HomeMy WebLinkAbout14-14920 ° - CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis)�so-oo20 14920
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 14920 Address: 7909 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 34-25-21-0010-00100-0000
Improv. Cost:
Date Issued: 1/22/2014 Name: RUBY TUESDAY RESTAURANT
Total Fees: 25.00 Address: 7909 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/22/2014 Phone:
Work Desc: FPM-SEMI ANNUAL HOOD SUPPRESSION FOR�RUBY TUESDAYS
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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$100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
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PERMIT OFFICE
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
, s�3-�8aoo2o City of Zephyrhiils Fire Fax-e�3-7so-oo2a
Permit Application
ate Received Phone Contact for Pertnit 3 5 2 7 3 2 5 3 2 6
wner's Name RT TAMPA FRANCHISE LP ATTN TAX&LIC DEPT ��ers PhonaNumber �� � �
wner's Add�ess 15 0 W CHURCH AVE MARYV I LLE TN 3 7 8 O 1-4 9 3 6
3e Simple Titleholder Name NA TiUeholder Phone Number C� � ��
�e Simple Tkleholder Address
�b Address �9 0 9 GALL BLVD Lot t� C�
�bDivision ZEPHYRHILLS COLONY COMPANY pareel# 34-25-21-0010-00100-0000
a BiaHazard Waste Stora e-ANNUAL --- -
9 � Fumigatlon Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardais Material(Tier II or acility)ANNUAL
Controlled Bum Hood Installation �� �
a Emergency Generator<30 kw � LP/Naturel Gas-Installatio ��I �
a Emergency Generator>30 kw � LP/Natural Gas-ANNUAL
� Fire ProtecUon Mairrtenance-ANNUAL � Places of Assembly-ANNUAL � ,p�
� em � er � L i
Sprinkler � ❑ ❑ ❑ � � Recreational Bum i f� �
Fire Alartn � p ❑ O � � Sparklers �
Hood Cleaning � O ❑ ❑ � � Sprinkler System Installations
Hood Suppressfon � Q T$ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofingffar Kettle
Fire Pumps � Waste Tire Storege ANNUAL
Fire Works
Flammable Application-ANNUAL
Valuation of Project
Fuel Tanks
Q Other:
�niractor Company AMERICAN FIRE & SAFETY SUPPLY
9"et�'B Registered Y/N Fee CurteM Y/N
Address 953 NE OSCEOLA AVE STE 100 OCALA FL Licenae# 06461500021985
.ECTRIClAN NA Company
gnature � Regfstered Y/N Fse Cument Y/N
Address License#
_UMBER NA Company
gr78t� Registered Y/N Fee Current Y/N
Address License#
cCHANICA
NA C°"'pa"y
3�t�� Registered Y/N Fee Curtent Y!N
Address
License#
�HER NA Company —
�nature Registered Y/N Fee CumeM Y/N
Address
License#
rections: •
Fill out applicaUon completely.
Owner 8 Contractor sign beck oi appiicetion,notanzed(Or,copy of signed cont2ct with owner)
if over E2500,a Notice of Commencement is required(Mechanical work over 55000)
Supply two(2)sets of drawings with applicable dxumentation
Ailow 10.14 days for review after submittai date. Parcel#-obtained from Property Tax NoUce(http://eppraiser.pascogov.com)
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NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBfLITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be iicensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may appty for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes,as amended): If valuation of work is$2,500.00 or more, f
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowners
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
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'S/OWNER'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, I promise in good faith to inform the owner of the permitting conditions set forth in
this a�davit prior to commencing construction. I understand that a se arate
plumbing, signs, wells, pools, air conditionin p Permit may be required for electrical work,
g, gas, or other installations not specifically included in the application. A
permft issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiabte cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN F ANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTIC F COM CEMENT.
FLORIDA JURAT(F.S. 117.03)
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OWNER OR AGENT '` -•�''
CONTRACTOR ,�.� � �
Subscribed and swom to(or affirtned)before me lhis ubscribed
bY ,`�� �� ��r'���swom to(or affirm be�J e me this
Who is/are personaily known to me or has/have roduced �"u-=�!LbY �/, ��/ /�/P/l'�/"
p Who is/are personally known tq e r has/have produced
as iden6fication. _��r�.,.,��`�f�as identification.
Notary Public - — Notary Public
Commission No. Commission No. *""�� Jame
? � My Comm.#EE835580
Name of Notary typed,printed or stamped � , �
Name of Notary typed,pri ad
�ubNc,Stata cf Florida
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