HomeMy WebLinkAbout12-13349 v i �'�^
CITY OF ZEPHYRHILLS �
5335-8TH STREET
-" (si3)�so-oo20 �� ' 13349
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13349 Address: 38130 PRETTY POND RD
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: 35-25-21-0010-07100-0000
Improv. Cost:
Date Issued: 8/16/2012 Name: LOAN FUNDING SOLUTIONS II LLC
Total Fees: 25.00 Address: 4600 WELLS FARGO CNTR 90S 7TH ST
Amount Paid: 25.00 MINNEAPOLIS, MN 55402-3903
Date Paid: 8/16/2012 . Phone:
Work Desc: FPM-SEMI HOOD S FOR BENTLEY COMMONS
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Chapter 633, Florida Statutes,authorizes the City to d�arge and aollect user fees to pay for the costs of fire
prevention and protection related activities such as inspections, plan review,administrative fees,and other
aosts 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 pennits 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 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
813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021
, Permit Application
ate Received � �� �Z Phone Contact for Permit �� Ot � �Q�
wner's Name ` C .J Owner's Phone Number � � C'�� "t�
wner's Address � � L h ('� � I S ` '
�e Simple Titleholder Name Titleholder Phone Number r-� � �
:e Simple Titleholder Address
,b Address (�N P( p,� 3 b � �jp �f� P • � Lot# C� ',
�b Division Parcel# ��� r�(� � � �3��
� Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)/�NNtfAL-.
� Comm Exhaust Kitchen HoodlDuct � Hood Installation �
� Controlled Bum � LP/Natural Gas-InstallaUon ��, , ��
� Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sa� �� �
� Emergency Generator>30 kw � Places of Assembly-ANNU L�� � �
� � ��
Fire Protection Maintenance-ANNUAL Recreational Bum ;°�
�y emi �n er
����Q(,� Sprinkler � ❑ ❑ ❑ � � Sparklers
(ZbQ„ Fire Alarm . ,.�=���""""'�� ❑ ❑ p- �_ � Sprinkler System Instailations
�l �-� , � �
fibod Clea�i� ❑ ❑ ❑ Standpipes(Sprinkler Sys)
r Hood Su ression
PP Q � Torch Roofi�glfar Kettle
� Fire Alarm Instaliation � Waste Tire Storage ANNUAL
� Fire Pumps
� Fire Works �
� Flammable Application-ANNUAL Valuation of Project
aFuei Tanks
� � Other:
� � ��
��0� ' Company
gnature Registered Y/N Fee Current Y/N
Addtess '
License#
_ECTRICIAN ��� 4� ��� 1,I Company
gnature 1 Registered Y/N Fee Current Y/N
Address License#
_UMBER
Company
gnalure Registered Y/N Fee CuRent Y/N
Address
License#
ECHANICAL Company
gnature Registered Y/N Fee Current Y/N
Address License#
THER
Company
gnature Registered Y/N Fee Curcent Y/N
Address
License#
irections:
Fill out appliption completely
Owner&Contractor sign back of appUption,notarized(Or,copy of signed contract with owner)
If over a2500,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(http://appraiser.pascogov.com)
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NOTICE OF DEED RESTRICTIONS. The u�dersigned understands that this permit may be sub�ect to"deed° r.estrictions"
whioh may be more restrictive than County regulations. The i ndersigned assumes responsibility for compiiance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESIPONSIBILITIES: If the owner has hired a-contractoror -
' contractors to undertake work, they may be required to be Ilc�nsed in accofdance with state and (ocal 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 t�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� l, 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 Agc,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'SIOWNER'S AFFIDAVIT: I 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 hereby made to obta n a permit to do work and insta[l`ation as indicated. f certify
that no work or installation has commenced prior issuance of a permit and that all work will be pertormed 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 1
,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 electricaf work,
plumbing, signs, welts, 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, cancef, alter, or
set aside any provisions of the technical codes, nor shall issu nce of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violati Q�ns of any codes. Every permit issiaed shall become invalid
unless the work authorized by such permit is commenced wifhin six months of permit issuance, or if work authorized by
the permit�s suspended or abandoned for a period of six(6)�onths after the time the work is cc�mmenced. An extension
may be requested, in writing, from 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 c�nsidered abandoned.
WARNINGITO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE .'1F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03) � �
OWNER OR AGENT � CON RACTOR�/ '
Subscribed and sworn to(or a�rmed)before me this Subs bed and sworn to(or affi )before me this
by by rr
Who islare personally known to me or has/have produced Who i are personally known to me or has/have produced
as identification. as identlfication.
� Notary Public Notary Public
Commission No. Com Ilss(on No.
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Name of Notary ryped,printed or stamped Name of Notary typed,printed or stamped
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