work and [nstallatlon as indicafed. f certffy
that no work or instalEation has commenced prlor to Issuance of a permlt� and�that �all work wlll be performed to
meef standards� of all laws regulating consfruction, County and City codes, .zoning regulations, and land
development �ragulations in �the jurisdictlon. I.afso certify �that l understand that the regulations of other
_ government agencies may apply�to the intended work, and that it is my responsibillty to identify what ac6ons !
must take'to f�e in complfance. �
If ( am�tha.AG�NT FORTH� OWNER, I pr'omise iri good faith to inform the owner of'the permltting conditions setforth i�
thls affidavit prlar�to�commenaing construotion. 1 understand fhat a separate permit mey.be required for efectrical work,
plumbing, slgns, wells, poals, air conditioning, gas, or other installations not spec�icalfy Included ln tf�e applicatlon. A
permit issued shall be construed to be a liaense to proaeed wikh the work and not as authori#y to vialate, cancel, after, or
set aside any provislons of the�technical codes, nor shall issuance of a permit prevent the $uilding O�ciai from thereafter
requiring a correction of errors In plans, constructEon or violations of any codes. Every permEY.lssued shall become Invalid
unless #he work autliorfzed'by such permlt is commenced within six months of permit issuance, or if work aufhorfzed by
the permit 'ss suspended or abandoned for a period of six (6) months after fhe �me the work is commenced. Ar� extension
may be requested, in wrlting, from the �ullding Officia! for a period not to exceed nlnety (90) days and w{li demon�trate
Justifiable cause for the sxten$ion. If wvrk ceases for ninety (90) conseautive days, the job is considered abandan�d.
" WARNING TD OWN�R: YOUR"�AILURE TU'RECORD A'N'GTICE'OF�GOMM�PICENl�NT MiqY=�RESULT=IN YOUR `=•
PAYINC IMPRON�MENTS TO YpUR i'ROPERTY. !F Y N'fEND Ta OBTAIN FINANClNG, CONSULT
WITH Y R L O. N ATTORN Y�B��OR� RECORDI OU T OF dMM NCE NT.
FLORIPA JU T (F. ' '
OWN�RORAG � CON7RAC7Q
Subscrlbed and suro (� ffirmed) before me th,s 5ubscdbed and swom to or a ed} before me this �
by by
Who is/ars persohalty knowrt to me or hasThave produced Wha Is/are personally known e or ha5/l7ave produced
_ as idarti��csUor_ � _ ' as edanttficsdon.
Nots,ry Public Notary Publ4c
GOmmiasion No. � _ Commission No,
Name o# Notary typed; printed or stamped � Name of Na�ry typed, printed ar s�mped
o � - o ��`� ,�
3 �� �
� N 3
rn m m
D � n
Z � � mWD c�
= m -p w � � C�
� � � < � p A3
� � m � = N ncnR
� � N � ��'r � _�`�
�
, Z rv (n%n� = Op
� " 1 ' mz '� °z=�
�m� � �Sz
T � r �p = ��WN
, � w rn r n,m�m
� r ' <<''„ � r w�,c�
r- : 1� —I fn o � T�
r N �ni�n
D �; �vy
� � �Z
m
Z � <W �
m
� r
c
� r
T �'
n �''
c f'
a
m ti
�
Z i•
n �
r
c
0
m
0
o Q
m
D O T
� O j o
• m � x *, n v
n � � x� �
� � rnpn
W * q'ZD
O r' , V �� � � ; _�
� � � � �\ ) * A m r D"
.� * rn-
� r �, ��� * ��oo
� � � � -� 1, � A z
� --' � o T.
� � �
• � D Z
� �
• rv � � D
o T
�
_ C .
(D
� �
c
n �. O
m
� � � O O
� � �
� * O
* ' � ` O
* � N ° �
N : N i � �
� � � N
o o�o � ° ~ � �
�
� �� �
� �
�