HomeMy WebLinkAbout12-13490 CITY OF ZEPHYRHILLS
5335-8TH STREET
(s13)�so-oo20 13490
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13490 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: 9/26/2012 Name: PHIL MOOK ENT.INC
Total Fees: 25.00 Address: 1108 W BRANDON BLVD
Amount Paid: 25.00 BRANDON FL 33511
Date Paid: 9/26/2012 � Phone:
Work Desc: FPM-QUARTERLY HOOD FOR KENTUCKY FRIED CHICKEN
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the oosts 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-Q020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
ate Receive d t Phone Contact for Permit � L-t�J � r�
wner's Name- C. Owners Phone Number � �� � ,
J
wner's Address , �`� r S , L
�e Simple Titleholder Name Titleholder Phone Number � C� � ,
�e Simple Titleholder Address
�b Address � S � �'-�-G� �1 ` S 'J 9
v 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/Natural Gas-Installation
� Emergenc,y Generator<30 kw � LP/Natural Gas-ANNUAL Sale
� Emergency Generator>30 kw a Places ofAssembly-ANNUAL , ��
�j Fire Protection Mainienance-ANNUAL � Rei;reationai[3um
i�� �_y] emi � er --� �
`�Lt r , r Sprinkler �- � � � B � Spariclers ,
Ir.n/t ylr�1
���•���� Fire Alarm -- -�� � p �,_ .g._ _ Sprinkler System Instailations /� )��J � � 'I
� 1�, 2 Hood Cle ng ❑ � ❑ / 9�'7 � l/
�r�vl �Standpipes(Sprinkler Sys) i 1 !
� � /
� ��� Hood Sup ession "--O ❑` Torch Roofing/Tar Kettle
Fire Alarm Installation C( yor(` � ��1.J c a Waste Tire Storage ANNUAL �
❑ "—• � T ► L�
Fire Pumps
� Fire Works
� Flammable Application-ANNUAL � Valuation of Project
� Fuel Tanks
� � Other:
�ntractor 1 . 1^���� ,1� t� ��� Company
gnature VV[.t, U
Registered Y/N Fee Current Y/N
Address ✓ —� Lice�se#
_ECTRICIAN �T' I �ij � ` . Company
gnature J t �.
Registered Y/N Fee Current Y/N
Address
License#
_UMBER
gnature Company
Registered Y/N Fee Current Y/N
Address
l�cense tk
ECHANICAL
gnature Company
Registered Y/N Fee Current Y/N
Address
License#
THER
gnature
Company
Registered Y/N Fee Current Y/N
Address
License#
irections:
Fill out application completely
Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner)
If 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 from Property Tax Notice htt //a
( p: ppraiser.pascogov.com)
vigil Inc
Hood&Exhaust Cleanmg Svc � � '�
�o BoX 2�3�a� m�
Tampa,FI 33688 � �f��r-�O S
P�813-932-9100 F 813-933-8988 �I�-� �-
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NOTICE OF`DEED RESTRICTIONS: The uniiersigned under5tands that this permit may be subject to"deed°cesfrictions"
which may be more restrictive than County regulations. The�ndersigned assumes responsibility for compliance with any
applica�le de��l restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RE PONSIBILITIES: If the owner has hired a-contractoror -
contractors to undertake work, they may be required to be IIC nsed in accojdance witli 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 ar 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 appiication for which they will be responsible. If you, as the owne� sign as the
contractor, that may be an indication that he is not properly 14censed and is not entitled to permitting privileges in Pasco
County. i
CONSTRUCTION LIEN �AW(Chapter 713, Florida Statute I, as amended): If valuation of work is $2,500.OU 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. 1f 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: I certify 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. Applicafion is hereby made to obta n a permit to do work and installation 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 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 #hat the regulations of other
�g�vernment agencies may apply to the intended ork, and that it is my responsibility to identify what actions I
, must take to be in compliance.
ff 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. 1 understand that a separate pe�mit may be required for e�ectrical 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, 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 e�rors in plans, construction or violatipns of any codes. Every permit issued shall become invalid
unless the In�ork authorized by such permit is commenced wifhin six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6) �onths after the time the work is cbmmenced. 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 fo�the extension. If work ceases for ninety( Oj consecutive days,the job is considered abandoned.
WARNINGITO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY R�SULT IN YOUR
PAYING TWICE FOR 1MPROVEMENTS TO YOUR PROPE .'IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENC MENT.
FLORIDA JURAT(F.S.117.03) ,
OWNER OR AGENT CON RACTOR__�
Subscribed and sworn to(or affirmed)before me this Subs 'bed and sworn to(or rmed)before m is
bY b
Y
Who islare personally known to me or has/have produced Who i lare personally known to me or haslhave produced
as identification. as identification.
� Notary PubliC Notary Public
Commission No. Com Ilssion No.
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Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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