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Home My WebLink About13-13904 ' CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 13904 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 13904 Address: 5048 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: 11-26-21-0000-01400-0000 Improv. Cost: Date Issued: 2/20/2013 Name: CUMBERLAND FARMS (NAK MOM) Total Fees: 25.00 Address: 777 DEHAM ST Amount Paid: 25.00 CANTON, MASS Date Paid: 2/20/2013 Phone: Work Desc: FPM- HOOD SEMI- HOLE N ONE DONUT a 5. �� L �� 3 �;� , �, ina 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 ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 s��3=780-0020 City of.Zephyrhilis Fire Fax-813780-0021 �Permit Application Date Received �� v� � � �� Phone Contact for Permit JrT.�J -/3 +;a,"�.,�'a..�r,"riC��S�e6:. ... +»..n�.....M,.. , w»w ..,..o..-..a,»..w. .,�u.u..,...:.r,..,..,...........,..>. Owner's Name ��^G' � LQ � Ovmer's Phone Number ��3 �T� 93.5� Owner's Address • O� �0, 7�3� 7��tMP,�J r -�� 33 6'7� Fee Simple Titlehotder Name TiUeholder Phone Number � � .� Fee Simple Titleholder Address ��z�.. � Jab Address �fat F ;N o .o� i�T .�0 8 �� .��v�. �ot# Sub Division Paroel# �� Bio-Hazard Waste Storege-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL � Controlled Bum � Hood Installation � Emergency Generator<30 kw � LP/Natural Gas-Installation � Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL r y emi � er Sprinkler � ❑ L7 ❑ � Recreational Bum ��/��(` Fire Alarm ❑ ❑ ❑ � � Sparklers � I I Hood Cleaning � ❑ �d ❑ � � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Installation � Toroh Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL Valuation of Project � Fuel Tanks Q Other: ;�„ �°�. Contrector �� •� Company �i�s� Signature � Registered Y/N Fee Current Y/N Address License# ELECTRICIAN Company 5ignature I Registered Y/N Fee Current Y/N Address License# PLUMBER Company 5ignature 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 Current Y/N Address License# �-------- . .. .�. .... _ . ,, eh��va.a.�'..ke�.e�2�.,._._e,_...�..W=,. . . . , � .� . . ,. !vuxa��r��c . Directions: Fill out application completely. Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) If over$2500,a Notice of Commencement is required(Mechanical woric over$500D) Supply two(2)sets of drewings with applicable documentation Allow�0-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappreiser.pascogov.com) �NOTICE OF"DEED:RESTRICTIONS: -fhe undersigned understands-that this permit maybe�subjecYto "deed"-restrictions" which may.be more restrictive�than County�regulations. ?he.undersigned assumes-responsibility for compliance with any applicable deed restrictions. UNLICENSED •CONTRACTORS�AND 'CONTRACTOR �RESP.�NSIBILITIES: 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 vio{ation 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 at727-847- 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(Chapter713, 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�owne�', 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'SIOWNER'.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 instalfation 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 AGEIVT 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 PAYINGTWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTENDTO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S. 117.03) OWNER OR AGENT COM'RACTOR Subscribed and swom to(or affirmed)before me this Subscribed and swom to(or affirmed)before me this by bY Who islare personally known t�me or has/have produced Who islare personally known to me or has/have produced as identification. as identlfication. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped