HomeMy WebLinkAbout13-13974 CITY OF ZEPHYRHILLS
5335-8TH STREET
- (sis)�so-oozo 13974
ANNUAL FIRE PROTECTION MAINTENANCE ,
Permit Number: 13974 Address: 5028 AIRPORT RD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Ciass of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Numbe�: 12-26-21-0000-04900-0010
Improv. Cost:
Date Issued: 3/12/2013 Name: CITY OF ZEPHYRHILLS
Total Fees: 25.00 Address: 5335 8TH ST
Amount Paid: 25.00 ZEPHYRHILLS, FL 33542
Date Paid: 3/12/2013 Phone:
Work Desc: FPM- FIRE ALARM ANNUAL- GOING POSTAL FRANCHISE
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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, administraNve 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
813 780-0020
City of.Zephyrhills�Fir:e• FaX-a�saso-oo2�
Permit Application
- - Phone Contact for Permit /� °2
Date Received� 2
� - Owners Phone Number ' .J ��• � /�
Owners Name r ^
Owner's Address c.lOv� l J�d
TiUeholder Phone Number C� � ��
Fee Simpie Titleholder Name
Fee Simple Titleholder Address
J�r Address
J�o�� \ S � � S' l Lot# ��
Parcel#
5ub Division
� Bio-Hazard Waste Storage-ANNUAL � Fumiqation Tent
� Comm Exhaust K3tchen Hood/Duct � H�roous Material(Tier 11 or R�Facility)ANNUAL
� Controtled Bum � Hood Instailatlon �
� Emergency Generator<30 kw � LPMatural Gas-Instaltation '�/� �� �
� LPlNatural Gas-ANNUAL Sale N,
Emergency Generator>30 kw � N�
Fire Protection Mafrrtenance-ANNUAL Places of Assembly-ANNUAL ��
�r'i�y emi �n er �
5prinkler ❑ p ❑ Recreationai Bum
Rre Atartn O � � 5parlclers
Hood Cleaning O ❑ � � � SprinklerSystem installations
Hood Suppression � O � 0 C� � 5tandpipes(Sprinkler Sys)
� Fire Alarm Insiallation � Torch RoofinglTar Kettle
Fire Pumps � Waste Tire Storaga ANNUAL
Fire Works
Flammable Application-ANNUAL Valuation of Project
Fuel Tanks
� Othe •
ConVactor Company Z
Ragtstered Y/N ee Current Y!N
Signature
License#
Add�ess -
ELECTRICIAN Company
, Registered Y/N Fee Gurrent Y/N
SignaWre
License#
Address
PLUMBER Company
Registered Y/N Fee Current Y/N
Signature
Address License# �- �
MECHANICAL Company
Signature Registered Y/N Fee Curtent Y/N
Address License# �
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
Directions:
FII out application completely.
Owner 8 Contractor sign back of application,notarized(Or,copy of slgned conVact with owner)
If over$2500,a No6ce of Commencament is requirad(Mechanical work over$5000)
Supply two(2)sets of drewings with applicable documentation
Allow 10-'14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http•llappraiser.pascogov.com)
�NOTICE �F=DEEDRESTRICTIONS: '�he undersigned understands,that this permit may_be subject.t��"deed°:restr'�tions"
which may be more restrictive than County�regulations. The.undersigned.assumes responsibility for:complian�e�with any
_applicable deed restrictions.
UNUCENSED CONTRi4CTORS 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 taw. 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 8uilding Inspection Division—Licensing Secfion.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-ta permitting privileges in Pasco
County.
CONSTRUCTION.LIEN.LAW(Chapter713, Florida Statutes,_as:amended): tf valuation of work is$2;�00.00 or more, I
certify that l, �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"owne�'prior to commencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
that all work wil! be done in compfiance with all applicable laws regulating construction, zoning and land
development. Application is hereby made to obtain a permit to do work and installafion as indicated. f certify
that no work or instalfation 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
govemment agencies may applyto 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 FORTHE 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 spec�cally included in the appfication. 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 (fi)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 ninery(90)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A`NOTICE OF�COMMENCEMENT 11Ai4Y RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 1F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N CE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTO
Subscribed and swom to(or affirmed)before me this Subscribed an s m to(or a rrn j before me this
by
Who is/are personally known to me or has/have produced Who is/are pe nalry known e or has/have produced
as idenfificatlon. as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed;printed or stamped Name of Notary lyped,printed or stamped