HomeMy WebLinkAbout08-7492
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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:
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020 7492
.ANNUALFIRE PROTECTION .MAINTENANCE
nr.~.'
Address: 6145 ABBOTT STATION DR
.zEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: SILVER OAKS VILLAGE
Parcel Number: 03-26-21-0200-00000-0000
..0l':
2/13/2008 Name: WESTOVER MANAGEMENT LLC
25.00 Address: PO BOX 48155
25.00 TAMPA FL 33646
2/13/2008 Phone: 813 782-8468
FPM-YEARL Y FIRE ALARM -LITTLE FRIENDS SCHOOLHOUSE-INSPECTION DONE
C~~-~t?J
Zh~lb<6
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 NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
City ofZ IpnyrhlllS Fi~--'
'Pennft plication._
Phone 00I'Ita!lt for'Permit .
JAN/29/2008/TUE 01 :56 PM
ZEPHYRHILLS BUILDING
~13-780-OO20
.Date 'ReceiVed .
Owner's Name
rY]D./Jc-;.
FAX No. 813-780-0021
. P. 0~3 .' ~ V
F~-81~7~~ 1
. OWn.,.. Phone' NuinIier
. J..l
III g~Jl~(.h;~J
. OWner's Address
Y315S
I N~
rL-'
....,....f~ ~~~ne~&.;.I~17 rr
n
."
BIo-:H8za~ W.., Sigrage ~ ANN~ ,': ) . 0 FumJg&tlon Tent. .
Com;" Exh8ust KItohen HoOdlou~ ',' '0: . H~~ M.rta'.(TIef II or RQ FacUlty) ,A~~
. CQntroIIeP Bum '. · .' 0 : Hood I~ilallon '. . ,
Emergency Gen...tor ~ SOkW . 0 : " LP/NaturBJ Ga..lnstalllltion . .
. E~nCY ~~r~ so'kWD,L~~I.GU~AL &ode,. .
~ Protection Maintenance. ANNUAL D. P1agee; of AAembI)'.,.ANNuA~': .
,Sprlnkler ..' 0.. . .' ' .... D. ~1l~tIonala\!m ""
f ~ ,h,S o..lr:~..J..t 'D. . ' ,
FlreAl8rm . ~~~ ,LdJ )'''S~~P: . ~~IB. .
'. Hood CIe..nlSuPPf8M1on 0 '--(owlc:l . ~1.1- '. : D Sprinkllllr Sys1IIm 1~II8tioIla,
D. Fl- A1ann.'.......'O-'&"- . o..bo...J f,v""if- D:. .....-..-.....;. (5 ....."....Sys)' '.
,- ...........-., .);o~ ne~:-: ". ..<>ID!....I"t.'"'- P.II-
o fire Pu.nipi "'. D Torot! RQOtIng. .
'D Fire Worb . D WesteTl,. stonage ANNUAL '.
,[j . F~mable ~'ANNUAL_
D . Fuel Tank5 .
D Other: '
Fee. Simple ~er Name
Fee Simple TItIehoh:t.r Address
Job Address'
SUb DlVlIlon
D
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Contractor
, Signatuni
AckIntu I fJofS'i- ?S'[ I HoNoJASSA ~~ I ~(/tI'I"2 !. r
.'=~Nl ". .. .',' . , '.,0.
. Address I iJ '
==-! - .....~ ..
MECHANICAL
Signature
AddreB8
OTHER
S/gnetunt.
. Addre8S
DlnKlllons:
.1
. Lot.,
: Lf'i'jq I
,
Pa~# '.
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) f / ;;<'0 ,CD
l Valu.tion of Proj~
Co,np~r .' r CVt\A. +' L. (:- T t; f /l.Jc.\t;l..nwJ" ,
RegIatered [=-Y..(N2] 'FeeCwmrt I Y .(~
'uo.nae# . j. (ir ;toooo-~39' "'-J
. ::d.1 'Y/N Fe.Current--:-'J ~'NI"
uOenee# I I
=.." "'N F"Current ~I' Y/N)
ue.nseil I I.
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Y I N I Fee Current
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qo.mpany
. Registrnd
,LIcenIe#
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, . R41stered
,
,Y I N .1. Fee'Current. ,I .Y.I N 1'--,
I.
Y/N ]
'1
FdI out appUceUon completely. . .1 . '. '.' .
Owner & Conlr8c:tor sisn b8ck of appllOlltlon. notarized (Or, COF1' of signed contract .....,,~.)
, If over $2500, . No1Ice of Commel1Ollmetlt. iIIl'l!Iquired (Med'laT Work <MIr $l5OOO) .
SUpply two (2) &ell of dravt1nga v.4ln appIlaable dooumenlBtIon .
~ 1o.~4 days for ~atl8r ~I datll. .
FEB ,1 3 2008 .'
JAN/2rj/2008/TUE 01: 56 PM ZEPHYRHILLS BUILDING
FAX No, 813-780-0021
P. 004
. .;.. " : ".' . .... I . "".. - / .
NOT'ICEO~ DEED RESlRlC:nONS: The undel'8ig'ned U'''de~' nds.that this per.mlt'may;be:~ub.leot.to "deed" restrictions"
whloh may be more re~trIctlve~than.Gounty regulations. The nderslgOed assumeuesponsibUity'tor .compllance with any ,
applicable deed restrictions, . . . . .'" .
. UNLICENseD . CONTRACTORS 'AND CONTRA-cTOR RE NSIBILttlES; If "the''Owncr hEls 'hired It contractor Or
cOt1tractors'to undertake' work, 'they may be.requlted to ~'I naedin accordance with sl13te ~ lo9al.ieguiatiOns. ..If the
, . contractor' ~s not lIc:ensed as required by law, both th8 .owner~nd oontl'actor:may be cited for a .misdofl:1e8nqr v1olliltlon
under state law. If.the owner or il)tended oontraOtor are u~ln as to.what 1i~lng fequlrernents may apply for the". .
jntended work, they are advised to .contact the Pasco COU~.ding Inspeotion .Dlvlsion-Licenslng Section at 727-a47- .
8009. Furthermore, If the .owner "has hlred.a, contraotor or contractors,' he Is. advistKt to have. the .contr8ctor(s) sign
portl~ns ot;the "contractor..Block" of this eppJicatlon for Wh" ~y will be responsible.. If.you, as the.owner sign. as the
~~:~or, :,that m~y be an. i~di~tIon ~at h~ is not P~PerlY .' censed ~nd is not ~ntitle,d ~Q .permltttng ,prIvHeges l~ Paeco
CO~STRUpTION L~E~ LAW. (Chapt.r 713, Flori~,a Statui , .. amended): . If .valuatlon: of W9.r:k -". $2,~O.OO or more, I . '. .
. certify that: I, tho apphoan.t. tlsve bean provided with a py of the "Flor1da Construction ,Lien L.aw-:-HOmeoWner's .
Protection Guide" 'prepared by the. Flor:lda Dep~rtment.qf A ou~re and Consumer Affairs. If the. ~pli~nt Is someone,
. other than tile "owner", I certlfy:that l-tlave' obtained a copy of e above described document and promise In good.faItb to
deliver it to ithe ~owner. prior-to commencement. , . . ...... ..' . . '. . ,
.. i CONTRACTOR'SJOWN-=~'S AFFID~VIT: '.,1 ~rt that all the Infonnatlon In this application is aqetJ"'lIte 'and .
! that all work will be done' in oompllSnce ~. a applloable..l~ reg~l!lting consinJotlpn, zoning and land
. ! development.. Appllcationls, hereby made to .ob n a permltto d~ work and Jnstalll;dlon ~ in~ic8ted. . I certify
that no work or installatlon"has commenced priOr Issuance of a permit and that all wort.< will be perform~ to .
, meet standards of all laws regulating cone\ru n, County and City codes. zoning regulations; and land
. ; development regulations .in the jurisdiction> I o' certify that 11Jnd~tand that the regulations of other
. . 'I goyernment agenc1es me>" apply to the intended and that. It Is ~y responsibility. to Identify what aotlons'i
must take t'O be In compliance. . '.. .' . . .
If I am the ~GeNT FOR THE OWNER; 'ptomis~ in good fait to inform the owner ofthe,permitting conditions seUorth In..
t~ affidav~prior to commencing. oonstruction.' I understand that 8' separate p,ertnit may be required ~or alec~ work,'.
, plumbingj. I!igns, wells, pools. air condlti9ning.' gas, or other Installations not speotrlcally included' ih the application. A
. permit Issued shall be'.construed to be a lioenseto Pl'9ceed the wOrk 'and nqt as authority to. violate, canoei. alter, or
set aside any proVisions of .the. techn~1 codes, nor shall issu nee of a pennlt prevent the BuDding ~Ia! from thereafter
requiring a ~' rreatioi'l of 'err~rs In plans, construction or Vlolatl ns of any c.;odes~ . !=vory permit IssLied shaD become invalid
unless the rk authorized by such 'permit is commenced wi In six mo~ of.permlt Issuance..~ if work authorized by
the permit', suspended 'or abandonEK;! for 8.. per~ of six (6) nths afte!' the time. the work Is commenced. A!l extenalon
may be requested, in writing; from the Building OffIcial for a not to exceed ninety (go) days and wID demonstrate
Justifiable cause for the extenBloh.lf.wor~ ceases foi' ninety ( .) consecutive days. the Job is col'I8ider~ abahdoned,
.W~RNiNGltoowNER: YOUR.'FAI~URE TO.RECORD'A NOTICE OF COM' .' ~ENT 'MA~ RESULT IN YOUR
.PA YING TWICE 'FOR'IMPROVEMENTS 'TO YOUlt PROPE . 'IF YOU I D t AlN 'FINANCiNG, CONSULT
.. N ., . .
FL.ORlf:?A JU'rT (F.B. ~17.0S~. ; .
.OWNER OR, AGEiNT
. ~bed a11d cwOm to (or aflinned) I;Iftn me thIII
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Who ~re PGfSO"8l1y knowl:\ to me Or h8sIl1ave produced
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07-26-2007
AlEX SINK STATE OF FLORIDA
CHlEFFlNANClALOFl-'1CER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERs- COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXu.T FROM RORIDA WOHlERS CIMlENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE:
PERSON:
FEIN: 593239071
BUSINESS NAME AND ADDRESS:
COMPLETE PROTECTION LLC
PO BOX 757
HOMOSASSA SPRINGS
08/26/2007
SCALZI
EXPIRATION DATE: 08/25/2009
TIMOTHY
FL
34447
SCOPES OF BUSINESS OR TRADE:
1- ALARM I SECURITY INSTALLATION
IMPORTANT, Pursulat to Chlpter 440 - 054141. F,5" I. officer 01 I carporltiaa wha eleClS exe.lo. Irom this chlp.er by liliog I certificate aI electi.. ....r lIIis
section mlY not recov.r beaelils Dr cap.lsati.. ....r this chlpter. Pursulnt to Chillier 44lI,D5UZl. F .5.. Cenilicetes 01 el.clion to be exe.pL, ....., _I, willll. tire
scope 01 the busi.ess or nlde Iisl.d 01 tire Htle. 01 election to b. exempl. PursuI.t to DllIter 440,05031, F.S., Notices of election to be ...... aN c.RiJiclI.s 0/
Ilecllol 10 be ex.mpt sholl b. subj.ct I. r...cetil. ii, It Iny tim. liter th. Iiling 01 tire _ic. Dr lbe issulnce 01 Ih. c.rtiliclle, the ,.rSllll '-4 II file IDlic. or
ceniliclte I. longer millS Ihe require.HIS .1 lIIis S.Cliol lor issuI.ce 01 a certiflute, TIle "PlrtlllAt shall revoke a cenjficate II oa, 11_ /. Iii... II tire perSllll
na..d on thl! certiliclte 10 meet the reqllir_s II lIIis seclion.
n\.,r_"K'J rCDY'CIf"ATr nc CI crTIn&. Tn DC CVD.o-r or".,....n nn n,..
QUESTIONS? 1851>> 4
From: Dana Davis At The Hagar Group FaxID: 352 726-2363 To City of Zephyrhills
ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 09 DATE (MM/DDIYYYYI
COMPL-2 01/31/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Hagar Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2121 S. E. Hwy 19 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Crystal River FL 34429
Phone: 352-795-2697 Fax: 352-795-0677 INSURERS AFFORDING COVERAGE NAlC#
INSURED INSURER A Scottsd.le t:nsuranc. cOllpany
INSURER B Old Republic Surety
comflete Protection LLC INSURER C
Pos Office Box 757 INSURER 0
Homosassa Springs FL 34447-1277
INSURER E
Date: 1/3112008 03:02 PM Page 1 of 1
COVERAGES
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 CONDITIONS OF SUCH
POLlCII::S AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
LTR NSRC TYPE OF INSURANCE POLICY NUMBER O'AW'(MMIDDNYI DATE (MMJODNY) LIMrrs
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
f--
A ~ COMMERCIAL GENERAL LIABILITY CLS1413485 10/23/07 10/23/08 PREMISES (Ea occurence) $ 50,000
tJ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 1,000
f--
PERSONAL & ADV INJURY $1,000,000
f--
~ Error & OJni.ssions GENERAL AGGREGATE $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS, COMP/OP AGG $ 1,000,000
I] nPRO, n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
1- $
ANY AUTO (Ea acc'denl)
f-
ALL OWNED AlITOS BODIL Y INJURY
1- (Per person) $
~- SCHEDULED AlITOS
HIRED AUTOS BODIL Y INJURY
~- $
NOill-OWNED AUTOS (Per acc'dent)
f--
f-- PROPERTY DAMAGE $
(Per acc'clent)
GARAGE LIABILITY AlITO ONL Y - EA ACCIDENT $
~~ ANY AUTO OTHER THAN EA ACC $
AUTO ONL Y AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
1--, o CLAIMS MADE
I--J OCCUR AGGREGATE $
$
~l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T6'R'v t:r.i,'rtt I IU~~
EMPLOYERS' LIABILITY $
ANY PROPRIETORlPARTNERlEXEClITlVE EL EACH ACCIDENT
OFFICE~'MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $
If yes, describe under EL DISEASE, POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
B STMT OF BONDING OFL05541l0 01/03/07 01/03/17 25,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Alarms & Alarm Systems-Install,service or Repair
CERTIFICATE HOLDER
CITYZEP
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10
DAYS WRITTEN
City of Zephyrhills Bldg. Dept
5335 8th Street
Zephyrhills FL 33542
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, rrs AGENTS OR
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988