HomeMy WebLinkAbout11-12339 CITY OF ZEPHYRHILLS ��,./
5335 - 8TH SIREET
(si3) �so-oo20 12339
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12339 Address: 5500 6TH ST
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: 11-26-21-0010-09000-0180
Improv. Cost:
Date Issued: 9/09/2011 Name: DAVIS, JAMES & SUE
Total Fees: 25.00 Address: 2605 ROBIN DR
Amount Paid: 25.00 PLANT CITY FL 33563
Date Paid: 9/09/2011 Phone: (813)754-3647
Work Desc: FPM- FIRE ALARM ANNUAL- BADCOCK FURNITURE
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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."
�..
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
813780-0020 City ofZephyrF►iIls�Fire• Fax-813-�80-0021
Permit Application
Date Received - Phone Contact for Permit �„ 53Q L �Sa
Owner's Name Owners Phone Number _� C�, �
Owner's Address s5
Fee Simple Titleholder Name TiUeholdec Phone Number ��� ��
Fee Simple Titleholder Address
, �� Job Address � � � Lot#
Sub Division Paroel #
� Bio-Hazarcl Waste Storage -ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material �er II or RQ Facilfty) ANNUAL
� ConVolled Bum � Hood Instaltatlon
� Emergency Generator < 30 kw � LPMatural Gas-Installation
� Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
r y emi �n er
5prinkler � O ❑ ❑ � Recreationai Bum
Fire Alartn �❑ p `� � � Sparklers � t,/ 7 ��
Hood Cleanin ❑ ❑ ❑ S rinkler S i�
9 � � � p ystem Installations
Hood Suppression � ❑ ❑ p� � Standpipes (Sprinkler Sys)
� Fire Alarm Installation � Toroh Roofingffar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
Fire Works
Flammable Applicatlon- ANNUAL Valuation of Project
Fuel Tanks
Q Othe -
ConVactor Company � • y r
Signature Registerad Y/ N Fee Current / N
Add�ess License #
ELECTRICIAN Company
Signature ° Registered Y/ N Fee Current Y/ N
Address license #
PLUMBER Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
MECHANICAL Company
Signature Registered Y/ N Fee Curtent Y/ N
Address License #
OTHER Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
Directions:
FII out application completely.
Owner & Contractor sign back of application, notarized (Or, copy of signed conVact with ovmer)
If over $2500, a Notice of Commencement is required.(Mechanical work over $5000)
Supply two (2) sets of drawings with applicable documentatian
Alfow 10-14 days for review after subm(ttal date. Par�el #- obtained from Property Tax Notice (httpJlappraiser.pascogov.com)
•NOTICE OF:DEEDRESTR�CTIONS: The.undersigned understands-that this permit ma,y-be•subject:to
which may be more restrictive than County�regulations. The.undersigned.assumes responsibility_for:compliar�e=with any
_applicable deed restrictions. -
UNLICENSED CONTRACTORS AND �CONTRACTOR RESPONSIBILITIES: tf the owner has 'hired�:a�contractor or -
contractors to undertake work, they may be required to be ficensed in accordance with state and local 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 which�they will be responsible. If you, as�the owner°sign as the
contractor, that may be an indication that he is not properly (icensed and is not entitled�ta�permitting privileges in Pasco
County.
CONSTRUCTION.LIEN•LAW (Chapter713, Florida Statutes,-as:amended): If valuation of work is $2;500.00 or more,
certify that t, �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 certrfy that I have obtained a copy of the above described document and promise in good faith to
deliver it to the °owne�' prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I cerfify that all the information in this application is accurate and
that all work will be done in compliance with al{ applicable taws regu{ating construction, zoning and land
development. Application is hereby made to obtain a permit to do work and instal{ation as indicated. I certify
that no work or instaliation has commenced prior to issuance of a permit and�that all work will b� perfarmed t�
meet standards of all laws regulating construction, County and City codes, .zoning regulations, and land
development regulations in the jurisdiction. I also certrfy that I understand that the regulations of other
government agencies may applyto the intended work, and th�t it is my responsibility to identify what actions I
must take to be in compliance.
lf I am the AGENT FORTHE 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 inc{uded 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 Buiiding Official for a period not to exceed ninety (90) days and wili 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
CONSULT
PAYING TWtCE FOR �OR AN ATTORNEY BEFORE RECORDING YOUR N� CE O COMMENCEMENT. �
W1TH YOUR LENDER
FLORIDA JURAT (F.S. 117.03)
CONTRACTO before me this
OWNER OR AGENT Subscribed an m to (or a rm )
Subscritred and swom to (or affirmed) before me this _
bY _ Who is/are pe naily known e o� has/have produced
Who is/are personally known to me or haslhave produced as identifiption.
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary tYPed. Printed or stamped '