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Home My WebLink About08-7212 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7212 11/19/2007 25.00 25.00 11/19/2007 FPM-FIRE ALARM - SEMI ANNUAL Address: 5923 7 T ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: Permit Number: 7212 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Name: JOHNSON, DAVID/DEBRA Address: 3225 S. MACDILL AVE #129-258 TAMPA, FL 33629 Phone: t losJ l"t\~fie. % (l -vi '7/0b rr k.'D l~tO ~ l \ ~~~ k %.r 'Ab+ t\leecl -b t--\(\*c{,~~~ l)j( ~ -l\.J. 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." ~~ CONTRACTOR SIGNATURE 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 813-780-0020 Date Received Owner's Name Owner's Address Fax-813-780-0021 City of.Zephyrhills Fire Permit Application Phone Contact for Permit Fee Simple Titleholder Name !J~.u-,g I I ~~~'f':;:;3'-;~..Br., · .",fL :33'> ~..---- ~ i-~ S,bDivi,ion ~~ I \U.'A':U'K~~" ',,^"u"~e) ~~, :;:Ml\IV.l~*~1W,,!?J~ ilW5 lVJl N 1m -k-....~Iim~ia!~r-=m-- IT" ,,~~~~ Fee Simple Titleholder Address D D D D D E8J !!iIt.1!Il,*_ Contractor Signature Add~" : rlf{.( ELECTRICIAN Signature Address I PLUMBER Signature Address I MECHAN I CALI Signature . Address I OTHER Signature ~. ill Addre~L"..... Directions: ~~r er's Phone Number I PL I II II ~ ..>$" 7A- W) a ~3te~ II II I Titleholder Phone Number Bio-Hazard Waste Storage - ANNUAL o o o o o o o o o o o o Fumigation Tent Hazardous Material (Tier II or RQ Facility) ANNUAL Hood Installation LP/Natural Gas-Installation LP/Natural Gas-ANNUAL Sale Places of Assembly-ANNUAL Recreational Bum Sparklers Sprinkler System Installations Standpipes (Sprinkler Sys) Torch Roofing Waste Tire Storage ANNUAL Valuation of Project 'i:l<' 'lI'T W"'i~~~ r ~~~ Company I Registered License # I Company I Registered License # I Company I Registered License # I Company I Registered License # I Company I Registered License # . ",L Y I N I Fee Current .l:::.7-00t::>/1./l. :3 Y/N D Fire Alarm Installation D Fire Pumps D Fire Works D Flammable Application- ANNUAL D Fuel Tanks D Other: I ~_~~~nh ~ I~~I W'W~ a.,.~ ~~J FL .$i~}J Comm Exhaust Kitchen Hood/Duct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL Sprinkler Fire Alarm ~ D Hood Clean/Suppression ,<;~=''''"",;Jw;';';,;;'''':''_;;;&;;';..;i:O:.ij"~-_'x;.:..:i';;'k''.''~''''" ""'""'=~=-'''',",'''-''''''''''' '" ..~..__. ~.".".,"...~,..l Y/N Y I N Fee Current Y/N Y I N Fee Current Y I N I Fee Current Y/N Y I N I Fee Current Y/N 'h-"..',., ~-:~f f'lki-"-t!lf-'\'l';"";.n~ I '--~"~"':V"W~~~*",~"""="""^"'~~ 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 documentatiofl Allow 10-14 days for review after submittal date. \ ---,...~-~...-..__#.._....-~..-_....._.~..._....- ..-........-.. .-~ .- . NOT,ICE.OFDEED.-RESTRICTIONS: The undersigned understands that this permit maybe 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;" 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", Lcertify 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 AFFIOA VIT: I certify that all the information in this application is accurate and ., ,.." ".. ..that. all. work ,will be 1:Ione in. compliance. with.. all-applicable.-Iaws ,regulatiRg.-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 performE!d 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 pE!rmitting conditions set forth in this affidavit prior.tocommElncing construction. I understand that a separate permit may be required for. electrical work, plumbing, signs; wells,l>ools, air conditioning, gas, or other installations not specifically included in the application. A permit":i~sued .s:haU:be construed to be a 'license to proceed with the work and not as authority to violate, cancel, alter, or setaside' any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter . requil'hlg.a.correction of errors in ph:~ns, construction or violations of any codes. Every permit issued shall become invalid . ,unle~s"1he:~cirk'authorized 'by such permit is commenced within six months of permit issuance, or if work authorized by tlie.perrmt..is"sU~'p~ridE!d or abandoned for a period of six (6) months after the time the work is commenced. An extension ma)rpe requested, -in writing, from the Building Official ,for a period not to exceed ninety (90) days and will demonstrate , j#~,~le c~use 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 IMPROVENiENT~ ~9 Y~LJ~..r.~9,~~!X':"","I~"yqfultfrl;t.<lp.19,q~J~lf'.I-~INAt<lC.ING, CONSULT ,. Wl+hI :y.:(j),UR:4L.ENDSR.,.(!)R,.A.l-A:r;:rfJRN.~iB6J;0RE~REOORD1NG'YCfCJR'm5TICE OF COMMENCEMENT. i='~~:~::~Z~-'~--'--------coNiRACTORl!~''':~' .. ....,..".,...... Sub~cribed and swom to {or aftinned) before m. e this Sub~cribed ~nd swor,!} to (or affirmed) before me this. , ' It h "'/0, by Lv\o..( \~--"" ~ _l-ttJU,-\d LlI~ -illt.... (0 J by (~....~. V. J'o. C;; < ~..-l.u u. ~ Who is/are personally known to me or has/have produ W~Jare personally known to me or haslh~ve produ~d V:-L ""() 12~...'2.. \J.. C as identification. 'r-L. ."b Q ~ L-l ~ as Identification. ~ b -'" <\-----r-Y\!1. U--'- Notary Public ~~"""" ~~i~' Notary Public Commission No. .Commission No. ~~~I Name of N . tl- er if: '~"\~' ommlssion 00609664 ~~~~ Expires October 29,2010 ')i?',j'l\"'" Bondod T~ F"" "_I!'".' II,. eao-aI-701e Name of Notary typed, Page 1 of 1 Jacqueline Boges From: Kerry Barnett Sent: Tuesday, February 26, 2008 4:39 PM To: Jacqueline Boges Subject: pERMIT Jackie, Permit # 7212 for Pasco Surgery Center on a fire alarm maintenance, I guess you can pull that and close it out in . the permit account. The property is for sale and I am not going to make them maintain the alarm because there is no sprinkler system there. Kerry 2/27/2008 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL ASSEMBLY PERMIT r- 69 Permit Number: 7215 Permit Type: FIRE PLACE OF ASSEMBLY Class of Work: FIRE-PLACES OF ASSEMBLY Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 37839 SR 54 WES ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 10-26-21-0100-12600-0030 11/19/2007 50.00 50.00 11/19/2007 Phon : PLACES OF ASSEMBLY-CLUBHOUSE_ Name: GOSS, JAMES Address: 37839 54 WEST ZEPHYRHILLS, FL. 33542 CJ~b OCCUPANCY LOAD: Occupancy by more than the number of persons above shall be considered dangerous and u awful. Occupant load determined by Florida Fire Prevention Code NFPA10l, Section 7.3.1.2 FIRE MARSHAL OFFICE: 813-780-0041 ~ OWNER NATURE ,. -. Ie R ER IT EXPIRES IN ONE (1) YEAR FROM DATE OF ISSUANCE THIS PER IT NE DS TO BE POSTED IN VISIBLE LOCATION IN MAIN ASSEMBLY AREA \ Z,E HYRHILLS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FL 33542 81" 780-0020 City otZephyrhills Fire Permit Application MO'''''''' .." __ P~~~~~c~l:,::~!....J,Lf: ~~ .LLZlZJ...l~~~" I G:\lLvr{w' c\ L-~f~~\"'\\~ L'fV',\-eA Owner's Phone Number I q,) ILS~Y I J 1531 h \) c-, \ d. N, 5 b l, s \- \~ ~p\.t "\ ~ H N..'"- J f" L 33 (0 , J I L".\4\i It"\! 0\ t~r""f"~ ,\\S' L~f'/'~,} I Titleholder Phone Number I q \ 3 114~ 4 Ius :3 ') I _D;te Re~:,'~~_t__,"~.,,,..__._,~,,,_L._ Owner's Name Owner's Address Fee Simple Titleholder Name S~'i'i'-t.. j,'." ,~-)~ .-- ~RI flA"rIrm'llllI!'III1Iffr"_ Fee Simple Titleholder Address Job Address Sub Division ':II D D D D D D o o D o D D _"II' Contractor Signature Address I ELECTRICIAN Signature I Addres~; I I PLUMBER Signature Address I MECHANICALI Signature Address I .u _ I 31 <619 S R S l1 (~(7\\~y ~:\ \5 /k)CLl J/t:-Ct.J ()J2<:PHYLI1/fr.LII;4 Parcel # , / o Fumigation Tent o Hazardous Material (Tier II or RQ Facility) ANNUAL o Hood Installation D LP/Natural Gas-Installation o LP/Natural Gas-ANNUAL Sale [S!;J Places of Assembly-ANNUAL o Recreational Bum o Sparklers o Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage ANNUAL J Valuation of Project r F':l" IF 1- lli1lMllilil Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum . Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL Sprinkler D Fire Alarm D Hood Clean/Suppression D Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks I' 1'''" IT 'F"iI'i'iMil''' ft1~1 -5 Fax-813-780-0021 +L I ~354l I Lot# ~ I ~:I~II~t:~~lu:1 ~~2}t:9Il~IL~~g~t:~'()030 ~~....y~rzv17 d~~ ~, ~fl ~, ,r I'ij~ "1W"'...4.- lk~_T ~1I![7':f>qW - 1 =_ Other: Y IN I I Y I N I Fee Current I Y I N I I Y I N I I Y / N I Fee Current I Y / N I I Y / N I Fee Current I Y I N I """.~~.~~""'_,"'h'@"',."".", '"'.'''''_k_,~"",L_~:::~.# -l~"~..__,..-",,,._.....~ I I I I I I I I I Company I Registered I I I I I I I I License # Company Registered License # Company Registered License # Company Registered License # Y/N Fee Current Y/N I Fee Current OTHER Signature ._"""<1 A~dress J Directions: "'l....ti".''''".;;.;-,..''';:,;,;,;.,;;,..:'.. '",,-,' "'''''"''''''';(,^' ~''ilQ"~' Fill out application compietely. 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. Company Registered ----_.._~..__..__.~_.------~_....._~~.....,,~..-- ..--.......-...-. . ~ .NOTrIGE.QF.'.DEED..RESTRICTIONS: The undersigned understands that this permit m~yb.e subject 10 ~deed" restrictions" .which may be. more r-estrictive .than County regulations. The 1:Indersigned assumesresponslbility'for compliance with any applicable d.eed restrictions. . '. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors. to und.ertake 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- 800~. 'Further~ore,if the own;r has. hired.a ~ontractor .or contra~tors, he is advised to have the contractor(s) sign portions .of the contractor Block of this 'appllcatlon for which they will be responsible. If y.ou, 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;" certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" pr-epar-ed 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 .regulatiAg.-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 performEld to meet standards of all laws regulating .construction, County and City codes, zoning regulations, and land developmElnt 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. i~entify what actions I musi'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 affi_davit prior .to coriu;nencing construction. I understand that a separate permit may be required for, electrical work, plumbing, signs; wells, ,-pools, air conditioning, gas, or other installations not l?pecificaHy included in the application. A Permit-issued _stiall:be construed to be a 'license to proceed with the work and not as authority to violate, cancel, alter, or setJaside! anyproVisions of the technical codes, nor shall issuance of a permit prevent the Building .Official from thereafter 'requiririlg.a:.correction of errors in plClns, construction or violations of any codes. Every permit issued shall become invalid . ,unless:'ilie:~ork;auth()rized'by such permit is commenced within six months of permit issuance, or if work authorized by tlie;:pebiilt.~js"su$.perided or abandoned for a period of six (6) mo~ths after the time th~ work is commenced: An extension may:'pe requested, tn writing, from the Building Officia! ,for a penod not t~ exceed mn~ty ~90)da~s and will demonstrate , j#~l!ble ca.i.Jse for the extension. If work ceases for mnety (90) consecutIve days, the Job IS conSidered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL.T IN YOUR PAYING TWICE FOR IMPROVENiENT~ ~() Y~~~"r~ge.E~!X~,..!.~.mYlt'<l:r5t'!P..;1;J? .9~J~lf'I.;~lt'<IA"'C.ING, CONSULT wr+H ~..QllU(4LENDSR"'(!)R-A ..A+rORN~IBEf;0RE-:RBOtmDIN'G.Y.OUR!YJOTICE OF COMMENCEMENT. ! ;;:::~j:_RmJtitm!l~;!!1~7t(3) I! .:".. .' , .. ...,.:.::";~.~:.:.,.I.~,.:.._..,,....:.... ". _............... ". .;,....... _........m.............--........--.-..--.--............-..............-......-... "...........".......... - --. ..,,-,,_.. ,OWNER D.R AGENT .../ . ~ CONTRACTOR S s d ..i\nd swo r a~e ) be~ me this Subscribed and sworn to (or affirmed) before me this ~/~ ~ O~ ~ o is/are 0 known to me or has/have produced Who is/are personally known to me or has/have produced as identification. as identification. I!'" LUTHER MOORE ~.. MY COMMISSION # DD394556 ~/ EXPIRES: 0A.20Q9.'JhI Notary Public "'''' _ - JXstE'etr. -Commission No. Name of Notary typed, printed or stamped -o,.",...,..,___,.~___.~".,..___.___""....,.