HomeMy WebLinkAbout11-12209 ' CITY OF ZEPHYRHILLS /.
5335 - 8TH SIREET �,.
(sis) �so-oozo 12209
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12209 Address: 7838 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: 3 5-25-21-0010-00700-0000
Improv. Cost:
Date Issued: 8/08/2011 Name: PRIMERICA GROUP ONE
Total Fees: 50.00 Address: 3629 MADACA LN
Amount Paid: 50.00 TAMPA FL 33618
Date Paid: 8/08/2011 Phone: (813)933-0629
Work Desc: FPM-SPRINKLER ANNUAU SUPPRESSION SEMI- PUBLIX
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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 $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
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P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RE5CUE DEPT - Fire Marshal Office - 813-780-0041
MARj28/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No,813
P� 001
s���sa-ooz0 CttY ofZephyrhlllsFine: Fax-a�aaso-oo21
permft Applicstion .�
Data Received •Phone �r Pertnit L IGV �
ownere Name • Owner'y Phone Number .�� �.�
Ownera Add2sa � � 3 ' �
Fea simple 7iUeholder Name lltleholder Phvne Numbar ���
F'eeSimpleTltlaholdcrAddress • � • ��J
Job Addreas \ ' Lof # • �
5ub Divislon �� #
� Blo-Hazard Waete Stvra9e -ANNUAL � �� FumlgaUon 7ent
� �. Comm Enhaust Kitchen Hoodlouct �• Ha�Mous Meterfat Rer 11 or Rq Fecility) fWNUAL
Conirol(ed Bum Hood InstalleUon
o �mergency G�necator < 30 kw . a LPlNatural Gas-Inatallatlon •
� ��mergency Generator> 3a kw � Lp/Natural Gas-ANNUAL Sale ,
Flre Ptotection Mairrtenance =ANNUAL . � p�aces oFpssembly-ANN�IAL
• 77 �� � emi � �D�ie7"'7 . ❑ T��`����
Sprinkier � p O Reoreatbnal BuR1
Fre Alarm ❑ L7' O� � SPwk�ers . • ��"--� F-- _—I
Hood c�eaN� � d ` o � �.��.� ��C1 �
� s
prinkler'Sy9tem Instaflations
a Hood Suppresslon � p � p� Ster�dplpes (SpdnklerSys) � g I$ I ZO I I
Fire alartn InstalJa6an , � Torch Roo��a� Keme �
Fire Pumpa • r=�i '
Flro Worke L,_ j WBSte Tire Storage ANNUAL
Flammable Appiicatlon-ANNUAL .
Valuetion oi P[oject
�uel Tanks .
Q � Other: • .
Contractor � •
Com an
Signawre �C1Cst� x ' Rep'wtered Y/ F�e Curtent
Address
"� ( a Lipense #
�t,ECTRICIAN . --
Signature . Comparry
Regtsiered Y/ N Fea cuRern. Y/ N
Addreee
Licertse �i
PIUMeER
Slgnature C
Raplstered Y/ N Fee Currant Y/ IV�
Addross •
Llcanea #
MECHANICAI. -
StgnalUl'e CD � a �y
Rcgistered Y/ N Fae Currcnt Y/ N
Address
Licenee #
OTNER � -
signature ' Compeny
Reaietered Y/ N Fae Current Y/ N
Addreae
DirecfionS: LtC6nea �!
FlII out aDD�ication complataly.
Owner & Contrector eign baok of applicetiort, nolartzed (Or, copy of eigned contract with owner)
If over 52500, a Notice of Commencemer�t is requlred.(Mechenical work avar $b000)
Supply Mro (2) aets of drawlnpe with appllcable docuMentadon
AlloW 10-14 daye for revloW aher eubmittal dale. Percel #- Obtalned from Property TaX NOUce (httpJ/epprsiaer_pascogov.com)
MAR/28/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FRX No,813 P.002
.'NOTIG� OF:DE�D'RE3TFtICTIONS: The.underslgned und'erstands•thatthis permif may-be•sub)ecf:to�"de�d"�res�trictlons"�
which may be more restrictive tfian County•regulations. 7he:undersigned.assumes responsibility:for�omplfara�e+anrith any
.appllaable deed restrlottons. . . "
�UNL•ICENSED �CONTR;4C'�ORS .AND •CONTRACTOR,RESpQNSI�ILITIES: If�fhe owner has •hired•:a~oontractor �or � °
contraators rte undertake work, they may be reqwir�d •to be Itcensed En accordance with state and local if the
conb'aotor (s nvt licensed as required by law, both the owner and •contracfor may be cited'for .a �rr�isdemeaner vlotation
.under st�te law. ff�the owner or Intended �cantractor are uncertafn �as'to what liceltsing •requirements may app(y for the
intended work, they are advlsed�to contact the•Pas6o County Butiding inspection divtsion—l.icensing Secdon.at 727-847-
8009. Furthermore, ff the owner has hired .a contrector or contPactors, he Is advised �to •have �the corrtractor(s) sign
portions of the °contractor Block" of thfs appllcation vi+hich`they wlll be responsibfe, tf you, a's•fhe owner�stgn �as the
cor►tractor, that may be an ind(cation �thaf he is �not proper{y liaensed end Is n�t enEitled�to �permifting .privileges in Pasco
County. . •
CONSTRUC710N•L.tEN.LAW (Chapter713,�Fforida 8tatutes�,as.amended): If valuation of Work Is �$2;500.00 or more, I
cerpfy 'that I, 'the applieant, have .been provided wlth a copy pf 'the "Florida. Gonstruction .Lien. Law—Homeowner's
Protection Gulde" prepared by�the Florida Depa[tme�t of Agriculture and Consumer Affairs. lf the applicant is �someone
other than the�°owner", I certif�r that ! have obtained a copy of the above descrtbed document and ppomise in good falth to
deliver it to the "awner" prior to comrnencement. • '
- CONTRACTOR'S/OWNER'•S •AF�IDAVIT: i certlfy that all the information In• thls applicatlon is•accurate and
that al) work will be d6ne fn compllance wlth ap applicabte laws regulattng oonstruction zoning and iand
devefopment. Application ls hereby made to obtain a permlt to do work and installation as fndicat�d. I certify
that no work or installatlon has commenced prior to fssuance of a perrnit and•that all work wIU be performed to
meet standards of all laws regulating construction, Cpunty and Clty codes..zoning regulatlons, and land
development regulations in the jurisdiction. I also certf{y fhat I understand that the regulations of other
. government agencies tnay apply to the intended work, and that it is my responsibfllty to identlfy what actlons I
musf fake�to be In campllance. �•
if 1 am the ACEN7'FORTH� OWNER, I prbmise fri good faith to Inform the owner of the permitting condifions set forth in
this affidavlt priar io commencing construction. �I understand that a separata permit may be required for electrical work,
plumbinc�, signs, wells, poals, air conditioning, gas, �or other lnstaltallons not spec�cally lncfuded in the application. A
permlt lssued shall be construed to .be a Ilcense to proCeed with the wol'k and nof a5 authorfty to vlolate, cancel, alter, or
set aside any provis;ons of the technical codes, nor shalf issuance of a permit prevent the �uilding. Official ftorn thereaiter
requiring a correation o# errors in plans, construction or violatlons of any codes. Every permit Issued shall become invalid
unless the work authorized by such permtt is commenced within slx months of permit Issuanr,,e, or If work authorized by
the permit Is suspended or abandoned far a period af slx�(6) months after the tlme the work Is commenced, An extension
may be requested, in wrlting, from the Bullding Offfcial for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for fhe extensfon. lf work ceases fior niriety (s0) conseci�tive days, the )ob is consldered abandoned.
'WARNING TO QWNER: YOUR �AIL'URE TO•REGORD A'NC►TICE'OF.COMM�NGEM�NT NIi�Y`RESULT IN'YC1UR "'
PAYING TNfIC� FOR IMPROV�MENTS�TO YOUR PROp�RTY. IF YOU INTENDTO OBTAlN �INANCING, GONSULT
WITH YC,�UR LENDER Ol� t1N ATTORNEY BEFORE RECORDING YDUR N�'fICE OF COMMENC�MENT
FLORIDA JURAT (F.5.117.03) �
OWNERORAGENT • cPN7RncTOR �
ed and swo to �r �d� s, me this S qi ed arx! bWO {or aftlrmed) b re me '
Y
/are� personapy fcnown to me or haelhave produced Who I e pe1'sonally pwn to me or dSltlave produc6d
� � as Identifica6on. \ as identlflCadon.
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Notary Pu6fic _NoOary Public
Commieslo No.� '"1 �� Commisslon No.
t�) i� �� ,� � �'I I�z; I,,�CI�
N8»1e of Nofary q�ped; pri�ted of stamped Name'of Nolary prped, printed or stsmped
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