HomeMy WebLinkAbout12-13634 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 �3634
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13634 Address: 7346 GALL BLVD
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: 35-25-21-0010-08800-0000
Improv. Cost:
Date Issued: 11/20/2012 Name: TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN STATE RD
Amount Paid: 25.00 BALA CYNEWYD PA 190042102
Date Paid: 11/20/2012 Phone: (888)777-3557
Work Desc: FPM-F IRE SPRINKLER QUARTERLY-TOWNVIEW
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Chapter 633, Florida Statutes,authorizes the City to charge and oollect user fees to pay for the oosts of fire
prevenHon and protection related activities such as inspections,plan review,administrative fees,and other
oosts 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 perrnits or opening up for commercial activity without an approved final
inspection shall be charged double perrnit 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
WITN 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 C�cy orZ�Pny�n�iis F��� Fa.-8137800021
P��m��Application
oa�e Re�e���d P�o�e co��a«,o�P��m,� 813 621 1357
ow�P.=N�m� TOWNVIEW RETAIL LLC ow�e��, P�o�e N�mee� 888 777 3557
ow�e�s Add,es� 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102
FA�s m���T„�eno�de�NamE �� � �
' T�nenoiae�Pno.,e N�,.,te.
Fee S�mpiP T,��ehoid��Aen.��,
��e Add�eS, 7346 GALL BLVD, ZEPHYRHILLS, FL �o # �
s�e p,�,,,o� CITY OF ZEPHYRHILLS PdfCe,# 35-25-21-0010-0880-0000
� B��-Ha�a�d Wa,�P S�o�a�� ANNUAL � F,. �ga��o„T�.,�
� C�mm E.ha,.=�K�«he„ Hood/D�« � Ha,a.do„s Ma�e��a�(T�e�II o�RQ Fa�,���y)ANNUAL
� Em ,g�„tlY G�„e�a�o�<30 kw � LP/Nal.��aa Ga o-I„=.a��a�,�„
� Eme���.,�y Ge�e.a���>30 kw � LP/Na�,,.a�Ga,-ANNUAL Sale
� F,�P P�o�P«�o„Ma�.,�e.,a„�e-ANNUAL � P�a�e�o,As,eme�,,ANNUAL
s����k�e� �� 0 �B ❑ R�«ea.,o�a�8��� `� � �� 3 �
F„P A�a.m � ❑ ❑ ❑ � � SPa�.�e�,
Hood C�.....,,,,� � ❑ ❑ ❑ � � S���.,k�e.Svs��.m I„=�a��a�,o„=
Hootl Supprca��on ❑ ❑ ❑ ❑ � � S�andpipes (SPrinkler Sys�
� F,,,.A�a�m I.,����,.,o., � To��n Roo.,�q/Ta.K�«�e
� F��^ P�mkps � Was�e T,.�S�o�ag�ANNUAL
F�. Wo
� F�ammah�FAPP�,�a�,o�-,nNNU,a� $25.00 Va�,.a��o„ ofP�o
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C�„«��.�. Co m P a„y
s�q�a.��E Reg=���eti Y/N Fee c���e�� Y/N
Add�e„ L����,e#
ELECTRICIAN Compa y
s��d��.A Re9, «�ed Y/N Fee c���e�� Y/N
Add�e�� L��e.,,e#
PLUMBER Com a Y
s�9�a���e R�g,t.��en Y/N Fee C,.�e�� Y/N
And�e= L�e.,«#
MECHANICAL Compa^y
S,q�T.��e R�9,=.A�ed Y/N F�e C„��e�� Y/N
An�,�e= L�«,,,e#
orHER JEFFERY D. BURNHAM c�maa�Y RODAN FIRE SPRINKLERS, INC
s,g�a��.� Re9�,�e�ed Y/N Fee c��.e�� Y/N
Addfe55 2501 N. 70TH T. TAMPA FL 3619 �1Ce�,e# 831531000120 6
D��e�.,,,.,_
F�ii ouc �.,.�on�ompi��eiy
0..,�e�&PCo„�..,���� � e.��. of �oi��a���„ .,o�„�ae (O. � py . ,d �o„��a<<„���h o.,,�� .)
I�o���$2500 a Nor��e o,Comm�„�eme„��.� q ,�e tl(Me�,..,,,,�a�wo9.o���$5000)
Supply�w �2� ets of drTwin�� wich applirable tlocumentation
A��o.,,10 14 h v .o��e��,,,,aae�s�em�r.a�d��� Pa�«�#-oe�a��ed.�om P, p . ��� a
r�y Ta No _ (h tp Ilappr ��ar pascogov com�
NOTICE OF DEED RESTRICTIONS� The undersigned understands that this permit may be subject to"deed" restrictions"
w h i c h m a y b e m o r e r e s t r i c t i v e i h a n C o u n t y r e g u I a t i o n s I h e u n d e r s i g n e d a s s u m e s r e s p o n s i b i I i t y f o r c o m p I i a n c e w i t h a n y
applicable deetl restrictions
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES I. the ow„e� „a= hired a contractor o�
contractors to undertake work, they may be required to be licensed in accordance with s2ate antl local regulations �fthe
c o n t r a c 2 o r i s n o[ I i c e n s e d a s r e q u i r e d b y I a w, b o[h t h e o w n e r a n tl c o n 2 r a c i o r m a y b e c i t e d f o r a m i s d e m e a n o r v i o I a 2 i o n
under staie law �f the owner or in2ended contracior are uncertain as to what licensing requirements
p may apply for tne
intended work, they are advised to contac2 the Pasco County Uuilding �nspection D�„��,o„—Licensing Section at 727-U47-
8009 F„�the�mo�P, �f ihe o,,,,., has h��ed a �o„t�a��o� o� �o„t�a�to�s, he ,s advised �o ha„e the o�«a�to�(=)
portions of the °contractor Block° of this application for which the w��� be �e ` 51g�'
y sponsible �f you, as 2he owner sign as the
c o n t r a c t o r, 2 h a[ m a y b e a n i n d i c a t i o n [h a 2 h e i s n o 2 p r o p e r I y I i c e n s e d a n d n o t e n t i t I e d e o p e r m i tt i n g p r i v i l e g e s i n P
asco
Councy 15
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended) I. „a�„at,o� of wo�k ,_ $2,500 00 0� more, I
certify that I, 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. If the a p p li c a„� ;_ =o m e o�e
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'S/OWNER'S AFFIDAVIT I �e�t,f,, t„at a„ t,,e ,,,fo�mat,o„ ,,, t,,;, application ,5 ���„�ate a„d
thai all work will be done in compliance with all applicable laws regulating construction, zoning and land
developmen[. Application is hereby made to obiain a permitto do work and installation as indicaied � certify
that no work or installation has com menced prior to �ssuance of a permit and that all work will be performed to
m e e t s 2 a n d a r d s o f a I I I a w s r e g u I a i i n g c o n s t r u c t i o n, C o u n t y a n d C i t y c o d e s, z o n i n g r e g u I a t i o n s, a n d I a n d
development regulations in 2he �urisdictlon I also cer[ify ihat I understand that ihe regula[ions of other
government agencies may apply to 2he mtended work, and that it is my responsibility to itlenLfy wha[ actions �
m u s t 2 a k e t o b e i c o m p I i a n c e
If I �m �,,e AGENTFORTHE OWNER, I P�om,=e ,,, 9ood fa,�„ to ,,,fo�m �„e owner ofthe permitting �o„d,t,o„s =e2fo�t,, ;
this affidavit prior [o commencing cons[ruction � understand that a separate permiT may be required for elec[rical workn
plumbing, signs, wells, pools, air conditioning, gas, or other installaiions not specifically included in the application A
p e r m i t i s s u e d s h a I I b e c o n s t r u e d t o b e a I i c e n s e i o p r o c e e d w i t h 2 h e w o r K a n d n o t a s a u t h o r i i y t o v i o I a t e, c a n c e I, a 1 t e r, o r
se[ aside any provisions of the technical codes, nor shall issuance of a permii prevent the Uuilding �fficial from thereafter
requiring a correction of errors in plan_, construciion or violacions of any cotles Every permit issued shall become invalid
u n I e s s t h e w o r k a u t h o r i z e d b y s u c h p e r m i[ i s c o m m e n c e d w i�h i n s i x m o n i h s o f p e r m i t i s s u a n c e, o r i f w o r k a u i h o
ed by
t h e p e r m i t i s s u s p e n d e d o r a b a n d o n e d f o r a p e r i o d o f s i x (�) m o n[h s a f t e r [h e t i m e t h e w o r k i s o m m e n c e d A n e x t e n s i o n
m a y b e r e q u e s i e d, i n w r i t i n g, f r o m [h e U u i I d�n g O f f i c i a l f o r a p e r i o d n o[ i o e x c e e d n i n e t y �9�)c
d a y s a n d w i I I d e m o n s t r a t e
�u s t i f i a b l e c a u s e f o r t h e e x i e n s i o n �f w o r k c e a s e s f o r n i n e t y �9�) c o n s e c u t i v e d a y s, t h e�o b i s c o n s i d e r e d a b a n d o n e d
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 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 NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F S 117 03)
OWNER OR AGENT CONTRACTOR `�— /� r-�_—
Subscribrtl antl sworn to �or aff�rmrtl) hefore mv this /
ed befo his
t'y � scribe=antl s�Y rn t:_l�ryayr �� ��,�� F ��
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Who���are pertionally known io me or has�hzve producc� WM1'.=is�are personally kn or M1as�nav� ptluced
- ' P�
s i�]encificatton
s identifir.ation
No� �Y P,.e��� Cl No� �,,P
�e���
Comm�,��o., No Comm����o„ No �
Name oFNo�a.Y�YP�,d, p��„��d o� ���mPPn Name�o� ` �r
ry c tl printed or scam ped
,�TYY
��t�Y PVI`n Notary Pudic State of Flonda
, Cheryl A Duffelf
N.� ' pf My Commission EE140324
�oi��� Expires 1t/72/2075