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Home My WebLink About08-7514 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7514 Permit Number: 7514 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 Oesc: Address: 38250 A AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 14-26-21-0010-01300-0010 2/18/2008 25.00 25.00 2/18/2008 FIRE PROTECTION MAINT- ANNUAL Name: ZEPHYR HAVEN NURSING HOME Address: 38250 A AVE ZEPHYRHILLS, FL. 33542 Phone: Jo4v . CY'~V~r Of! 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 INSPECTlON CALL FOR INSPECTlON - 8 HOUR NOnCE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 I 813-780-0020 Date Received Owner's Name Owner's Address City of.Zephyrhills Fire Permit Application Phone Contact for Permit -/~~ ,;l~ I Z<p~" j/<--- (7~~ ~ Owner's Phone Number Fee Simple Titleholder Name I Titleholder Phone Number I I I 1~38djL)A-~ 1J I lIRJi Fee Simple Titleholder Address Job Address Sub Division u_ --0 D D D D D c D D D D D D Parcel # Ijlo-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw :::~e"o" Ma;"~~"7~~UV Fire Alarm .. .:::~<---~ Hood Clean/Suppression D Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fax-813-780-0021 ~~ II II II II I Lot# \Vl) I AII'\ICU rt'(VIVI t"'t'(Vt"'Ct'( 1 Y I",^ I'\IV 11\.,,1;;) EI l"ullliYi:diull Telll o 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 RecreationalBum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage ANNUAL Fuel Tanks Other: Contractor Company Signature Registered Address License # ELECTRICIAN Company Signature I Registered Address I License # PLUMBER Company Signature Registered Address I License # MECHANIC' Company Signature . Registered Address I License # OTHER Company Signature Registered Address I License # Directions: ..",;",A""",..,,'. .,=""'~== ~i Valuation of Project :S~Jr'afk;1e r ~.9f"'oe./ Y I N Fee Current Y I N Y I N I Fee Current Y/N Y/N I Fee Current Y IN I I I I I J Fee Current Y/N Y/N I 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. ----~..._--~..__...._...._..~_... - "-..--. .-- .- .NOT,ICE.OF:.DEED.RESTRICTIONS: The undersigned understands :that this permit m~ybe subject to ~deed" restrictiens" .which may he more restrictive.than County regulations. The undersigned assumes respensibilityfor compUance with any applicable deed restrictions. . . . UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILmES: If the owner has hired a contracter or contracters. 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, beth the owner and centractor may be ,cited for a.misdemeanor violatien under state law. If the owner or intende~ contracter are uncertain as to .what licensing 'requirements may apply for the intended werk,they are advised to contact the Pasco -County Building Inspectien Division-Licensing Sectien at 727-847- 8009. . Furthermore, if the owner has hired a contractor or centractors, he is advised to have the centracter(s) sign portions.ef the "contractor Block" of this application for which they will be responsible. If you, as.the ewner sign as the contractor, that may be anindicatien that he is not properly licensed. and is not entitled to permitting privileges in Pasco. County. CONSTRUCTIONLlEN'LAW (Chapter713, Florida Statutes, as amended): Ifvaluatian efwerk is $2,500.00 er mere;" certify that I, the applicant, have been previded with a cepy of the "F1eridaCenstructien Lien Law-Hameewner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs, If the applicant is someone other than-the "owner", I.certify that I have obtained a copy of the above described document and promise in goed faith to deliver It to the "owner" prior to. .commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and -;that.. all.work . will be '<ione in. compliance. with.. aJl..applicable.,laws .regulatiRg.-oonstruction;...zoning..and..land.....---... development. Application is hereby made to obtain a permit to do werk and installation as indicated. I certify that no work or installation has commenced prior to. issuance of a permit and that all work will be performed to. meet standards ef all laws regulating .constructian, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify .that I understand that the regulatiens ef ether government agencies may apply to the intended work, and that it is my responsibility to. identify what actions I must'take to be in cempliance, . If lam the AGENT fO~ THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior -to coiill:nenciilg construction. I understand that a separate permit may be required for. electrical work, plumbing, signs; wells,llools, air Conditioning, gas, or other installations not specifically. included in the application. A ~rmit:is$Ued .shall:b~ construed to be a 'license to proceed with the work and not as authority to violate, cancel, alter, or setasidei any' provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter . requirirng.a.oorrection of errors in pl~ns, construction or violations of any codes. Every permit issued shall become invalid . .unleSS.itiE6vork'authqrized"by such permit is commenced Within six menths of permit issuance, or if work authorized by . tli(;:peOiiH.'is~u$.pi:lrided or abandoned fer a period of six (6) months after the time the work is commenced. An extension ma'y:7~reqtlested, tn .writing, from the Building Official.for a period not t~ exceed ninety (90) days and will demonstrate . j~~~h~ c~i.lse 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 PAYINGTW!CEfOR IMPRo~NiENTS -.:~ Y~~R:..r~gp.E:~1):':.I~,l,~l!!~HP..xg,g. J ....I"'Af'4CJNG.. CONSULT WI+t.I ~.ouR.L-EN.D6R"'(!)R,AN ' '1sE!J;mllE-R~.Y.OtlK!m5i. NCEMENT. i.~:{~~~-:" ;J1:f1105..".... ". ' " . ..... -" - ..... .....................- N .._.,._...~' "f.....,..:......_......,.. ....-,. . ...... ..... .OWNER OR AGENT Subscribed and sworn to or affi re me this . by Who isJare personally known to me or haslhave produced . as Identification. Notary pubnc Notary Public Commission No. .Commission No. Name of Notary typed, printed or stamped Name of Notary typed. printed or stamped Date of Work: Not Scheduled District : 292 Technician Work Report Technician Francis Lewis Mckinney Task Number scheduled start Service Request Service Request Customer Acct CUstomer Name Site Name Contact Name Site Address city State BillTo Name BillTo Address: City State Owner Christopher R Brackett 1.2497230 In Planning Time Type Number 21390 Zephyr Inspection-Auto Gen 8667294 Payment Terms: Immediate Haven Nursing Home Neal Frasier Phone 813-7825508 38250 A Ave, zephyr hills FL Zip 33541-5759 Zephyr Haven Nursing Home 38250 A Ave, Zephyrhills FL Zip 33541-5759 Contract Number: 139398 Inspections: Jul 2007, Jan 2008 Task Type Task Name Problem System Summary Notes Service Plan: FA-FULL 2 Person Inspection FA-Jan 2008 Priority Medium Current Inspection: Jan 2008 Inspection SYSTEM-FA-SIMPLEX 4002 simplex 4002 System Jan 2008 Created BY AutoGen serial: LEGACY CUSTOMER NUMBER - 01142858 INSPECTION INSPECTION - 1-100% Inspection In January, Smoke Detector Cleaning As Needed, Ahca Inspection In July 100% Sensitivity Testing Required Every Even Year GENERAL SERVICE SERVICE - Inspection Comments - KITCHEN PART - 360d FUSIBLE LINKS -- Quantity: 2 -- Interval: Semi-Annually do not charge service call, $85 plus parts 125.00 a hood cleaning no service call