HomeMy WebLinkAbout13-13900 CITY OF ZEPHYRHILLS
5335-8TIi STREET 13900
(813)780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13900 Address: 6040 8TH ST
ZEPHYRHILLS, FL.
Permit Type: FIRE PROTECTION MAINTENANC Book:
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Blo ck:. Section:
Proposed Use: NOT APPLICABLE Lot(s):
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est.Value: Parcel Number: 02-26-21-0080-OOA00-0010
Improv. Cost: Name: FIRST CHRISTIAN CHURCH
Date Issued: 2/19/2013 Address: 6040 8TH ST
Total Fees: 25.00 ZEPHYRHILLS, FL. 33542
Amount Paid: 25.00
Date Paid: 2/19/2013 Phone: (813)782-1071
Work Desc: FPM-ANNUAL HOOD CLEANING FOR FIRST CHRISTIAN CHURCH
5.
f- 1 ��
��_(3
`�- �..
ina
Chapter 633, Fiorida 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 RECO FOR MPROVEMENTS
COMMENCEMNT MAY RESULT IN YOU D O OBT NIFINANCING, CONSULT
TO YOUR PROPERTY. IF YOU INTEN
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
Fax-813-780-0021
~ gl3aeo-oo2o City of Zephyrhills Fire
Permit Application
�, Phone Contact for Pertnit
ate Received .��..,.�,� � .. Y , =.,y,�:�-•���,. .,.__.,.,. C�
..:..�a..�u:c>.;�:. . " ��
r_..+ - _ . ..:«�:�au� ��
r t� n � Owner's Phone Number
nnmer's Name L °Y`
Mrner's Address SCS( +-^�`'� � � � �`0'�� �! 3 �� � C�
Titleholder Phone Number C-.—� .J
ee Simple Titleholder Name
�ee Simple Titleholder Address �, ���`'""�"""�''"``"�*�"����� �
;;���.��,.a�e.����:�����a� �;
.�- s.:ar��.:,.�>:�^��s-.��>� C�
� O .,D ✓ 8�� �� Lot#
<•�
lob Address
Parcel# , ,��..��,,,.,..
5ub Division �<,_ , , ..:,4 . .. �. ., , '�. ' `,. �.,�. . �. ,
� „ .� . {��.��:.� ._. .a�,.�����a.���g_�. .��,.a o. .,. .: n
� Fumigation Tent
Bio-Hazard Waste Storage-ANNUAL �
� Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL
aHood Installation �'`
aControlled Bum a ' � �l `� �
� LP/Natural Gas-Installati (� G
Emergency Generator<30 kw � LPlNatural Gas-ANNU L Sale �
� Emergency Generator>30 kw � j�
a Places of Assembly- UAL /
Fire Protection Maintenance-ANNUAL �/
❑� emi � er ❑
� � � Recreational Bum
Sprinkler � ❑
❑ � � p Sparklers
Fire Alartn ❑
Sprinkler System Installations
Hood Cleaning � � � � � ❑
Hood Suppression � ❑ ❑ � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch RoofinglTar Kettle
� � Waste Tire Storage ANNUAL
Fire Pumps
� Fire Works
❑ Valuation of Project
Flammable Application-ANNUAL
� Fuel Tanks
� Other: �_��:�.��_ . , �, .� .
R��..: . �� . �.�.. �>.,..�.�:
, ��:-�-.., ., H.,�, .,�,.. �.����,�.�. , _
Company eS r� � reS'ac'�- �''°
Contractor n Registered Y/ F Current Y/N
Signature r �
License#
Address
Company
ELECTRICIAN
Registered Y 1 N Fee Current Y/
Signature
� License#
Address
Company
PLUMBER Registered Y/N Fee Current Y/N
Sig�ature
License#
Address
Company
MECHANICAL
Registered Y/N Fee Curtent Y�
Signature
License#
Address
OTHER Company
Registered Y/N Fee Current Y/N
Signature
License# ,�—
Address
e
Directio�s:
Fill out application comp�etely
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings with applicable documentaiion
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(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 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 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 Lien 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 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 installation 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 all 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 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 technical 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 considered 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 COMMENCEMENT.
FLORIDA JURAT(F.S 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirtned)before me this Subscribed and swom to(or affirmed)before me this
by by
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped