HomeMy WebLinkAbout11-12644 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(si3) �so-oo20 12644
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12644 Address: 38410 6TH AVE
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:
Improv. Cost:
Date Issued: 12/22/2011 Name: ZEPHYRHILLS FIRE DEPT.
Total Fees: Address: 38410 6TH AVE
Amount Paid: � ZEPHYRHILLS, FL. 33542
Date Paid: Phone:
Work Desc: M- ERLY FIRE SPR KLER FOR ZEPHYRHILLS FIRE STATION #2
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Chapter 633, Florida Statutes, authorizes the City to charge and aollect 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 pertormed 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 - 8I3-780-0041
sis-�saoo2o City of.Zephyrhilis Fire Fax-813-780-0021
Permit Appiication
Date Received f?, 2 2 / Phone Contact for Pertnit �
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Owners Name Z.�u (�( LL 'r�� � O Owners Phone Number �� � I
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Owner'sAddress ����Q CD� �1� �£P�1��N)`,(_s
Fee Simple Titleholder Name Titleholder Phone Number ���
Fee SimpleTitleholder Address
�:
Job Address �� �1 � Lot # �
Sub Division Paroel #
d � Bio-Hazard Waste Storage - ANNUAL � Fumigation?ent
� Comm Exhaust Kitchen Hood/Duct � Hazarclous Material (Tier 11 or RQ Facility) ANNUAL
� Controlled Bum � Hood Installation „_
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator> 30 kw Q LP/Natural Gas-ANNUAL Sale �!�
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL J_ ��
�y emi �n er l �. (�
Sprinkler � ❑ ❑ � � Recreational Bum �
Fire Alartn �❑ O �� � Sparklers _
Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
� Fire Alartn Installation � Toroh Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
Flammable Application-ANNUAL Valuation of Project
� Fuel Tanks
Q Other:
Contractor Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
ELECTRICIAN Company
Signature I Registered Y/ N Fee Current Y/ N
Address License #
PLUMBER Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
MECHANICA Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
OTHER �` �' Company � Tl'�C�f7�1�L
Signature y,f�t— Registered Y/ N Fee Current Y/ N
Address � � z yqZLCy� + �= L f License # �� j zpn
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notar¢ed (Or, copy of signed contract with ovmer)
If over $2500, a Notice of Commencement is required (Mechanical work over $5000)
Supply iwo (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: ?he undersigned understands that this permit maybe:subject to "deed"
which may be�more�restrictive County•regutations. 'fhe undersigned assumes compliance with any
appiicable deed restrictions.
UNLICENSED •CONTRACTORS AND �CONTRACTOR �RESPONSIBILITIES: If the owner has hired a contractor 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 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 for which will be responsible. If you, as the owner sign as the
contractor, that may be an indication�that he is not properly licensed and is not entitled permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW (Chapter713, Florida Statutes,_as.amended): If valuation of work is $2,500.00 or more, I
certify that 1, 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", 1 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 regutating 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 pertormed 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 undecstand that the regutations of other
govemment 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 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 etectrical 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 Official from thereafter
requiring a correction of eROrs 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
just�able 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?WICE FOR IMPROVEMENTS TO YOUR�PR�PERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to (or affirmed) before me this Subscribed and swom to (or affirmed) before me this
by bY
Who islare personally known to me or has/have produced Who islare personally known to me or has/have produced
as identification. as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped