HomeMy WebLinkAbout14-15003 CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oozo 15003
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 15003 Address: 7348 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: 35-25-21-0010-08800-0000
Improv. Cost:
Date Issued: 2/25/2014 Name: TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN STATE RD
Amount Paid: 25.00 BALA CYNWYD PA 190042102
Date Paid: 2/25/2014 Phone: (610)667-5800
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, pian 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 INSPECiION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
813-780-D020 City of Zephyrhills Fire
Fax-813-780-0021
Permit Application
Data Received �--1 Phone Contact for Permil $13 62j
_ , 1357
owner's Name TOWNVIEW RETAIL LLC owner's Phone Number 610 667 5800
Owner's Address 725 CONSHOHOCKEN STATE ROAD, BALA CYNWYD, PA 19004-2102
Fee Simple TiUeholder Name �— � �� ��
Titleholder Phone Number
Fee Simple Titleholder Address
Job Address 7348 GALL BLVD,ZEPHYRHILLS, FL ��
Lot#
sub Division CITY OF ZErHYRHILIS Parce�#
OBio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen HoodlDuct � Hazardous Malerial(Tier II or RQ Faciiity)ANNUAL
Q Controlled Bum � Hood Installation
QEmergency Genere[or<30 kw � LPINatural Gas-InstallaUon
QEmergency Generator>30 kw O LPINatural Gas-ANNUAL Sale
aFire Protection Maintenance-ANNUAL � Piaces of Assembly-ANNUAL u 3
� r y emi � er ❑ � lj��
Sprinkler � ❑ p Recreational Bum r
Fire Alarm ❑ p � � � �
❑ Sparklers
Hood Cleaning ❑ ❑ ❑ Sprinkler System Installaqons
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch RoofingJTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Appfication-ANNUAL
� $25.00 Valuation of Project
Fuel Tanks
Q Other:
ConVactor
Signature
Company �
Registered Y/N Fee Current Y!N
Address
License#
ELECTRICIAN
Signature
Company
Registered Y/N Fee Current Y/N
Address
License#
PLUMBER
Signawre Company �----t
Registered Y/N Fee Cunent Y/N I
Address
License#
MECHANICAL
Signature
Company
Registered Y/N Fee Current Y/N
Address
License#
OTHER JEFFERY D. BURNHAM company RODAN FIRE SPRINKLERS INC.
Signature
Registered Y/N Fee Current Y/N
Address
License# 1 1 1
Dvections
Fill out applica6on completely.
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work over 55000)
Supply two(2)sets of drawings with applicable documentation
Allow�0-tq days for review after submittal date. Parcel t/-obtained lrom Property Tax Notice htt //a
( p: ppreiser.pascogov.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.
UNLICENSED 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 727-847-
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 wlll 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 1, the applicant, have been provided with a copy of the "Florida Construction Lien 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'SlOWNER'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
govemment agencies may apply to the intended work, and that it is my responsibifity 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 permittiny conditions set forth in
this a�davit 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 installations 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 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 Officiai for a period not to exceed ninety (90) days and will demonstrate
justifiable 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 OBTA(N FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORbING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOF�` —
Subscribed end swom to(or a�rmed)before me this S �bs_c�ri�bed�f}d o
by J�==F=�- .� b rr,y�o(ot�rmed)be�re m his
Who is/are personally known to me or has/have roduced y-'�� ;�l"P�U �'� ����^ �"r
as identification. W.,��re persona�lv known to me o has/have produced
as identification.
Notary Public
Notary Public
Commission No. r� D�Z
Commission No. F-
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Name of Notary typed,printed or stamped Name of Notary typed,printed or st �
^ Chery!A Daffeb
� My Commission E�5+703�i
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