HomeMy WebLinkAbout13-14165 CITY OF ZEPHYRHILLS
� � 5335-8TH STREET �y.�
�sis)�so-oo20 14165
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 14165 Address: 5214 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: 11-26-21-0010-16600-0250
Improv. Cost:
Date issued: 5/10/2013 Name: VICHRIS INC
Total Fees: 25.00 Address: 5214 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/10/2013 Phone: (813)782-9556
Work Desc: FMP- HOOD CLEAN - QUARTERLY-VILLAGE INN
j V�
_ � � ( �
� � �
�
�
ma
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
oosts 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 COMMENCEMENT."
.- , �, ; " � ,.
� � �
��
�tr.�-�r�.- �� �,��`�-��'
PERMIT OFFICER `
PERMTT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
sis-�so-oo2o City of Zephyrhilis Fire Fax-813-780-0021
' + PermitApplication
Date Received � Phone Contact for Permit � � �
Owner's Name • � Owners Phone Number � �
Owner'sAddress �. � S• .�Z �e
Fee Simple Titleholder Name Titleholder Phone Number � � �
Fee Simple Titleholder Address
.r. .. -' -.;. .::Sa M,�°C`�'..a'S".��.r:" >' � %;'��:a.^.c'+ -i �'rt,�`��'=i=.:,3.: ='�Id:K."'�,'=F'1'� •,�:.. ^°"�{g-,'�:bEiiC ..=�'t"��. ,. � - �t�:. `a�i
n.-; ' . _ . �;�
Job Address % (� � � („ . 3 Lot#
Sub Division Parcel#
-:s°-`ra�, .. x,�. , ;, . ,,, ..,��.;.
�rd'v% �gt .. ..�d. qL;�l, :.`e�«i+�"A�-"»«. � .. �. �::"'k�".'e°, � ...-. . .-3..1'�_ ,:Sitt�'.: ,;�.f-,_ H � .-» - .._-�. ._ n- .- , .fi .
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator<30 kw � LP/Naturai Gas-Installation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
�y emi �n er
-- - ----- - — -- - -- - - - -
Sprinkler Q � � � Recreational Bum
Fire Alarm ❑ ❑ ❑ � � Sparkters �� �
Hood Cleaning � ❑ ❑ � � Sprinkler System Installations
��
Hood Suppression ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation a Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL Valuation of Project
� Fuel Tanks �( r � ( �T
Q Other� � �
- z, , � . : . d. ., .. ,.}� . � � .
`:
Contractor " � Company
Signature Registered Y/N Fee Current Y/N
Address License#
ELECTRICIAN Company
Signature Registered Y/N Fee Current Y/N
Address License#
PLUMBER Company
Signature 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#
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 work over$5000)
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
FEB•;20/2Q07/TUE 11 : 10 AM ZEPHYAHILLS BU1LDIhJG FAX No, 813-780-0021 P, 003
- :�.����_" .. �--�-�^.°�`��=�-'.:�. . ::�°'°..;;,.°F-.:'_�
- �.. ��;Y.-:x ' . .. � -=b�'LC`";,Y:: ---— -- � '-�v_��"��
`:,�flP7i�"F�c.—.- . •.':i;u fior���=:�:- - . ,. -,,�*_",Y���—�
�;��•p;�j�.;C�:F,D�EDR�STRICTIPNS: �'he.undersigned��und��,n�s_�that�this`per.mfE may.be�subject�to�"de�d.".:�'estr.lctlp�t.�„�tr�
�.;�.,; , :..:_:. _ iarr�a.wlfh�� r
-.;,r-:swtaiCh'emay'.b'emore•restrictive'than County'regulations�."The�ur,rd�r.s�ned�assumes�re�ponsibliily�for�omp�' ,�.��.��.I
'—;aFpllcable-desd restrictlons. �� aG:r�ii��T-���:- =- ������•i:��'��1
:-'''"y1JNL:M�ENS�D .CONTRA.GT.DRS!AND=CONTRACTOR'=R�SR(?NS1BIl:l'TIE�S:='°If-the-owner has-hired'�a°�ontract�C� 'cYa'�:�",:-^F'I
-:contracfors-to underEake work,'they may�.be required�to be Ilcensed�in�accordance with state and local-regulatiQns, if�he_:.-::=;
contractor is not licensed as requlred:by law, �both�the owner;and:contrador�may.be cited`For a�misdemeanor violatiori, � . .�
�.under�state�law. If�the owner or intended�cantractor:are uncerfafn=as�to what Ilcensing�requirements may:apply�for�the���-:�- �
infended�work,'the,y are�advlsed�to contacf the•Pasco CountyiBuilding�Inspection.Dlvision—Licensing SecUon:at727=847
-BOp�. :F.ur�hermore, if the owner has hired-a contractor or�contracfors,:he is�advised to •have-the contractor(s)$tgri
portions of tfis "contractor Black" of thls applicafion-For which•they will be respbnsibie. If you, as�the owner��sign:as.the
-• � ;contractor,'fhat�may�bean indication:that�he�isnot�pr.operiy liaensed,and is notentltled�fo�petmitting_privileges inYP.asao ,�� ��.� ,
-Gounty.
=CONSTRUCTEQN.LIEN-LiAW�(Chapter7'13,'�lorlda`StatuEes,�s�mended): lf�vafuatlon�ofworkis�$2;500.d0.or'mor�,:l , '�
aertify �that l, �the appilcanf, have been provided-with a copy�.of=fhe °F(orida Construction Llen Lav,�-Homeowner's
`Pratection Guide" prepared by'the �lorida Department Qf Agriculture;and Consumar AfFalrs. If the appllcant is•someone.
other�than the'°owne�', 1 oBrfify��t! h�ve obtained:a copy of.the�above described document and promise in goodfalth�to .
deliver It ta the"ownar"prior�to commsncement. I
CDNTRACTC)Ft'.S�OWNER'S-AFFIDAVIT: I certify that all the information in this appiicafion"Is accurate and ,
Y ��h+at-at{-wo�i�will_-b� done in com�liance with ali appl�cabie laws regulatfng constrvctfon, zoning and land
development. App�ication Is hereby made�to�faln a perm���o c�o warkand instaNattarras-kndieatee�-�-eertlfy-
that no work or installation has commenced prlor to Issuance of a permlt�and•that�all work wlll be performed to
meet standards•of all laws ragulating consfruction, County and City codes,.zoning regufations, and land
devalopment�ragulations in�the jurisdictlon. I .atso ce�lfy-that l uhderstand that the regulations of other
_ govemment agencies may apply�to the intended work, and that lt is my responsibillty to id�ntify what actions(
must taks'to lae in complEance. :
�If 1 am-tha.AG�NT'FORTN�OWNER, I p�omise iri good faith to inform the owner of�the permltting conditions set-forth in
thls afffidavit prlor'to�commencing constrwation. �1 understand�that a separate petmit may.be raquired for eiec�rical work, .
F
plumbing, slgns, wells, pools, air conditioning, gas, or other installafaons not speclfically Inckuded in the applicatlon. A
permit issued shal) be construed to be a license to proceed with the work and not as authority fo vialate, cancel, after, or
set aside any provislans of the�technical codes, nor shall issuance of a permif prevent the �ullding Official from therBafter
requiring a correctlon of errors In plans, constructfon or violaHons of any codes. Eve.ry permEf.lssued shall be�ome invafid
unl�ss the work authortzed'by such permlt is commenced within six months of�perrnit issuanee, or if work authorfzed by
the permit is suspended or abandoned for a period of six(6)months after the fime the work is comm�nced. An extension
may be raquested, in wrlting,from fhe Sullding Offiiciat for a period not to exceed nlnety(90) days and wlli demonstrafe
)ustifiable cause for fhe axten�ion: If work ceases for ninety(90) consecuf'Ne days,the job is considered abandon�d.
''WARNING"i'4�dWN�R: 'YOL1R'�AIL'URE T4'R�CORD A'NOTICE'OF^CbMM�NCEM�NT MAY=�RESULT=IN�YOUR �=< -
PAYINCy TW10E��R IMPR0II�MENTS TO YpUR PRf�PERTY TEND TO OS �'1NANCING,CONSU�T
WITH Y U �R OR. N N Y'BEFOR�RE�O jING YOUR T(CE M NCE NT.
FLORIA RAT(F.S.1 03) � . ,.
� CONTRA ���
OWN�R G GHN'f '
Subscrlbod an to(or a rmed)befo me th)s _ 5ubscd�Y m�(or afflrm )bef ine thls
by , . .
Who is/are persotially known to me or ha . � P�o4uc� Wh��slare personaliy known to or hasThave roduced
2s identitice on- . , tificstion_
Noiary Public Notary Publ�c
Gommiesion fJo. . Commission No. ,
'Name of No1ery typed;prfnfed or stamped Name of Notsry typed,printed or stHmped _ .