HomeMy WebLinkAbout12-13524 CITY OF ZEPHYRHILLS
� 5335-8TH STREET
(si3)�so-oozo 13524 "
ANNUAL FIRE PROTECTION MAINTENANCE '
Permit Number: 13524 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: 10/10/2012 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: 10/10/2012 Phone:
Work Desc: FPM- FIRE ALARM ANNUAL-THE COMMONS ON PRETTY POND
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to 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 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
81�-780-OG20 Ciry of Zephyrhills rir:e Fax-813-780-OC21
- �. Permit Application
Dace Received I� � `� �'� ph
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one Contact for Pertnit �
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Owner's Name n��t�n)r `r � �JuLUT �C Owner's Phone Number �� C� ��
Owner's Address (��_ S - — _ JC�C+� � _, D 3
ree Simole Titleholder Name Titleholder Phona Number � � �
Fee SimpleTitlehold=rAddress
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Job Address � 3 � ��--��..) P �� '� �
Lot r
Sub Diwsion
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Parcel� ��rJ�
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Bio-Hazard Waste Siorege-ANNUAL � Fumiaation Tent
� Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL
Controlled Bum � Hood Instaltaiion
� Emergency Generetor<30 kw � LPlNaturai Gas-Installation ��/" 3��'/
� Emergency G=nerator>30 kw � LP/IVat�ral Gas-ANNUAL Sale �
n Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
`'r-' ny emi ni ner ❑
Sprinkler � ❑ ❑ RecreaUonal Bum
Fire Alarm � O G �. � � Sparklers
Hood Cleanmg � u ❑ ❑ � � Sprinkler System Installations
Hood Suppression � G ❑ ❑ �� � Standpipes(Sprinkler Sys)
� Fire Alartn fnstallation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL �� Valuation of Project
� Fuel Tanks
� Other
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Company
Signature Registered Y 1 N Fee Current Y/N
Address
License#
ELECTRICIAN
Company
Sigrature Registered Y/N Fee Current Y/N
Address
License#
PLUNiBER Company
Signature Registered Y/N Fee Curtent Y�N I
Address
Licensa#
McCHANICAL Company
Signature Registered Y/N 'ree Current Y/N
Address License�
OTH�R ����_ Company , �I� �r2C� � YL�T Lr�� T,uC
9 `
Si nature L-�_�� Registered I �/N Fee Current Y/N
Address a( � -
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icense .
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irecfions: - - • =
Fiil out appiicaiion completely .._. ,_.�_.�..._,.u..�..: ...... ....<_...,. .._�,. . .,... ----- .-.
Owner 8 Contractor sign back of aoplication,notarized(Or,copy of signed contract with owner)
li over�250U,2 Notic=o:`Commencement is required(Mechanical work over W 5000)
Suppiy two(2)sets of drawing=_with appiicable documenta[ion
Aliow 1 C-1�days for roview after submittal date Paroel r-obtamed from Property Tax Notice(httpJ/appraise;.pascogov.com)
NOTICE OF DEED RESTRICTIONS"ount redulations The undersigned a'ssumes�espons b Iby for�ompl a'nce v�ch any
which may be more restrictive than C y 9
applicable deed restrictions
UNLICENSED CONTRi41C�T0�heAmay be�requ�red tOo be�ePsO dSfBac'co dance th s ate a d locafe egulatior,sc I`rthe
contractors to undertake , Y
contractor is not licenssd as required by law, both the owner.and contractor may be cited for a misdemeanorivioolat�hG
under state law lf the oavised to conta c the Pasco CountycBuadingsinspection'Div sI on reL cens ngtSection a��7-u47-
intended work, they are a
8009 Furthermore, if the owneroh�slshaep��c�tiontfor�whi�h theyrwil�be espons�ble.ptlftyouaas the wnteasign assththe
portions of the cont;actor Slock P
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in asco
County.
CONSTR't1C i iuiv LicFv i-i�+vJ (�i�a�►rr7�3, F{�ri�a Statutes, ��V f tic d�orida�Const uction �r en Law��H meo�er's
ce!-tif;� that I: the applicant. have been provided with a cupy `
Protection Guide" prepared by the rlorida Department of Agriculture and Consumer Affairs if the applicant is so���eene
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. o lication +s accurate and
_ CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify thalcable �aws r egu'latingtconst�rPction, zoning and land
that all work will be done in compliance with all app� '
development. �,pplication is hereby made to obtain a permit to do work and installation as indicated. I certiTy
that no work or instailation ha e�u at nen constructionS Counry�andPCitytcodesh zon'i g regu abio Ps,rf�d eand
m e e t s t a n d a r d s o f a l l l a w s g 9
development regulations in the �o�the'initended workcand thatat is my eespo n bility to eide n Ufy twhat act ons I
government agencies may app y
must take to be in compliance.
If I am the AGENT FOR THE OWNER, � P tion!S I lu derstand thatna�separate permit ma ybe regug ed for'electrie I work;
this afiidavit prior to commencing constru y lication A
plumbing, signs, wells, pools, air c�e a'lice n e to p oceed with the wark and not a�s auithorty t�o aiolateecapPel, alter, or
permit issued shall be construed to
set aside any provisions of the technicalco st uct onsoa'violations of any codesprEvery perm t is's ed slhafl be ome invaf d
requiring a correction of errors in plans,
unless the work authorized by such permiaise pd of six (6) mhonths after�the timeethetwo kas commenced Anhextension
the permit is suspended or abandoned fo p gp days and will demonstrate
may be requested, in W�xtension. If work Icela esofo�c'ninety(90)rcon ecutive day s thee b(is considered abancioned
justifiable cause for the e
WARNING TO OWNER: YOUR FAILUR� T o�R PROPERTY.��F YOU iNTOE D�TO OBTAINnFINANC NG COIvSOULR
?F,YIfvG TWiCE FOR lMPROVcMEt�TS TO Y
WtTH YOl3R LEND'tR OR�.N �TTORN�Y BEFG'RE RECORL�lNG YOUR NOTICE OF C�MMENCEMENT.
FLORIDA JURAT(F S.117.03)
CONTRACTOR
OWNER OR AGENT Subscribed and swom to(or affirmed)before me this
Subscribed and sworn to(or affirmed)before me this bv
by a Whc is%are perso^ally known to me er has/nave produced
NJho is— /a�e personally known to me or has/have produceu as identification.
as identification.
Notary Pubiic
Notar,�Public
Commission No
Commissior No
Name cf Notary tyPed, Printed or stamped
Name ot Notary rypeo� pnnied or stamped