HomeMy WebLinkAbout12-13457 ' � CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oo20 13457
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13457 Address: 5963 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: 10-26-21-0020-00000-0021
Improv. Cost:
Date Issued: 9/17/2012 Name: SUNRISE EATERY
Total Fees: 25.00 Address: 5963 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/17/2012 Phone:
Work Desc: FPM- HOOD CLEAN QUARTERLY- SUNRISE EATERY
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Chapter 633, Florida Statutes,authorizes the City to charge 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 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. Ail
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 WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
rermit Nppucatron
��ate RE t;ived - _
^ Phone Contact for Permit (3 �t?�i ��
�-�- .
Qwners Name ..��,�.� �� 1r�. ,
Qwners Phone Number C� � ��"'�
Owners Address S'�'j�j �i�rL-G -3�//� � ��/ J
Fee Simple Titleholder Name �� �� �
Titleholder Phone Number
Fee Simple TiUeholder Address
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Job Address ' '
Lot# �
Sub Diwsion .J
Parcel#
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Bio-Hazard Waste Sto2ge-ANNUAL �
aFumigation Tent
Comm Exhaust Kitchen Hood/Duct a Hazardous Matenal(Tier II or RQ Facility)qNNUAL
� Controlled Bum a
a Hood I�stallation
Emergency Generator<30 kw a
� LP/Natural Gas-Installation
Emergency Generetor>30 kw a LP1Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL �
Places of Assembly-ANNUAI
❑�r1y em� nf er � j�^
Sprinkler O O O �f�� �
� RecreaUonai Bum f -� (
Fire Alarm ❑ � � � � �
� � Sparklers �
Hood Cleaning �p
!'` � � � � Sprinkler System Installations
Hood Suppression � t � �
� Standpipes(Sprinkler Sys)
Fire Alarm Installation a Torch Roofing/Tar Kettle
a Fire Pumps a Waste Tire Storage ANNUAL
aFire Works
aFlammable Application-ANNUAL
aValuation of Project
Fuei Tanks
Q Other:
Contracior � '"
Signature Company y1'� G _ �, �_������
Registered Y/N Fee Curtent Y/N
Address y'7(^i/ .�iG �-rc�r l4 - --T�
ELECTRICIAN � License# � �y���l��o j����
Signature Company
Registered Y/N Fee CuRent Y/N
Address
License#
PLUMBER
Signature Company
Registered Y 1 N Fee Current Y/N
Address
License#
MECHANICAL
Signature Company
Registered Y/N Fee Current Y/N
Address
License#
OTHER -
Signature Company
Registered Y/N Fee Current Y/N
Address
Directions� License#
Fill out application completely.
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
H 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 frvm Property Tax Notice h J/a
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OF DEED RESTRICTIONS: The undersigned The undersigned a1ssPumes esponsib Ibry fort�ompl an e wi h any
NOTICE ulations
which may be more restrictive t han C o u n t y r e g
applicable deed restrictions
UNLICENSED CONTRACTORS AND C O N T R Aed o Rbe E enosedSiBacicoEdance th s ate an d l o c a le eg u l a t i o nr sC �fr t he
contractors to undertake work, they may be requ
contractor is not licensed as required by law,
both the owner and contractor may be cited for a misdemeanorlvif at}he
under state law. If the owner or intended contrasco County Bu Idingslnspection D v s onf eL cen ngtSecti on.ap727-847-
intended work, they are advised to contact the Pa
. Furthermore, if the owner has hired a contraf`°hich�theyrwill be esponsblee�lftyouaas the ownteasign aasgo
8009 lication fo ��
portions of the "contractor Block' of this app� e�� �icensed and is not entitled to permitting privileges in
contractor, that may be an indication that he is not prop y
County. Chapter713, Florida Statutes,.as amended): If valuation of work is $2;500.00 or more, I
CONSTRUCTION LIEN-LAW ( of the "Florida Construction Lien Law—Homeowner's
certify that I, the applicant, have been provided with a copy licant is someone
Protection Guide" prepared by the Florida Department of A�gf Ithe above des�r bed document and prompse in good faith to
that I have obtained a copy
other than the"owner", I certify lication is accurate and
deliver it to the"owner" prior to commencement. that all the information in this app�
CONTRACTOR'SIOWNER'S AFFIDAVIT� I certify
obtain a permit to do work and installation as indicated. I ce�i{�y
that all work wil� be done in comp�iance w�ith all applicable laws regulating construction, zonin9 a rmean
development. Application is hereby made
that no work or installation has commenced prior to issuance of a permit and that all work will be pe o
eet sfandards of all laws regulating construction, County and City codes, zoning regulations, and land
m that I understand that the regulations of other
development regulations in the jurisdiction. I also certify
9
overnment agencies may apply to the intended work, and that it is my responsibility to identify what actions I
must take to be in compliance.
the AGENT FOR THE OWNER, I promise in good faith to inform the ow er��may be req g ed for'electr cal work,
If I am construction. I understand that a separate p y 1�cation. A
this affidavit pnor to commencing as, or other installations not specificall included in the app�
plumbing, signs, wells, pools, air conditioning, g
shall issuance of a permit prevent the Building Official froCm��e inval'd
rmit issued shall be construed to be a license t�orproceed with the work a�d not as authoriry to violate, cbae ce, a er, or
Pe ermit issued shall
set aside any provisions of the technical codes, n codes. Every p
requiring a correction of errors in plans, construction or violations of any
ork authorized by such permit is commenced W�mhonths after the timPe the'tworkas co�mmenced. Anhext nsion
unless the w eriod of six(6)
the permit is suspended or abandoned for a p
re uested, in writing, from the Building Official for a per onsecutive days the job isocons de ed ba donedstra e
may be q
justifiable cause for the extension. If work ceases for ninety�90� T�CE OF COMMENCEMENT MAY RESULT IN YOUR
WARNING TO OWNER: YOUR FAILURE TO RECORD A NO
PAYING TV1►
ICE FOR IMPROVEMENTS TO YOUR PR�CORDING YOUR NOTICE OFOBTAMENCEMENT.' CONSULT
WITH YOUR LENDER OR AN TT RNEY BEFORE RE
FLORIDA JURAT(F.S.117.0 CONTRACTOR � �
OWNER OR AGENT '� affirmed before me this
ed)before me his Subscribed and swom to( )
Subscribed and swom to(or a
by
by Who+sja�e personally known to me or hasasade P f cat on.
Who is personally known to mas dentificat onroduced
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary tyPed,printed or stamped
Name of Notary typed,printed or stamped