HomeMy WebLinkAbout11-12203 CITY OF ZEPHYRHILLS
' S335 - 8TH SIREET
(813) 780-0020 �
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12203 Address: 38130 PRETTY POND RD
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: 35-25-21-0010-07100-0000
Improv. Cost:
Date Issued: 8/04/2011 Name: PARKERS CREEK II LLC
Total Fees: 25.00 Address: 365-B NEW ALBANY RD
Amount Paid: 25.00 MOORESTOWN NJ 080571105
Date Paid: 8/04/2011 Phone: (516)496-1505
Work Desc: FPM- HOOD SEMI - BENTLEY COMMONS
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 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."
�
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
813-780-0020
City of Zephyfiiils Fire Fax-813-780-0021
Permit Application
' � Phone Contad for Pertnit �� 1 a ��.J R��
ate Received C �
^ �� Owners Phone Number � f � �� ` �
wner's Name � �
3� � 3� cG 2 �1 '' h � � � s f
wners Address ("—'� �� ��
TiUeholder Phone Number �__
3e Simple Titleholder Name
�e Simple Titleholder Address
�b Address
n-�-e rnav�s 'vg 3o r,� cw h 1►� L�ot# �
Parcel #
�b Division
� Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Comm Exhaust Kitchen HoodlDuct � Hood Installation
a Controlled Bum � LPMatural Gas-Instaltation ��� �
� Emergency Generator < 30 kw � LPMatural Gas-ANNUAL Sale
� Places of Assemby-ANNUAL
� Emergency Generator > 30 kw �
� Fire Protection Maintenance - ANNUAL Recxeational Bum
�y mi � er
��C��d Sprinkler � ❑ ❑ ❑ � � Sparklers
`/ Fire Alartn � ❑ ❑ � C] � Sprinkler System Installations
v� 1 ` Hood Cleaning ❑ ❑ 0�� � Standpipes (Sprinkler Sys)
� �� Hood Suppression � ❑ �� � Torch Roofingffar Kettle
� � � Waste Tire Storage ANNUAL
Fire Alarm Installation
� Fire Pumps
Fire Works
� Flammabie Applic�tion- ANNUAL Valuation of Project
Fuel Tanks
� Other
�ntractor , f Company
�/J � V� I�' Registered Y/ N Fee Current Y/ N
gnature
Address (.. {�f f C�'1 �� License#
_ECTRICIAN Q ���
gnature ` h ��f��- Ct s Registered Y/ N Fee Current Y/ N
License #
Address
_UMBER ��
Registered Y/ N Fee Current Y/ N
gnature
License #
Address
ECHANICAL Company
gnature Registered Y/ N Fee Current Y/ N
� License #
THER ��
Registered Y/ N Fee Current Y/ N
gnature
Address License #
irections:
Fill out application completely.
Owner 8� ConVactor sign back of applicafron, notarized (Or, copy of signed contrad with owner)
If over 32500, a Notice of Commenoement is required (Mechanical work over $5000)
SuPPIy lwo (2) sets of drawings with applicable documentation
Allow 10-14 days Tor review_s�r��l�r Paroel #- obtained from Property Tax Notice (httpJ/appraiser.pascogov.com)
�/ f ilr��
H������ � a����s
po. H� 2T3�T "'�• � � � � S!�
P: S13 �-3� F: �� �
gatora�thewaq�ar-COn'
_ :_- _ -. � , 1 ��
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed"-cestrictions
which may be more restrictive than County regulations. The �ndersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTQRS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a
contractors to undertake work, they may be required to be IIG�nsed in accordance with state and local regulations. If the
contractor is not licensed as required by law, bbth the own�� and cohtractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are unc�ertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County uilding 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 I' ensed and is not entitled to permitting privileges in Pasco
County. �
CONSTRUCTION LIEN I.AW (Chapter 713, Florida Statute , as amended): If valuation of work is $2,500.00 or more, I
certify that l, the applicant, have been provided with a c�py of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the F{orida Department of Agr,culture and Consumer Affairs. 1f 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. I
- CONTRACTOR'SIOWNER'S AFF1DAVIT: I certifiy that all the information in this application is accurate and
that all work will be done in compliance with al applicable laws regulating construction, zoning and land
development. Application is hereby made to obta n a permit to do work and installation as indicated. I certify
that no work or installation has commenced prior issuance of a permit and that all work will be performed to
meet standards of all laws regulating constructi n, County and City codes, zoning regulations, and land
development regulations in the jurisdiction. I so certify that I undecstand that the regulations of other
� government agencies may apply to the intended ork, 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 fait 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 ith the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issu nce of a permit prevent the Building Official from thereafter
requiring a,correctior► of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the �vork authorized by such permit is commenced wi�hin six months of permit issuance, or if work authorized by
the permit i's suspended or abandoned for a period of six (6) � onths after the time the work is cbmmenced. An extension
may be requested, in writing, from the Building Official for a�eriod not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety ( 0) consecutive days, the job is considered abandoned.
WARNINGITO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE . 1F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTIGE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) , !
I�ON RACTOR ���
OWNER OR AGENT '—'
Subscribed and sworn to (or a�rmed) before me this 'S�ps bed and sworn to (or a ed) be ore me �s
bY bY
Who islare persona!ly kno�vn to me or has/have produced Who iilare personally known to me or has/have produced
as identification. as identification.
� Notary Public Notary Public
Commission No. Com Ission No.
I
Name of Notary ryped, printed or stamped Name of Notary fyped, printed or stamped
�
I
I
�
�
�