HomeMy WebLinkAbout12-13138 , CITY OF ZEPHYRHILLS �
5335-8TH STREET �3138
(813)780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13138 Address: 5506 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: 11-26-21-0010-05700-0256
Improv. Cost:
Date Issued: 6/07/2012 Name: PHIL MOOK ENT.INC
Total Fees: 25.00 Address: 1108 W BRANDON BLVD
Amount Paid: 25.00 BRANDON FL 33511
Date Paid: 6/07/2012 Phone:
Work Desc: FPM- HOOD CLEAN SEMI- KFC
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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 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
, ats-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 �v>�
Permit Application
ate Received ,�t31c J� ��-- Phone Contact for Pertnit � a � � ��u
/ Owner's Phone Number � ? �d` J� 2 `
wnefs Name C..� '`
wner's Address � 3� �,L� ' � ' � � ��� � S �� 3 4-a`��� i�A
;e Simple Tdleholder Name Titleholder Phone Number C� �� C� ";
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ib Address
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�b Division Parcel#
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� Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tfer 11 or RQ Facility)ANNUAL
� Comm Exhaust KitChen Hood/Duct ����� � Hood Installation p
� Controlled 8um �� '�',L� LP/Natural Gas-Installation
� Emergency Generator<30 kw LP/Natural Gas-ANNUAL Sale µ
� Emergency Generator>30 kw RT ���� � P�aces of Assembly-ANNUAL _ '
■■�-����]].. Fire Protection Maintenance-ANNUAL Recreational Bum _f�—j ��� �
►y" r y emi �n er `�—f � �
f'� Sprinkier � C ❑ O � � Sparklers
Fire Alarm � � ❑ ❑ � � Sprinkler System Installations
`� Hood Cleaning ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) "`
Hood Suppression � p ❑ p � � Torch Roofingffar Kettle
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aFire Alarm Installation � Waste Tire Storage ANNUAL
� Fire Pumps �
� Fire Works ;
� Flammable Application-ANNUAL � VelUatiOn Of ProjeCt `
� Fuel Tanks "
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� � Other: �-
�nttactor . 't/►_ ��� �� '� � Company `
gnature VV��� Registered Y!N Fee Current Y f N
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�d�� r Lice�se#
_ECTRICIAN � Company
gnaWre Registered Y/N Fee Current Y/N
Add ss License#
_UMBER � tC�` Company
gnature Registered Y/N Fee Current Y/N
Address � License#
ECHANICAL Company
gnaiure Registered Y/N Fee Current Y/N
Address License#
THER Company
gnature Registered Y/N Fee Current Y/N
Address License#
irections:
Fill out application completely
Owner&Contractor sign back of appiication,notarized(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
5upply hvo(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Pa1ai��l Tex Notice(http:l/appraiser.pascogov.com)
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NOTICE OF DEED RESTRICTIONS: The undersigned under�tands that this permit may be subject to"deed"rsstrictions"
which may be more restrictive than County regulations. The ndersigned assumes responsibility for compliance with any
applicable deed restrictions. -
UNLICENSED CONTRACTORS AND CONTRACTOR RES ONSIBILITIES: If the owner has hired a-contractoror
contractors to undertake work, they may be required to be IIC i nsed in acco.�dance 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 unc��tain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County uilding Inspection Di�ision—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 "contractor Slock" of this application for whicb they will be responsible. If you, as the owner sign as the ���
contractor, that may be an indication thaf he is not properly I ensed and is not entitled-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, I
certify that I, the applicant, have been provided with a c�py of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agr culture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of he above describecl document and promise in good faith to
deliver it to the"owner" prior to commencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
that all work wil{ 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 standar�s of all faws regul�#►ng constructi n, County and 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 i.,
,must take to 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 elec#rical 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 vio�ate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issu i nce of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violatiQns of any codes. Every permit issued shall become invalid
un less t h e V v o r k a u t h o r i z e d b y s u c h permit is commenced wifhin six months of permit issuance, or if work authorized by
t he permi t is su s p e n d e d o r a b a n d o ned for a period of six(6) � onths after the time the work is c bmmence d. An ex tension
m a y b e re quested, in writing, from the Building Official for a�ieriod not to exceed ninety (90) days and wi l l demons tra te
justifiable cause for the extension. If work ceases for ninety( 0)consecu tive d a y s,t h e j o b i s c o n s i d e r e d a b a n d o n e d.
WARNINGITO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY R�SULT 1N YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE , .'1F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO tCE OF COMM NC NT.
FIORIDA JURA7(F.S,117.03)
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OWNER OR AGENT ON�RACTOR —
Subscribed and sworn to(or a�rmed)before me this bs bed and sworn to(or a� ed)before� �i
by by—
Who islare personally known to me or haslhave produced Who i lara personally known to me or haslhave produced
as identifica6on. as idenBflcation.
Notary Public
I Notary Public
Commission No. Cam I Ission No.
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Name of Notary ryped,printed or stamped Name of Notary typed,printed or stamped
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