HomeMy WebLinkAbout13-14402 CITY OF ZEPHYRHILLS
' S335-8TH STREET
(si3)�so-oo20 1 402
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 14402 Address: 6020 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: 03-26-21-0010-12800-0000
Improv. Cost:
Date Issued: 7/29/2013 Name: GALL BOULEVARD LAND TRUST
Total Fees: 25.00 Address: 350 HARBOR PASSAGE
Amount Paid: 25.00 CLEARWATER, FL 33767
Date Paid: 7/29/2013 Phone: (727)643-8922
Work Desc: FPM- SPRINKLER ANNUAL - FAMILY DOLLAR
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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 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.
"WARMING 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 YOUI� 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
813-780-OG20 City of Zephyrhills Fire FaX-s;a-�ao-ooz�
, Permit Application
Dat=Received � —�
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Fe=Simple?itleholder Address
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� Bio-Hazard Waste Storage-ANNUAL � Fumioation Tent d '
� Cornm Exhaust Ki'tchen HoodlDuct � Hazardous Material(Tier II or RQ racility}ANNUAL
� Controlled Bum � Hood Installation
� cmergency Generetor<30 kw � LP/Natural Gas-Installafion
� Emeroency Generetor>30 kw � LP/Naturel Gas-ANNUAL Sale
`-�- Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
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Sprinkier � ❑ ❑ � � � Recreafional Bum ! v
Fire Alarm � p ❑ ❑ � � Sparklers j���
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Hood Cleaning � � ❑ u � � Sprinkler 5ystem installations
Hood Suppression � ❑ ❑ n �� � Standpipes(Sprinkler Sys)
� Fire Alartn tnstallation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
a Flammable Appiication-ANNUAL Valuation of Project
� Fuel Tanks
� Other:
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Contrector
Company —�
Signature Registered Y/N ree Current Y/N
Address
License#
ELECTRICIAN Company
5igraiure Registered Y/N Fee Current Y/N
Address
License�
PLUMBER Company
Signature Registered Y/N Fee Current Y/N
Address
Licensz�
McCHANICAL
Company
Signature Registered Y/N Fee Curren? Y/N
Addr=ss
License�
OTHEP, . Company = — �/�2O
Signature Registered Y/N Fes Current N z
Address
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Fill out applicaiion completely
Owner&Contrector sign back oi application,notarized(Or,copy of signed contract with owner)
I�over 52500,z Notice o•`Commencement is required(Mechan�cal work over W5000)
Supply two(2)s=ts of drewings with applicabl=documentation
Allow 1 G-14 days 1or revi=w after submittal date Parcel r-obtained trom Properiy Tax Notice(http.happreiser.pascogov.com)
NOTICE OF DEED RCS i RICTiON Countv r gulat ons -f ae u de�rsig ed ss umes�esp ns"b fby ror Qompl anTCe w;ft-�o�Y
whicn may be more restrictive tha ,
applicable deed restrictions
UNLICENSED CONTRe wo�F they�may bO�requ�ired too beECePOe SIBac'coEdance th s ate and Socalea gulationl acroTrt�oe
contractors to underta4. ,
cortracto; is no: licensed as required by law, both the owner and contractor may be cited for a misdemeanor'vio�latih�
under s±ate law tf the owner o toncont�ac�t the Pasco CountycBuadingsinspectionl Div sl on r�L cens ngtSection at�727-u47-
intended work, they a,e advised
8009 Furthermore if the owneroh hfsh�pd����tiortfor�whi�h th yrwill be respons bl�s��lf{youaas the owntea sign asstge
portions of the "contractor Slcc{. P
contractor, that may be an indication that he is not properly licensed and is not entitled 'to permitting privileges in Pasco
County ,�L__ ---��3, Fi��i�a �.a.�tes, a�.a^:e����,: if�J�IU3tI�n pf�ninrk iS $2,5QO.00� cr more. I
C�NSTKU�i iGiv �icN �E'`�►v ;`'fQN`C` ' of �;-tie °�forida Construction Lien Lav��—.N,omeowners
certify that L the apoficant. have been provided with a �opy
Protection Guide" prepared by tna� Ilhav�e obta ned ancopy of'thetabove des�rbed docum'ent and pr�mpsean�good 'ath to
other than the "owner", I certify th
deiiver it to the "owner" prior to commencement. a p ►ication is accurate anC
_ CONTRACTOR'S10WNER'S AFFIDAVIT ! certi"ry thal a�ble taws r egu�latingtconst�rpction, zoning and land
that all work will be done in compliance with ail app�
development. �ppiication is hereby made to obiain a permit to d� wark and installation as indicated. ! certify
that no work or instailation ha e�u at nen cons�tr�ctions County�a dPCitytcodeshazon�i g regu'latio Ps,�and eand
meet standards of all laws g 9
development regulations in thi {o�{hd�inftended workCand thatat !s m yeespon�s bility toeidenify twhat act ons I
government agencies may app y
must take to be in compliance.
I; I am the AGENT FOR TI-IE 01(VNCR, � P%mise iU 9�e°atand thatna�separate permit may be req g ed for'electri al work.
this afridavit prior to cammencing construc lication A
plumbing, signs, weiis, poois, air co eda'license to p oceedewith the work a�d noe a's ault ority tlo�violateecapPel, alter, ar
permit issued shall be construed to b
set aside any provisions of the technical code uct onSOalviofafions of any codesPrEverytperm t'is's ed shall be orne invabd
requiring a correction of errors in pians, const
unless the work authorized by such pero ia�Se od of six (6) mhonths after the timeethetworl:fs commenced Anhext nsion
the permit is suspended or abandoned f p
may be requested, in writing, from the Building �fricial for a per od secu�ve days, the job(sOcons�dered a�al donedstra °
justifiable cause for the extension. If work ceases for ninety (90)
WARNING TO OWNER: YOUR FAILURc TO RcCORD A NOTICE OF COMMENC=MEN'T MAY RESULT IN YOUR
PAYiNG TWICE FOR tMPROV�MENTSc O�o�pc poCORLl�lG YOU'NO NDE OFOCOMM N�CEMENT.' COtvSULi
WiTH YOUR LENGcr2 O��+(v •,TT�RN�� B�.
FLORIDA JURAT(r S 117 03)
CONTRACT�R
pWNcR OR AGcNT Subscribed and swom to(or afrirmed)before me this
Subscribed and sworn to(or affirmed)before me tnis bY —
by Whc is;ere personally known to me or has/have produced
Who isjare personally known te me or nas/have produced as identincation.
as identification.
Notary Pubiic
Nota�,�?ublic
Commission No
Commission Ne
Name c�Notary ryp°�. Pnni�d or s,amped
Name of Notary ryperi pnnced or starnpad