HomeMy WebLinkAbout12-13668 CITY OF ZEPHYRHILLS
- . 5335-8TH STREET 66$
(813)780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13668 Address: 5316 11TH ST
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: CHURCH Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcei Number: 11-26-21-0100-17100-0100
Improv. Cost:
Date Issued: 12/05/2012 Name: SAINT JOSEPH CATHOLIC CHURCH
Total Fees: 25.00 Address: 5316 11 TH ST
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/05/2012 Phone: (813)782-2813
Work Desc: FPM- FIRE ALARM ANNUAL- ST JOSEPH CATHOLIC CHURCH
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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
IZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
s��-�so-c3b2o City ofZephyrhills'Fi�- Fax-813-780-002i
Permit Application
Date Received - ������r��� �
Owners Name ����r �"'"""'—"'
Owners Address � Up w �
Fee Simple Titleholder Name � SJ� � - � �Titleholder Phone Number �� �� �
Fee Simple"Iitletwide�Address
Job Addtess 5 � � Lot# �
5ub Division
- Part�l#
a Bio-Hazard Waste Stotage-ANNUAL Q F�m�igafion Tent
� Camm Exhausi Kitchen Hood/Duct � �b����R�r 11 or RQ Faciiity)ANNUAL
� Cortbvlled Bum � FI°°cl lnsfatlation
� Emergency Generator<30 kw � LP/IJahnal Gas-Ir�sfallatian
(—j Emerge�y Generatar>30 kw � LPMahaal Gss-AMNUAL Sale
��� Fre ProtecBon MaiMenance-ANNUAI. � Piat�s of Assembly-ANNUAL
�—� r
L�]��].Ll� ���'
Sprinider � D O ❑ � Rec�atiorel Bum // j
� /
Fire AtaRn � D ❑ J1� �� 5pa�rs '� �
Hood Cleaning O D ❑ � � SPn�B�Sy54�n�n��°�'
Nood 5up�xession � 0 � D L� � ���5P►��SYS)
� Fire A►arm Ir�llatbn � Tor�h Ftoaiing�far Kettle �� 3�
�re Pumps Q Waste Tire Storage ANNUAL
Fre Works
Flammable Appticatiorr ANNUAL. Vaivafion of Project
FuetTanks
Q Other. �
ConVactor ��Y
s�gnature ' Reyis�ed Y/N Pee current Y/N
Address � _ Llcense#
�����`� compeny Russell _Electrical Eonst
Signature FtegisUered Y/N Fee Current Y/N
Address j , ucense#
PLUMBER �y
signature Regwerod Y/N Fea cunenc Y/N
Address License# _
MECHANICAL COm��Y
Signature 'Regi�ed Y/N Fee CuRerrt Y/N
Address �icense#
OTHER �m��y
signaWre Registered Y/N Fee Current Y/N
Address License# _
plreciions:
Fiit�t application caf�letety.
Ownst&Conq�aetor sign back af app(ication.notar¢ed(Or.copy of signed corrtract with owner)
. �E owr S250D.a Notice af Commencement is required.(Madiardcal work over S50U�)
� Supp1Y two(2)ssfs af drawings with applicable documer�ation
. ANow 10-'14 daYs for revi�v after sutxnittal date. Paraef#-obtained frorn RnPg►lY Tax Notice(htfG��PPraiser•W'�'A9ov.com)
'IdOTICE OF:DEED RES'I'R�CT�pidg; 't'fie.undersigned undersfands that this permit maybe-subject:to-°de�d';rs�r;c��ons"
which may be more restrictive than Courrty regulations. The:undersigned assumes responsibitity=for:�ompliars�e�with any
applicable deed restricqons.
�UNLICENSED �CON7'RqCTORS ANID-CON7RACTpR RESP.ONStBILI'T1E$: tf-the owner has •hired�:a°contractor or
�°ntr��tors'to undertaice work, they may be required-to be licensed in acxordance y�th s�te and loca!-rngulations. if the
contracfior is not iicensed as required by law, both the owner�nd contractor may be cited-for a misderneanor violafion
under state Iaw, tF�the owner or ir�tended cor�tractor are unoertain.as�to what �icensing•requiremenfs may�pp�y for the
Intended work, they are advised to corrtact the•Pasco Courrty BuUding inspecfion Divisian—Licsnsing Section.at 727-8q.7_
8009. Furihermore, if the owner has hjred=a contrac�or or contractors, he is advised to have the corrtractor(s) sign
portions ofi the "corYtractor Btock' of this appfication�for which-they wil� be responsibie. tf you, as�the owner�sign as the
cor�'actor, that may be an iruiicafion that he is not properly ficertsed and is not enfitled�to�permitti�g PrivJ�9ges in Pasco
Counfy.
CQNSTRUCTION.LiEN.LAW(Chapter713, Flori�S�,,a�s:amended�: If��uatian of work is�2;�00.00 or more, f
certify that l, -the applicant, have been provided with a copy of�the `F(orida Construction Lien Lav►�—Homeowner's
Protection Guide' prepared by•the �lorida Departrnerrt of qgricutture and Consumer qf�airs, tf the appiicant is�someone
°��r tha�the°owne�', I certify that i have obtained a copy of the above described document and promise in good fiaith to
deEiver i�ta the"owne�'prior fio commenc:emertt.
' C�NTRACTOR'S/OWNER'S-A�IDAVfT: I certiry that ait the information in this appliqtion is acc�cate and
that all work will be done in comp{ia�ce w�h ail appiic�ble laws regulating construc�on, zoning and land
developmerrt, qppiication is hereby made to obtain a permit to do work and instaliation as indicated. t cerfify
that no worlc or instailation has commenced prior to issuance of a permit and�that all work wi�1 be perto�ed to
meet standards of all laws regu�ating �strt�c�on, �u�j, and City codes, zoning regulations, and tand
developmerrt reguiations in the jurisdicti�on. I atso certify that � understand that the regufations of other
- govemmerrt agencies may appiy to the irrtended work, and that it is my responsibility to idenfify w►�at actions I
must take�to be in compliance.
tf i am the AGENT FORTHE OWNER, 1 promise in good iaith to��the owner of the permftti�g condfions set forth in
this affidavit prior to commencing constructian, t understand that a separate permit ma be
plumbing, signs, wdls, pools, air condiiti�oning, gas, or other instaitations not s Y required for electrical work,
permi�issued shal!-be construed to be a ticense to �fi��y induded in the app{ication. A
set aside an �°�����and not as authority to viotate, cancel, alter, or
y provisions pf the technica! �des, nor shali issuance af a pecmit praverrt the guitding Officiat from thereafter
requiring a correction of errors in plans, consfrt�dion or violations of arry codes. Every perrnit issued sha(1 hecome invatid
unless the work authorfz� by suc� permit is cbmme�ced wrth�n sa morrths of permit pssuance, or if work authorized by
the permit is suspended or ahandoned fnr a period of six(6) rnonths after the time the wark is commenced. An extension
�Y � requested, in wrfting, from the Building O�ciai for a perio�J not to exceed ninety (90) days and wi11 demonstrate
jusfifiabie cause for the extension. ff work c�ases fw�inet�,�gp���s��da�t�job is considered abandoned.
WARNING 70 �WNER: YOUR FAILURE TO itECORp A�Wp't7CE'p�'COMMENCEMENT M�►Y RESULT IN�YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'IY; 1F YOU tNTEND TO OBTAIN FINANCING, C�NSUlT
Y R N R B CORDI G YDUR NOTICE OF OM NCE
Fl-ORIDA JURAT(F.S.1 i7.03)
�WNER OR AGBdT ����/'��-d,.� _ � � 6�
Subscribed and swom t�(or a�rmed)before me th's Subscxibed and swom b or �r•R.
by �a�med)betore me this
VVho is/are !�2°5-/a bY...��5 Sa f (
��� as ideatii�tion.� Who istare p�imown tio me or has/have pr�iuc:ed
1^�Or,cl _J�v;,,. 5 • v.. cr aS id9n�iCaiiorl.
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CommEssion No. n"�, �- U�✓
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Name of Ncrtary fYP�d:P�ad or sfamped Narne of�►Y 1YPed,Prirrted or stamped
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