HomeMy WebLinkAbout12-12740 CITY OF ZEPHYRHILLS
• 5335-8lli SIREET �
. (si3)�so-oo20 12740
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12740 Address: 5214 GALL BLVD
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: 11-26-21-0010-16600-0250
Improv. Cost:
Date Issued: 1/30/2012 Name: VICHRIS INC
Total Fees: 25.00 Address: 5214 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/30/2012 Phone: (813)782-9556
Work Desc: FPM-HOOD CLEAN QUARTERLY- VILLAGE INN
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 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-813-780-0041
FEB/20/2007/TUE 11 : 10 AM ZEPHYPHILLS BUILDII'�dG FAX No, 813-780-0021 P, 002
' '893-?80'D020 City of.Zephyrhills�i����='• •Fax-873-780-0021 • •�f�:;..
` -� Permit Application�-�-• . •� ��,;`
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-Data Received .. --�Ptione Contact for pormt[ _
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Owne�'s Nama �' ' — Owne�'s Phona Number /
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pwnsr'sAddress �02 (� �% .J ,(>,s ) � ��� C�//�,
Fee Sfmple7lUeholdar Name Titleholder Ph�ne Number �] � �
Fee Slmpie"T7tlr,holderAddresa �
Job Address � �` �„ � Lot�f �
Subb�vlslon ' Parcel#
� Hio-HazardWasteStorage-•ANNUAL � �umlga6onTent ' ,
� Comm Exh�ust Kitchen Hood/buct ' � Hazariious Materlai(Tier II or RQ Kacill(y)ANNUAL
� Canlrolled Bum n Nood Ir,etsila0on
� Emergency Oenerator K 30 kw � LPINewrai Gas-Installatfon .
� 'Emargency Ganerator�30 Kw � LPMatural Gas-ANNUAL 3ale
� �tre Protac6on Malntenance-ANNUAL O Places of AssemblY-ANNUA�
' � � Bfn� � e
Sprinkler � p ❑ ❑ B � RecresEional Bum.
Fre Afarm •❑ ❑ D � � Sparklers � �/���j
Hood CleeNn9 ❑ O � � Sprinkier System Installations . �
' Hood Suppressfon [] p � � Standpipea(Sprinkler Sys)
' O FiTe Alart»Inatallatlon ' � Torch RooflnglTar Kettle . �
F{re Pumpa ' ' � Waete'ilre StorageANNUqL.
Fire Worfcs �
Flammabla Appllca0orr ANNUAL ' Vaiva6otl of I'rof eCt '
� ,FueiTanks '
�tY19P: "
ConVaC C Company
$igneture � Registersd� /N Fea Current Y/N
Addreaa _ License# �—^ �
ELECTRICIAN Company '�
Signature • Re9lstered Y{N Fae Cttmertt Y/�)
Addrass Llcense# r ^ � ��
PLUMBER ' - ���na;,f �
. Signature , _ Reglstered Y/N Fea Current Y/N
Address � � Llcense# � �
MECHANiCAL Company
Signature Reglstered Y/N Fee Currant Y/N
Addreee -Licanea� • "
07}iER Company • '
Slgnature Registsrad Y/N Kee Current Y/I�l
Addrass - lJcense#
bfrectlons; .
FII out applicailon complet0ly.
Owner&CohVaeloi e18n hack of appllCatlon,no�r¢ed(Or,cnpy aF slpned contran[wfth owner)
if over S25op,a NoUce of Commencemenf Is raqu�red.(Mechanfcat work over S5000) •
Supply two(2)sete of drawings wlth appficable documentation �
Allow 10-1d deys for rovlew sftar eubmlttal data, Parcel#�obtainad hom Properiy Tax No6ca(httpJ/9ppraiseJ'.p8scogov.com)
FEB/20/2007/TUE 11 : 10 AM ZEPHYPHILLS BUILDIPJG FAX No. 813-780-0021 P, 003
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�A!'OTI:C�E+C?:F;D�EDR�STRlCTIONS: -T'he_underslgned=und�r�j�n�s.�tha#�fhls_pet.mlf may.he�subject:to'`de�d":�.estr.lctl9�1. ''`�'-' tt�
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"�-�-�^►whiCh�may'.be•moreTestric4ive than County're,gufatlotls�.`7he�ur,rd�r.si9ned�assumes_responsibll[ry�for�omp)iarace.wlth��,�y�ar��
' .appllcable desd restrictfons. � ;���GiicaT-,-.:s- - .. ' ---- -`�;�:,�i;;;�;�:�
--'"'"'1JN!':I�•EIVS�D �CONTRACT.PF2S�AND�CONTRA�TOR-=R�SRt?NS1BI�l7'IE�S:=':If-the 'owner has-hired'�wcontractor� ',,,_,4_�;.-:�'
;contractors to undertake work,�they may�be requlred'to be llcensed.in�accordance with stafe and local-regulations. hf.the_=-::�• I
confractor is not ficensed as requlred�.by law, 'both�the owner;and�contractor'may.be cited'for:a�misdem�anor�viola6ori. - �
-.under-state law. If�the owner or intended cantractor:are uncerfain:as�io what Ilcensing•requirements may:apply�for�the�-���-
infended work,•the,y are advlsed�to contact the•Pasco County:Bttildingslnspection-Dlvision—Licensing Sectlon_at727=847
-.80D9. =F.urfhermore, .if the owner has hired-a cantractor or contractors, :he is advised�to •have�tha contra�tor(s}$ign
porElons ofi the "contractor Block" of thls appllcation�for which-#hey will be respbnsible. If you, as�the awner��slan:as.the
-• � =contractor,'Ehat�may.bs an indlcatioh:that he is not�pr.operly lieensed�and is nof entltled�fo:perm�t��n9�Arivileges in�;Rasaa = �� ,
-Gounty. , ;
=CONSTRUCTtON.LIEN-LAW�(Chapter7�t3,'�lorlc�a`Statutes,�s:amended): lf�valuatlon of work is'$2;500.DO.or'mor�,:) �
aert(fy �that I, �the applfcanf, have been provided�with a copy .of�the °Fiorida Construction Llen Law—Fiomeowner's
pratection Guide" prepared by�the �lorida Department of Agriculture.and Consumer Af�alrs. !f the appflcant is•someone
other�than the"`owner", I oertifiy that l have obtained.a copy of.the-above described document and promise in good falth�to _
deliver it to fha°owner'prior:ta commencement. j
- CONTRACTOEt'.SIqWN�R'S-AFFlDAVIT; I certify that all the informatlon in this applicafion Is accurate and I
�thai alf wark will .be done in compiiance with all applicable laws regulating constrvctf�n, zoning and land
development. Application Is hereby made to obfa[n a permit to do work and Installatlon as fndicated. I certffy
that no work or installation ha5 commenced prlor to IsSUance of a permlt�and'that�all work wlll be perFormed t�
meet standards� of all laws regulating constructi�n, Counfy and Gify codes,.zoning regulations, and land
development�ragu}ations in the jurisdictlon. 1 .afso certlfy-that 1 understand thaf the regulafions of other
. government agencies may apply�to the lntended work, and that It is my responsibillty to idenfify what actions!
must take'to tie in compllance.
If f am'thaAG�NT�OR'TH��WNER, I pi'omise iri good faith to inform the owner of�the permltting conditions setforth in
thls affidavii prlor�to�commencing �onstruction. �1 understand fhat a separate permit may.be required for elBCtrical work,
plumbing, slgns, wells, pools, air conditioning, gas, or other installations nof spectFlcaily lncluded ln the applicatlon. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, after, or
set aside any provislons of the�tachnical aod�s, nor shall issuance of a permit prevent the �ullding Off�cia!from thereafter
requiring a correction of errors In plans, constructEon or violati�ns of any codes. �ve.ry permE�.lssued shall become Invalid
unless the work auttiorEzed'by such permlt is cammanced within six monfhs of permit issuance, or if work aufhorfzed by
fhe permit is suspended or abandoned for a period of six(6) mdnths after fhe fime the work is commer�ced. Ar�exfension
may be requested, in wrtting,from the Bullding Official for a period not to exceed nlnety (90) days arid wlli dernonstrate
Justifiable cause for the extansion. If work ceases for ninety(90)consecutive days,the job is considered abandon�d.
- ''WARNING TO'OWN�R: 'YOUR'��iILURETa"�RECORD A"NGT �GbMMENC T�Mi4Y=�RESULT=IN YOUR = = -•
PAYIN�TWIC �4R fMPR01l� NTS TO YpUR PR�PER�f. 1F YDU i TEND TD ST (N FINANCING, CONSULT
WITH Y L ND OR.A A ORN Y BEFOR�RECD DING Y�UR N TICE MM NCEN�,�NT.
FLORIPA RAT{F.S.11 .03) � '"—�������
OWN�R GR A T _ CON7 7 __.
Subsctibod and surom Yo(or affirmed) 6fo me itlls Subscribed an swom to(or afflrm )be e me this •
by �Y
Who is/ars persohally knowtt to me or h � e produced Who Is/are personally Knpwn to me or asli'sa e produCed
as iden� Uon_ � 6ntlficadOn.
Notary Public _No1ary Pub{�c
Got'nmission No: Commission No.
Name qf Notgry typed;printed or stamped Name of No�ry typed,printed or s�mped