HomeMy WebLinkAbout12-13195 CITY OF ZEPHYRHILLS �'
, 5335-8TH SIItEET
(si3)�so-oo20 13195
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13195 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: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03-26-21-0010-05300-0000
Improv. Cost:
Date Issued: 6/21/2012 Name: KOENIG WEST WINDS LLC
Total Fees: 25.00 Address: 37411 EILAND BLVD
Amount Paid: 25.00 ZEPHYRHILLS FL 33542
Date Paid: 6/21/2012 Phone: (813)783-8100
Work Desc: FPM- HOOD CLEAN QUARTERLY-WEST WINDS A.L.
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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
` 813-780-002o City of Zephyrhilis Fire
Fax-813-780-OU21
Permit Application
ate Received
Phone Contact for Pertnit ' ( ' �� �C�U
wner's Name J (.1�� �j 1 i �Ch1� �� [ '—.�J �
Owners Phone Number
wner's Address �' f , .� (� � •� � 2� �
J
�e Simple TRleholder Name � �� ��
Titleholder Phone Number
�e Simple Titleholder Address
ib Address ��\ � � � ( �j ` i� � V
� L J Lot#
�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/Naturai Gas-Installation
� Emergency Generator<30 kw � �P/Natural Gas-ANNUAL Sale
� Emergency Generator>30 kw � Piaces of Assembiy-ANNUAL /J��
Fire Protection Maintenance-ANNUAL � ���IN
Recreational Bum �
( � �y emi � er ❑
�+��Il,o,l�\ Sprinkler � p ❑ ❑ Sparklers
'-'�-(?'v
�j a7/I Z Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Instaliations
Hood Cieaning ❑ ❑ � � Standpipes(Sprinkler Sys)
��'3�a - • Hood Suppression p � ❑ �
� ❑ Torch Roofing/Tar Kettle '
Fire Alartn Installation � Waste Tire Storage ANNUAL
� Fire Pumps
� Fire Works
� Flammable Application-ANNUAL
� Valuation of Project
Fuei Tanks
' ❑ Other:
�ntractor L . \ 1
gnature ���L� V � l. Company
egistered Y/N Fee Current Y 1 N
Address �, ' �
License#
_ECTRICIAN�
gnature �� ��S Company
Registered Y/N Fee CuReot Y/N
Address
License# �—
_UMBER
gnature Company
Registered Y/N Fee Cutrent Y/N
Address
License# � �
ECHANICAL
gnature Company
Registered Y/N Fee Current Y/N
Address
License# --�
THER
gnature Company
Registered Y/N Fee Current Y/N�—
Address
irections: License#
Fill out appiicatio� pletely.
Owner&Contrac r sig�back of application,notarized(Or,copy of signed contract with owner)
If over$2500,a otice of Commencement is required(Mechanical work over$5000)
Suppiy twp(2) ts of drawings witli applicable documentation
Allow 10-14 ys for review after submittal date.
Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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NOTICE OF DEED RESTRICTIONS: The unclersigned 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 RES ONSIBILITIES: If the owner has hired a-contractor-or
contractors to undertake work, they may be required to be Ilc nsed in accotdance witti state anci focal 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 rtain 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 "contractor 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 ensed and is not entitled to permitting privileges in Pasco
County. i
CONSTRUCTION LIEN L.AW(Chapter 713, Florida Statute , as amended): If valuation of work is $2,500.00 or more, I
certify that 1, 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 described document and promise in good faith to
deliver it to the"owner"prior to commencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: ( certi�y 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 hereb made to obta n a ermit to do work and installation as indicated. I certify
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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 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
,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 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 ith the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issu nce of a permit prevent the Building Official from thereafter
�equiring a,correction of errors in plans, construction or violati Q�ns of any codes. Every permit issued shall become invalid
unless the irvork authorized by such permit is commenced wifhin six months of permit issuance, or if work authorized by
the permit i's suspended or abandoned for a period of six(6) onths after the time the work is cbmmenced. An extension
may be requested, in writing, f�om the Building Official for a�eriod not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety( 0)consecutive days, the job is considered abandoned.
WARNINGITO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY R�SU�T IN YOUR
PAYING TINIGE FOR IMPROVEMENTS TO YOUR PROPE . IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03) �
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OWNER OR AGENT �,/`FON RACTOR�
Subscribed and sworn to(or affirmed)before me this Sutis 'bed and sworn to(or �fined)before U1is
by by
4Vho is/are personally known to me or has/have produced Who i are personally known to me or haslhave produced
as identificafion. as Idendfication.
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� Notary Public Notary Public
Commission No. Com Ilssion No.
�
1Jame of Notary ryped,printed or stamped Name of Nota
� ry typed,printed or stamped
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