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Home My WebLink About11-12558 CITY OF ZEPHYRHILLS / ' S335 - 8TH STREET .,.� �ais� �so-oozo 12558 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12558 Address: 6851 WIRE RD Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02-26-21-0010-01200-0000 Improv. Cost: Date Issued: 11/23/2011 Name: ELKS LODGE Total Fees: 55.00 Address: 6851 WIRE RD Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/23/2011 Phone: (813)782-4604 Work Desc: FPM- SPRINKLER ANNUAL- ELKS LODGE � U� I � Z�'� 1 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 Zephyrhills Fir�e Permit Application Fax Date Received �---� - . Phone Contact for Pertnit 7 2 7 _ 2 I S C.l� p � Owner's Name z,�PH �H«�S t�k o(di � z'j Owner's Phone Number $ i 3 7$'L �(, O� Owner's Address �s $ S/ (fu�, Rk �o,o� z,Gp� � y�uS J�G 3 3 S 3 �1 Fee Simple Titleholder Name � �� Titfehoider Phone Number Fee Simple Titleholder Address Job Address �o � s/ ��a �2.� l�e p� �=�►�.�q N�� LS fG. 3 3� 3 '� � Lot # � Sub Division .. . ....... .. .._...,...__,_, _ Paroel � :. . _ . ;,. . __. _._.. _._ -.-„- -- � BiaHazard Waste Storege - ANNUAL a � � Fumigation Tent Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlted Bum Hood Installation � Emergency Generator < 30 �, � LP/Natural Gas-Instalfation � Emergency Generetor > 30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance -ANNUAL Q Places of Assembly-ANNUAL [QCrTy emi � er Sprinkler � � G' � � Recreational Bum Fire Alartn p ❑ ❑ � � Sparklers Hood Cleaning � � � � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ C� � Standpipes (Sprinkler Sys) � Fire Aiartn Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL Fire Works � Flammabie Application- ANNUAL Z SO, o�, Valuation of Project Fuef Tanks Q Other: __�..__�_.,�.___�_.�:�._... _ _. ._ _ _ - ... _.._. __ - - - _ _ - — � _..__.-. -- - - - -. ontractor - _ _ -- -- --- .�,_. ._ .- -- Signature ��"`+ • �- CompanY (,eJ S� t �+i ;tc r�a.. ,� � v�G ' LLG Registered Y/ N Fee Current Y/ N Address Z.�E, i�o , � �. vA �;.NST n-a � rG �3 3 770 License # st3r67 avu,zoc�, ELECTRICIAN Signature Company Registered Y/ N Fee Current Y/ N Address License # PLUMBER Signature Company Registered Y/ N Fee Currerrt Y/ N Address License # MECHANICAL Signature Company Registered Y/ N Fee Current Y/ N Address license # OTHER Signature Company Registered Y/ N Fee Current Y/ N Address -..„<,-._.�...., -_..w License # _<.._..�.._._ . _.._.__M.._ , Directions: - -°-- _ _ - - - --- -• - _ - �. _. ..- - - ` _. _._ _ M.a..-..,-,_-�-_.. ill out application completely -- -- - ---..�. .__. .,,,_._- ___..__ _ _ Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice o# Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with apPlicabla documentation Allow � 0-14 days for review after submittal date_ Parcel #- obtained from Pro perty Tax Notice (http://appraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to�°de�l":r�st�'ictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliarrce with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBIL1TlES: I# the owner has hired -a 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�vif�lat� under state law. If the owner or intended contractor a�e uncertain as to what licensing requirements may app y intended work, they are advised to contact the Pasco Counry 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 for which they wilt be responsible. If you, as the ov egesgn Pasco contractor, that may be an indication that he is not properly licensed and is not entitled to permitting p County. 500.00 or more, CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, - ofmhe d� �ida V Construct on L en Lav�--Homeowner's certify that I, t he 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'SIOWNER'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 faws regu{ating canstruction, 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 aiso certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to idenfify what actions I must take to be in compliance. If I am the AGENT FOR THE OWNER,�u tion1 d rstand a�separat permit may be requg ed for work, this affidavit prior to commencing con lication. A plumbing, signs, wells, pools, ai �to be a I'icense o oceed with the work and not as euthorcty to v iolatee ancel, alter, or permit issued shall be construed set aside any provisions of the technical� s�� on oa of any codesp ery t iss ed shall be ome in al d �equiring a correction of errors in plans, unless the work autho�ized by such permiaise d of s�(6) m after he time h k is ommenced. An exte sion the permit is suspended or abandoned for p g0 days and will demonstrate may be requested, in writing, from the Building Official for a � onsecutive days, theeob considered abandoned. justifiable cause for the extension. If work ceases for ninety () WARNING TO OWNER: YOUR FAILURE YOUR PROPERTY IF YOU 1NT TO BTAIN NGTCO SULT PAYING TWICE FOR IMPROVEMENTS TO VYITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) CON7RAC70R OWNER OR AGENT Subscribed and swom to (or affirtned) before me this Subscribed and swom to (or affirtned) before me this by bY Who istare personally known to me or haslhave produced Who is/are personally known to me or haslMave produced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, Printed or stamped fVame of Notary iYPed, P�nted or stamped ,.�,�.,,. _.,