HomeMy WebLinkAbout11-12469 _ CITY OF ZEPHYRHILLS �,,,..-
5335 - 8TH STREET
(sis� �so-oo20 12469
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12469 Address: 7839 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot s:
Square Feet: � ) Block: Section:
Est. Value: Subdivision: CITY OF ZEPHYRHILLS
Improv. Cost: Parcel Number: 34-25-21-0010-01700-0010
Date Issued: 10/21/2011 Name: MICROTEUJAMM HOTELS,LLC
Total Fees: 25.00 Address: 7839 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/21/2011 Phone:
Work Desc: FPM- ANNUAL SPRINKLER - MICROTEL
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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 r'e�ated to the aforementioned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written a
the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an appro ved 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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PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTIpN OFFICER
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
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�iry or cepnymuis rire
Permit Application rax-ai,�-i�u-uun
Date Received t� ���
` .. _ .. , . . Phone Contact for Permit Y �
Owner's Name r�/�T � � �) J�� � �� '�
Owner's Phone Number �
Owner's Address G� L C � j �`
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Fee Simple Titleholder Name ^ �� ,�—^
Titleholder Phone Number L__� u
Fee Simple Titleholder Address
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Job Address � � T- K � ��`°��':
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Sub Division
Lot # ��
r N�., . .�; � ��. Parcel #
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Bio-Hazard Waste Storage - ANNUAL �
� Fumigation Tent
Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Burn a
� Hood Installation
Emergency Generator < 30 kw �
LP/Natural Gas-Installation
Emergency Generator > 30 kw �
LP/Natural Gas-ANNUAL Sale
Fire Protection Maintenance - ANNUAL �
Places of Assembly-ANNUAL
� �y emi � er ❑
Sprinkler � �
❑ Recreational Bum
Fire Alarm � � � � ❑
� Sparklers
Hood Cleaning p � � �� ❑
❑ Sprinkler System Installations
Hood Suppression ❑ � � � ❑
� _J Standpipes (Sprinkler Sys)
Fire Alartn Installation �
� Torch Roofing/Tar Kettle
Fire Pumps �
❑ Waste Tire Storage ANNUAL
Fire Works
� Flammable Application- ANNUAL
� Fuef Tanks Valuation of Project
Q Other:
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COfltfaCtOf � ` '� '.,
Signature Company � �
Registered Y/ Fee Current Y/ N
Address
ELECTRICIAN License #
3ignature Company
Registered Y/ N Fee Current Y/ N
Address
License # �—
'LUMBER
iignature Company
Registered Y/ N Fee Current Y/ N
Address
�ECHANICAL License #
ignature Company
Registered Y/ N Fee Current Y/ N
Address
License #
THER
ignature Company
Registered Y/ N Fee Current Y/ N
Address
rections: License #
Fill out application completely
Owner & Contractor sign back of application, �otarized (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 (http://appraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS: The �ed ulations. The undersig ed a esponsibilbty for compl a t w th�any
which may be more restrictive than County g
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contrac or or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may app y
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 ha as the own sign as the
portions of the "contractor Block" of this application for which they will be responsible. If you,
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
500.00 or more,
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, of a F orida Construct on L en L aw—Homeowner's
certify that I, the applicant, have been provided with a copy
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If 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.
CONTRACTOR'SlOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
that all work will be done in compliance with all applicable laws regulating construction, zoning and land
development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify
that no work or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of all laws regulating construction, County and City codes, zoning regulations, and land
development regulations in the jurisdiction. I also certify that I understand that the regulations of other
government agencies may apply to the intended work, 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 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 included 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 Off'icial 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 Building Official for a period not to exceed ninety (90) days and will 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
PAYING TWICE FOR IMP AN AnORNEY BEFORE RECORDING YOUR NOTICE OF COMMENC MENT.' CONSULT
WITH YOUR LEN�ER �R
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to (or aifirtned) before me this
Subsc�ibed and swom to (or affirmed) before me this by
b y Who is/are personally known to me or has/have produced
Who is/are personally known to me o� has/have produced as identification.
as identification.
Notary Public
Notary Public
Commission No. Commission No.
rinted or stam ed Name of Notary typed. Printed or siamped
Name of Notary typed, P P