HomeMy WebLinkAbout12-12994 CITY OF ZEPHYRHILLS d,,
5335-8TH STREET
(si3)�so-oazo 12994
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 12994 Address: 7254 GALL BLVD
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:
Improv. Cost:
Date Issued: 4/18/2012 Name: HAUNG, JAMES
Total Fees: 25.00 Address: 7254 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/18/2012 Phone:
Work Desc: FPM-SEMI HOOD SUPPRESSION FOR CHINA WOK
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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 aforemendoned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written a
the Fire Department's Fire Marshal or r uired pproval of
eq 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$100.00, whichever is greater. All
work shall be pertormed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO IN Y R NOTICE
OF COMMENCEMENT." '
PERMIT OFFICER
PERMIT EXPIRES IN 30 DAYS WITIiOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
8J3-780-0020 City of Zephyrhills Fire
Fax-813-780-0021
� Permit Application
M1ate Received ' _ � -
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hvner's Name C /�/�- l,� b � #
Owners Phone Number �� �� � ��
hvner's Address ` v�s � G�-��, � L v'�,
ee Simple Titleholder Name Titleholder Phone Number � �� ��
�ee Simple Titleholder Address �-J
�LC ;, "$�3•, ' _
�ob Address - �� ��
� Lot#
iub Division
�. ,:��. �.- Paroel#
aBio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Bum � Hood Installation
� Emergency Generator<30 kw � LP/Natural Gas-Installation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �
❑ rly emi � er ❑ � � C���/,
Sprinkler � 7
� � � Recreational Bum
Fire Alarm � ❑ ❑ p Sparklers
� � ❑ �..._....___._...�..
Hood Cleaning O ❑ ❑ C] � Sprinkler System Installations
Hood Suppression � ❑ � � � ❑ �sr � ���-
Standpipes(Sprinkler Sys) c� /';�� � ///ttt _ , J
� Fire Alarm Installation � �+��� ,r�: ��
� Torch RoofinglTar Kettle ! ��,�! /`�"� �
Fire Pumps � Waste Tire Storage ANNUAL �../�
� Fire Works ____.,� '
� Flammable Application-ANNUAL
� Valuation of Project
Fuel Tanks
Q Other:
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;ontractor �
iignature / ` Company pl� r/�C� L � ��
Registered Y/N Fee Current Y/N
Address
License#
:LECTRICIAN
ignature Company
Registered Y/N Fee Current Y/N
Address
License#
LUMBER
ignature
Company
Registered Y/N Fee Current Y/N
Address
License#
ECHANICAL
gnature Company
Registered Y/N Fee Current Y/N
Address
License#
fHER
�nature Company
Registered Y/N Fee Current Y/N
Address
License#
•ections:
Fill out application 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)
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice htt //a
( p: ppraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS� The �nd u�'s�9ons. The undersigned alssumes respons bilty for compl a'nce w th any
which may be more restrictive than County eg
applicable deed restrictions.
UNLICENSED CONTRACTORSeAND bON qRAe�TO�R e E�S�P�edS�BaLI�T+olE�ance th ate a d locae egul tonsc Ifrthe
contractors to undertake work, t y Y
contractor is not licensed as required by taw, both the owner and contractor may be cited for a misdemeanorlvif�lat�he
under state law. If the o�v sed toncontact thenPastco County Buadingslnspectionl D v s!orrLicen ngtSecfion at727-847-
intended work, they are a
8009 Furthermore, if the owner has hired a contractor or contractors, he is advised to haas the owntea sign assthe
portions of the "contractor Block" of this application for which they will be responsible. If you,
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County. If valuation of work is $2,500.00 or more, I
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as f he d�Orida Construction Lien Law—Homeowner's
certify that I, the applicant, have been provided with a copy
��
Protection Guide" prepared by that I Ihave obta ned ancopy of Ithetabove descr bed document nd prompse ntgood fa th to
other than the "owner", I cert fy
deliver it to the"owner" prior to commencement. lication is accurate and
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this app'
that all work will be done in compliance with all applicable laws regulating 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 performed 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 understand that the regulations of other
government agencies may apply to the intended work, and that it is my responsibility to identffy what actions I
must take to be in compliance.
If I am the AGENT FOR THE 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 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 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 errors in plans, construction or violations of any codes. Every pe�mit 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 command will demonstrate
may be requested, in writing, from the Building Official for a pe�iod not to exceed ninety (90) days
the ob is considered abandoned.
just�able cause for the extension. If work ceases for ninety(90)consecutive days, j
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPR NV�EMTORNEY BEFORE RECORDING YOUR NOTICE O COMMENC MENT.' CONSULT
WITH YOUR LEN�ER�R A
FLORIDA JURAT(F S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirtned)before me this
Subscribed and swom to(or affirmed)before me this by
by Who is/are personally known to me or has/have produced
Who isJare personally known to me or has/have produced as identification.
as identification.
Notary Public
Notary Public
Commission No Commission No.
rinted or stam ed Name of Notary ryped,printed or stamped
Name of Notary typed,p P
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