HomeMy WebLinkAbout13-14242 ' CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 � 2
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 14242 Address: 38422 VALLEY OAKS CR
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: GRAND RESERVE
Est. Value: Parcel Number: 35-25-21-0010-09200-0000
Improv. Cost:
Date Issued: 6/03/2013 Name: GRAND RESERVE APARTMENTS LTD
Total Fees: 50.00 Address: 580 VILLAGE BLVD STE 360
Amount Paid: 50.00 WEST PALM BEACH FL 33409
Date Paid: 6/03/2013 Phone:
Work Desc: FPM- FIRE ALARM & SPRINKLER ANNUAL - GRAND RESERVE APT
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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 DepartmenYs Fire Marshal or required permits or opening up for commercial activi without an a
inspection shall be charged double permit fee ry pproved final
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."
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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��•,sc-oozo Ciiy oi Zephyrhilis Fire Fax-813-78C-0021
Permit Appiication
Dats Received � � Pho Contact ror Fermi
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Owner's Name � � +�tl1�TS �, —, Owner's Phone Number � `�� �
Owner's Address SgC� Vr�L % L . .J�O W�,57' r�F1l.,r►� �j�/�Gµ �(� ���{d
Fe=Simole Titieholder Name Titleholder Phone Number �� �� �
Fe>Simple i itl=nolder Address
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Job Address ��jl�y�� ��L�„L� D�KS +Z Lot r f���
Sub Division Parcel�
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� Bio-Hazard Waste Storage-ANNUAL � Fumioation Tent ' """ ' ' `.YYU-'^ V�FF,.
� Comm Exhaust Kiichen HoodlDuct � Hazardous Material(Tier II or RQ racility)ANNUAL
� Controlled Bum � Hood Installation
� cmergency Generator<30 Kw � LP/Naturel Gas-Installafion
� Emergency Genereior>30 kw � LP/Natural Gas-ANNUAL Sale
'� Fire Protecfion Maintenance-ANNUAL � Places of Assembly-ANNUAL
❑ tny emi ni ner
Spnnkler ❑ ❑ `� � � Recreauonal Bum �(,����,
Fire Alarm � ❑ ❑ � � � Sparklers � /
Hood Cleaning � � ❑ ❑ � � Sprinkler System Installations
Hood Suppression � ,_r', ❑ ❑ �� � Standpipes(Sprinkler SysJ
� Fire A�arm Instailation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammabie Application-ANNlIAL Vafuation of Project
Fuel Tanks
� Other
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Contractor
Company
Signature Registered Y/N Fee Current Y/N
Address
License#?
ELECTRICIAN
Company (
Sigrature Registered Y/N Fee Current Y/�1
Address
License�
PLUMB�R
Company
Sigrature Registered Y/N Fee Current Y/N
Address
Licensa#
M�CHANICAL Company
Signature Registered Y/N Fe=Curren? Y/N
Address License#
OTH�P, • Company -r�c-iZ ,C7/�r` C 2G7�GTTCJhJ .�-/�c�G
Signature Registered I �/N ree Current N
Addross L°p ; _ _
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v ) License�
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Directions: __,.,_,......�a_ ._._ ,, _._. .�-_..�._.x.�..:....,,_._,.:,.� .._.__ <<,,,.
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Fill oui application completely .� F(�Q O 1 r�. ���
Owner 8 Contractor sign back o`aoplication,no:arized(Or,copy of signed contract with owner)
f�over 52500,a Notics o.`Commencement is required(Mechanical work over W5000)
Supply two(2)sets o`drawings with applicable documentaiion
Allow 1 G-1�tiays ior r=view after submittal aate Parcel�-ob,ained from Property Ta>:Notice(http./fappraiser.pzscogov.com)
NOTICE OF DEED RESTrZiCTIONS. The undersigned understands that tnis permi: may.be subject to "deed":restrictions°
which may be more restrictive than County regulations The undersigned assumes responsibility ior compliance v��tn arrv
applicable deed restrictions
UNLICENSED CONTRe worOk�heymay beNequAed o be E ePsoedS!Bactco�dance th s ate a d local a gulationac �?rthe
contractors to undertak ,
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanorlvio�lat�hc
under state iaw If the o�vised toncon ac�t the Pasc�o County Buldingsinspection Div s onrPL c nsing�Secton aP727-u47-
intended work, they are a
8009 Furthermore, if the oW k�of thi�happli�tiontfor whi�h theyrwiil be espons ble.plftyouaas the owntea sign asSthe
por'tions of the "contractor Sloc
contractor; thaf may be an indication that he is not properiy licensed and is not entitled ia permitting privileges in asco
County. .
�f'jhj$T�{CjC;f IUIV LIE1V i-!;�� (��aF'i8i�Ti3, Fl�ric3a Stat::#es,-3��f �� ���`�id,a Cionst uction L en Lau���Homeow�er s
certify that I; the app lican t. have been provided with a cGpy `
Protection Guide° prepared by the`Flhav�e obta ned ancopy oi'thetabove des�ribed docum'ent and prompsean�good a th to
other than the "owner", I certify tha
deliver it to the "owner" prior to commencement. o lication is accurate and
_ CONTRACTOR'SIOWNER'S AFFtDAV1T. ! certify tha caible laws r egullatingtconst�rpction, zoning and land
that all work will be done in compliance with all app�
development. Hppfication is hereby made to obtain a permit to do work and instalfation as indicated. I certify
that no work or instalfation has �u at nen con sPtructionS County�a dPCitytcodeshazon'i g reguilatio Ps,rfand land
meet standards of all laws g 9
development regulations in thi to�thel initended workcand tht tat is m y espon�s bility toeide n i�fy twhat actions I
g o v e r n m e n t a g e n c i e s m a y a p p y
must take to be in compliance.
If I am t he A G E N T F O R T H E OWNER, � P t�o�S I 'u derstand that a separa te permi t m a y be r e q ug d for'electrical work.
this a f ii davi t p r i o r t o c o m m e n c i n g c o n s t r u
plumbing, signs, welis, pools, air co�da��cense to p oceed with the work a�d not a's au ithorty ao�violate eca p P lel aaliter, or
permi t issu e d s h a l l b e c o n s t r u e d t o b e
set aside any provisions of the technical o d truct onsoa�violations of any cod s P rEvery tper m t i s ls ed shali be ome invaf d
requiring a correction of errors in plans, c
unless the work authorized by such permiaise o of six (fi) mhonths after the timeethetworl:as commenced Anhextension
the permit is suspended or abandoned fo p
may be requested, in writing, from the Buil�d�ia 9Of'�Iainety (90)r on secutive days theeob isocons de ed a al doneds�ra �
justifiable cause for the extension. If work
WARNING TO OWNER: YOUR FAILURc TO�R��OQE N�IF YOt1 INOENa TO O TAINnFINA1dC NG COhSOULR
PAYiI�{G TINICE �OR IMPP.OVERAElSITS .O YJ
WiT"rl YOLiR LCiVDcR OR Ah1 L'+TTCRl�lEY BEFOR� aFC�RD!!�!G YOUR NOT�CE QF COMMENCEMENT.
FLORIDA JURAT(r S.117.03)
CONTRACTOR
OWNER OR AGENT Subscribed and swom to(or affirmed)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
VVho is";are personally known to me or nas/have produced as identification.
as identification.
Notary PubGc
Notary?ublic _______ --
Commission No "
Commissior,Nc �
Name of Notary ryPe�,pfinted or stamped
Name oi rvotary rypec,Pnnted or starr�ped