HomeMy WebLinkAbout12-12957 • CITY OF ZEPHYRHILLS
5335-8TH SIREET '
(si3)�so-oo20 12957
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12957 Address: 7838 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class o#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: 35-25-21-0010-00700-0000
Improv. Cost:
Date Issued: 4/10/2012 Name: PRIMERICA GROUP ONE
Total Fees: 25.00 Address: 3629 MADACA LN
Amount Paid: 25.00 TAMPA FL 33618
Date Paid: 4/10/2012 Phone: (813)933-0629
Work Desc: FPM- SPRINKLER QUARTERLY PUBLIX
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the costs of fre
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$100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO IN Y R NOTICE
OF COMMENCEMENT." '
PERMIT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
� MARj2$/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No. 813-780-002( P, 001
a��7so-oozo City ofZephyrhlllsFidet Fax-813-780-0021 '!:
permft Application ._.
Date Recelved ,. .Phone Co��ntacF�for Pertnft
Ownere Name • Ownei's Phone Number � 8l3—� � �
� .
Ownera Add2se
Fee Simple T1Ueholder Name � Titletrolder Phone Numbar �� � �]
Kae SimplelltleholderAddre;s ' � � `
Job Addreas '� ' 1.vt# • �
5ub Divislon Par�e{#
� Blo-Hazard Waate Storage—ANNUAL �� FumlgaUon 7ent
� Comm Exhaust Kitchen Hood/DUCt �• Ha�rdous Meterlai�er 11 or RQ FeclUry)ANNUAL
� Gontroiled Bum � Hood fnalalleUon
� �margency Generator<30 kw • � LP/Natu�el 6as-Inetallatlon '
� �•�mergency Generator>3o kw � LPMatural Gas-ANNUAL Sale ,
Flre Protaction Mafrrtenance=ANNUAL O Places vf Assembly-ANNUAL
y em� e
Sprinkler � D��� � Reoreatb�l Bum • � ��� `�,��
Fre Alarm � ❑ C]' ❑ � � Spwk�ers . ����
Hood Claening � O� ❑ C.] � 3Winldsr'Sy9tam Installutions � �`��
Haod Supprasslon � p ❑ ❑ � � 5tendplpes(Spdnkler5ys) � « 4 l t d l�Z
a Fire Alarcn Inetnllefion � Torch RoafinglTal'Ke1de , '
Flre Pumps � Weste Tlre Storage ANNUAL
Flro Worka •
Flemmabte Appficauon-AnlNUaL • Valuation of Project
Fuel Tanks
[J • Other: ' �
contraclor � • Company
Signawro ' Regist�red / Fee Curtent N �
Address icanse#
�l,ECTRICIAN � � Compa�ry _�
Signature Reglsiered• �'/N Fea Current. � Y/N
Addre:e License#
PLUMBER Company �
Slgnature �aiaterea Y/N Fee Current Y/N
Addross � Llcanaa# �
MECHANICAL Company
signature Rcgistered Y/N Fea Currtnt Y•/N
Address Licenae#
OTH�R ���y �----^-----
L_�. � -
signature Regietered Y/N Fee Ctufent Y/M
Addreee Llcanse�F
Oirectio��;
Fltl out aDA�ics6nn tompletely. �
Owner�Canvactor eign baok of applice6on,notadzed(Or,copy of eigneci contrad wuh owner)
If over 5�00.a Notice of Commencement ia requtred.(Mechenical work over$6000) •
Supply Mro(2)eeis o1 d►awinpa with appllcable documentatlon
Ailow 1�-14 daye far ravlaw aher eubmitlal date. Percel dt.Obtal�ad irom Property Tax Notice(h[tpJ/eppreiear.pescOgov.com)
MAR/28/2007/WED 07:20 AM ZEPHYAHILLS BUILDING FAX No, 813-780-0021 P, 002
, 'P10T{C�OF:DE�p�RESTitICTIONS:-Che.underslgned und'erstands•thatthis pErmit may-be•subJ�cf:ta�"de�d°�restrictlans"�
which may be more restrictiv�than County�regulations. 'The•.undersigned.assumes 1'esponsibil'�ty�for�compliara�ce+uvifh any
.appliaable deed restrlotlons. '
'UNLICENSED�CpNTRAC70R5.AND-CONTRACTOR..RESP�NSI�ILiTtES: if�the owner has�hired•:a�oontractor�or � -
conttaotors rto undertake work,they may be required-to be licensed in accordance with state and local-regulation5. If the
cond'aotor Is not licensed as required by law, both the owrier:and�contractor may be cited�For.a'misdemeanvr vlolation
.under st�te law. If the owner or Intended�contracfor are �ncertain•.as'to whaf licensing�requirements may app(y for the
intended work,they a�e advised�to aontact the•Pasoo County Sullding Inspection Division—L.icens(ng 5ection.at 727-847-
8009. Furthermore, ff the owner has hlred.a contracfor or cantCactors, he ls advised�to•have�the contractor(s) sign
portions of the°contractor Black"of this appllcation�for which'they wlil be responstbie. ff you, a's�the owner�stgn�as the
coritractar, that may be an indfcation�that he is�not properly liaensed and Is not enEitJed�to�permitting.privlleges ic� Pasco
County. • �
CONSTRUC`f10N•L.IEN.LAW(Chapter7�13,�Florida Statutes,.ss.amended): lf valuation of work Is'$2;500.�0 or more, I
certity'that 1, 'the applicant, have .been provided wlth a copy af'the °Florida. Gonsfivction .Lien. Law—Homeowner's
Protection Gulde° prspared by�the Florlda pepartment of Agriculture and Consumer Affairs. !f the applicant is�someone
other than the�"owner°, I certify that I have obtained a copy of the above descrlbed document and promise in good faith to
deliver it to the"awner"prior to comrnencement.
_ �ONTFiACTOR'S/OWNER'•S�AFFIDAVIT: I certliy that all the information in thls appl(caElon is accurate and
that all work will be dbne In compliance wlth all applicable Vaws regulat(ng construction; zoring and land
development. Applicafion ls hereby made to�obtain a permlt to do work and installation as Indicated_ I certify
that no work or installation has comrnenced prior to issuance of a permit and-that all work wUl be perFormed to
meet standards of all taws regulaUng construction, Cpunty and Clty codes..zoning regulations, and land
development regulations in the jurisdiction. t also cert(fY that I understand that the regulatlons of other
.government agencies 1n2y apply to the intended work,and that it is my responsibllity to identffy what actlons I
must fake�to be In campllance. '
1f I am the AGENT�FORTHE OWNER, I prbmise iri good faith to Inform the owner of the permitting conditions set forth in
thts affidavit priar to commencing cor�strucaon. �I understand that a saparate�permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas,.or otber installatlons not specifically Included in the application. A
permlt lssued shall be construed to be a Ilcense to proceed with the work and nof as authority to violate, cancet,alter, or
set aside any provisions of the technical codes, nor shall issuance ot a permit prevent the�uilding.Official from thereafter
requiring a correc6on o#errors in plans,construction or violatlans of any codes. Every permit tssued shall become invalid
unless the work authorized by such permit is commenced within sfx months of permit Issuanr�e, or If worlc a�thorized by
the permit Is suspended or abandoned far a period aF slx(�)months after the tlme the work is commenced, An extension
may be requested, ln wrlting,from the Building Offlcial for a period not to exceed ninety (9a) days ar►d will demonstrate
justifiable cause for ftie extenston. lf work ceases f�r niriety(s0)consecutive days,the)ob is considered abandoned.
'WARNING TO OWNER: YOUR �A{L'URE TO�RECORD A'NOrfICE'OF:COMRA�NGEM�NT M�41�"R�SULT IN'YOUR "
PAYING TWlC�FOR IMPROV�MENTS�TO YOUR PROP�RTY. IF YOU INTENDTO OBTAlN�tNANCING,CONSULT
WITH OUR LE DER O AN Al?ORNEY EFORE RECO .DING YOUR NC)'fICE OF COMMENCENtENT.
FLORfDA JURAT(F.5.117.03) � ,
DWNEii ORAGEN'r CPNTI2ACTOR
� �a f • d antl swo (or afflrtned) fore m this
Y �'y
W ls/ re�o�al vm to me or hasltlave produCed Wh I�/ e�1 ona to me or dshiave produCed
as Iden6fica6on. _ as identlticadon.
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Notary Pubiic
Commf slon No. . I � Commisslon No. 1 ` w �.--
- '. • _��Z�l V va�C'P ,
Nam's of Nofary q�ped;printed o�stamped Name'of No�ry plped,printed or stamped
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