HomeMy WebLinkAbout14-15503 CITY OF ZE FIYRHILLS
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ANNUAL FIRE PROTEC ION MAINTENANCE
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Permit Number: 15503 Address: 7643 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Ciass 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: 34-25-21-0010-03100-0000
Improv. Cost: ` ` 'w�,, ""OUVNER'INFAORMATION _ �����f� _
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Date Issued: 7/21/2014 Name: CHILI'S BAR& GRILL
Total Fees: 25.00 Address: 7643 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 , �
Date Paid: 7/21/2014 Phone:
Work Desc: FPM- HOOD CLEAN QUARTERLY- C ILIS
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•'�CONTRACTOR S . "�-� ��� � � p APPLICATION FEES: ` � ���°` � � �� ��R� =
�SUNSHINE PRESSURE CLEA ING FIRE PERMIT FEES 25.00
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FIRE ACCEPTANCE Final
Chapter 633, Florida Statutes,authorizes the City to harge and collect user fees to pay for the costs of fire
prevention and protection related activities such as i spections, plan review,administrative fees,and other
costs related to t e aforementioned.
Complete Plans, Specifications and Fee Must Accompany Ap lication. Commencement of work without written approval of •
the Fire Department's Fire Marshal or required permits or pening up for commercial activity without an approved final
inspection shall be charged double permit fee per day of o eration or a minimum of$100.00, whichever is greater. All
work shall be performed in accord nce with City Codes and Ordinances.
"WARNING TO OWNER: YOUR F ILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTE D TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORN Y BEFORE RECORDING YOUR NOTICE
OF COMM NCEMENT."
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PERMIT OFFICE
PERMIT EXPIRES IN 30 DAYS ITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RE CUE DEPT- 813-780-0041
a�s-7aa-oo2a City af Zep yrh"slls Fire �ax-s��-7so-oo2�
Permit A plication
Oate Rece;ved, ���—� Pho�e Cor�tact far Permit � C__� �___�
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Owner's Name t `l f 'C' Qwrser's Phor�e Number �� �� �
Owner's Address �'�� G✓e � � U(�
Fee Simple Titleholder Name Titleholder Phone Number �� �� [�
Fee Simple Titleholder Address
i`°'m_.�_....._.�.....,.�- - - �_.�..__ "�
Job Address � ��___�
Lot#
Sub Division Parcel#
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� Bio-Hazard Waste Storage-ANNUAL � � Fumigation Tent
o Comm Exhaust Kitchen HoodlDuct � Hazardaus Materiai(Tier Il or RC2 Facility}ANNUAL
� Controlled Bum � Hood Installatian
� Emergency Generatar<34 kw � LP1Natural Gas-Instaila#ion
� ergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale �
Fire Protecfion Maintenance-ANNUAL � Places of Assembly-ANNU,4� !d�{/
�y emi � er 'v t�
Sprinkier � ❑ 4 Cl � Recteational Bum < <y( {
�,
Fire Alarm � �O � Sparklers
Naod CSeaning � ❑ ❑ � Sprinkler System Installations
Hood Suppressian � ❑ ❑ ❑ � Standpipes(Sprinkler Sys)
� Fire Alarm tnstallatian � Torch RoofingtTar Kettle
� Fire Pumps � Waste Tire Starage ANNUAL
� Fire Works
� Flammable Application-ANNUAL � �, Valuatian of Project
� Fuel Tanks
Q Othe :
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Contractor Company St,1,ti,.5 �.t ,S,Cwc. Cc,�.h,�F,�,
Signature Registered Y!N Fee Current Y/N
Address License#
ELECTRIGIAN Gompany
Signature Registered Y!N Fee Current Y/N
Address License#
PLUMBER Company
Signature Registered Y 1 N Fee Current Y!N
Address License#
MECHANIGAL Gompany
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y 1�1
Address License#
Directions.._.�.,..___.._.-_._____ _...���:. _,�.,�._._._.__.�, _�.,�.._.�.__� ___.-. __._w�a__.,,..a....A......._.__,.._.�_ -,.T_._......�_:m_._�..._..._^_.,._._e_�....._.�__�__
Fill out application completely.
Ownar&Gontractor sign back af appticafian,notarized(dr,capy of si ned contract wifh owner}
If over$2500,a Notice of Commencement is required(Mechanicat wo over$5000)
Supply two{2)sets of drawings with applicable documentation
AIIow 10-14 days for review affet submittal date. Parc t#-obtained fram Property Tax Nofice{hEtp:llappraiser.pascogov.com}
fdOTIC� OF DEED P2�SY92oC�VONS: 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 com�liarrce�with any
applicable deed restrictions.
UNLICENSED �ONTI2ACTO�tS AIVD CONT9�ACTOR �tESPO�ISI�ILI�'lES: 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 in
tended 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 uvill 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 LI�YV LAVY(Chapter 7'03, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, 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'S/ONVNER'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 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 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 Official 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.
W�►VtN11NG TO OdVRI�R: YOl9V2 �AILi9RE TO ��COQ2� A WOTICE O� COMMEPdCEMENT CVIAY R�SULT IN YOUR
PAYING TWIC� FOR IM�ROVEMENTS TO XOUR PROPERTX. IF YOI� 9NTEND TO OBTA9N FINANCeNG, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOItDING YOUFt YVOTICE OF COMM�NCENIENT.
FLORIDA JURAT(F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirmed)before me this Subscribed and swom to(or affirmed)before me this
by by
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. � as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped