HomeMy WebLinkAbout12-13255 r CITY OF ZEPHYRHILLS
5335-8TH STREET
�sis)�ao-oozo 13255
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13255 Address: 36841 CLUBHOUSE DR
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Biock: Section:
Square Feet: Subdivision: SILVER OAKS
Est. Value: Parcel Number: 0426-21-0000-00100-0020
Improv. Cost:
Date Issued: 7/17/2012 Name: S 8 R DEVELOPMENT LLC
Total Fees: 25.00 Address: 36841 CLUBHOUSE DR
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/17/2012 h ne:
Work Desc: FPM-SEMI ANNUAL HOOD CLEANING � a _
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Chapter 633, Florida Statubes,authoMzes the City to charge and aollect user fees to pay for the oosts of fire
prevention and probection related activities such as inspections, plan review,administrative fees,and other
oosts related tio the aforementloned. .
Complete Plans, Specifications and Fee Must Aocompany Application. Commenoement 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 pertormed in aaordance 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
� v�ay vi�.c���y�iiuw� uo rax-25i's-780-0021
. , Permit Application
Date Received Phone Contact for Pertnit� !3 L�7�i ��J
_ s
Owners Name ('�'�--�—��
� Qwners Phone Number ��3 I �G I
Owners Address �8'.�j/� L'a � ��
� ,P Z .� =� 33s-
Fee Simple Titleholder Name Titleholder Phone Number � � ��
Fee Simple TiUeholder Address
� `L..�:=9"-- -.�:�-s-s"t'.an��c�-- .arw�."nw�n�'�.-�isi'^mv _
Job Address ��
Lot#
Sub Division Parcei#
� � �.-�--,�--=._x ��-�.S.;�ar_- - .;- ..z_ -
o :...��.�:.._�-�. - ,
Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent
aComm Exhaust Kitchen Hood/Duct a Hazardous Matenal(Tier II or RQ Facility)ANNUA�,
QControlled Bum a Hood I�stallation •'
� Emergency Generator<30 kw a LP/Natural Gas-Installation ,,%��+ ;
a �-
Emergency Generetor>30 kw � LP/Naturel Gas-ANNUAL Sale J ��j �
aFire Protection Maintena�ce-ANNUAL a Places of Assembly-ANNUAL ��l �`�� � .�.-�
❑� em� � er �
Sprinkler ❑ ❑ p � a Recreational Bum ��Y
Fire Alami � p ❑ ❑ �� a Sparklers ~
Hood Cleaning � ❑ � ❑ C� a Sprinkler System Installations
Hood Suppression � t ❑ ❑ � a Standpipes(Sp�nkler Sys)
� Fire Alartn Installatio� a Torch Roofing/Tar Kettle
a Fire Pumps � Waste Tire Storage ANNUAL
aFire Worics
aFlammable Application-ANNUAL �
� Valuation of Project
Fuei Tanks
Q Ofher:
Contracfor �' Com an
a v Yrl G - j`J /.�-F�,-�Y�-��
Sig�ature Registered Y/N Fee Current Y/N
Address y"]�( ,�"iG �-r�rr C4" '-�`
� License# � �y���1 ��n ra���
ELECTRICIAN
Company
Signature Registered Y/N Fee CuRent �'/(v
Address
License#
PLUMBER
Signature Company
Registered Y/N Fee Current �'/N
Address
License#
MECHANICAL
Company
Signature Registered Y/N Fee Current Y/N
Address -
License#
OTHER �
Company
Signature Registered Y/N Fee Current Y/N
Address
License#
Directions:
Fill out applicafion completely
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
tf over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings wittt applicable docume�tatio�
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice h J/a
i ( ttp' ppraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS: The fed ulations The-undersigned a'ss�umes espons b Ibry for:�mpl an�e tw th any
which may be more restrictive than County g
applicable deed restrictions
UNLICENSED CONTRACTORheANID bONeq Aed o be E en�s dSi Bacico dance w th s ate and locale egulations.0 Ifrthe
contractors to undertake work, t y Y
contractor is not licensed as required �ed contractorhare unce�tan as to what�licensengt equ��emen'ts may apply�foatthe
under state law. If the owner or inten
intended work, they are advised to contact th�eP cont�rac�o ntorB o��n�trag to sp hel�s Ddv sed to I haveln he cotntractor( ) 8 ign
8009. Fu rt hermo r e, i f t h e o w n e r h a s h i r e
portions of the "contractor Block" of this application for e���licensed I la d is not en titled t ypermitting pr v ileges gin Pasco
contractor, that may be a n i n d i c a t i o n t hat he is not prop y
Counry.
CONSTRUCTION LIEN LAW(Chapter713, Florida Statutes, a ofm�e dF o)ridla C'onstruc�on L en $awOOHomeow�e's
certify that I; the applicant, have been provided with a copy
Protection Guide" prepared by the Florida Department of Aof'thetabove des�ribed documlent and promPseantgood ai h to
other than the °owner", I certify
that I have obtained a copy
deliver it to the"owner"prior to commencement.
_ CONTRACTOR'SIOWNER'S AFFIDance�with al appli alblelawsf egu'atingtconstrpcton� zon ngUand land
that all work will be done in comp
development. Application is hereby made to obtain a permit to do work and installation as indicated. I certi y
thai no work or installation has co at nen constructionS County�a dPCitytcodeshazonli g regulat'o psrfand eand
meet standards of all laws regu , g
development regulations in thi torthe in'tended workcand thatat is m y respons bili y t eide gt fy twhat act ons I
government agencies may app y
must take to be in compliance.
If I am the AGENT FOR THE OWNER, I pro nis i�understand that a�separate permit may be req g ed for�electr cal work�,
this affidavit prior to commencing constructio
plumbing, signs, wells, pools, air cond'a'I ce n e to p oceedewith the work and not ascaul horty ao aiolateecapPelaa'Iter, or
permit issued shall be construed to be
set aside any provisions of the technical codes, nor shall issuance of a permit prevent therm t iss ed shall become inval d
requiring a correction of errors in ptans, construction or violations of any codes. Every p
unless the wo�k authorized by such permit �S r od of six(6) mhonths after�the fimpe the'tworkas commenced. Anhext nsate
the permit is suspended or abandoned for a pe
may be requested, in writing, from the BU�ce'a esOfo'rininety(90)f consecutive days the job isOco�ns de ed ba�ndonedS
justifiable cause for the extension. If work
WARNING TO OWNER: YOUR FAILURE TO RREPROPERTY.T�F YOU INTOENDENO OBTA NnFI ANCSNG,TCONSULT
PAYING T1N�CE FOR IMPROVEMENTS TO YOU
WITH YOUR LENDER OR AN TT RNEY BEFORE RECORDING YOUR NOTICE OF MENCEMENT.
FLORIDA JURAT(F.S 117.0 �
CONTRACTOR
OWNER OR AGENT Subscribed and swom to( affiRned)before me this
Subscribed and swom to(or a ed)before me his by
by Who islare personally known to me or has/have produced
� Who is'— �a�e personatly known to mas dentific�afioproduced
as idenffication.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed;printed or stamped
Name of Notary typed,printed or stamped