HomeMy WebLinkAbout14-15354 CITY OF ZEPHYRHILLS
5335-8TH STREET
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LP/NATURAL GAS PERMIT
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Permit Number: 15354 Address: 7331 GALL BLVD
Permit Type: LP/NATURAL GAS ZEPHYRHILLS, FL.
Class of Work: FIRE-LP/NATURAL GAS Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 34-25-21-0000-00300-0020
Improv. Cost: 2,500.00 � ' '°` '`"OWNER INFORMATION`_�°�'`��:�`��#:�:'=::.~�`��_��:
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Date Issued: 6/06/2014 Name: MERCHANTS STATION c/o PHILLIPS
Total Fees: 125.00 Address: 7331 GALL BLVD
Amount Paid: 125.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/06/2014 Phone:
Work Desc: INSTALLATION GAS LINE - BREAKFAST STATION
`�CONTRACTOR S APPLICATION FEES �
SUNCOAST PLUMB&ELEC RIC GAS FEE 50.00 FIRE PLAN REVIEW FEES 50.00
FIRE INSPECTION FEES 25.00
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� Ins ections Re �ti ed �
FIRE SITE INSPECTION-Final
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 pertormed in accordance with City Codes and Ordinances.
"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."
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CO TRACTOR SIGNATURE PERMIT OFFICER
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received �P —��� _ Phone Contact for Permit ,���y�
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Owner's Name aK,C Q�lL�,s'F !� vn) Owner's Phone Number � � �
Owner's Address Fj 1 I � V
Fee Simple Titleholder Name Titleholder Phone Number � � �
Fee Simple Titleholder Address
C.°.:_.�__.�...._..r - _ �_...._... - �y_._,�.�.�.�._..�._m.._.a.�..,
Job Address • - Lot# �
Sub Division Parcel#
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� Bio-Hazard Waste Storage-ANNUAL � � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator<30 kw � LP/Natural Gas-Installation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
t y emi �n t er �`.��
Sprinkler � ❑ ❑ ❑ B � Recreational Bum J �
Fire Alarm � ❑ ❑ ❑ � � Sparklers �
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Instaliations
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL � �5"p0°— Valuation of Project
� Fuel Tanks
Q Other:
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Contractor Company L�C6LZS�j Q
Signature Registered Y/N Fee Current Y/N
Address License#
ELECTRICIAN Company
Signature Registered Y/N Fee Current Y/N
Address License#
PLUMBER Company
Signature Registered Y/N Fee Current Y/N
Address License#
MECHANICAL Company
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
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Directions:
Fill out application 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$5000)
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
C p�.etJ. �35�- 2t3a - 03J�
Pl0710E OF DEED RESTRICTIOAIS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more resfrictive than Goanty regulations. The undersigned assumes responsibiEity far oompliance with any
applicable deed restrictions.
UMUCENSED CONTRACTORS AND CONTRACTOR RESPON3IBILITIES: If the owner has hired a contractor or ,
carrtractars to undertake work,they may be required to be lioensed in accardance wlth stafe and 1oca1 regttla#ions. If#he .
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
"sntended wprk,they are advised ta confact the Pasco Caunty Bui{ding tnspection E7ivisian--Licensing Sectlon 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
contractar,that may be an indication that he is not properly licensed and fs nat er�titled ta permitting priv�leges in Pasco
Counfy.
TRAPdSPORl"ATIOM IMPAGT/UTILI'1"IES IRflP/4CT AtdD RESdURGE RECOVERY FEES: The undersigned understands
fhat Transpottation Impac#Fees and Recourse Recavery Fees may appiy ta fhe consfrucfian of new buiidings,change of
use in existing buildings, or expansion of existing buiidings, as specified in Pasco Gounty t7rdina�ce number 89-07 and ,
90-07, as amended. The undersigned also understands,that such fees,as may be due,will be identified at the time of
permitting. 2t is further understood that Transpartation Impaot Fees and Resource Recovery Fees must be paid prior to
receiving a"cert�cate of occupancy"or finai power release. tf the project does not involve a certiiicate of occupancy ar
final power release, the fees must be paid prior to permit issuance. Furthermore, tf Pasco County WatedSewer Impact
fees are due,they must be paid prtar to permit issuance in accordance with appNcable Pasao County ardinances.
CONSTRUCYION LtEht iJaW(Chap4er 793,ftocid�Statutes,as amendet6}: if vaivation af work is$2,50d.00 or more, 1
certify that I, the applicant, have been provided with a aopy of the "Flarida Construction Lien Law--Homeowner's
Protectian Guide"prepared by the Fiorida Department af Agriculture and Cansumer Affairs. if the applicant is someone
� other than fhe°owner°,i certify fhat 1 have obtained a copy of the abave described dacument and promise in good faith to
� deliver it to the"owner"prior to commencement. � �
, CO�YTEtACTOR'SICSYVt�ER'S AFfIDAVlT: t certffy that alf the information in this application is accurate and thak a!I work
witt be dane in comptiance wfth att appticable iaws regulafing canstructian,zoning and land development. Appl�catian"ss
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has .
commenced prior to Issuanae of a perm+t and thaf all work will be performed to meet standards of all laws regulating
construcfion, Caurtfy and Giiy codes, zoning regulatians, and land developmenf ragulafions in the jurisd3etian. i aEso
certify that I tinderstand that the regulations of otfier govemment agencies may apply to the intended work,and that it is
my responstbility to identify what actions!must iake to be in compliance. Such agencfes include but are not limited to:
- I7epartmenf of Enviranmental Protectian-Cypress Bayheads, 1Nef4and Areas and EnvironmenfaDy Sensitive
Lands,Water/Wastewater Treatment.
' - Southwest Florfda Water Management Distrlct-WeAs, Cypress Bayheads, Wetland Areas, Altering
Watercoutses.
- Army Corps of EngineersSeawalis,Docks,Navigable Waterways.
- Depaitment of Health & Rehabllitatfve ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Proteation Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
1 understend#hat the fo8owing restrictions apgly fo fhe use of fi13_'
- Use of flll is not allowed in Flood Zone°V"unless expressly permitted.
- If the flll material (s to be used in Flaod Zone "A", It is understood that a drainage plan addressing a
j °campensating votume"will be submtfted at time of permitfsng which is pregared by a ptofessional enginesr
� licensed by the Skate of Florida.
- If ttie fill material is to be used in Flood Zone"A° in cannection with a permitted building using stem wall
construction,1 certify that fitl wt11 be used only to f�11 fhe area with3n the stem wa11.
- If ftll material is to be used in any area, [ certify that use of such fitl wilt not adversely affect adjacent
properties. If usa of fill is found to adversely atiect adJacent properties,the owner may be cited for vfolating
fhe candltions of the buitding permif Issued under the attached permit appiicatlon,for lots less than one{1}
acre which are elevated by fill,an engineered drainage pian is required.
If I am the AGENT FOR THE OWMER,I pramise in good faith to inform the owner of the permitting conditions set forth in
' this affidavlt prior to commencing construction. !urrderstand that a separate permit may be required for electricaf work,
ptumbing, signs, wells, pools, air conditianing, gas, or other insta(lations not specifically inetuded in tfie appticafion. A
ali be construed to be a license to roceed with the work and not as authority to vialate,cancel,alter,or
permit issued sh P
set aside any provisions af the technica!codes,nor sha31 Issuance of a perm�t prevent the Buildirig Officia!from thereafter
requiring a correcfion af errors in plans,construcfion ar viotations of any cades. Every pertnit issusd shall become invalid
unless the work authorized by such permit is commenced within six months of permlt issuance,or ff work authorized by
the permit ts suspended or abandoned for a period af six{Sj months after the time the work is commenced. An extension
i may be requested, in wrifing,from the Suifding Ofticial for a period nof to exceed nfinefy(90}days and wil!demonstrate
Just�iabie cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
W�iRW11dG 70 OWPtER: YOUR FAILURE Td RECORD A NOTICE dF GO�t3MENCEMEt�T�AY FtESU�T IN Y4Uii
PAYING TWICE FOR IIi�IPRdVEhAEPlTS YO YOUR PROPEF2TY. IF YOU INTEND TO OBT/�11N FIIdIANCIMG,COWSULT
� Y1tITF#YOUR LENDER OR APt ATTORNEY BEFORE RECORDING YQUR tdOTICE OF COMMENCEAAENT.
FLORIDA JURAT(F.S.117.03}
I OWNER OR AGENT COIdTRACTOR
Svbscrlbed and swom to{or affirmed}betore me this Subsalbed and swom to(or aftlrmedj before me this
6y �Y
Who is/are personally known to me or has/have produced Who Islare personally knovm to me or has/have produced
� as identlficatlon. as Ident�ioatlon.
Notary Public Natary Pu6fic
Commisston No. Commission No.
Name af Nata[y typed,pilnted or stamped �Name of Natary typed,pr{nted ar skamped
. , . _ , .. • ,: }
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�., ZEPt-iYRFBtLLSi F�REt�}E�e4��°6�df EN3°
� 6907 Dairy Road,�ephyrhills, FL 33542
FIRE SERVIGE USER FEES
l7ccupancy No.:
Ptan No.: Contracfor.
1 J�
Business Name: ``i� � � ���� Billing Address:
Business Address: ���if3� C��
Business Phane Na.: Billing Phone No.;
Business Fax Na.: Bil(ing Fax Na.:
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMtT FEE FALSE ALARM FEE
�itePlan N/C Annual N/C Sprinkler $50 1stAlarm N!C
uiti-Famiiy/CommercPai .06 sf 1st Re-inspec6on N/C Standpipes $50 2nd Alarm N/C
{Minimum Charge$25.00 2nd Re-inspectian $100 Fire Pump $50 3rd Alarm N/C
�Pian Revisians DB� 3rd Re-i»spection $250 Hoads $50 4#h Alarm $1Q0
4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150
SPRtNKLER SYS'fEMS {Business clased until $50 8th Alarm $2QQ
0-25 Heads $50 vlolations corrected) Natural Gas $50 NON COMPLIANCE $15Q
26 pluS Heads $1QQ SPRINKLER SYST S Fuei perzank $50
S7ANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100
�Per Riser $54 Nydrostatic Test $85 per system Fire Warks $50p
FtRE RUMP AcceptanceTest $45 persystem Camp Fire $25
� Per Pump $100 Hydrant Flow $75 Controlled Bum $100
FIRE ALARM SYSTE{VI HoodlDuct $50
8 0-25 Devices $50 FIRH ALARM SYSTEM Place of Assembly $50 Mnual
26 ptus Devices $100 Systern Acceptance $5D Fire Protection $25
SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $5Q �v,nual
Wet $50 OTHER Wasts Tire Storage $50 a.nr�nai
Dry $50 Fire WaIl/Smoke Wall $15 perwall Genel'ator{KW $100
GQ2 $50 Gas�� $25 per tank Generator>30 KW 150
•
Other 0 Natural Gas $25 per system Bio-Hazard Waste $100 nnnual
KITCHEN EXHAUST Furnigation 7enting $50
� Hood/Ducts $50 Tent 10'xt0'or greater $15 per tent Torch PoUApptied $50
OTHER Fire Pump $45 Haz.Materials $100 Mnual
�.P Instatiatton per tank $54 Fire Suppression $30
Fuel Tank Installation $50 System Acceptance
._.—....{��ntc} ��a 8 EXFiStlSt FI40t�IDGGt �sa
" Natural Gas InstallaUon 50 Re-inspection pBL
(Per System} (other than annuat}
Spray Booth 0 � Inspection scheduled DBL 8
and cancelted less than
24 hours
ConstrucUon lnsp. N/C
Emergency Vehicle At $5Q � FACSE ACARM
' PLANS TOT INSPEGTION TOTAL,�'7���' PERMIT TOTAL.�� TOTAL�
ac,-:*�
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A GRAND TOTAL _y��"L�
Co�imen#s: � t�
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Date: � �--
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