The URL can be used to link to this page

Home My WebLink About08-7580 . I CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7580 Permit Number: 7580 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: MEDICAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 7050 GALL BLVD ZEPHYRHILLS. FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 35-25-21-0010-10500-0000 25.00 25.00 3/06/2008 Phone: FPM-FLORIDA HOSPITAL-FIRE ALARM -ANNUAL Name: FL HOSPITAL OF ZEPHYRHILLS Address: 7050 GALL BLVD ZEPHYRHILLS, FL. 33542 'J C6 ~ 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. II -... 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 DETACH BEFORE DEPOSITING No. 3012834 -:;.~ INVOlCE DISCOUNT AMOUNT >OA.TE NUMBER 03042008 PERMIT030408#6 0 00 25 . 00 I 1 t)~U 056313 0 . 00 25 .00 813-780-0020 Date Received OWner's Name OWner's Address -5" ~~ FICK(Cj~ tJo...7p. ~^, ~h.--lt~ City of.Zephyrhills Fire Permit Application ~169o Fax-813-780-0021 Phone Contact for Permit OWner's Phone Number II Fee Simple Titleholder Name II I ! 17D5O b11 J3/. I Fee Simple Titleholder Address Job Address Sub Division -0 D D D D D D D D D D D I Titleholder Phone Number I II tllo-Mazard \lvaSte Storage - ANNltAL Comm Exhaust Kitchen HoodlDuct Controlled Bum . Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance ~U~ Sprinkler D Fire Alarm 0 Hood Clean/Suppression D Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Other: Contractor Company I Signature Registered Address I Lf7t:)( CX&k PtMr I!(,~ -r~ ~ "1'J~ License # I ELECTRICIAN I Company I Signature I Registered Address I I License # I PLUMBER I I Company I Signature Registered Address I I License # I MECHANIC4 I Company I Signature Registered Address I I License # I OTHER I Company I Signature Registered Address I I License # Directions: Lot # Parcel # I (Utl. AINt:U r-~UIVl t"~Ut"t:~. r I "'^ I~U 11\..t:) EI l"umiycdiulI T .:II! 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 D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage ANNUAL -lI:5m I . f Valuation of Project t5Jm-rtI~ 6-t-.ne<eJf Y IN r Fee Current Y I N Y/N Fee Current Y/N Y/N I Fee Current I Y/N I I Y/N I Fee Current I Y/N I I Y/N I Fee Current I Y/N I _... I All out application completely. OWhef'& .ContractbFsigrfl)aCk-of apPlicafi6i1;notaJiZed{Ot,-cop~njfsignecr roiltractWitl1 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. - -_...._.__....---_.._-"..._..~_.._.._..__..---- .--..... .-.... ..NOT1CE.ClFDiiED.RESTRlCTlONS: The undersigned understands fuat fuis permtt ml!}'be subject to 'deed" restrictions' -which may be. more restrictive than County regulations. The undersigned . assumes responsibility for compliance With any applicable deed restricticms. . . . UNLICENSED CONTRACTORS AND .CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contraetors. to undertake ""rk, they may be required to be Iieensed in accamanee with s_ and local regillallons. Ii the contractor IS not licensed as required by law, both the owner and contractor may be.cite.dfor 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 Pasc~ .County Building Inspection Division-Licensing Section at 727-847- SOD9. 'FurthermOre. Ii the owner has hired a contractor 0' contractors. he Is advised to have the contractor(s) sign portions. of !he 'contractor Block" of this appllcallon for which they will be responsible. .Ii 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. CONSTRUCTIONLlEN'LAW (Chapter713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more" I certify thall. !he applican~ have been provided with a copy of the 'Ronda Construction Lien Law--Homeowne~s Protection Guide' prepared by the Florida Department of Agriculture and Consumer Allairs. Ii the applicant Is someone other than' the 'owner". I.certlfy thall have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to .commencement. - CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and . ... ethal' all.work -will. be <lone in' compliance.with..all--applicable..laws .regulating..oonstruction,..'.zoniRg.: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 perform~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 thal ft Is my responsibility to. idenllly what aellons I must-take to be in compliance. . . Ii I am the AGENT rOil. THE OWNER. I promise in good faith to inform the owner of the permitting conditions set torlh in this affIdavit Prior 10. coin..enc;ng construction. I understand that a separate permtt may .be requlred for. electrical work. plumbing. sIgns; wells. .1>Dols. air Conditioning. gas. or other Installalions not specl1lcally included In the ""plication. A ~llis~il""StialJ.-be coilstrued to be a license to proceed.wIth the ""rt< and not as authorIty to vio_. cancel. alter. or Set..9sIdii ami PJi>V1sions of the technical codes. nor shall issuance of a permft prevent the Buldlng OfliOlalfrom thereafter . requlriJig.a """"clion of errors in p~. construclion or violations of any codes. EvelY permtt Jssued shall become Invalid . uIJ!;;$S'Iti8:ii<oiK'aulJ1orized--by suchpermft is commenced within six month!; of permit issuance. or ff wort< aulhorlzed by .lfiii:peiiTil!;;S~rided or abandoned for a period of six (6) months after the time the wort< Is commenced. An extension _1Oe iequested. in .wrlling. from the Building ()fficIa1.for a I""iod not to exceed nin~ (90).days andwm demonstrate . ~e cause fOr the extension. Ii wort< ceases for ninety (90) consecutlve days. the job Is considered abandoned. . ..... -.. ~. .-.... .. ..-. . . ... _...- ..-.~ ... '.. .--.... ,."--'''.' ..... .-- .----....-..--..--..--........--....-..--.-.......--- CONTRACTOR Subsaibed and SWO . by Who islare personally known to me or haSlhave produced as Identification. Notary PubUc Notary Public .Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped Technician Work Report Date of Work: Not Scheduled District : 292 Technician Owner Christopher R Brackett 13221332 Task Number Scheduled Start Service Request Service Request Customer Acct Customer Name Site Name Contact Name Site Address City State In Planning Time Type Number 614030 Florida Hospital Zephyrhills Payment Terms: Immediate Inspection-Auto Gen 9107712 Gwen Compton Phone 813-783-6189 7050 Gall Blvd, Zephyrhills FL Zip 33541-1399 BillTo Name BillTo Address: City State Florida Hospital Zephyrhills 7050 Gall Blvd, Zephyrhills FL 33541-1399 Zip Contract Number: 704167 Inspections: Mar 2007, Sep 2007, Mar 2008, Sep 2008, Mar 2009, Sep 2009, Mar 2010, Sep 2010, Mar 2011, Sep 2011 Task Type Task: Name Problem System Summary Notes Service Plan: FA-TEST/INSP 2 Person Inspection FA-Mar 2008 Medium Current Inspection: Mar 2008 Priority : Inspection SYSTEM-FA-GENERIC PANEL Other Panel Fire Alarm System Mar 2008 Created BY AutoGen Serial: CONTRACT COVERAGE PANEL COVERAGE, MONDAY THROUGH FRIDAY, BAM TO 5PM. THIS COVERS THE LABOR TO TROUBLESHOOT AND REPAIR NORMAL SYSTEM PROBLEMS AS WELL AS ANY PANEL PARTS NEED FOR THE REPAIR. DOES NOT COVER PERIPHERAL DEVICES. DOES NOT COVER VANDALISM, LIGHTNING OR WATER DAMAGE, FAULTY WIRING OR ACTS OF GOD. *** NOTE: AFTER- HOURS CALLS TO BE BILLED AT NORMAL DAYTIME RATES. *** ***** TWO 50% INSPECTIONS PER YEAR ***** SEMI-ANNUAL INSPECTION OF THE FIRE ALARM SYSTEM, IN MARCH AND SEPTEMBER. CLEANING AND SENSITIVITY TESTING TO BE DONE AT THE RATE OF 100% EVERY OTHER YEAR (ODD YEARS). LEGACY COSTOMER NOMBER - 19283985 GENERAL SERVICE PANEL COVERAGE ON FIRE ALARM SYSTEM, MONDAY THROUGH FRIDAY, SAM TO 5PM. COVERS LABOR TO TROUBLESHOOT AND REPAIR SYSTEM AS WELL AS ALL PANEL PARTS. PERIPHERALS ARE BILLABLE. '6