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Home My WebLink About07-7008 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 HOOD SUPPRESSION SYSTEM 7008 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: 1,550.00 Date Issued: 9/11/2007 Total Fees: 80.00 Amount Paid: 80.00 Date Paid: 9/11/2007 Phone: Work Desc: REPIPE NOZZLES FOR ANSUL SYSTEM 7008 FIRE HOOD SUPPRESSION SYS FIRE HOOD SUPPRESSION SYS MEDICAL Address: 7050 ALL L ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 35-25-21-0010-10500-0000 Name: FL HOSPITAL OF ZEPHYRHILLS Address: 7050 GALL BLVD ZEPHYRHILLS, FL. 33542 35.00 b'nCLla d) \d,IO'FK6 lQy\ iRBNSREuI~C1JNSFEES:Reinspection fees will comply with Florida statute 553.80(2)(c) when extra inspection trips are necessary due to anyone of the following reasons: a)wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when called d) work not ready for inspection when called e) permit not posted on job site f) plans not on job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. nWarningtoowner: 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. n Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Code and Ordinances NO OCCUPANCY BEFORE C.O. /OLu...a 4luuAak4-JZ) ~ CONTRACTOR SIGNATURE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED I~~~N . CALL FOR INSPECTION - 8 HOURS NOnCE REQUIRED PROTECT CARD FROM WEATHER Date Received a _ Owner's Name Ad ve /1n ~ + J...I e a H-h Owner's Address 170506Ctll bIrd Fee Simple Titleholder Name I 813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Owner Phone Number I g I Owner Phone Number I ~ ::::>- Fee Simple Titleholder Address 1 1'050 60.. il IF/aI" ou JOB ADDRESS SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK BUILDING SIZE l3/vd t+o~~ i+r-t/I B D D BLOCK D FRAME D IRep~ n02;2-Ic~ ..f(y. A f1,stJ' I SQ FOOTAGE I I - rY)CL/rJ '<'t1c~n PARCELlD#13s'2S-21'CX)IO' /05C(). (OBTAINED FROM PROPERTY TAX NOTICE) LOT # B D ~ DEMOLISH NEW CONSTR INSTALL D ADD/AL T REPAIR MOVE D SIGN SFR o I o ..<.. <.J ~ k-(Yj HEIGHT I COMM OTHER I I (~.cJ ~h~,i) <J-{j adl qos I lra.lv-e.'~ a u..:J-D ~w-()Il OTHER I STEEL VALUATION OF TOTAL CONSTRUCTION D BUILDING D ELECTRICAL D PLUMBING rtJ MECHANICAL 1$ 1$ 1$ 1$ i5m .CO D GAS D FINISHED FLOOR ELEVATIONS I I I I I D I SPECIALTY ~ OTHER F'r-t ~.nf'lY) FLOOD ZONE AREA DYES DNo D AMP SERVICE VALUATION OF MECHANICAL INSTALLATION D ~. C1 h len ~ClRC\ U'0\1l2. S\<("l"' PROGRESS ENERGY w.R.E.C. ROOFING BUILDER SIGNATURE COMPANY REGISTERED ~ ~ FEE CURRENT Add ress License # ELECTRICIAN I SIGNATURE . Address I PLUMBER I SIGNATURE Address I MECHANICAL I SIGNATURE . Address I ~I~HN~~URE b/1.Lt-UU ~(/lrW I Address I iPl: 57 OJ flu Uj ..30 I -Rl Y( me.w iK AlIach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submillal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster AlIach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submillal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. AlIach (2) sets of Engineered Plans. ---PROPERTY SURVEY required for all NEW construction. COMPANY REGISTERED ~ FEE CURRENT ~ License # COMPANY REGISTERED ~ FEE CURRENT ~ License # COMPANY ~ ~ REGISTERED FEE CURRENT RESIDENTIAL COMMERCIAL SIGN PERMIT COMPANY REGISTERED Directions: Fill out application completely. Owner & Contractor sign back of application. notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades Ale Driveways-Not over Counter if on public roadways..needs ROW Fences (Plot/Survey/Footage) 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 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. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance 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. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, 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/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. Such agencies include but are not limited to: Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterlWastewater Treatment. Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V' unless expressly permitted. If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. 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. 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 (FS ).;7.03) ,., 7 OWNER O~U" e {iA OA1JlLI.Lur.iJ CONTRACTOR U~~_/-t4uil sc 'bed'~~m to (or affirmed) belore me this . Subscribed and ~,r...atfjr!)Jej,l) twlore flJlI:!his . r- /1, I . 1 ::- '-f by The rt' c,a... <::aut'fW,n0 bY-/!ffLE-~/:2/1 -'Q/-Jt,b:_N:u./j~F . lare ersonall known to me or has/have produced 'M10 is/are nnaIlY1>ow~o me or has/have produced aSldentlficallon. ./." _.__._.~. - a:7den2:2;:'l' Notary Public ~~'vj~UbliC Commission No. Fire Chief Robert Hartwig ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Bus (813) 780-0041 Fax (813) 780-0044 FIRE SERVICE USER FEES ~\A/rxler: Occupancy No.: Plan No.: . Business Name: ;;c-i.- d.5)d' ..1'~ BusinessAddress: '7v.)O ~~ Business Phone No.: Business Fax No.: Contact: PLAN REVIEW FEES ~ Site Plan N/C Building Plans .04 sf Revision .06 sf STANDPIPE SYSTEM D Per Riser $25 SPRINKLER SYSTEMS [l 0 - 25 Heads $30 D 26 plus Heads $60 FIRE PUMP D Per Pump $100 FIRE ALARM SYSTEM n 0 - 25 Devices $30 D :26 plus Devices $60 SUPPRESSION SYSTEMS B~~~ ~$/335 55 " ,. X ~ther ~ ~ G. REASENENTILATION ood/Ducts $35 > /Of.) PLANS TOTAL I 35 r Comments: INSPECTION FEES Annual N/C 1 st Re-inspection $25 2nd Re-inspection $50 3rd Re-inspection $125 4th Re-inspection $250 5th Re-Inspection $500 Construction $15 Commercial $25 SPRINKLER SYSTEMS Hydro Undergrounds $45 Hydrostatic System $45 Wet Acceptance $30 Dry Acceptance $45 Hydrant Flow ~.~ Hood / Booth '. $30 . 15 FIRE ALARM SYSTEM D System Acceptance $50 D Recall Acceptance $50 Billing Phone No.: .PI a-2-~.-~t?.J"/ Billing Fax No.: Contact: PERMIT FEE FALSE ALARM FEE 1st Alarm N/C 2nd Alarm N/C 3rd Alarm N/C 4th Alarm $25 5th Alarm $50 6th Alarm $75 7th Alarm $100 8th Alarm $150 9th Alarm $200 10th Alarm $250 Non Compliance $150 "Affidavit of Service/Repair" SPRINKLER SYSTEMS D Automatic $15 FIRE PUMP D Fire Pump $15 FIRE ALARM SYSTEM D Detection $15 OTHER OTHER Fire Wall/Smoke Wall $15 ~ lP G.. $45 LP Gas $25 Natural Gas $45 Natural Gas $25 Fire Works $25 Fuel Tanks $25 Fuel Tanks $45 Tent $15 GREASENENTILATION ~OOd/Ducts $15 ~ If'~'"'" S"Ppre~i~" ~ INSPECTION TOTA~ PERMIT TOTAL ~I ~r~ FALSE ALARM I TOTAL GRAND TOTAL r:r II'C>;; 7 I d #' 7/ . /'1 LJt//j/~ Date~ Inspector~ iio "" - o~ ~ ui IV) C I >< c( N W 0"" 'I"t::) a::: :----------@ ~ I ~ I .... 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Cd ,,-:':::~~.b ;;.~"_C/) ~C/)ca 8...0 o..='-l U Or--- Cd- ~ ~ ii: ~ ~ 8.& d1 ~ ~ .Q ~ ~ J: ~ 0'\ 00 - _10'\ '- '1""'4 OJN .0 0 EO ::JO z~ ~~ C:'1""'4 OJ",," U :.:::::i OJ c: .~ Q) ::J 1tI U) >.~ .0 OJ c: '- s: OJ ~~ C STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL TALLAHASSEE, FLORIDA FIRE EQUlPMENT DEALER LICENSE THIS CERTIFIES THAT: GULFCOAST FIRE & SAFETY CO., INC. 6329 US HWY 301 S RIVERVIEW, FL 33569- QUALIFIER: ROBERT L BURCH HAS COMPLIED WITH FLORIDA STATUTES AND HAS QUALIFIED FOR THE TYPE AND CLASS SHOWN HEREON TO SERVICE, REPAIR, INSTALL OR INSPECT ALL TYPES OF PRE-ENGINEERED FIRE EXTINGUISHING SYSTEMS. ~~ ~w Chief Financial Officer 01 01 2006 07 04 Issue Date Type Class HiUsborough County 41093100021989 6830230001 12 31 2007 LicenselPenriit Number Application # Expire Date ~, DATE (MM/DD/YYYY) 09/06/2007 PRODUCER Aon Risk Services, Inc. of ohio c/o client Service Center 1000 Milwaukee Avenue Glenview IL 60025 USA PHONE- 866 283-7122 FAX- 847 953-5390 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED xpect First Aid Corp., Cintas Fire Protection d/b/a Gulfcoast Fire & safety Co., Inc. 6657 us Highway 301 South Riverview FL 33569 USA INSURER A: Greenwich Insurance Company westchester Fire Insurance Co XL Specialty Insurance Co N Of"> NAIC# u. 22322 ... .. 21121 == -= 37885 .. '0 - ... .. '0 '0 == INSURER B: INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAl~, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' L TR II\'SR TYPE OF INSURANCE POLICY I\'UMBER POLICY EFFECTlV POLICY EXPIRA TJOI\' DATE(MMIDD\YY) DATE(MMIDD\YV) 07/01/07 07/01/08 LIMITS A ~'ERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [!] OCCUR RGD943715702 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurence) 'D, (Anyone person $2,000,000 $100,000 PERSONAL & ADV INJURY $1,000,000 $2,000,000 $1,000,000 \!l 0"1 .-I \!l 0"1 "- ~ N o o "- '" GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: D POLICY D PRO- I)(l LOC JECT L.:...J PRODUCTS - COMP/OP AGG A AUTOMOBILE LIABILITY RAD943715802 X ANY AUTO Auto - AOS A RAD943715902 ALL OWNED AUTOS Auto - MA SCHEDULED AUTOS X HIRED AUTOS X NON OWNED AUTOS 07/01/07 07/01/08 07/01/08 COMBINED SINGLE LIMIT (Ea accident) $ 5 , 000 , 000 Q Z .2:l <'l '" 5 ... ... .. U 07/01/07 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY B ANY AUTO EXCESS IUMBRELLA LIABILITY ~ OCCUR D CLAIMS MADE AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: B AGG G22035277002 07/01/07 07 01 8 EACH OCCURRENCE AGGREGATE DDEDUCTlBLE E]RETENTlON $10,000 c c c RWD RWR943511402 RWE943512102 ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICER/MEMBER EXCLUDED" WORKERS COMPEI\'SATlOI\' AND EMPLOYERS' LIABILITY OTH- ER !ryes, describe under SPECIAL PROVISIONS below E.L DISEASE-EA EMPLOYEE E.L DISEASE-POLICY LIMIT $1,000,000 = $1,000,000 = $1,000 , 000 iiii ~ ~ ---= .e.- ~ :i; -= Ii!fi ~ ~ ~ ;; Il:- OIl!!.! ~ - OTHER DESCRIPTION OF OPERA TIONS/LOCA TlONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Workers Compensation coverage noted above applies in the State of Florida. city of zephyrhills 5335 8th Street Zephyrhills FL 33511 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY , OF ANY KJND UPON THE INSURER, ITS AGENTS OR REPRESENT A TlVES. AUTHORIZED REPRESENTATIVE ~b~~ (tl GULFCOAST FIRE & SAFETY CO., INC. P.O. Drawer 3190, Brandon, FL 33509-3190, Telephone 813-671-3733, Fax 813-671-3827 A ciNrA\. '---= ~ -.-.,-=! COMPANY SPECIFIC POWER OF ATTORNEY I, Robert L Burch of, Riverview, Florida, the undersigned, hereby grant a limited and specific power of attorney to: Theresa Sauerwine, FI Drivers License Number S650-813-70-784-0, of Oldsmar, Florida as my attorney-in-fact for the limited purposes specified herein below: The attorney-in-fact shall have full power and authority to undertake and perform only the following acts on my behalf: Apply for permits, Sign all permit applications, pick up permits, register contractors licenses and Sign all forms necessary for obtaining a permit and/or registering contractor's licenses for Gulfcoast Fire & Safety. Contractors License #: 41093100021989 (exp. 12/31/2007) to include such incidental acts as may be required to carry out and perform the specific authority granted hereinabove. This power of attorney is effective upon execution. This authorization may be revoked at any time, and shall automatically be revoked upon my death, provided any City of Zephyrhills Building Department employee may accept and rely upon same until receiving written notice of revocation hereof. Signed this 5th day of September, 2007 STATE OF FLORIDA ~ COUNTYOFHILLSBOROUGH ,-~' ---~ SIC:; Ht:. OF LICENSE HOLDER (R6bert L Burch) Sworn to and subscribed before me this 5th day of September 2007. Type of J.D. Sl~ i^- ~. t1A- ~~-y '---- NOTARY PUBLIC, S te ot Florida My Commission Exp: sid "11 0 ~ -LPersonally Known to me or _Produced as Identification Witness: ....~~~~..~::l', SHANNON LYNN ~~o . ~',. <~<." Notary Public - State of Florida ~. : : . EMyCanmissbnE>q::ies Ma(29 2m3 ':o1Jl .. . ~.. 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