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Home My WebLink About08-7685 CITY OF ZEPHYRHILLS 5335 - 8TH STREIT (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE /7685 Permit Number: 7685 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: Address: 6937 MEDICAL VIEW LN ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 02-26-21-0290-00000-0060 3/28/2008 50.00 50.00 3/28/2008 Phone: FPM-ANNUAL -FIRE ALARM/SPRINKLER-DAUGHTERY RD -DONE WEDNESDAY Name: RYMAN, KEVIN Address: 6937 MEDICAL VIEW LN ZEPHYRHILLS, FL. 33542 ~ ifo ct" Q;, 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 NOnCE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 813-780-0020 Date Re"eived Owner's Name Owner's Address City of Zephyrhills Fir-e Permit Application Phone Contact for Permit I ~~~~h~~ /t:j::~;:I(t~ I ~,Phad_' I I Titleholder Phone Number I I Fee Simpie Titleholder Name Fee Simple Titleholder Address Job Address 1S~~'fflj;~m I Lot# II Sub Division D D D D D D PLUMBER Signature Address I MECHANICAL! Signature Address I OTHER Signature Address Directions: 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 ~ 0 0 lA L-J Fire Alarm 0 0 0 0 C:=J Ooooc=J Ooooc=J Hood Cleaning Hood Suppression Fire Pumps Fire Works Flammable Application- ANNUAL o o o o o o D D D D o o Parcel # 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/Tar Kettle Waste Tire Storage ANNUAL [lJ-ef'XJte ~ ~. Valuation of Project Company Registered License # Company Registered License # Company Registered License # Company Registered License # Company Registered License # ~, 1 JltWl~ IJ J I IQN I I Y/N I I Y/N I I Y/N I I Y/N Y/N Fee Current ~ ~~:~~~~".~~oo D Other: I ~~~::::r i~~ . ! Address 135"3/ KE.lls-fon~ /l.rJ 7 Art.lon VJtJ~,j FL I ELECTRICIAN Signature ~~I I I I I I I Y/N Fee Current Y/N Fee Current Y/N Fee Current Y/N Fee Current 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. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov,com) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may.besubjectto-"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:acontractor 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 (Chapter 713, Florida Statutes,asamended): 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 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 regulating 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 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 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 permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause 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 IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117 03 ( # ('" /L1 . ( OWNER OR AGENT /s.e CONTRACTOR~/& &~~ Subscribed ans! sworn or affirmed) before e this z.. Subscribed and sworn to ~r affirmed) Qefore .me t!js " ~/J_,...Ch :2e1P~Y c;;7bt!.~-r' ~ ~ V'; Arch 201) j- by ...eo he-," r- L ~< v' .j /1' 'Who is/are persona Iy known to me or has/have produced Who is/are personally known to me or has/have produced as identification. as identification. Notary Public Notary Public Commission No. l) iJ (p "3 <79/ J ~ ~ b.-c.-'-+;, 'Ue ~ ..So j .) ame of Notary typed, printed or stamped Commission No. 0 1J ~ '3 e:7 7'1"" C> E "Z~b c... --n-.O<. J~~..J 0 Name of Notary typed, printed or stamped o..,.".~. PII..<f.,. Notary Public State of Florida : . Elizabeth De Jesus ~1- - i My Commission 00639910 o~~~,~~E.elres 02/13/2011 ~""':':"",,;",~- ~p ~ ~, . , ~ c: ,,~,f ",0} Or: .,..,.eq$. ~otary Public State of Florida dlzabeth De Jesus My Commission 00639910 ~ ?.'"!2.~" 02!,13120 1/ ."-~""''''',''' -~_. 813-780-0020 Date Received Owner's Name Owner's Address City of Zephyrhills 'Fire Permit Application Fax-813-780-0021 Phone Contact for Permit I\q 01 II ~}]?51 'I I Titleholder Phone Number I Fee Simple Titleholder Name Fee Simple Titleholder Address Job Address 1I"",,,!!WJ!ll:i ~",::iM~_~w~ I Lot# Parcel # II II Sub Division OTHER Signature Address Directions: D D D D D D Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum o o o o o o D D D D 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 RoofingfTar Kettle Waste Tire Storage ANNUAL OXfksj~ '6YJr.e-- Valuation of Project Company Registered License # Company Registered License # Company Registered License # Company Registered License # Company Registered License # C~ntractor I fL. 11 , L ./) , Signature ~ Address i3S"JI &f{~Ia}E g) 7/l~n ~W,,( FL ELECTRICIAN Signature Address I PLUMBER Signature Address I MECHANICALI Signature . Address I Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL 19!!!B ~ ~ ~ Sprinkler 0 0 0 0 L-J ~ ~ ~ ~B Do DOL:] Fire Alarm Hood Cleaning Hood Suppression ~ D Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Other: Y/N Y/N Fee Current Y/N Y/N Fee Current Y/N Y/N Fee Current 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. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) NOTICE OF'DEED RESTRICTIONS: The undersigned understands that this permit may.besubject'to-"deed"<restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for:c:ompliancewith C!ny 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, 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 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 regulating 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 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 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 permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause 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 IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117 3 / / vi _ ./ OWNER OR AGENT CONTRACTOR P~r ~ Subscribed and sworn to (or affirmed) bejpre me this Subscribed and swom;go or affirmed) before me thisz... g MIV::.~ j, zoo2by ,4 k,,/t '-,;Z..~4- v, oS $.rc.h z.;o~y l> b,."r- L L,.. 0/. ,. Who is/are personally known to me or has/have produced Who is/are personally nown to me or has/have produced _CJ ^- as identification. as identification. Notary Public Notary Public Commission No. b)) (~ "3 '7 "7/0 ~/r:2--~~ ~ J~.svS Name of Notary typed. printed or stamped Commission No. b /) {, '3 ~ 9 / 0 ~: ~~--/-rI ~ J e3ut. .::, Name of Notary typed. printed or stamped ri,tlAY "1I~ Notary Public State of Florida ~'J ": Elizabeth De Jesus ~1-~'; My Commission 00639910 ~~~J!E!!~sO?! 1~@gJ.1 ~~ p~ Notary Pu he tate 01 Florida R'~" Elizabeth De Jesus ,~... .i My Commission 00639910 ~ o. ~c:l" E Ires 0211312011 Certified: EF0000441 CITY OF ZEPHYRHILLS CONTRACTOR CERTIFICATE 5335 8TH ST. .~.~. 'ty ;,..,,: ZEPHYRHILLS, FL 33542 .... .... c . .. PERIOD COMMENCING OCT. 1,2006 TO SEPT. 30, 2007-n\ ,. :'C.c Type: CERTIFIED ALARM SYSTEM$,..... Qualifier: ROBINSON, JOHN S. Expirest'~8/31/2008 Ph: (727)942-1993 Workers Camp: 285256 Notes: Expires: 4/01/2008 f~,~,::'f~~t~i~{::':' . 20.00 lSUiJ2007 '~ ":-';<'~'_,:-,,~",:.~i~:,'l:i:"' . ' ,-~ ';; .l ;". -! .' " $.~jL c A TOTAL SOLUTION, INC 3531 KEYSTONE ROAD TARPON SPRINGS, FL 34688 .' . .,.. .'", ;... . :: '"7'C'. -.' S~~I?A"'NA~ 0~~ "___""'_'\;lo"~ ~~ This registration expires each year on Sept. 30.