HomeMy WebLinkAbout11-12657 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020 12657
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12657 Address: 4645 AIRPORT RD
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: 13-26-21-0080-00000-0020
Improv. Cost:
Date Issued: 12/28/2011 Name: ZEPHYR PALMS EVENT CTR
Total Fees: 50.00 Address: 4645 AIRPORT RD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/28/2011 Phone:
Work Desc: FPM-SEMI HOOD CLEANING & SEMI HOOD SUPPRESSION FOR AMVETS
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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 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 A7TORNEY 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 - Pire Marshal Office - 813-780-0041
' � r 813-780-0020 City of Zephyrhills Fire Fa�c-s��-�ao-oo2�
Permit Application
Date Received — �/ Phone Contact for Permit 352 � 7� 7340
Owner's Name Amvets Owners PFrone Number �� �� ��
Owners Address
Fee Simple Titleholder Name Titleholder Phone Number 813 780 8180
Fee Simple Titleholder Address
Job Address Lot # �
Sub Division Parcel #
� Bio-Hazarcl Waste Storage - ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material (T'rer II or RQ Facility) ANNUAL
� Controlled Bum � Hood Installation
� Emergency Generetor < 30 kw a LPlNaturel Gas-Instailation
� Emergency Generator > 30 kw Q LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Piaces of Assembly-ANNUAt �'� �
� � � e� 0 S
Sprinkier � O ❑ O Recreational Bum �� �
Fire Afartn ❑ ❑ ❑ �� � Sparklers
Hood Cleaning X�X ❑ � ❑� � Sprinkler System installatio
Hood Suppression XX � � ❑ C� � Standpipes (Sprinkler Sys) �
� Fire Afarm Installation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL �_—, Valuation of Project
Fuel Tanks
Q Other.
ConVactor Company
Signature Registered Y/ N Fee Curt�ent Y/ N
Address
License #
ELECTRICIAN Company
Signature � Registered Y! N Fee Current Y/ N
Address License #
PLUMBER Company �—
Signature Registered Y/ N Fee Current Y/ N
Add2ss
Lice�se #
MECHANICA
�►+a�m
Signature Registered Y/ N Pee Current Y/ N
Address License #
OTHER � Comparry Securitv Fire EauiDment LLC �
S�g"a�"re �'alt�'�� Registered Y/ N Fee Cument Y/ N
Address 18330 Lawrence Rd License#
Directions:
Fill out application completefy
Owner & Contractor sign back of applica6on, notarized (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 drawi�gs with applicable documerrtation
Allow 10-14 days for review after submittal date. Parce{ #- obtained from Property Tax Notice (http://appraiser.pascogov.com)
• NOTICE OF DEED RESTRICTiONS: The undersigned understands that this permit may be subject to "deed' restrictions°
which may 6e more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicabte deed resirictions.
UNUCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILiTIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accArdance with state and local reguiations. If the
cbntt8ctor is not licensed as requited by law, bottt the owner and contrdctor may be cfted for a misdemeanor violation
under state law. ff the owner or intended contractor are uncertain as to what licensing requirements may appty for the
intended work, they are advised to contact the Pasco Courriy Building Inspection Divisiorr—Licensing Sectlon at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractws, he is edviaed to have the wntractor(s) sign
poAions of the "cordrador Blodc' of this application for which they wiil be responsible. N you, as the owner sign as the
contrador, that may be an indiCation that he is not properiy licensed and is not en� to permitting privileges in Pasco
County.
TRANSPpRTATION IMPACTNTiLIT1ES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that TransportaHon Impact Fees and Recourse Recovery Fees may apply to the cons6vction of new buildings, change of
use in existing bulldings, or expansion of existin8 bu8d'mgs, as specified in Pasco Courrty Ordinanoe number 89-07 and
90-07, as amended. The understgned aiso understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Ttansportation impact Fees and Resource Recovery Fees must be paid prior to
receivfng a'certficate of occupancy" or finat power refease. if the project does not involve a cerFrficate of occupancy a
final pa�ver release, the fees must be paid prior to permft issuarroe. Furthermore, if pasco County WatedSewer Impact
fees are due, they must be patd priar to permft issssuance in acrArda�ce wfth applicable Pasco County ordinances.
C�NSTRUCTION LIEN LAW (Chapter T13, Florfda Stah�tes, as amended): H waluaHon of work +s $2,500.00 or more, 1
certiy that I, the applicant, have baen provided vWth a copy of the "Florida Coristrucfi�on Lien Law—Homeowner's
Protection Guide' prepared by ihe Florida Dep�tment of Agricxilture and Consumer Affairs. K the applicant is someone
other than the 'owner", I certify ttrat 1 have obtained a copy of the above desaibed document and promise in good faith to
deliver ft to the `owner" prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: 1 certify that ail the iMortnation in this appiication is accxuate and that all work
wili be done in compliance with all applicable laws regulatirn� constrvction, zoning and land development. Application is
hereby made to obtain a permit to do wwk and installation as Indicated, I certify that no work or instaNation has
commenced prior to issuanc;e of a pertnit and that s1i wo►k will be performed to meet standards of ail laws regulating
cot�shuction, County and City codes, zoning regulations, and land devebpment reguladons fi the jurisdiction. I also
certHy that I understand that the reguiations of other govemment agenaes may appiy to the ir►tended work, and that it is
my responsibility to identiry wlmt ac�ions 1 must take to be in rbmpliance. Such agende,s ir�dude but are not Bm)ted to:
' DeRartrnent of Ernmonmental ProtecUon-Cypress Bayheads, Wetland Ar�s and Environmentally Sensitive
Larxis, WeterlWastewat� Treatment
- Southwest �lorlda Weter Management District-Wefls, Cypr•ess Bayheads, Wettand Areas, Altering
Wate►courses.
- Afmy Corps of Engineers�eawalls, Docks, Navigabte Waterways.
- Departmenf of Heafth 8 Rehabllitative Services/Environmental Heaith Unit-WeNs, Wastewater Treatment,
Sepfic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authoriy-Runways.
i understand that the following restrictio� appiy to the use of fill:
- Use of fll fs not allowed in Flood Zone 'V' urdesa expressly permitted,
- tf the flll materfai Is to be used in Flood Zone 'A", it is understood that a dreinage pian addressing a
'compensating vdume" will be submitted at time aF pertnitting which is prepared by a professional engineer
Ucensed by the Stete of Florida.
- If the fill rnaterial is to be used in Flood Zone 'A" in connec4ion wfth a pennitted building using stem wall
consUuctfon, i certify that flH wIN be used only to fdi the area withln the stem wall.
- If fiil materiai is to be used in any area, I certify that use of such fili wili not adversey afFect adjacent
properties. If use of fdl is found to adversefy affect adjaceM proper�es, the owner may be dted for vidaling
ihe conditia�s of the building pertnit issued under the attac�eed pertnif appik;etion, for lots less than or� (1)
acre whk:h are elevated by fiii, an ergineered dr�nage pian is required.
If I am the AGENT FOR TNE OWNER, I promise in good faith to iMorm the owner � the pertniriing conditions set forth in
ihis eflidavit prior to commencing construcfion. I understend that a separate permit may be requfred for electrical wo�lc,
plumbing, signs, weHs, pools, air �nditioning, gas, or other instaliations not specffically induded in the application. A
pertnit issued shall be c:onstrued to be a license to proceed with the w�ork and not as authority to violate, cancel, alter, or
set aside any provisfons ot the technical caies, nor shall issuance M a permit prevent the BuBdirig Official from thereafter
requiring a r,omection of errors in plans, construckiort or violations of any codes. Every permit issued shall be�ome lmal(d
unless the work authorized by such pemdt is commenced wlthin six motrttis ot permft issuarxx�, or iF work authorized by
the pem►it is suspended or abandoned for a period of six (8) months after the time the work is commer�ed. An extension
may be requested, in wrtting, from the Buiid'mg Oflicial for a period not to exceed ninety (90) days and will demonstrate
justifiable cause tor the extension. tf 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 TYYICE FOR IMPROYEMENTS TO YOUR PROPERTY. � YOtI �ITEND TO OBTAIN FINANCING, CONSULT
WI7'FI YQUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMNIENCEMENT
FLORIDA JURAT (P:S. 117.09)
OWNER OR A6ENT CONTRAC70R
S� and swom to (or artirtned) befare me tlds S�ibed and swom ta (or aflirmed) bsfae me this
e!' 6Y
riho Islare personapy knoMm t� me or heert�eve praduced Who k/are pxmraY�r In� fo � or haaRmve produced
as iddNlficaBOn. as identlRcation.
Not�y P�ic No1ary PubQc
Commlesbn No. Commiss� No.
Name of Notary typed, prlMed or stamped Name oT NoFary ryped, pr3Med or stemped