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Home My WebLink About08-7582 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7582 Permit Number: 7582 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-QUARTERL Y- SPRINKLER Name: FL HOSPI Address: 7050 GALL BLVD ZEPHYRHILLS, FL. 33542 ~'rJ'lI/O ,\ 3 / ~ 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 813-780-0020 Date Received Owners Name Owners Address City of-Zephyrhills Fire Permit Application ,(f 1b <D 1/ Fax-813-780-0021 s-- I F/(::md, ~f:J .~Ay6hd/~ I Phone Contact for Permit Owners Phone Number II I I /7!f50 &11 13/vd- I I Titleholder Phone Number I II /I Fee Simple Titleholder Name Fee Simple Titleholder Address Job Address Sub Division -----0 D D D D D D D D D D D I Lot# Parcel # ~ Ul:S I AINl::.U r-KUM /"'KU/"'t:K I I I FV- NU Ilvt:) El FUllligdtiUII T ..Ill D Hazardous Material (Tier" or RQ Facility) ANNUAL D Hood Installation D LP/Natural Gas-Installation D LP/Natural Gas-ANNUAL Sale D Places of Assembly-ANNUAL D ReaeationalBum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage ANNUAL ... l:Slo-Hazartl "vaste Storage - ANNUAL Comm Exhaust Kitchen HoodlDuct Controlled Bum . Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ~ Sprinkler [l2( Fire Alarm D Hood Clean/Suppression D Fire Alarm Installation Yr Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks ., Valuation of Project Other: Contractor Signature Address I ELECTRICIAN Signature I Address I PLUMBER Signature Address I MECHANICAL!. Signature . I Address I OTHER Signature Address I Directions: Company J Registered I!t. "7.~ f2I... ., ""q Ucense # I I Company I Registered I License # I I Company I Registered I License # I I Company I Registered I Ucense # I I Company ! Registered I Ucense # L'S, fTl'((J I~ 6-t-. ne If Y / N r Fee Current Y I N Y I N I Fee Current . Y/N Y/N I Fee Current I Y/N Y/N I Fee Current I Y/N Y/N I Fee Current I Y/N I -~~ l All out application completely. OWhet&ConttacrotsigiioaClc Of applicatioh~notariZea{Ot ,C6py~ofsignea oohtract:Witll 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 maybe subject to ~deed" restrictions" -which may be. more restrictive.than County regulations. The undersigned .assumesresponsibilityior compUance with any applicable deed restrictions. . . .. . . UNLICENSED CONTRACTORS ANDCONTRAC"f.OR 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.LtE'tfLAW (Chapter713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more;. I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than. the "owner", I.certlfy that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to .commencement. - CONTRACTOR'S/OWNER'5 AFFIDAVIT: I certify that all the information in this application is accurate and . .. _ "that. all.work .will. be 'Clone in- ceml3liance.with..aU..applicable.-laws .reg\:JlatiRg.-construotion,-~,zoAiF1g..and..laAd- .-.. ___.u development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating .construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to. i~entify what actions I must.take to be in compliance. If lam the AGENT FOR THE OWNeR, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior .~o conu:nelncing construction. I understand that a separate permit may .be required for. electrical work, plumbing. Signs; wells. ..pools. air Conditioning. gas. or other installations not specillcally includad In tha application. A ~U;s$u.,ds\ialI1!!> coii!;troed to be a .licenSB to proceed with the work and not as authority III violate. cancel. alter, or setaside aoiprovlsions of the technical codes, nor shall issuance of a permit prevent the Building Official from tnereafter . requiflAg.a<Xll1'Bction of errors In~. construction or violations of any codes. EVllIY permll Issued shall become invalid . .inliiSSi\:iil;iioii<'outhorized.by such pannUs commenced Wllhln six months of pennll.issuance. or 11 work authorized by . .fliii:peffliiI:lS.u~ed or aban<Joned lor a period of six (6) months aIler tha time the work is commenced. An extension ..Ra0ie ieqgested. In writing. from tha Building OfIicIa\.lor a ",,"od not to exceed ni~ (90) <l~ andwtl1 demonstrate . ~ cause lor \lie extension. llwork ceases lor ninety (90) consecutiVe days. tha Job IS COnsIdered abandoned. . ..... ...." ._.'. ................._06_... . . ..,~. ._._. .___...~. _._ .0. ...._..-..-~----..-_....._-_..-..-..-...-...........- CONTRACTOR Subscribed and swo . by Who islare personally knoWn to me or haslhave produced as Identlfication. . Notary pubRe Notary PubRe Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed. printed Dr stamped 03042008 NUMeER PERMIT030408#4 056313 DISCOUNT AMOUNT DETACH BEFORE DEPOSITING 0.00 25.00 0.00 25.00 No. 3012832 // .' --I 1~q,,- ~-- Technician Work Report Date of Work: Not Scheduled District : 292 Technician Miguel A Rivera Task Number Scheduled Start Service Request Service Request Customer Acct Customer Name Site Name Owner Christopher R Brackett 13221737 In Planning Time Type Number 614030 Florida Hospital Inspection-Auto Gen 9108524 Payment Terms: Immediate Zephyrhills Contact Name Gwen Compton Phone 813-783-6189 Site Address City State 7050 Gall Blvd, Zephyrhills FL Zip 33541-1399 BillTo Name BillTo Address: City State Florida Hospital Zephyrhills 7050 Gall Blvd, Zephyrhills FL Zip 33541-1399 Contract Number: 708277 Inspections: Dec 2006, Mar 2007, Jun 2007, Sep 2007, Dec 2007, Mar 2008, Jun 2008, Sep 2008, Dec 2008, Mar 2009, Jun 2009, Sep 2009, Dec 2009, Mar 201 Service Plan: SP-TEST/INSP Medium Current Inspection: Mar 2008 Task Type Task Name 1 Person Inspection SP-Mar 2008 Priority : Problem System Inspection SYSTEM-SP-WET SPRINKLER Wet Sprinkler System Mar 2008 Created BY AutoGen Serial: Summary Notes CONTRACT COVERAGE ***** SPRINKLER IN ADDITION ***** INSPECTION OF ONE MORE RISER (AND THE TAMPERS AND FLOWS) IN THE ADDITION, WHICH WAS DONE TO THE HOSPITAL IN 2006. 100% INSPECTION IS DUE IN DECEMBER, AND QUARTERLY INSPECTIONS ARE DONE IN MARCH, JUNE AND SEPTEMBER. LEGACY CUSTOMER NUMBER - 19283985 INSPECTION GENERAL SERVICE PANEL COVERAGE ON FIRE ALARM SYSTEM, MONDAY THROUGH FRIDAY, 8AM TO 5PM. COVERS LABOR TO TROUBLESHOOT AND REPAIR SYSTEM AS WELL AS ALL PANEL PARTS. PERIPHERALS ARE BILLABLE. ~ District : 292 Technician Work Report Miguel A Rivera 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 Date of Work: Not Scheduled Technician Owner Christopher R Brackett 13246647 In Planning Time Type Number 614030 Florida Hospital Inspection-Auto Gen 9137818 Payment Terms: Immediate Zephyrhills Gwen Compton Phone 813-783-6189 7050 Gall Blvd, Zephyrhills FL Zip 33541-1399 Florida Hospital Zephyrhills 7050 Gall Blvd, Zephyrhills FL Zip 33541-1399 Contract Number: 155825 Inspections: Dec 2007, Mar 2008, Jun 2008, Sep 2008 Service Plan: SP-TEST/INSP Task Type Task Name Problem System Summary Notes 1 Person Inspection SP-Mar 2008 Priority Medium Current Inspection: Mar 2008 Inspection SYSTEM-SP-WET SPRINKLER Wet Sprinkler System Mar 2008 Created BY AutoGen Serial: LEGACY ACCOUNT NUMBER LEGACY CUSTOMER NUMBER - 19283985 INSPECTION GENERAL SERVICE PANEL COVERAGE ON FIRE ALARM SYSTEM, MONDAY THROUGH FRIDAY, 8AM TO 5PM. COVERS LABOR TO TROUBLESHOOT AND REPAIR SYSTEM AS WELL AS ALL PANEL PARTS. PERIPHERALS ARE BILLABLE. (f)