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Home My WebLink About08-7425 :CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE c ~ TY:. 7425 Permit Number: 7425 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: LIGHT INDUSTRY Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 4330 20TH ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block:. Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 13-26-21-0070-08900-0020 1/25/2008 25.00 25.00 1/25/2008 FPM-FIRE ALARM - ANNUAL NESTLE WAT RS NA, INC 4330 20TH ST ZEPHYRHILLS, FL. 33542 Phone: ~'<Y\(J~ ~ K'6 rr :'\ 2ll2-to~ tC:Z'" 6t6 ) ~ 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." ..... P IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 813-780-0020 Date Received Owner's Name Owner's Address City of Zephyrhills Fire Permit Application --;2 I /lJtSrte Wffl~S M1411 /!ACK./?A I Fax-813-780-0021 Phone Contact for Permit Owner's Phone Number II I J I J II I Titleholder Phone Number Fee Simple Titleholder Name Fee Simple Titleholder Address Job Address I Lot# Sub Division ~ S-\- I J.+33b I Parcel # (UtsIAINcU I-KUM I-'KUl-'cKI Y lAX NUIIL;c) D D D D D D D D D D D D D Fumigation Tent D Hazardous Material (Tier II or RQ Facility) ANNUAL 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 o Standpipes (Sprinkler Sys) D Torch Roofing o Waste Tire Storage ANNUAL Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen HoodlDuct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL Sprinkler D Fire Alarm [RJ N'\ L.- Hood Clean/Suppression D Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Valuation of Project Other: Y I N I Fee Current Y/N ~~~:~~::r l~~. ~ Address r'lc1 i 11m" .7nnr'1 PT ELECTRICIANj Signature . Address I PLUMBER Signature Address I MECHANICALl Signature . Address I OTHER Signature Address ~?7r:;n Company Registered License # Company Registered License # Company Registered License # Company Registered License # Company Registered License # Directions: Y I N Fee Current Y/N . Y I N I Fee Current Y/N Y I N I 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 (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 I 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, I 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 ary 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 \Nork 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. WARNINGITO 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 JU~T (F.S'?l.~. () _ " OWNER OR AGENT Lk.~ ~ CONTRACTOR tJ,~ ~ Su crib g,pnd swo or IiIffirmlJd) bfl re me this Subscribed and sworn to (or affirmed) before me this Z~ ,'( u ~ V" (L11 Ol't 1/16/08 by wi 11 i am Romi n1" Who is/ar e own to me or has/have produced Who is/are personally known to me or has/have produced as identification. N/A as identification. Commission No. ~'-J '---\ '\ .>.- DD445853 Notary Public ~ , Karen D Herrmann Name of Notary typed. printed or stamped CD KAREN 0, HERRMANN Notary Public. State of Florida My comm. expires July 13, 2009 Comm. No. DO 445853 ACI 274 7 860 STATE OF FLORIDA DEPARTM1Qft' OPBl1SXQS$..A!R> PROFBSSIONAL REGULAT1:0N 1mBCTRICALCON"l'RACTORS LICENSING BOARD SEQ#L06082402045 ; . LICENSE NBR 08 24 2006 068030696 1"20000371 The ALARM SYSTEM CONTRACTOR I Named below IS CERTIF;IBD ODdex. the provisions of Chapter 489 FS. Expiration date: AUG 31, 2008 ~mcEWi~~i~Rg~~ION SERVICES CORP 1932 CALADIUM PLACE LONGWOOD FL 32750 JBB BUSH GOVERNOR w S:IM:ONB MARSTJ:LLBR S1!:CRETARY LOOllO III I :p!ed alea OO'''S $ :p!ed lunoWV OlSIOOI'llLOOlLlOI :# ldJ33311 NHor WYITIIA\ nuWOll -.I3!J!l8nb ILEOOOOl.!lJ: - #'3n 3J8JS aJ:~v'1fl~:rn 960 I'll:# lUnO;);)V us:rnd> J:mWOll r WVITIIM. OSL'lf L!I 'aOOM~NO'I 'ld WGI<<V'1V3 'lf6I dlI03 S:1I;)IAlI:1IS NOI~33~Olld :.nIM 3;)NVITIV 80/0(/60 H~I101lH.L arIV A ~J O'X CJ;} I 0 U!W as'.\\ .\\. \\ OOOI-S99-LOf> :auoqdalal. . Of90-ZLLZf 'l:I 'pJOJUCS . 0[9 xo8 Od lIOJ.;)3'1'10:J XV.l AJ.NilO:J 3'lOi\'U\3S 'S30'lY.\ ,\ VlI ~dI33311 XV.L SS3NISilH A.LNil033'10NIW3S 3d.' 377 -;;2\ \5 407 d-~O '6'6Co~ C~) - -':-c ACOR1J.. CERTIFICATE OF LIABILITY -INSURANCE OP 10 IlY T OAT! IMMlDDIVVVY) AI.t.u'-2 01/25/0B I'ttOOucft ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Znsuranc. Nark.t ON I.. Y AND CONFERS NO RlOHTS UPON THE CERTIFICATE Plac. (200Jl:) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND DR 2BOl S W Coll.ge Ilci . ate 12 AL. TER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Ocala 7L3U74 PbaDe;352-237-2700 Fax:352-237-5884 INSURERS AFFORDING COVERAGE HAle __ INliIUlUiD INSURER A: MercurY.. INSUASFlII: A.cru1Ca1:l ProarlUll. Ac!m.:i.n * * A11i~c. Pir. Pift.ct1~ INSLlRE/'( C: Serv ces ar~. -B 11 Jlc:ml De ~11oll9C'" !all_..... ~ 1932 C&la um Place INSUReR 0: Longtltood FI. 32750 INGUFlER E: Jan 25 200812'41PM COVERAOES No.6983 p. 1/1 - E~:- .. THE POUCIES OF INSUAANce USTIi!D IIEJ..ow HAV'" BeEN I$SUCD TO THE INSURED NAMiD ABOVE FOFl THE POuey F'ERlOO INDICATeD. NOTWITHSTANDING AHY ~OUIREMI!NT, TERM 0" CONOmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY lie ISSUED OR MAY P~TAIN, THE INSUAANce AFFORCED BY THe POUelE8 CESCRJ8SD HeRE!IN IS SUIiJEcT TO AU. THE """"MS. EXCLUSIONS AND CONDITIONS OF SUCH POUCISll. Al9<JREGATE UMlTS SHOWN Wo.Y HAVE SeeN M!Duceo IIY PAID ~Mll. LTR lMaar TYPE OF INSURANcE "OLleY NUM8!R OA~llilm~ ~ LIMITS ~NUA1. LWIILITY EACH OOCU"AeNCE $ SOOf 000 C! X COMMERCIAL GENERAL LIASIllTY 6303002212 OS/28/07 OS/28/08 ~;is Ib Ol:Cllfllnce\ 5100,000 - U CUlIMG MACE [!] DCCLI" MED I!l(p IAny aile ~l $ 5, 000 PSRSONAL & AIJV INJURY $ SOD, 000 .....J GSHEAAL AGGREGATe 11,000,000 GeN'LABGn UMIT A"'n P~: P~OOUCTS.COMP~PAGG 11,000,000 ~. PRO. POUCY JECT LOC ~lITDMO"LE LIAIIIUTY COMBINED 81NGLe LIMIT S 5DDOOO A Nt( AVTo PLC700S7914 08/11/07 02/J..J../OB (e. III:CIll8rIl) "-- f-- ALL OWNED AUTOS IlDDIL Y INJUFlY I SCHEDULED AUTOS (Per I*$CIn) - - HlRfO AUTOS BODILy INJU~ I NON-OWNEc AUTOS (Pw.c:c:J_,) - - PROPeRTY DAMAGE S (Pet aooid8nl) RAftAGE UA8lLITY AUTO ONLy - EA ACCIDeNT' I ANY AUTO OTHE~ THAN .....ACC $ AUTO ONLY; AGG $ EllCEllSlUMElFW.u. UA81LITY eACH OCCUAAENCE S ::J OCCUR 0 CLAIMS Wo.oe AGGFtI!!GATE I S R DS:lUCTlIlLE S FlE'l'arnoN $ S WOIUC!RI CO...SNSATlON AND TToRY LIMrrS T Ig~- 3 eMPLOYl!ltlr LlAIIIUTY WC0707017J. 06/17/07 06/17/08 E.L. EACH ACCIDENT 1100000 APoI'( P"OPRI~RIPARTNl!F\lEX!CUTlvS OFFICEMEMBER ElCCl.UClED? E.l.. CIGEASE . EA EMPI.OVEE , 100000 ~"llI1be unGer E.L. DISEASe. pouer LIMIT $ 500000 L. PROVISIONS below OTH!It DQCRIF'TlOH 01' oli!iiiATlONa 1 LOCATIONS J \lEHICLU I !XCW8.0NIl ADDI!tJ IIY iNDORSl!M!NT ,.PECIAL PftOV.810NS 1999 Farci wnma'rAR 2PMZASJ..~8XBA327JS Alarm ~.tallatian CANCEL.LATION C:r'1'YOZB SHOULD ANY 0' TH! AIIOVi DEBCIUIll!C POUClElllle CANC!L.L!!D '&FORE T"I! I!XPlFU.T10N DATE THeltI!OF, THIlIUUlNG INSUReR WIL.L. ENDBAVOI\ TO MAIL. ~ DAYe WRmEN NOTICI! TO THE CERTIFICATe MOLDER NAIlED TO ntI LEFT, IIUT FAlLUIII TO DO .0 SHAll 'MI'O.! NO OBLIGATION em LIABILITY OF ANY 1CI1i1D UPON THE INIlUItl!!".1T8 AQiNTS OR. 1tI!!"~8ENT"'TIWS. AUT~ REl'ItI!!ANTATIVE PM ~e..(. '""""=h- CERTIFICATE HOLDER. City of Z.pbyrhilla 5335 Bighth at Zephyrhi1l. PL 33542 ACORD 25 (2001'OB) RPORATlON 1988