HomeMy WebLinkAbout11-12472 CITY OF ZEPHYRHILLS --�
5335 - 8TH STREET
(si3) �so-oozo 12472
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12472 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: 35-25-21-0010-00700-0000
Improv. Cost:
Date Issued: 10/25/2011 Name: PRIMERICA GROUP ONE
Total Fees: 55.00 Address: 3629 MADACA LN
Amount Paid: 55.00 TAMPA FL 33618
Date Paid: 10/25/2011 Phone: (813)933-0629
Work Desc: FPM- FIRE SPRINKLER QUARTERLY- 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."
a..
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
�ARj2�%2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No,Bl3 P.001
813-7$0-0U20 Ctl�/ �fZ9ph)/ff1III6Fl(�6� Fau-813-780-0D21 '!:
permit Applfcation . _.
Date f�eceived •Phone Ce�ntact tor PermR
(hmer'e Name • Owners Phone Number .� � �
r ' �
Oumera Addresa
Fee simple TlUeholder Name ' Tjtleholder Phone Numbar ����
KeeSimplaTltlaholdt�Addre,s • � �
Job Addreas � � ' l.of # • �
Svb Divlslon Paree{ #
� 610-Hazard Weate Storage –ANNUAL � � Fumigatlon 7en[ .
� Comm �xhaust Kitchen Hood/DUCt : •� Hazardous Meterlal (Tier II or RQ Feclllry) ANNUAL
� Conirolled Hum � Hood Inslallailon
� �margency G�nerator < 30 kw • � LPINaturel Gas-InatallaUon '
• � � �mergency �aeneralor y 3o kw , � i..PMatural Gas-ANNUAL 5ale ,
� �Ire Protac6on Malrttanence = ANNUAL O Places vf Assembly-ANNuAL •
� � emi � � � ��
Sprinkler p p Reoreatlonal Bum •
Frs Alarm � . ❑ C7' ❑ � � 3pa�klers . ����� '"�
Hood Cleaning � [] � ❑ [] � � gprinklar'Syatam Instqlla6on5 � � 1 �� I � I
1
Hood Suppresslon � p ❑ D�� � Standpipes (SpdnklerSys) �
� Rra Alamt inetellatian � Torch RoofinglTa� Keltle ,
Flre Pumpa � Weste 71ra Storage ANNUAL
Flro Worka •
Flammable Applica0on-ANNUAL •��_—� Valuetiofl of P�ojeCt
Fuef Tanks
Q • Other: ' � ,
Contraclor � Company �
Signawro ' Registered Fee Curtsn[ / N•
Address �D �icense #
��EC7RICIAN . • Comparty
Signature Reglstefed Y/ N • Fee Current Y/ N
Addreee License �i '
PIUMeEFt Cnmpany �
Slgnalure Raglstered � Y!'N Fee Current Y/ N �
nddross ' � Llcenea # • -
MECNANICAL Company
si9nature wcgistared Y/ N Fee currcnt Y/ N
.4ddress Licanse #
OTH�R ' Compeny '
signature Re9��red Y/ N Fee Curtant Y/ N
Addreeg - Ucanes �!
Direction�;
Fltl Out appl'�caiion tompletaly.
Owner & Coniractor e�Bn baok of applica6on, nolarized {Or, copy of eigned contract wlth owner)
If over 825�0, a Notice of Commencament ia reqwred.(Meehanical work over $6000) -
Supply two (2) sets o1 drawinge with appAcable documentatlon
Allow 1 D-14 daye for rev{aw aher eubmitlal da1e. Percei �t - obtel�ad frvm Propsriy Tax No9ca (h[tpJ/apprsieer.paSCOgov.com)
MAR/28Y2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No,8(; P.002
,'NOTICE OF:DE�D'RESTizICTtONS: 'fhe.undersigned und'erstands•thet this permit may-be•subJecf:fo'"de�d"�restt(ctlons"'
which may be more resfrictive than Countyregulations. 7he�.undersigned.assumes responsibility:for:compliara�e+uvifh any ..
.applicable deed rastrfotions. •
UNLICENSED �CU�[TRi4C"fOR5 •AND'CONTRACl'OR:RESpf�NSlgIL'IT[ES; If fhe owner has •hired�:a~contractor �or �-
contraotors rto undertake work, they may be required •to be {icensed fn accordance with state and local If the
conb'actor Is not licensed as required by law, both the owrier and •contracfor may be cited'fot �'misdemeanor vlolation
.under st�te law. ff the owner or Intsnded �cantracfor are uncertain :as to what ficensing �requirements may �pp(y for the
intended work, they a�e advIsed�to �ontact the•Pasco County Bulldfng Inspection division—l.icensing 5ection.at 727-847-
8009. Furthermore, ff the owner has hired .a cantracfor or'contractors, he Is advised �to •have �the cordractor(s) sign
portions of the "contractor 81ock" af this appllCation�for v�ihich`they wfli be responsibfe. If you, a's•the owner�sign �as the
corrtractor, that may be an indfcation'thet he is �not properly licensed and Is not entitled�to �permitting.privileges in Pasco
County. • '
CONSTRUC710N.L.IEN.LAW (Chapter7'13,•Florida Statutes,.as.am�nded): If valuation of Wo1'k fs'$2;50D.OQ or more, I
certify �that i, �ths applicant, have .been provided wlth a copy af �the °Florida. Consfivction .Lisn. Law—Homeowner's
Protection Guide" prepared by�H�e Florl�a Department of Agriculture and Gonsumer Affairs. lf the applirnt is �someone
other than the "owner", I certify that ( have obtained a copy of the above described document and promise in good faith to
deilver it to the "awner" prior tb commencement. • '
- CONTRACTOR'SIOWN�R'S •AF�IGAVII': I certlfy that ali the ir�formation ln thls appticaElan is accurate and
that al) work wiU�he�dbne in compllance wlth all applicable Iaws regulating construction zon{ng and land
dev�lopment. Application Is hereby made to obtain a permlt to do work and installation as Indicated_ 1 cert�fy
that no work or instaliatlon has comrnenced prior to issuance of a per•mit and all work wlll be performed to
meet standards of alf laws regulaUng vonstruction, Cpunty and City codes, •zoning regulatlons, and land
development regulations in the jurisdiction. i ais4 cert(rty that I understand that the I'egulat'tons of other
. goverriment agencies � apply to the intended wor{� and that it is my responslbtllty to identlfy what actlons (
must fake�to be fn campllance. �
if 1 am the AC�EN'C FOR1'H� OWfJER, I promise Iri good faith to fnform thA owner of the permitting condifi�ns set forth in
thls affidavit priar fo commencing construction. •I understand that a separata permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, .or other instaAatlons not specific�lly lncluded in the application. A
permlt issued shall be construed to be a Iicense to proceed with the work and nof as authotity to violate, cancel, alfer, or
set aside any provisions of the technical codes, nor shalf issuance of a permit prevent the�uilding.Offc4af from thereafter
requiring a correction of errors in plans, construction or violatlons of any codes. Every permit lssued shall become invalid
unless the work authorized by such permit is commenaed within six months of permit Issuanqe, or ff work authorized by
the permft Is suspended or abandoned for a period aF slx (6) months after the tlme the wark Is commenced, An extension
may �e reyuested, in wrlting, from the Bullding Official for a period not to exceed ninety (90) days and will damonstrate
)ustifiable cause for th�e extenslon. lf work ceasas for niriefy (s0) consecut{ve days, the )ob is consldered abandoneci.
WARTtING TO OWNER: YOUR �AtLURE TO �RECORD A'NOTICE'OF ;C4MM�NCEM�NT M;41("R�SULT IN'YOUR '"
PAYtNG f11VIC� FOR IMPROV�MENTSfiO YOUR PROp�RTY. IF YOU INTEND'TO OBTAIN �INANCING, CONSULT
WITH OUR LENDER OR �4N ATi'ORNEY �EFORE RECO�DING XOUR N�'fICE OF COMMENC�IVIENT.
FLOR{DA JURAT (F.S. 117.03 •
OWN�RORAGENT � CPNTRAC70R . �
S ed and swo or sffi me this Sub c11 d and s of afflrmed) fOre m this
y by '
Who 1�(are pe ona�nown to me or has/l'iave produCed � Who Isla e e1's^. rLnawn to me or h ave producetf
� as Identfication. as idenUflCatJon.
� NoYary Public Nabary Public
Comm(eslon o. Y�`7y71 Ti,-1 Commis6lon o. ���� _
1�'ll a � �M�� U�c�� -
Name of otary �ped; printed Of stamped Nama'of No�ry typed, prihted or sismpad
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