HomeMy WebLinkAbout13-14704 CITY OF ZEPHYRHILLS •
� 5335-8TH STREET
• (si3)�so-oozo 1. 4
ANNUAL FIRE PROTECTION MAINTENANCE j�
Permit Number: 14704 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: 11/13/2013 Name: PRIMERICA GROUP ONE
Total Fees: 55.00 Address: 3629 MADACA LN
Amount Paid: 55.00 TAMPA FL 33618
Date Paid: 11/13/2013 Phone: (813)933-0629
Work Desc: FPM-QUARTERLY FIRE SPRINKLER FOR 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
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.
"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��28%2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No. 8[3-780-0021 P.001
8137$0-OUZO CityofZephyrhillsFine� � � Fax-ataaeo-oo2t ��
permft Appltcation •--
Data Recaived .. • . ',- .Phons�1or Permlt .
Ownere Name • awner�Phone Number � � �
Ownera Addreoe O g� �
Fea Simple T1Ueholder iJame � ' ' • lltleholdar Phohe Numbar � � �
�ee�mpleTltlehaldtrAddres3 ' � ' '
• � . . . • ��Lot# • �
Job Address ' ' ' '
5ub Divtslon Paroel#
�mvavtu�imyy�asenm.-�minni rhr�
� Blo-Hazard waete Storage—ANNUAL • � " � FumlgaUon 7ent , • .
� Comm Exhaust K�lchen HoodlDUCt: •' �• Hazardoua Malerial(fier 11 or RQ Feclliry)ANNUAL ,
�� Controlled 8um � Nnod(n9talleUon '
O �mergency Generator<30 kw • . � LP1Naiurel6as-inebliatlon '
� '•Emergency Ganerator>30 kw ••, � ,l.PlNatur�l Gas-ANNUAL Sele .
Flre Protac6an Nfafntenance=ANNUAL. a Places of AssemblY-ANNUAL '
. . � y em� �� . �
SpdnWer � p " ❑ ReoteaUonal Bum ; .
• � Fre Alartn �. � I7' ❑ �� � 3Pwklers : .• . • "—r,,`�
Hood Claening � O� O O� � � SPrinkier'3yolem Instntladons : ���`�„�^ _� �� n
L'.r�C)U '' ��
Hood 5uppresslon � {] d ❑ �� , � Stendpipes(Spdnklersys) U�
' O F�e Alamt Ineta�ation . . . � TorCh Roafiing/Tal'KeWe; . . �(�� r,I ,��13
Flre Pumpa ' ' ' � ' ' � � Waste 71re Storage ANNUAL . , �.J�
Flro Worke ' • ' • � • • �
. Flemmable AppRcaOon-ANNUAL • •• •�_�+� • ValueUoTl of P[ojeCt .
Fuel Tank6 . � � � �
Q • Other: ' ' ' ' '
conuactor . , • . . • Company
Signawre ' Registered Y V Fee Current Y N •
Address � Lipense#F
�I.ECTRICIAN � � . ' � � Comperry •
Siynaturc ' Reglslerecl• Y 1 N • Fee Curtant• Y/N
Addrese License�l ' �
PLUMBER • . Campany —�
Slgnature � � Reglstered Y/TI Fee Curtent Y/N
Addrass � Llcenea# • •
MECHANICAt. ��'�Pa�Y
Signature � Reqlste�ed Y/N Fae current Y/N
Addre9s •Licaqse#.
OTHF-ft ' Company ' ��
signature � � Reg�atered Y/N Fea Curtant Y/N
Addreea � • ' Llcenea#
.
Direction&: .
. Fltl oUt applicafion compiately.
Owner&Coniractor eign baok of applicalian,notatized(Or,copy of aigned cortract wlth ovimer) . .
If over S25oo,a Notice of�mmencemaM is reqwred.(Mechanical woirk wer$6000) •
5upply two(2)eals of drawlnBe vn'lh appllcabie docuinentaUon .
Aliow 1 D-14 daye for revlaW aher eubmiflal daie. Petcel#•obtafned from Property Tax NoUce(httpJ/appreiaer.pascogov.cam)
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MAR/28/2007/WED 07:20 AM ZEPHYRHILLS BUILDING FAX No, 813-780-0021 P. 002
, 'NOTIG�OF:DE�D'RESTR1CTlONS:'Che.underslgned und'erstands.that this permit may•be•subJecfrto'"de�d"RSStrlCtlons""•
which may be more restrictive than County•regulations. The:undersianed.assumes responsibllity for�omp�(ara�ce�with any.' .
.appllaable deed restr(otlons. , • ' '
�UNLiCENSED�CONTE2ACrOR5.IAND•CONTRACTUR,R�SpqNSI�1LITIES; If�the owner has•hired�:a�•oontractor�or•��� °
contraotors-to undertake work,ihey may be req�aired-to be licensed(n accordance with sfate and looai•regulations. If the
contractor ls not lioensed as required by law, both the owner�nd•coFltractor may be cited'for.�'misdemyan�op ylolation
.under st�te law. IfthB owner or Intended•cantracfor are uncertain.as to whaE licensing•requiremenis ma � f for ihe
. intended work;they ar,e advlsed�to aontact the•Pas�o County Buliding lnspection D(vision—Liaenstng 5ection.at 727-847-
8009. Fu�Ehermore, tf the owner has hired.a contracfor or'conhacto�s, he Is advised�to•have�the contractor(s) sign
• portions of the°contractor 81ock" of this application•for vuhiah�they wlll be responsib(e. tf you, a's•fhe owner�sfgn�as the
cotrtractor, that may be an ind(cation'[haf he is'not properly lioen.sed and Is not enfiUed-to•permitting.privileges in Pasco
County. •
CONSTRUC710N•L.tEN.LAW(Chapter7�13,•F(nrida 5tatufes,.as.am�nded): If valuatian of Wo�k Is'$2;50D.00 or more,I
certify'that 1. 'ihe applicant, ha�e .been pravided with a copy af'the °Florida Consfruation.Lien. Law—Homeowner's
ProteCtion Gulde°prepared by•the Florida pepar.tme�t of Agriculture and Cons�mer Affairs, lf the appiicant is•someone
other than the�"owner°, I certity that I have obtained a copy of the above descrlbed document and promise in good fafth to
deilver it to the"awner"pcior to eommencement. • ' • IfcaElon is•acc�rate and
CONTRACTOR'SIQWN�R'•S•AF�IDA�'i':.1 certlfy that all lhe information In•thls app
T that all work will�be�dbne In compllance w4th all appliaable laws regulating construction,•zoning and land
devefopment. Applica4on is hereby made to-obtain a permlt to do work and installation as Indicaf�d. I cettify •
that no work or installafion has commenced prior to issuance of a per•mit and•that all work wlll be performed to
meet standards of alI laws regulaiing aonstruction, Cpunty and Clty codes,zaning regulations, and land
development regulations in the jurisdiction. t also certffy fhat I underst-and that�the regulatlons of other
.govePnment agencies tnay apply to the intended wotk,and that it is my responsiblllty to identlfy what actlons t . •
must fake'to be in comp�lance.,
If I am the AGEN'�'FORTH�OWNER, l prbmise Iri good faith to Inform Ehe owner af fhe permitting conditions sef forth in
thfs affidavlt priar to commencing cohstruciion. •I understand fhat a separata permit may bs requir�d for electrical work,
plumbinc�; signs, wel{s, pools, air condiGoning, gas,•or otber installatlons not specifically lne(uded in the applica6on. A �
permtt Issued shall he construed to be a Ilcense to proceed with the work and not as authority to vialate,cancel,aifer,or
set aside ahy provisions of the technical codes, nor shali issuance of a permit prevent the�uilding.Official from thereafter
requiring a correction of errors in plans,construcfion or violaflans of any codes. Every permit Issued shall become invalid
. unless the work authorized by such permit is commenaed within six months of permif�Issuanpe,or If work aufhorized by
the permit Is suspended or abandoned far a period of slx•(�)months aiter the ilme the work Is commenced, An extension
may t�e reyuested, in wrlting,from tha Building official for a period not to exceed ninety(90) days and will demonstrate '
Jus6fiable cause for ftie extenslon. lf work ceases for ninety(so)consecutive days,the)ob is considered abandoned.
•WARNING TO OWNER: 'YOUR �AIL'URE"f�•REGORD A'NCYTICE'OF;C�MM�NCEM�NT Mf�Y"'R�SULT 1H'YUUR "' '
PAYING TWIC�F�R IMPROV�MENT5fi0 YDUR PROpERTY. IF YOU INTENDTO OBTAIN�INANCING,GONSULT
WITH UR LE ER O ' N ATl' RNEY EFORE RECO ItJG OUR NU ICE OF COMMENCLMENT.
FLORIDAJURAT(F.5.117.03) ' ' ' .
' OWN�RORAGENT �i" CPNTR�►C70R` �'-' � .
S b0d and swom W( ed fo , e is . .S s 11bed and b o�lu(or�flI d) 0l'8 me ihis �J ,
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` o slare pe►sona k to me or haslltave produced o s/are personally kn a me or�idslhave produced
• as Iden6ficatian. , � •as ide1lUACaUon.,
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Notary Public Notary Public ,
Commtsslon No. . r "� i� (• . Commis6lon No. ���lJ�� ,
( Name'of Notary p�p e d,printed or stempad .
Name of Noiary�yped;printed o�stamped . •
' . � , MITZI LEIGI-I VAN�
M1nI LEIGH V/1N�f Nornar .COMMISSION q FF 49081
PUBIIC fXPIRES OctotSer 9,2017
NOTARV COMMISSION N FF 49081 � � � sTATE OF
PUBLIC pXPIRESOctober9,ZAIT FLORfDA • BONDEDTHRWGH
STA7E OF RU INSURANCE COMVANY
FlORIOA RU�NSURA�N�CE�CdMPANY •