HomeMy WebLinkAbout13-14086 �—
� CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oozo 14086
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 14086 Address: 7838 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class 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 Number: 35-25-21-0010-00700-0000
Improv. Cost:
Date Issued: 4/15/2013 Name: PRIMERICA GROUP ONE
Total Fees: 25.00 Address: 3629 MADACA LN
Amount Paid: 25.00 TAMPA FL 33618
Date Paid: 4/15/2013 Phone: (813)933-0629
Work Desc: FPM- SPRINKLER QUARTERLY- PUBLIX
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees M 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$100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMEN�EMENT."
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PERMIT OFFICE
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION -8 HOUR NOTICE REQUIRED
ZEPHYRIiILLS FIRE RESCUE DEPT- 813-780-0041
- MAR128/2007/WED 07:20 AM ZEPHYRHILLS Bl1ILD1NG EAX No, 813-780-0021 P. 001
81�78o-onz0 City vfZAphyrh1116Fi�er Fax.staaeo-ao21 '!;
Penntt Appllcation .__
Date Receiv9d •Phona Confacfior Pam►It �
Ownere Narne Owna's Phono Number � �
.
Oumera Addresa
Fee simple Titleholdor iJame � ' ' Titleholdar Phone Number � � ��
KaeSimplelltleholderAddress • � � `
Job Addres9 ' Lot�
5ub Diviclon Perce11F
� Blo-Hazard Weete Stocape—ANNUAL ` FumlqeUon 7ent ,
� Comm Fxhaust K�cfien HoOd/DUCt � Haardous Mate�lal(lier II or RQ Fedliry)ANNUAL ,
OConiroNed Bum Hood fnstalletbn
� �mergency C-,anerator<30 kw � Q LP/Natur'e16es-Inatallatlon '
••� �•Emergency Gensrator>30 kw � ,LPMatursl Gas-ANNUAL Sals ,
FtreProtBCtionMal►►t9nence=ANNUAL . � PIaCCSdAssembly-ANMUAL
�I�' �' �L___� C� t 'of�.
sprinkle� Reoreaaons�sum .
� Fre Alerm � ❑ f7' ❑ C� � SpwMors : • c���l„nl \�� �
Hood qeanin ❑� ❑ p 3prinider'S tem Installations '�Jf ��U.(J U
Haod 5uPP+e slo� � p D o � � Stendpip SprhNclerSys) � �y 1 tS I�
� Flre Alarttt InBtapaflon � TotCh Roo$nylTM Ke@le , �
Fke Pumpa Waate Tho Storage ANNUAL
Rre worko �
Flammabie Apnficauon-ANNUnI • Valustion of P[oject
Fuel Tanks
Q • Other: � .
Contreclor t . Company 1
Signawro ' Ftegictared N Fee Current /N •
Addrasa License#
EI.ECfRICIAN � COmpenY
Signatutt Re9�s��aa• Y/N Fee Curtent, Y/N
Addrese Licer,se�i '
PIUMBER Company
Slg�ah,re � Raplstered Y/N Fee Current Y/N
Addross � Llcenae� •
MECHANICAI_ ���y
signature Rtg[stered Y/N Fao cument 1(/N
Addreas •Lbenee#
OTHER ' ��y •
Signature Ftegiefered Y!N Fea Curtent /
Addreee - Ltcanoa# �
D�f9c1Wh5. '� r wsy I�W�
FlU out application complately.
Owner b ConlrACtor eign baok of applicatioh,nola�kted(Or,eopy of eigned contrad wlth ovimer)
If over 52500,a NotlCe oF Commshcement ia requlred.(Mechenical work ovar 36000)
5upply lwo(2}se�of dtawinpa vnlh appllcable documentadon
Allow 70-14 daye for revlow atter submiltal dale. Peicel#-obtalned from P�operty TaX IJOUce(httpJ/appteieer.pdSCOgov.com)
. '.
MAR/28/2007/WED 07:20 AM ZEPHY�HILLS BUILDING FAX No, 813-780-0021 P. 002
, 'NOTIG�dF:DE�D'RE3TFtICTtONS: The.underslgned understands•that this permit maybe•subJect��O-°de�d"�estrfCtlons"�
.which may be mora restrictive ttian Gountyregulatfons. 7ha�.undersigned.assumes responsibllity for:COmp�iara�e+vvith any .
.8ppliaablo deed restrloUons. • •
�UNLICENSED�CONTRACTORS •AND-CONTRACTOR,.RESP.QNSIBILITIES: If the ovmer has•hired•��oontractor�or - •
contraators rto undertake work,they may be requi�ed�to be Ileensed in accordance with state and loaal-re�ulations. If the
corlb'�ator Is not liaensed as required by law, both the owner and�contractor may be cited`for.a'misdemeanar vlolation
.under sbe►te lew. If'the owner or Intsnded�cantraetor are uncertain�as to whet licensing•raquirements may apply for the
intended wcrk,they are advised'to contaat the•PasCso County Bullding Inspection Division—l.laensing Sec�ion.at 727-847-
8009. Fu�hermore, ff the owner has hired.a cantreator or aontl'actors, he is advtsed'to•have'the conh�ctor(s) sipn
portions o�the"contraator Block"of this appllcation•for whiah'they wlll be responslbfe. !f you, a�•the ownersign�as the
cot�tracto�, that may be an indication�that he is�not pcoperly lioensed and la not enEiUed�to�pe�mitting.privileges tn Pasco
Counry. •
CON8TRUC'f10P1.L.lEN.LAW(Chapter713,•Fforida Statutea,.as.amended): If valuation of work(s�$2;500.00 or more, I
cerGfy'that I, 'the applicant, have .been provided wlth a copy af'the °Florida Consfivatlon .Lien. Lav�Homeowner's
Protsction Gulde°prepared by�the Florlda Qepartme�t of Agriculture and Consumer Afifafrs. lf the applicant is�someone
pther than the"owner°, I certNy that I have obtained a copy of the above descrlbed document and promise in good faith to
dellver it to the"awner"prior to commencement. • '
- CONTRACTOR'S/DWN�R'S•AFFIpAVIT: I certliy that all the information in thls applicatlon is accurate and
that all work wilf be dbne In compllance wlth aU applbable laws regulattng aonstruction; zoning and iand
development. Applicafion is hereby made to obtain a permlt to do work and installation as Indicated_ I certify
that no work or installation has comrnenced prior Co issuance of a perrnit and•that all work wUl be performed to
meet standards of aA laws regulattng constructio�, Cpunty and Cfty codes,zoning regulatlons, and land
development regulations in the jurisdiction. t also certKy that I understanC the�t the regulations of other
.govarnment agenoies tnay apply ta the intended work,and that it is my'responsibillty to identify what actlons I
mustEake�to be fn campllance. �
If I am the AGEN'C fORTH�OWNER, l promise in good faith to Inform the owner of the peRnitting conditions set forth in
thfs aifidavlt prior fo commencing coinstruction. �I understand that a separate permit may be required for electrical work,
plurnbing, signs, weUs, pools, air conditi�ning, gas,�or otk�er installafions not specificaily Included in the application. A
permlt lssued shall be construed to,be a Ilcense to proceed with the work and not as authority to violate, cancel, alter, or
set aside any ptovisions of the techNcal codes, nor shall issuance of a permit prevent the fiuilding.pffi�al from thereafter
requiring a coirecdon of errors in plans,construction or violations of any codes. Every permit lssued shall become invalid
unless the work authorized by such permlt is commenced within six months of permit Issuan�, or if woric authorized by
the permft Is suspended or abandoned for a period aF slx(6)months aite�the tlme the wark Is commenced. An extension
may be requested, in writing,from the Bullding Offlcial for a period not to exceed ntnety(90) days and will demonstrate
Justifiable cause for the e�enslon. lf work ceases f�r ninety(s0)consecutive days,the Job is consldered abandoned.
'WARNING TO OWNER: YOUR �AIL'URE TO�R�GORD A'NOTICE'OF:C4MM�NCEM�NT Mi41�'R�SULT IN'YOUR ' '
PAYING TWIC�FOR IMPROV�MENTS�TO YOUR PROPERTY. IP YOU IMTENDTO OBTAIN�INANCING,GONSULT
H UR ER O Ti' RNEY EF RE O ING UR NU I OF C ENT.
FLORIDA JURAT(F.5.117.03) ' �
OWNER OR A(3ENT CONTRAC7QR� /� ��""�1�
8 ed to ) re me is ed a � twam afflrmed this
�� i � y ��°`rav����r
Who1���y to me or haslhave produced Who Is✓are parso�a ro me or eslhave producad
as Idenfification. as identlflCadon.
Notary Public Notary Public
Commisslon o. � Commis�lon�
M r`�2i���(1Q�_ � �
Nante of NoFery�ped;pri�ed of sbmped Name'of Notary prped,printed or stsmped
MITZI VANCE M�V'4�E
Cc�wsa�oH s oovt3oeo " � �Ct��o0ot�oeo
�a� E�PNIES OCT 09 2013 ���18
MI Nd1�AM�c�oANvrn �����