HomeMy WebLinkAbout13-14239 ` CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis)�so-oozo 14239
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 14239 Address: 7254 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:
Improv. Cost:
Date Issued: 5/31/2013 Name: HAUNG, JAMES
Total Fees: 25.00 Address: 7254 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/31/2013 Phone:
Work Desc: FPM- SEMI ANNUAL HOOD SUPRESSION FOR CHINA WOK
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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,administradve 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 pertormed in accordance with Ciry 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
� s�3��so-oozo Crty ofZephyrhills"Fir:e�- Fax-aisasaooz�
Permit Application
Date Received =- Phone Contact for Pertnit �
;�
Owner's Name L(f(� Owners Phone Number � �� �
Owner's Address
Fee SimpleTitleholder Name Titlehotder Phone Number � � �
Fee Simple Titleholder Address
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JobAddress G f� (f Lot# y
�
5ub Division Paroel#
� Bio-Hazard Waste 5torage-ANNUAL � Fumigation Tent �'""�-
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(l'ier II or RQ Facility) NUAL ��
� Controlled Bum � Hood Installation ���.�
Emergency Generator<30 kw LP/Natural Gas-Installation
� Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL Sale � �i
� Fire Protection Maintenance-ANNUAL � ��
Places of Assembly-ANNUAL
❑� em� � er
5prinkler ❑ ❑ L7 � � Recreational Bum J ��
Fire Alartn � ❑ ❑ ❑ � � Sparklers � / �� _Y_...
Hood Cleaning � ❑ ❑ ❑ � � 5prinkler8ystem Installations�
Hood 5uppression ❑ O Standpipes(Sprinkler Sys)
� Fire Alartn InstallaUon � Torch Roofingll'ar Kettle
Fire Pumps � Waste Tire 5torage ANNUAL
Fire Works
Flammable Application-ANNUAL Valuation of Project
Fuel Tanks
QOther:
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
5ignature -
Registered I Y�N I Fee Current Y/N
Address License#
OTHER
� �� Company
Signature ! %" _ Registered / Fee Current Y/N
Address
_ License#
Directions: -
Fiil out appiication completely.
Owner 8 Contractor sign back of applicafion,notar¢ed(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required.(Mechanical work over$5D00)
Supply two(2)sets of drawings with applicab{e documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained frvm Property Tax Notice(httpJlappraiser.pascogov.com)
NOTICE OF DEED RESTRICTIONS: unt re ulatgon s The undersig ed a'ssumes resp nsibiity for compl ance tw th any
which may be more restrictive than Co y 9
applicable deed restrictions.
UNLICENSED CONTRACTORSeAN,D bON qRAea�Rbe E ePOedS!Ba�I�oEdancef th s ate a d localeregulati nsc Ifrthe
contractors to undertake wo , y Y
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanorlV'fortthe
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may app y
intended work, they are advised to has hi edea contractor torg ontractorsp hel�s advised to'ha e' t�he contractor(s)s g�
8 0 0 9. F u rt h e r m o r e, i f t h e o w n e r
portions of the "contractor Block"t ofn that hel is n'ot p�operly I censedl land is not en ttled t perm tting prv leges gn Pasco
c o n t r a c t o r, t h a t m a y b e a n i n d i c a
County.
CONSTRUCTION LIEN LAW ha he pbeen 1provided wSh a tcopy of he�F o)rida Construct on L en Lawo�Homeowner's
certify that I, the applican , licant is someone
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. tf the app'
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"owner" prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
that all work will be done in compliance with all applicable laws regulating construction, zoning and land
development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify
that no work or installation 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
government agencies may apply to 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 FOR THE OWNER,tructionise iu derstan'd that a�sepah at permit may be req u ed for lelectr ct I work,
this affidavit prior to commencing co
plumbing, signs, wells, pools, air cond'a►oCe nse to p oceedewith the work and not alscault or'ty to violateecanclelaallter, or
permit issued shall be construed to be
set aside any provisions of the technicalconstruct onsoalviolations of any codesprE erytperm t iss ed shall be ome invatl d
requiring a correction of errors in plans,
unless the work authorized by Sdonedefor�alpe od of six (6) mhonths after t e timeethe workas commenced Anhextension
the permit is suspended or aban
may be requested, in writing, from f Work'cela es�ffor1ninety(90)rc nsecutive days, theeob iso ons de ed abal donedstra e
justifiable cause for the extension.
WARNING TO OWNER: YOUR FAILU TO YOUR PROPERTY TIF YOU INTOEND TO OBTA N FIANANC NG CONSULT
PAYING TWICE FOR IMPROVEMENTS
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F S.117.03)
CONTRACTOR
OWNER OR AGENT Subscribed and swom to(or affirtned)before me this
Subscribed and sworn to(or affirmed)before me this by
bY Who is%are personally known to me or has/have produced
Who islare personally known to me or has/have produced as identification.
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary tYped,printed or stamped
Name of Notary typed,printed or stamped