HomeMy WebLinkAbout13-13898 CITY OF ZEPHYRHILLS
5335-8TH STREET
�sis��ao-oozo 13898
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13898 Address: 7909 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: 34-25-21-0010-00100-0000
Improv. Cost:
Date Issued: 2/19/2013 Name: RUBY TUESDAY RESTAURANT
Total Fees: 25.00 Address: 7909 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/19/2013 Phone:
Work Desc: FPM- SUPPRESSION SEMI - RUBY TUESDAY
1 �
U��
� , ��- I ��
� �
,
inal
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 pertormed 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
a��-�saoo2o City of Zephyrhills Fire
Fax-813-780-0021
Permit Application
ate Received Phone Cornact for Pertnk 3 51 7 3 2 5 3 2 6
wner's Name RT TAMPA FRANCHISE LP ATTN TAX&LIC DEPT ��rs Phona Number �� � ��
� 150 W CHURCH AVE MARYVILLE TN 37801-4936
�,ers ndd.�SS
3e Simpie Tdleholder Name NA T1Ueholder Phone Numbx C� � C�
" �e Sitnple Titleholder Address
�b Address �9 0 9 GALy�LVD �
Lot#
.ib Division Z E PHYRH I LL S COLONY COMPANY ���� 3 4-2 5-21-0 O 10-0 O 10 0-0 0 0 0
a Bio+fazsrd Waste Storage-ANNUAL � Fumigatbn Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Faciliry)ANNUAL
� Confrolled Bum � Flood Installation
aEmergency Generator<30 kw � LPMatura!Gas-Installation
a Emergency Generator>30 kw � LPMatunl Gas-ANNUAL Sala
• a Fire Protaction MaiMenance-ANNUAL � Piaces of Aasnmbty-ANNUAL `, �
� n �I
❑� mi � ar
• Sprinkler ❑ L] ❑ � � ►�re�p�l Bum I �
Fire Alarm � ❑ ❑ ❑ � � S�*� � �
1� !�,S
Hood Geanin9 � ❑ O ❑ � � Sprinkler Systam InstallaUons � �/(
Hood Suppression � O � ❑ Standpipes(Sprinklsr Sys)
� Fire Alerm Installation � Toroh Rooflng/Tar Kettle
Fire Pumps � Waste Tire Storage ANNUAL
Fire Works
Flammable Applicatiorr-ANNUAL Valuation of Project
Fuel Tanks
[� Other.
�ntractor Comparry AMERICAN FIRE & SAFETY SUPPLY
gnacure Repistered Y/N Fee Cument Y/N
Address 953 NE SCEOLA AVE STE 100 OCALA FL �icense# 06461500021985
.ECTRICIAN NA Compeny '-�
gnatwe � Regtsterod Y/N Fee CurroM Y/N
Address
License#
_UMBER ��
pnature NA �m��y -1
��scered I Y!N I Fee current Y/N
Address
License#
_CFiANI
�nature NA �OmPa^Y ~
Registered Y/N Fee Current Y/N
Address
License#
rtieR NA ' '-
�nature �Om�"y
Rep�stered Y/N Fee curnern Y/N
Add►ess
License# �'�
rections: •
FA out application completey
Owner&CoMractor sign back M aPplication.notarized(Or,copy of signed contract with owner)
N over 52500,a Notice of Commsncement is requirad(Mechanical woric over 35000)
Supply two(2)sets o{d���s�m applicable dxumentation
Allow 70-14 days fcr review after submittal date. Pareel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.eom)
c
NOTii,f 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 responsibility 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 ta 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 contractar(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 1, the applicant, have been provided with a copy of the "Fbrida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agricutture 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 taith to
deliver it to the"owner"prior to commencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that ail the information in this application is accurate 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 instaliation as indicated. I certify
that no work or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of al! laws regulating construction, County and City codes, zoning regulations, and land
development regulations in the jurisdiction. 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 a�davit prior to commencing constructior�. I understand that a se arate
plumbing, signs, wells, pools, air conditionin p Permit may be required for electrical work,
g, 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 conection 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 considered abandoned.
WARNiNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCE ENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND T O T N FINANCING,CONSULT
WITH YOUR LENDER R AN ATTORNEY BEFORE RECORDING YOUR NO
FLORIDA JURAT(F.S. 117.03) O ENCEMENT.
OWNER OR AGENT CONTRACTOR'b
Subscribed arxl swom to(or affirmed)before me this
by 7S�ubsc,ripb-ed,a,nd swo r me this
Who is/are personally known to me or has/have produced G�by
ho is/a_re pe__,rsonal�kn me haslhave p uced
as identification. '
as identlfication.
t�%'"�-'r
--_--�_
Notary Public 1' u�l
Notary Public
Commission No. I
Commission No.
Name of Notary typed,printed or stamped
Name of Notary typed,p�ed o�mp�v� ,p�
•i�/ Gr•( i
oa�����James Feathers
: � Mr Comm.�EE835580
Expiros Sspt. 17,2018
�""� Natary PubliG,3tete oi Florids
c