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Home My WebLink About07-7230 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7230 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 7230 FIRE PROTECTION MAINTENANC FIRE-PROTECTION MAINTENAN E NOT APPLICABLE Address: 7254 GALL BLVD ZEPHYRHILLS, FL. Township: Range: Book: Lot(s}: Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11/26/2007 25.00 25.00 11/26/2007 Phone: SEMI-ANNUAL INSPECTION FS- CHINA WOflft< HAUNG, JAM S 7254 GALL BLVD ZEPHYRHILLS, FL. 33542 ~tl(,uI ?ft { }-~]-tJ / U FIRE LIGHT TEST-Final FIRE SYSTEM ACCEPTANCE Fina 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 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." ~AC.l.'-o~ ';;( ~ CONTRACT~TURE P IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 Date Received City of Zephyrhifls Fire Permit Application Phone Contact for Permit 813-780-0020 Owner's Name C (;,. Y1 0.. ()J)k Owner's Phone Number Fax-813-780-0021 II II Owner's Address " I Fee Simple Titleholder Address I ----.~ j~ (; .?J. ~T Job Address I ~ ~ / / Y(J I I Fee Simple Titleholder Name I Titleholder Phone Number I II ~4!jm Parcel # \UI:II AINt:.U r-KUIVI t"'KUt"'t:.K I Y I f\A I'IU 11L.t:.) Sub Division D Bio-Hazard Waste Storage - ANNUAL o Comm Exhaust Kitchen HoodlDuct D Controlled Bum D Emergency Generator < 30 kw o Emergency Generator> 30 kw 00 Fire Protection Maintenance - ANNUAL Sprinkler [XI Fire Alarm D Hood Clean/Suppression D D Fire Alarm Installation D Fire Pumps D Fire Works D Flammable Application- ANNUAL D Fuel Tanks ~ Other: 1m!~I!M~1 Lot # &~~~ I I I D Fumigation Tent D Hazardous Material D Hood Installation D LP/Natural Gas-Installation D LP/Natural Gas-ANNUAL Sale D Places of Assembly-ANNUAL D Recreational Bum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage Contractor Signature Address Company Registered License # ELECTRICIAN Signature Address I PLUMBER Signature Address I MECHANICALI Signature . Address I OTHER Signature Address Directions: Company Registered License # Company Registered License # Company Registered License # Company Registered License # Y/N Y/N Fee Current Y/N Y/N Fee Current Y/N Y/N Fee Current Y/N Fee Current Y/N Y/N Fee Current Y/N 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. --_..""--"_.._,~..-~----,._._-,..-._......_------_._..-.__...,..-..-_..~" ---.. 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. CONSTRUCTION LIEN LAW (Chapter713, 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 <lone in compliance with all applicable laws regulatingdconstruction, 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 musttake to be in compliance. If lam 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 maybe 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 PROPERrv.IFYOU It,lTl;tjDTOOi:STAlf1lFINANCING, CONSULT WITH Y-()UR;L.eNDER_OR,AN'AtTORNEVIBEFORE~REdORDIN(;;YOUR' .." -riCE OF OMMEN CEMENT . . ,. UEttc)RIBAilBRA-T!(E;-SJ'117t03) ; . - - __ - ._u _____+ __ _ -- ---- --. --" ~-,... -- - . ...~. CONTRACTOR ;::::....-c.... ..... su~cribed and sworn to (or affirmed) before this ~ r../c;17 by o is/~~l!rCll'c1l1y kn~to me or haslhave produced . . as identification. OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this , by Who is/are personally known to me or has/have produced as Identification. Notary Public Notary Public Commission No. . Comm# 000728322 5 Name of Notary or ~ 111912011 : . ~'~.P florida Notary Assn.. Inc 5 ................. ................... ..... .... ..; Name of Notary typed, printed or stamped ACDBQ.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) 01/10/2007 tOOUCER (863)688-5495 FAX (863)688-4344 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION lerndon " Associates Insurance. LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR n Lake Morton Dr. ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. =>> 0 Box 3608 Lakeland. FL 33802 INSURERS AFFORDING COVERAGE NAIC# S~ B Wayne Enterprises Inc INSURER A: Colony Insuance Group DBA: COmmercial Fire Equipment Company INSURER B: POBox 2442 INSURER c: Bridgefield Employers Ins Co Brandon. FL 33509 INSURER D: INSURER E: :OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmoNS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO CLAIMS. ~ TYPE OF INSURANCE POUCY ~ POUCY EFFECTIVE ~ EXPIRATION ~UABIUTY GU254150 02/21/2007 02/21/2008 EACHOCCURRENCE X COMMERCW.. GENERAL L1ABa.rTY DAMAGE TO RENTED I ClAIMS MADE [K] OCCUR A. f-- LM1S S S MEV EXP (Any one person) S PERSONAl. & ADV INJURY S GENERAl.. AGGREGATE S PRODUCTS - COMPIOP AGG S 1. 000 . OO(J 50.0()(J 5.00 1.000.00 1.000.00 Inc 1 ude4 GEN"L AGGREGATE LIUIT APPlIES PER: h POliCY n ~ n LOC AUTOMOelLE UABlUTY f-- AN'( AUTO f-- All OWNED AUTOS f-- SCHEDULED AUTOS f-- f-- HIRED AUTOS r-- I- ~WNEDAUTOS COMBINED SINGlE LIUIT S (Ea acddent) BODILY INJURY S (Per person) BODILY INJURY S (Per acxidenl) PROPERTY DAMAGE S (Per acxidenl) GARAGE UABlUTY R AN'( AUTO EXCESSIUM8RELLA UABlUTY :=J OCCUR D CLAIMS MADE I DEDUCTIBLE I RETENTION S WORKERS COMPENSATION AND EMPLOYERS" UABIUTY C ~~~cme=CUTIVE If yes, desalbeunder SPECIAL PROVISIONS below OTHER AUTO O.NL Y - EA ACCIDENT S EAACC S AGG S S S S S S EACH OCCURRENCE OTHER THAN AUTO ONLY: AGGREGATE 083028471 01/14/2007 01/14/2008 X we STATU- I IOJ.1;'- E.L EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POliCY LIUIT S 100.00 100.004 500.004 DESCRIPllON OF OPERATIONS I LOCATIONS I VEHICLES I EXCWSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ER City Of Zephyrhills 5335 Eighth Street Zephyrhills. FL 33540 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCElLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAlWRE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATlON OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Bett "1J?e JJL~ @ACORD CORPORATION 1988 ACORD 25 (2001108)