HomeMy WebLinkAbout13-14100 CITY OF ZEPHYRHILLS
5335-8TH STREET -
(813)780-0020 1�'100
ANNUAL FIRE PROTECTION MAINTENANCE �
Permit Number: 14100 Address: 7446 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: 35-25-21-0010-08800-0010
Improv. Cost:
Date Issued: 4/19/2013 Name: SYBEA,INC.(ARBY'S)
Total Fees: 25.00 Address: 7446 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/19/2013 Phone:
Work Desc: FPM- SEMI SUPPRESSION-ARBY'S
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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,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 commerciai 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 pertormed 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 COMMENCEMENT."
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PERMIT OFFICE
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
�'ermit Applicatron
Date Received _
Phone Contact for Permit �3 Lt 7�i �
Ovmers Name � �� � -- �-
Owners Phone Number � � '�
Owners Address J
Fee Simple Titleholder Name �� �� �
Titleholder Phone Number
Fee Simple Titleholder Address
`�i'' "` -- ,�s,�e, —�.
Job Address � � ,/� ;
V �
Sub Diwsion
Lot#
� ,�����L� _ Parcel#
� '{'�_»_.,.�'',.�r`��x` � -.."' '�'„�:£?�"i�..��.°_'�;ex:,�iSc.�.2ss_
Bio-Hazard Waste Storage-ANNUAL a
aFumigation Tent "
Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL
aControlled Bum �
� Hood Installation
Emergency Generator<30 kw �
aLP/Natural Gas-installation
Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale
aFire Protection Maintenance-ANNUAL �
Places of Assembly-ANNUAL � ��/�\ �1
❑� emi � er l!l/
Sprinkler � � 0 �
❑ Recrea6onal Bum
Fire Alarm � � � �� �
❑ Sparklers
Hood Cleaning � 0 � (—'-� �
� L__J Sprinkler System Installations
Hood Suppression � � 0 �� a
� Standpipes(Spnnkler Sys)
Fire Alartn Installation �
aTorch Roofing/Tar Kettle
Fire Pumps a
� Waste Tire Storage ANNUAL
Fire Works
aFlammableApplication-ANNUAL �—�.�_.�
� Fuel Tanks Valuation of Project
� Other:
Contractor `��-� l�=--v�
�'
Signature Company m G _ �, /�._F�r�m�
Address y�o� �G Registered � Y/N I Fee Curre�t Y/N
�crr l�?-
ELECTRICIAN T � License# [- �Y���l�oof�.�o��
Signature Company
Address
Registered Y/N Fee Current �'/N
License#
PLUMBEI2
Signature Company
Registered 1'/(�I Fee Current �'/N
Address
License#
MECHANICAL
Signature Company
Registered Y/N Fee Current Y/N
Address
License# �—
OTHER �
5ignature Company
Address
Registered Y/N Fee Current Y/N
)irections: ''`�; License#
Fill out application completely
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
tf over$2500,a Notice of Commencement is required(Mechanicai work over$5000)
Supply two(2)sets of drawings with applicabie documentation
Aliow 10-14 days for review after submittal date
� Parcel#-obtained irum Property Tax Notice(httpJ/appraiser.pascogov.com)
TRICTIONS: The undersigned understands tha�a�s P mes espons b Ibty fortc mpl an e tw th any
NOTICE U� DEED RES ulations -The_undersigne
which r�-�'�` '}� "'��re restrictive than County reg
aPP�;�a��� ,ie�o restriCtlons
o be licensed in accordance with state and local regulations. If the
NSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES� If the owner has hired-:a'cD�nrra olation
UNLICE be required
law, both the owner and contractor may be cited for a misdemean I for the
contractors to undertake work, they may
contractor is not licensed as required by
o County Building Inspection Division—Licensing Section_at 727-847-
under state !aw If the owner or intended contracC r are uncertain as to what licensing�requirements montractor s sign
intended work, they are advised to contact the Pas ou, as the owner sign as the
ermore, if the owner has hired a contractohich theyrwill be espons blee�lfty have the � .( Pasco
8009 Furth lication for w
portions of the "contractor Block" of this app� erl licensed and is not entitled to permitting privileges in
contractor, that may be an indication that he is not prop Y
Counry. Chapter713, Florida Statutes, as amended): If valuation of work is $2;500.00 or more, I
CONSTRUCTION L.IEN LAW ( of the "Florida Construction Lien Law—Homeowner's
licant, have been provided with a copy licant is someone
certrfy 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
deliver it to the"owner" prior to commencement.
all a licable laws regulating construction, zoning and land
_ CONTRACTOR'SIOWNER'S AFFIDAVIT: Ilthertify tPhPt all the information in this application is aec�ura certify
that all work wi�� be done in comp�iance w
development. App
lication is hereby made to obtain a permit to do work and installation as �n ica
tion County and City codes, zoning regulations, and lane
t
hat no work or installation has commenced p fuc to issuance of a permit and that all work will be perfo�f oth o
meet sfandards of all laws regulating cons that I understand that the regulations o
development regulations in the jurisdiction. I also certify
ment a encies may app�y to the intended work, and that it is my responsibility to identity what actions I
govern 9
must take to be in compliance.
I romise in good faith to inform the�W ermit ma Pbe req g ed for Ielectrc I work,
If I am the AGENT FOR THE OWNER, p lication. A
this affidavit prior to commencing construction. 1 understand that a separate p Y .
plumbing, signs, wells, P
ools, ai� conditioning, gas, or other installations not specifically included in the app
I issuance of a permit prevent the Building Official froC�e invalid
d shall be construed to be a license to pro�ed with the work and not as authority to violate, cae ce, a er, or
permit issue ermit issued shall b
set aside any provisions of the techans,l onstruction oaviolations of any codes. Every p
requiring a correction of errors i� P ermit is commenced within six months of permit issuance, or if work authorized by
untess the work authorized by such p months after the time the work is commenced. An extension
the permit is suspended or abandoned for a period of six (6)
from the Building Official for a period not to exceed ninety (90) days and will demonstra e
may be requested, in writing, gp consecutive da s, the job is considered abandoned
y
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 N NG YOUR NOTICE OF MENCEMENT.
OR IMPROVEMENTS TO YOUR PROPER D. IF YOU INTEND TO OBTAIN FINANCING, CONSUL
PAYING TW�CE F RNEY BEFORE RECOR
WITH YOUR LENOER OR AN � �
FLORIDA JURAT(F.S 117.0 CONTRACTOR
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 personally known to me or hasas?dentificatfon.
Who is�personally known to ma o ae bm�tlonfOduced
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary tyPed,printed or stamped
Name of Notary typed.Printed or stamped