HomeMy WebLinkAbout12-13723 _ CITY OF ZEPHYRHILLS '
5335-8TH STREET
(si3)�so-oo20 13723
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13723 Address: 7643 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: 3425-21-0010-03100-0000
Improv. Cost:
Date Issued: 12/20/2012 Name: CHILI'S BAR& GRILL
Totai Fees: 25.00 Address: 7643 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/20/2012 Phone:
Work Desc: FPM-SEMI ANNUAL HOOD SUPPRESSION FOR CHILLI'S
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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
aosts 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
. II13-780-0020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received �� Phone Contact for Permit C5� 7 3 2 5 3 2 6
Owner's Name �r't'};FI F lcri�a inc c o r�,�r�in r Foez h �..omp3��; Owner's Phone Number C� � �
PO Hor 802206
Owner'sAddress ll�lla;. 't'x 75��o-??nh
Fee Simple Titleholder Name Titleholder Phone Number C� � �
Fee Simple Titlehoider Address
JobAddress �E'�-j Gall t:��ule�iard, zeptryr�hill:;, f'I� 33Sa1 �I321 � Lot# �
SubDivision zephyrhi_lls S��ipeL Cenr,ci A Parcel# 3] 25 zl olln )onon u0.10
� Bio-Hazard Waste Slorage-ANNUAL � Fumigation Tenl
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood InstallaUon
� Emergency Generator<30 kw � LPlNatural Gas-Installation ,
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL,SaIe �
oFire Protection Maintenance-ANNUAL � Places of Assembly-AN�UAL /� ��
try emi �n t er ��
Spnnkler � ❑ ❑ ❑ � � Recreational Burn � � �'`
Fire Alarm � I I I_I LJ � � Sparklers ,` �
_..�'",,.�
Hood Cleaning � ❑ ❑ ❑ � � Spnnkler System Installatians
Hood Suppression � [] � f I � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettie
aFire Pumps � Waste Tire Storage ANNUAL
� Fire Works
❑ Flammable ApphcaUon-ANNUAL � Valuation of Project
� Fuel Tanks
� Other
Contractor Company �� � � � �
Signature Registered Y/N Fee�urrent Y/N
Address 953 NI? Osceo7a Avenue, ucala, P'1� 34�170 License# n6-96150002198:�
ELECTRICIAN Company
Signature Registered Y/N Fee��urrent Y/N
Address License#
PLUMBER Company
Signature Registered Y!N Fee Current Y/N
Address License# �
MECHANICAL Company
Signature Registered Y/ N Fee Current Y!N
Address License# �
OTHER Company
Signature Registered Y/N Fee Currenl Y/N
Address License# —�
D�rections
Fill out application completely
Owner 8 Contractor sign back of appl�cation,notarized(Or,copy of signed contract w�th owner)
If over$2500,a Nohce of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings wilh applicable documentation
Allow 10-14 days for review after submittal dale Parcel#-obtained From Properry Tax Nolice(http//appraiser pascogov com)
NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County regulations The undersigned assumes responsibilit�y for compliance with any
applicable 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 law 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 (Chapter 713, Florida Statutes, as amended) If valuation of work is $2,500 00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction l_ien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs If 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'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and
that aii work wi�i 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 of a permit and that ail work will be performed to
meet standards of all laws regulating construction, County and City codes, zoning regulations, and land
development regulations in the �urisdiction I also 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 FOR THE 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 technicai 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 commenced An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension If work ceases for ninety (90) consecutive days, the job is con:sidered abandoned
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 CO CEMENT.
FLORIDA JURAT(F S 117 03)
OWNER OR AGENT CONTRACTOR �
Subscribed and swom to(or affirmed)before me this Subscribed � swom to(or affirmed)be �Tfi�.
by 12-19- �_,
Who islare personally known to me or has/have produced Who is/a personally kno to me or has/have produced
as identificatfon. � -- as identification
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Notary Pubhc ,.--_�/ /j/ `�'�J3 Notary Pubhc
Commission No \. Commission No
� o�RY��,G James Feathers
Name of Notary typed,printed or stamped Name of otary ty ed printed or tamped • . • 5B0
'"� Expires Sept. 17,2016
�O�n`�Notary Public,State of Plord: