HomeMy WebLinkAbout12-13505 � CITY OF ZEPHYRHILLS
5335-8TH SIREET
(si3)�so-oo20 13505
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13505 Address: 5500 6TH ST
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: 11-26-21-0010-09000-0180
Improv. Cost:
Date Issued: 10/02/2012 Name: DAVIS, JAMES & SUE
Total Fees: 25.00 Address: 2605 ROBIN DR
Amount Paid: 25.00 PLANT CITY FL 33563
Date Paid: 10/02/2012 Phone: (813)754-3647
Work Desc: FPM-ANNUAL FIRE ALARM FOR BADCOCK FURNITURE
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees M 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 Marshai 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
�i�-�so-oozo City of.Zephyrhills�Fir:e� FaX_$1�-�8apoz�
� Permit Application
Date Received a7 /� - Phone Contact fir Permit a, ��
<,.; � K.,���sr �..�,a= ,.�..,,...r _
Owner's Name C � Owners Phone Number �� ��,[C�
Owner's Address � � ��� �
Fee Simple Titleholder Name Titleholder Phone Number � �� �
Fee Simple Titleholder Address
Job Address � 1 ��I Lot# �
5ub Division Parcel#
� Bio-Hazarci Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Bum a Hood Installation
aEmergency Generetor<30 kw � LPMatural Gas-Instaltation �
� Emergency Generator>30 kw � LP/Natural Gas-ANNU Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly NNUAL
�y emi �n er �
�DSprinkler � ❑ ❑ ❑ � Recreational Bu • /� rJ
Fire Alarm � ❑ O � � � 5parklers J
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installa
Hood Suppression � ❑ p ❑ � � Standpipes(Sprinkfer Sys)
� Fire Atarm Installation � Toroh Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
Fire Works
Flammable Application-ANNUAL �--� Valuation of Project
Fuel Tanks
Q othe �
Contractor Company
Signature Registered Y/N Fee Current /N
Address License#
ELECTRICIAN Company
Signature Registered Y/N Fee Current Y/N
Address License#
PLUMBER Company
Signature Registered Y/N Fee Current Y/N
Address License#
MECHANICAL Company
Signature Registered Y/N Fee Curtent Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
Directions: � -
FII out application completely.
Owner&Contractor sign back of application,notarized(Or,copy of signed contrect 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 1 D-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com)
�NOTICE OF=DEEDRESTRICTIONS: �The.undersigned understands-that this permit may-be subject:to��deed":restrictions"
which may be more restrictive than County�regulations. -fhe.undersigned.assumes responsibility.for:�omplian�e�with any
_appiicable deed restrictions.
UNLICENSED CONTRACTORS AND�CONTRACTOR RESPONSIBILITIES: If the owner has �hired-:a°contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local-regulations. If the
contractor is not licensed as required by law, both the owner:and contractor may be cited�for a�misdemeanor violation
under state faw. If the owner or intended contractor are uncertain.as to what licensing�requirements may:apply for the
intended work, they are advised to contact the=Pasco County Building 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 licensed and is not entitled-to permitting.privileges in Pasco
County.
CONSTRUCTION.LIEN,LAW(Chapter713, Florida Statutes,.as:amended): If valuation of work is$2;500.00 or more, I
certify that l, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by�the Florida•Department of Agriculture and Consumer Affairs. ff the applicant is someone
other than the "owner°, I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner" prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is acc�rate and
� that all work will be done in compliance with all applicable laws regulating construction, zoning and land
development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify
that no work or installation has commenced prior to issuance o1 a permit and-that afl work wiil be pe�orme� ro
meet standards of all laws regulating construction, County and City codes, .zoning regulations, and land
development regulations in the jurisdiction. I aiso certify that I understand that the regulations of other
government agencies may apply to the intended work, and that it is my responsibility to identify what actions I
must take to be in compliance.
If I am the AGENT FORTHE OWNER, I promise in good faith 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 with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is cvmmenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and wili demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A`NC)TICE�OF COMMENCEMENT 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 RECORDING YOUR N ICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT C�M���
Subscribed and swom to(or affirmed)before me this
Subscribed an m to(�r a )before me this
by Who is/are pe nally known e or haslhave produced
Who islare personally known to me or haslhave produced as identification.
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed�Printed or stamped Name of Notary typed.Printed or stamped