HomeMy WebLinkAbout14-15001 ' � CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oozo 15001
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 15001 Address: 7340 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: 35-25-21-0010-0880-0000
Improv. Cost:
Date Issued: 2/25/2014 Name: TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN SR
Amount Paid: 25.00 BALA CYNWYD PA 19004
Date Paid: 2/25/2014 Phone:
Work Desc: FPM-SPRINKLER QUARTERLY- TOWNVIEW
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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 a
the Fire Department's Fire Marshal or r uired pproval of
eq 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 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 OFFICER ''
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
a�a-�so-�o2o City of Zephyrhills Fire
Fax-813-780-0021
Permit Application
Date Received Phone Contact tor Permit 813 621 1357
owners Name TOWNVIEW RETAIL LLC
Owner's Phone Number �� �� �
Owners Address 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, r/4 19004-2102
Fee Simple TiUeholder Name � �� (�� �
Titfeholder Phone Number I
Fee Simple TiLeholder Address �--•
Job Address 7340 GALL.BIVD,ZEPHYRHILLS, FL �
� Lot 1t C�
sub Division CITY OF ZEPHYRHILLS Parcel tt 35-25-21-0010-0880-0006
� Bio-Hezard Weste Storage-ANNUAL � Fumigation Tant
� Comm Exhaust Kitchen HoodlDuct � Hazarclous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator<3D kw a LPMatural Gas-Instellation
O Emergency Generator>30 kw � Lp/Natural Gas-ANNUAL Sale ` /
� Fire Proteclion Maintenance-ANNUAL O Places of Assembly-ANNUAL ��f / ��
��(t y emi �n er ❑
Sprinkler � ❑ G Recreational8urn
Fire Alarm � O ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑ Sprinkler System Installations
Hood Suppression � p �7 ❑ C] � Standpipes(Sprinkler Sys)
� Fire Alarm Mstailation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Worlcs
� Flammable Application-ANNUAL
o $25.00 Valuation of Project
Fuei Tanks
QOther:
Contractor _ +,
Signature
Company
Registered 1�/N Fee Current Y/N
Address
License t1
ELECTRICIAN
Signature
Company
Registered Y/N Fee Curcent Y/N
Address
License# ��
PLUMBER �
Signature
Company
Registered Y/N Fee Current Y/N
Address
License#
MECHANICAL ,_„
Signature
Company --
Registered Y/N Fee Current Y/N
Address
License#
OTHER JEFFERY D. BURNHAM v RODAN FIRE SPRINKLERS, INC.
Signature
Compan
Registered I Y�N I Fee Current Y!N
Address
Directions: — License# �1 531 0001 20�6
Fill out application completely.
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
It over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date Parcel iS-obtained irom Property Tax Notice htt //a
( p: ppraisecpascogov.com)
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.
UNLlCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed 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 apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727_g47_
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, I
certify that f, the applicant, have been provided with a copy of the "Florida Construction Lisn Law—Homeowner's
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 pertormed 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 woric, 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 affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other instaAations not specifically included in the application. A
permit 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 pfans, construction or violations of any codes. Ever
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
y permit issued shall become invalid
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
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
period not to exceed ninery (90) days and will demonstrate
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 FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT
Subscribed and swom to(or a�rmed)before me this CONTRACTOR ,�.
by Su cri d om r r med)befo me��iis
Who is onally known to me or has/have produced ✓ r J by .
_as identification. Wr � �re personalty known to me or as/have produced
as identification.
Notary Public �
Commission No. Notary Public
Commission No. � � 4,
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Name of Notary ryped,printed or stamped �I`V'V`.1�9�,,� -
Name of Notary typed,printed or st �19 �, �TCt3—
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