HomeMy WebLinkAbout12-12742 CITY OF ZEPHYRHILLS
• ' S335-8TH STREET
(s13)�so-oo20 12742
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12742 Address: 37411 EILAND BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL..
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Seation:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03-26-21-0010-05300-0000
Improv. Cost:
Date Issued: 1/30/2012 Name: KOENIG WEST WINDS LLC
Total Fees: 25.00 Address: 37411 EILAND BLVD
Amount Paid: 25.00 ZEPHYRHILLS FL 33542
Date Paid: 1/30/2012 Phone: (813)783-8100
Work Desc: FPM- SUPPRESSION SEMI-WEST WINDS
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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."
�
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal OfFce- 813-780-0041
�• 813-780-0020 City of Zephyrhiiis Fire Fax-813-780-0021
Permit Application
ate Receiv,.i Phone Contact for Permit uL'LJ 1_J�,I �
wner's Name s Phone Number [�� �
wner's Address
�e Simple TRleholder Name Titleholder Phone Number C� � ,
�e Simple Tilleholder Address
ib Address W � Lot# �� �
J
�b Division Parcel#
� Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL -
� Comm Exhaust Kitchen Hood/Duct � Hood Installation
� Controlled Bum � LP/Natural Gas-Installation
� Emergency Generator<30 kw � LP/Natural Gas-ANNUAI Sale
� Emergency Generator>30 kw a Places of Assembly-ANNUAL
1v1 Fire Protection Maintenance-ANNUAL � Recreational Bum
���� r y emi �n er �
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Sprinkler � ❑ ❑ ❑ � � Sparklers
�,� Fire Alarm ❑ ❑ O S rinkler S stem Installations
� � C� � P Y
�� ood Cleaning � ❑ ❑ ❑ � Standpipes(Sprinkler Sys)
, Hood Su ❑ ❑ ❑ � � Torch Roofingffar Kettle
ppression �
� a Fire Alartn Installation Q Waste Tire Storage ANNUAL
� Fire Pumps
� Fire Works
� Flammable Application-ANNUAL � Valuation of Project
� Fuel Tanks
� � Other.
�
�ntractor � ' '� � Company
gnature Registered Y/N Fee C;urrent Y/N
Address
License#
-� f 0 s� Company
9 Registered Y/N Fee Current Y/N
Address
License#
_��a � � o x a�
Company s
Registered Y!N Fee Current Y/N
Address
License#
ECHANICAL Company
gnawre Registered Y/N Fee Current Y/N
Address �
License#
THER
Company
gnaWre Registered Y/N Fee Gurrent Y/N
Address
License#
irections:
Fill oui appliption completely.
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Suppry two(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)
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NOTi�E OF IaEED R�STRICTIONS: The uniiersigned under�tands that this permit may be subject to"deed° cestrictions"
which may be more restrictive than County regulations. The�ndersigned assumes responsibility for compliance with any
applicable deed restrictions. ,
UNLICENSED CONTRACTORS AND CONTRACTOR RE PONSIBILITIES: If the owner has hired a��contractor-or -
contractors to undertake work, they may be required to be IICQnsed in acco,�a�ance with state and local regulations. If>the
contractor is not licensed as required by law, both the own�� and contra�tor may be.•cited for a misdemeanor violation ,
under state law. If the owner or intended contractor are u�c�ertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County uilding 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 "cantractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, ,that may be an indication that he is not properly I censed and is not entitied to permitting privileges in Pasco
County. i
CONSTRUCTION LIEN �AW(Chapter 713, Florida Statute , as amended): If valuation of work is$2,500.00 or more, 1
certify that� l, the applicant, have been provided with a c�py of the "Florida Construction Lien Law—Homeowner's �
Protection Guide" prepared by the F{orida Department of Agr,culture and Consumer Affairs. 1f the applicant is someone � �
other than the "owner", I certify that I have obtained a copy of�he above describetl document and promise in good faith to ��
deliver it to the"owner" prior to commencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: 1 certi��fjr that all the information in this application is accurate and '�
that all work will be done in compliance with al applicable laws regulating construction, zoning and land
development. Application is hereby made to obta n a permit to do work and instaflation as indicated. I certify
that no work or installation has commenced prior issuance of a permit and that all work will be performed to �
� meet standards of all laws regulating constructi n, County a�d City codes, zoning regulations, and land �
development regulations in the jurisdiction. I so certify that I understand that the regulations of other
�government agencies may apply to the intended ork, and that it is my responsibility to identify what actions I 1 .
; must take t�be in compliance.
If I am the AGENT FOR THE OWNER, I promise in good fait to inform the owner of the permitting conditions set forth in ;''
this affidav�t prior to commencing construction. I understand that a separate permit may be required for electrical 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 ith the work and not as authority to violate, cancei, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building O�cial from thereafter r','
requiring a correction of errors in plans, construction or violati Q�ns of any codes. Every permit issued shall become invalid ;
unless the iivork authorized by such permit is commenced wifhin 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 cbmmenced. An extension ? _
may be requested, in writing, from the Building Official for a Qeriod not to exceed ninety (90) days and will demonstrate � ,.
justifiabfe cause for the extension. If work ceases for ninety( 0)consecutive days,the job is considered abandoned. tt
WARNINGITO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY R�SULT IN YOUR �
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE .'1F YOU INTEND TO OBTAIN FINANCING, CONSULT ,�
WtTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM NC MENT.
FLORIDA JURAT(F.S.117.03)
. i
OWNER OR AGENT CON RACTOR�,__
Subscribed and sworn to(or affirmed)before me this ubsc'bed and swofn to(or� ed)befofe is
by by
Who islare personally known to me or has/have produced Who i are personally known to me or haslhave produced
as identification. � as Identification.
� Notary Public Notary Public s,
Commission No. Com Ilssion No.
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Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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