HomeMy WebLinkAbout13-14429 � � CITY OF ZEPHYRHILLS
5335-8TH STREET
, �' (si3)�so-oo20 14429
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Nurr�ber: 14429 Address: 7838 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: 35-25-21-0010-00700-0000
Improv. Cost:
Date Issued: 8/12/2013 Name: PRIMERICA GROUP ONE
Total Fees: 50.00 Address: 3629 MADACA LNV
Amount Paid: 50.00 TAMPA FL 336'M8
Date Paid: 8/12/2013 Phone: (813)933-0629
Work Desc: FPM- SPRINKLER ANNUAL & SUPPRESSION SEMI- PUBLIX
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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
wsts 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$100.00, uvhichever is greater. All
work shall be pertormed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
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PERMIT OFFICE
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION -8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
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� �AR��B/2007/WED Q7:20 AM Z,EpHY�$II,[,S Si1;LD11VG FAX No. 813-78D-0021 P..DO1
s,a�eo-o�o CItY of.zophyrhlllsl�•. .
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PermR App�catf'on
C�b q�eetvad � +' �Pparo�P�elrqt .�:
L�1Mqe�0 Na1112 • CPIIM�C PFI01JV Nun�IfM � �
OVl�tare Add1�70 °� . �
Feestmple'IlYahelderiJeme ' . . . � . • 710eUOI�rPhd�eNurnbor ���� 1` i
CweB�npb'f1dN�ald�Addnses • • ' ' •
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Jabllddrses ��I.otN'
8ub DMNen pe,p�*
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' � 61o�F+m,t�waeto 81orAO6–AA1DN/J. � • „ p�N►�Stlon'fooe � . '
, � Conrn E�.wkfqdnn Hoodl�uet, .''�• tieardous PAdartai(l�r H orRQ�rdGry)ANNUAt. . �///
� Cnn6dled Bwn Q iMad A�OoAatlon . ��/CY(.� �
Q E.malpM0y6onerslarc3Dkw • . LP�kMil6e�-YalaU3Uon ' . , . , 6 l (
. , �'���Y Generabora 8D kw . � ,I.PA�r�i�NNUIU.s.le �
� � �1r.�ai�wrce d�HNtl�►� p �k�a or as�smblvaaNUA� � '. .
. • �°� �.�A:'� � 'RaoreaB�mABUm , . , –•.�
� FiI��Al2fIn . G G' O � BpNrldars . . . ��� ���
. � Hoetl GeenNp ' G� D Cl� �'SS+�lam 1rISINM1Nons • ;�}�/� Q� ��7 � �
Hood Supp�sfalan 17 � � . • �andp�M(SPdNCIa�S�a) ' 11.Y ([a 4
� Fhe�f171 MIOt41N�60n . . . Ta�l1�eflf10R�1'KdR�a; •
' �Pun�pri . . . • • • ' � Wq�is'T1(e SmrapE ANNl1A1. � ', . ' '
Fke 1Nake • . , . , . .
. Ftann+able Apalu�@on-ANNUAL . . . • V0luetlon of I�t'ojeCt
, �uel7�nke ' .. . . • . .
. � OQf�r: ' • . . .
c�+aabor /..�..s+w+.s �.� • ' CamP�Y ' .
�bA'° � ' Rop�red Fee dment N �
Addraea ^_j.�g� •
EI.EG7'RIG ' - � � � C6mPCt+Y .��
s�a+vwrc � - Rop�.la�atl. Y/N • F..qmen�., '!/N
aAelydreae � uenxee# • • •
ALl111BER .
�f°�s � � � ' Raa� Y!N `F�c;iuierrt — �N
AddneSS � 41C�nes1P� r
t�AECHANI ' � .
sla��+ � Re�D�od 1 Y!N�Fee Cu�hent � y �"�
� �dd�s •�e2se�. —
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�A� � R�erd • Y N �as Cu�rota ""
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. FMIOUtaP011�ne0mplo191y. • .
Ownotdc CaAr�lc6o�et9n b�ok ofspF�n01ar1Ad(O,;Capy o�stBrod eWlp4elwRh aYhfe�) ,
If over i2s�0.�I+to1Nx of Cemm.n00!elOnt Is nquMed,SNls�l w0lk.ever ie0D0) • �
�8�pply two(21 s�ls of df�YAnCe.�llh sppik�6le daam�errd�tlon
aheW10-14daYOiarrevlewaflorsubnpWd�le, PeRalQ.able�►ediromPraP"KYTaxFbUca(htlpd/eppretear-Pa�J�mm)
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�(AR/28/2007/WED 07:20 AM ZEP�YBHILIS BUILb1PiG FAX No, 819-78Q-0021 P, p02
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. 'I�OI'10E OF�E�C1'RESTaIC71oNS:Tha.underalgn�d uml��ds�retttiis permR mQybe�subk+r.�to'"dee�'�re�ttle�ions"•�•
whlah ma�y be mar+e restricthre than Counq+�r�allstinns. The:undersignedaasaumas responelb�tqr�oraoomp�tarme+with arry.� .
apPlbable deed re�trlatlons. . • • .
•t�rFt��c�NSED SC4NTRnc'PoRS ,,�►i+tp'�COPt'I'R�►cTC7R.R�SPAM.s18ll:1T�ES: !f•�he owner has�h'ued�:a�uomrecsor ror•... ,
t�n�aoEor�'to uRdeCb�ke wark they may be requq�ed�to be ileeheed In acc,qtd�noe 1nAlh BEgte attd(ooed•re,gul�ttCns. If the
conbaPtor le nat l�Sad as I�equved by'law� twth the vwner�nd•oonlracter moy be olbdYor��►liedemear�or vl�atl.on
.under�e lew If�lhe owtier or fntended�contrao#or ere uncer�aln+aa'to what Itcenalhg•I�quirefi�+ts mey�apply tor�1e
. 111tended Nro�'k,�i►a�edVleed�to oornaot RhiS�sdo Coul'�Y�Iding It�ep+9cdon�JMs'bn--�t,toensin9 8e.M'oon,at 72T-BA�-
8009. Furft�ermore, Sf the �ner has hhed.a cotyp�otor or'cont�c�ars, he Is advised'�o.f�a�ve^Ihs ccrdracta(s)sipn ..
� portlo�o�!he"ocrrtraotvr Slodc*oF thls epplk�llon�fvo�whioh'they wNi be respohsble. lF yau,a��the awner�slg��as the
onMracSOr,that msy be an IndkBtion`�hat he is not propedy lioensed end 1s not enbtled•to�pet�nit6r�g.pllvpeges m Pasco
COU
C�S'TRUC710N�L1�N.LAW(Chapter7�3,•Flarida�tatuEvc�,a�.atne�'idex�: If v.aafuetion dFworlc(s'�2,�OD.00 ar more,l
. o�rt�'that (� �the appli�ari#, heve .peen pt�vided ur11h a wqy dF'th9 'Florld�, Consfivofbn.4.ien. l�w--i�omeowner's
ProE�ctlon Gulde'prepared by�the Flo�itla Aepst�me�ot Agria.tlture and Gonsumer A�sh�s. if ttte eppllpnt�sumeo�e
othar th�n tha�'owr�er",I cerdfy that 1 have ob�ained a copy of ihe above deeaibed aoa�n�ent�d prornlse!n good fa�th to
del4ver it.to the"owner"prior t�comrnerroeme�E. • • • '
-- GON't'RACTOR'SIQWNLR'.S AFFtDAViT:.l cartffy tfiat all the informatlon E�rtltls appllc�tlon is�accura�e and
that�III vuorlC Will'be'dbna k� com¢118nce vV�1N all sppllo�bk 18NV8 regulat�l8 �cllonr�h1S1 e�1d iand
devalopment. Appllc�an Is hereby made W'obtain a permit to do work aad(ns6aNation as Indlcated. 1 certlfyy �
� that eo work ur ins�llatlon hae commenced pricx to�suance of a p�omnit and�khat�Il work wllll be Perfatmed to
rr�eet standsrds af all lavus reputaUng oac�truo�an, �Punty and Cl�r oodes�,mn�+g re��aibns, and land
devafo�ner�t reguletior� in thc jutisdicHon. I also cart�j►that I qn+derstsntl that�the 1'egulalloris of other
.eovamrnent agehates tn�l apply.to the ir,tended worl�snd thart it is my'responslbUlb to EdenNfy whst ac�ons I , ,
must ieke�to be M compllance., ' -
If t arn tl�e A6EN't"'FORTH�oWNER,I prbmise In good fahh to Infonn the owner of the permhling c�ndidens set forlh m
ti�iss 8�f►davit priar io commencing odr�uctlon. �1 tmde�+stard that a sepq�te�permR m�Y be required for elec�ical work.
plurnbfng; s�ns� we�s, pnola, ax condiliontrrg, 9�s,.or oiber 1115tepatbt� nak a�pec�ally incktded 'm the ep'plk�tlon. A'
permtt lesued sMrall be c�nstiued to b$���e t�proceed with'the work and noC as sutltoHty m vbl�te,oancx�l,elter�or
set aside ary ptovislone of#he bechnical codes,na'shali�SSUance ai a permtt prevent the�uAding.OtflCiel�/om tl�reailer
reQuh�inp a carteatiah of errors in plans,aor►sht�ctlon or vlolatlot�s of any oodea �very perm�Iseued shall�soome hrvalW
. unless the work authorized by such permR is commenced withtn six moi�fhs of pe►m�IesuanQe,or i�work authorized by
the Qermk!s su�per►ded or abancbned tor a•period of sa•(�rnoMhs a�ter the�me the wao�k Is commenaed. An�eneton
may be requeated� t�wMting.from the Buikihlp CXfldal far a period rtot to eocceed nmety(90)da�►6�nd wAI demonstrete
just�eble cauce imr 4he e�ct�slo�. If work oe�sas far nntsty{gQ)cansea�tive days�the leb i�cohstdered abandoned.
'WARt�[Mra TO �R: 'YOUR�rAiL:UElt?TO•R�CORD A'PtOT1�E'OF;COMM�NCEM�M['MAY�"R�SULT IN'YbUFi� '" '
paYtM6�wtC�FOR IMAROVE�RE�"3'ro Youh P�op�RTY� I�YOU�ND'T�Oa'CWN�IHANCING,COMSII�,y'
O ' EY EFO C 0 NQ E�IC�ME '
FtOR�DA JIIRA,T(F .117 ' ' . . ' .
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' pYVMF7t OR 1v►6ENT �Q � "^"`�""
, g sv� r ,tn " .,�� (or�IA rr�a�is .
ro pe�a Eo me orhasmave prod�uee� $i I�hre aer�onll tn o me or eeAmvs praducvd �
• aa ldenalleatlon. , e IdetrtlflcaMnn., , .
✓�-�—� Notaly Public ' . . • Nt�arl+Pubpo ,
" 130� '
�,� �� . � ����� � � �
hlalp'e of NolerY q'pe :Pr�t�or s�amped . � Nema'Of Nol�'0'Peu,prin�d or s�mped . •
NuTZI 1/ANCE ' � ' ' �� i pD41�OSD
�ocro�i�° ' • � � � � , ,aa��'��a
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MAR�`28/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P. 001
a��-7so-oazo City ofZephyrhllls'Fidd= � Fax-s�aaso-oo2t �t;
permlt AppllCetion ._.
Data Ftecelved '� •Phone Co'�ior Permft �
Owne�e Name • • Owner'�Phone Number � ��
Ownera Addresa ' � '
Fea simple TiUeholder Name � � ' ' • ' 7ltleholder Phone Numbar � L� �
KeeSimpleTltlehaldcrAddreas ' ' ' � � '
JobAddreas j ..Lot# • �
5ub Divislon Paroel#
' � 610-Hazard Weate Storaee–�'1NUAL • � '" � Fumlgetlon 7ent , •
� Comm Exhaust K�lchen Ho0dlDUCt: .' �• Hamrdous Metedal(Tier II or RQ Fecltlty)ANNUAL .
� Controiled Bum Q Hood tnstailaUon �
� �mergency Generator<30 kw • � LPINaturel Gas-fnetalladai� ' � '
� 'Emergency Generator>3o kw , � ,I.PMatur�l Gas-ANNUAL Sale .
Flre Protac6on Melntenence=ANNUAL . � Places s�f Assembly-ANN�AL -
`�°�' �y ' emi �t_..—J � . .�.,`y� �/.�� �
Sprinkler C7 ' O ReoreaUonal Bum • • • 1 j� � t'�li� �+-��
� F�eAlarm . ❑ Q' ❑ �� � SP�ars . , •�-1•l I�:�,k–�--'1�-i 1
Hood Cteaning d� O D� � � Sprinkler'Syslam installa6ons : •,��.,/ ' Q I (�I �
Hood Suppresslon � {7 0 �� . � 5(endpipes(Spdnkler5ys) �u� "
' O R�a Nartn Inst6�ation � . . , � ToICY1 Roafing�a�Keltle; ,
Flre pumpr ' ' ' ' � Weste Tlre Storage ANNUAL . ' ' _
Flro Wotke ' • � • ' •
, � FlenvnableAppiicatlon-ANNUAL • • •� �� • Valuation o�P[oject .
Fuel Tanke � � ' ' ' '
Q Other: ' ' �
canvactor �y .�t � ' � • Company '
Signawro / '�`� �' �'�°�""�`� ' Regist�red Fee Curtent Y N •
Address � License# •
�l.EC7RICIAN � . . . Comparry .
Sig�ature � Reglstared• Y/N • Fee CurtenG Y I N
Addreee License�! • ' �
PIUMeER • . C,ompany
Slgnalure � ' Reptstered Y!N Fea Cuirent Y/N
Addross ' Llcanae# • •
MECHANICAL Company
signature ' Rtgistared Y/N Fea current Y/N
Address •Licaqse#. �
OTH�R ' Cpmpeny '
s�9nature � � Reeietared - Y/N Fse Current Y/N
Addrees � • � • Llcanea iF
�irecfiona:
. FlII out apqicsGvn tompletely. �
Owner&Cbntractor eign 6aok of applicetion,notarized(Or,copy of aigned contract wlth owner) . .
If over 52500,a Notice of Commencemar�t is reqwred.(Meohenical work over 35000) •
Supply two(2}ee�of drawlnpe wiih appllcable doc�nnentatlon
Allow 10-14 daye for�evloW ahar submiflai date. Percel#.obtel�ad irom Ptoperty TaX NoUce(httpJ/eppreiaer.pasc�ogov.cam)
, � .
MAR/2S/2�07/�Ell 07:20 AM ZEPHYRHILLS BUILDING FAX No, 813-780-0021 P, 002
, 'NOT{C�OF:DE�D'RESTRICTIONS:'fhe.undersigned und'erstands.thatthis permit may.be•subJecfito'"de�d"�estrl�tlons""�
which may be more restrictive than County•regulations. °The:undersigned.assumes responsibility for:�ompllara�e+wifh any.' .
appiiaable deed raffitrlotions. . . ' '
'UNLiCENSED�CONTRAC�'ORS•AND�'CoNTRACTOR.RESpANSI�IUTIES: If�the owner has•hired':a�contractor•or••• -
contraotors rto undertake work,they may be req�aired to be licensed in accordance with sfate and laoai-regulations. lf the
cond'aator ls not licensed as required by law, both the owner�nd•contracior may be cited'fot.2'misdemeanor vlolation
.under st$te law. If the oWner or Intended•cantracfor are uncertain.as to what licensing•requirements may�pp(y for the
intended work,they a�e advised�to contacf the•Pasco County Bulidfng Inspection D(vision—l.toensing Section.at 727-8Q7-
8009. Fu�thermore, ff the owner has hfred•a contracfor or'contl'actors, he Is advised'to•have�the contractor(s) si�n
• portions of the"contractor Block" of th'ts appllCation'for 1Nhiah`they wlll be respohslble. If you, a's•the owner•slgn�as the
cot�tractor, that may be an indication'that he is'not properly liaen.sed and Is not enfitled�to•permitting.privileges in Pasco
County. • '
CONSTRUC'f10N•L.1EN.lL1W(Chapter713,•Florida Statutes,.as.amended): If valuation of Wo�k(s�$2;5p0.00 or more, I
certify'that I, 'the applieant, have .been provided wlth a copy af'the °Florida Consfruafion.Lien. Lav�-Homeowner's
Protection Gulde"prepared by•tl�e Florida Qepar.tment of Agriculture and Consumer Affai�s. lf the applicant is�someone
other than the�"owner°, I certify that I have obtained a copy of the above descNbed document and promise in good fatth to
dellver it to the"avrrner"prior tb Comrnencement. � • •
- CONTRACTOR'SIpWNLR'•S•AF�IDAV17':.I certify that all the information In•thls appiicatlon is•accurate and
that all work will�he�dbne In comPliance wlth al) appiiaable laws regulating construcfion,•zoning and land
development. Application ls hereby made to�obtain a permlt to do work and insEallation as Indicafed_ 1 certify
that ho work or inst�llafion has commenced prior to issuance of a permit and•that all work wlil be pe►formed to
meet standards of al( laws regulating construction, Cpunty and Clty codes.•zoning regulations, and land
development regui�tions in the jurisdlction. I aiso certi�y that I understand that the regulations of other
.govel'1lment agenctes tnay apply to the intended wotk,and that it is my'responslbfllty to identlfy what actlons l
must fake'to be In¢ampllance.. ' '
if l am the AGEN7fORTli�QWNER, I promise tri good fatth to Inform ths owner of the permitting conditions set forth in
thls affidavlt priar io commencing canstruction. �I understand fhat a saparate permit may be required'For elecb�ical work,
plumbing, signs, wel{s, pools, air conditioning, gas,•or otk�er Installatlons not spec�c�lly Included in the application. A
permlt Issued shall be constru�d to.be a Ilcense to procead writh tha work and not�as authority to viol�te,cancel,alfer, or
set aside any provisions of the technical codes, nor shalf issuance of a permit prevent the�uilding.Official from thereafter
requiring a correation of e�rors in plans,construction or violatlons of any codes. Every permlt Issued shall become invalid
unless the work�uthor,zed by such permlt is commenaed wlthin slx months of permiE Issuanpe,or ff work authorized by
the permit fs suspended or ab�ndoned far a period af slx•(6)months after the tlme the work Is commenced. An exfension
may be requested, in wrlting,from the Bulldine ���al for a p�riod not to exceed ninety(90) days and will demonstrete �
justifiable cause for ttie extenslon. lf work ceases for niriefy(so)consecuflve days,the)ob is cohslder�d abandoned.
'WARTlING TO OWNER: 'YOIUR �AIL'URE T�'REGORD A'NC�TICE'OF:C�MM�NCEM�NT IVI�Y'R�SULT IN'YC1UR "" '
PAYlNG'fWICE FOR IMPROIJEMENTS�TO YOUR PROf'�RTY. IF YOU INTENDTO OBTAIN�INANCING,CONSULT
WITH UR LE ER O ' ATT RNEY EFORE RECO ING OUR NO ICE OF COMMENC�MENT. '
FLORIDA JURAT(F.5.177.03 ' ' ' • : �
' OWN�R ORAGENT CONTR�►C70R
S ed nd swo o r fi J efi .me i , gSub bad nd b (orafll ) Pe me this
y y .
o slare persona to me oR haslhave produced � o Islare personally o me or �s!ltave prod�tt:�d
�as Irlentifica6on. •as idenUflCaGon..
✓�--� Notary Public _Notary Public .
Commfeslon � Commis6lon IVo. 'v O�
1 J • •• 1'L�TL� �J! Y'P�
rtam'e of Nofaty lyped',printed o�stamped . Name'of Nohary typed,printed or stamped .
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MITZI VMICE
MITZI'VANCE • � ' � ��ION r covtaoeo
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