HomeMy WebLinkAbout13-13997 , , � CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis��so-oozo ��,gg�
�. -
ANNUAL FIRE PROTECTION MAINTENANCE <
Permit Number: 13997 Address: 5014 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: 11-26-21-0010-20700-OOAO
Improv. Cost:
Date Issued: 3/20/2013 Name: CHATTERBOX CAFE
Total Fees: 25.00 Address: 5014 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/20/2013 Phone:
Work Desc: FPM- SUPPRESSION SEMI- CHATTERBOX
5.
� _ ,
.
� ( �
�- C��
, �
,
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
F'ermft Application
Date Received _
� ^ Phone Contact for Permit (3 Lt 7�i ��
y ��
Owners Name � C C�� ��� /t -- - ,
L Owners Phone Number � �� ��
Owners Address ���� ��vl, ��
i � � I (t
7
Fee Simple Titleholder(Vame � � ��
Titleholder Pfione Number
Fee Simple Titleholder Address
- - :,��
Job Address
Lot# ��
Sub Division ��
.�-.q-�... -- Parcel#
aBio-Neza d Waste Storage-ANNUAL 9 ���`� ���`�' -�;,,,
0 o Fumigation Tent
Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Faciliry)qNNUAL
� Controlled Bum a
a Hood InstallaGon
Emergency Generator<30 kw a -
aLP/Natural Gas-Instaltation
Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
aFire Protection Maintenance-ANNUAL � �� ��� �
Places of Assemb�y-ANNUAL �
❑� emi � er �
Sp�nkler � � �
❑ Recreational Bum
Fire Alarm � � � � �
❑ Sparklers
Hood Cleaning � � � �
Hood Su Sprinkler System Installations
ppression �r ❑ �/ ❑ � a
� �� Standpipes(Sprinkler Sys)
Fire Alarm Installatio� a
� Torch Roofinglfar Kettle
Fire Pumps �
� Waste Tire Storage ANNUAL
Fire Works
� FlammableApplication-ANNUAL ��
Q Fuei Tanks Valuation of Project
Q Other:
♦'�L.F°YaN:J�54.-3ts'o-sm45^^b�
CO�itr'dCtOf �, � °�
Signature Company m G - � �-���J��
Address y7�/ �G Registered Y/N Fee Current
Y/N
�=c�rr C�-
ELECTRICIAN T I � License# [� �Y���1 �on fa�o��
Signature Company
Registered Y/N Fee Current �'/N
Address
License#
PLUMBER
Signature Company
Registered Y/(� Fee Current �'/N
Address
License#
MECHANICAL
Signature Company
Registered Y/N Fee Current Y/N
Address
License#
OTHER
Signature Company
Address
Registered Y/N Fee Current Y/N
?irections: "'" License!F
Fil out application completely
Owner&Co�tractor sign 6ack of application,notarized(Or,copy of signed contract with owner)
ff over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date
� Parcel f�-obtained from Property Tax Notice(httpJ/appraiser.pascogov.�om�
D RESTRICTIONS� The undersigned undersn�e sitned a'ss�umes esponsibilbry for:�compl a�e wth�any
Np�{CE QF DEE ulations. The u 9
which r?�ay bc� nore restrictive than County reg
appiicat�ie d�ed restrictions
o be licensed in accordance with state and local regulations. If the
NSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES. If the owner has hired -a-c°�nrraolation
UNLICE be required be cited for a misdemean
contractors ta undertake work, they may �aw, both the owner and contractor may � for the
contractor is not licensed as required by
o County Building Inspection Division--Licensing Section at 727-847-
u
nder state law If the owner or intended contract�or are uncertain.as to what licensing�requirements ma tractor s sign
intended work, they are advised to contact the Pas
' ation for which�they will be responsible. If you, as1the o v 1e�esgn Pasco
8009 Furthermore, if the owner has hiredl'C contractor or contractors, he is advised to h�tt n e con g
portions of the "con trac t o r B l o c k" o f t h i s a p P ro erl license d a n d i s n o t e n t i t l e d t o p e r 9 P
contractor, that may be an indication that he is not p P y If valuation of work is $2;500.00 or more, I
County. Chapter713, Florida Statutes,-as amended)�
CONSTRUCTION LIEN LAW ( rovided with a copy of the "Florida Construction Lien Law—Homeowner's
licant, have been p licant is someone
certify that I, the aPP the Florida Department of Agriculture and Consumer Affairs. If the app�
Protection Guide" prepared by of the above described document and promise in good faith to
other than the"owner", I certify that I have obtained a copy
" rior to commencement. that all the information in this application is accurate and
deliver it to the"owner p construction, zoning and land
CONTRACTOR'S10WNER'S AFFIDAVIT: � Ce��fi' licable laws regulati�g
that all work will be done in compliance with all app
velo ment. App�ication is hereby made to obfao 15 uance of a p t and'that'alltwork willdbe performed'to
de P
that no work or installation has commenced p��o County and City codes, zoning regulations, and lan
meet standards of all laws regulating construction, that f understand that the regulations of other
development regulations in the jurisdiction. I also certify
govern
ment agencies may apply to the intended work, and that it is my responsibility to identify whaf actions I
must take to be in comp�iance.
d that a separate permit may be required for electrical nor A
GENT FOR THE OWNER, � promise in good faith to inform the owner of the permitting conditions set o�rt in
If I am the A construction I understan 1�cat�
this affidavit prior to commencing as, or other installations not specifically included in the app
plumbing, signs, wells, pools, air conditioning, 9
I issuance of a permit prevent the Building Official froc�e invalid
ed shall be construed to be a license to pro�ed with the work and not as authoriry to violate, c e ce, a er, or
p e r m i t i s s u e r m i t i s s u e d s h a l l b
set aside any provisions of t he tec h n i c a l c o d e s, n o r s h a
ermi t i s c o m m e nced within six months of pe�h it�is�s k?s c o m m e n ced. Anhext nsion
r e q u i r i n g a correction of errors in�ph ns, construction or violations of any co de time v e ry p
unless the work authorized by s P eriod of six(6) months after the
the permit is suspended or abandoned for a p
from the Building Official for a period not to exceed ninety {90) days and will demonstra e
may be requested, in writing, g0 consecutive days,the job is considered abandoned
justifiable cause for the extension. If work ceases for ninety� ) T�CE OF COMMENCEMENT MAY RESULT IN YOUR
WARNING TO OWNER: YOUR FAILURE TO RECORD A NO MENCEMENT.
OR IMPROVEMENTS TO YOUR PROPER D�NG YOUR NOTI E O�BTAIN FINANCING, CONSULT
PAYING TW�CE F RNEY BEFORE RECOR
WITH YOUR LENDER OR AN �
FLORIDAJURAT(F.S ��7•0 CONTRACTOR
J affirmed)before me this
OWNER OR AGENT Subscribed and swom to(
Subscribed and swom to(or a
ed)before me his by
by Who is—lare personally known to me or ha asadentficztion•
who is� e�a personally knovvn to ma°de b��o�roduced
Notary Public
Notary Public
Commission No.
Commission No
Name of Notary tYPed,printed or stamped
Name of Notary lyped.Printed or stamped