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Home My WebLink About08-7745 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7745 Permit Number: 7745 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: 38250 A AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 14-26-21-0010-01300-0010 4/14/2008 25.00 25.00 4/14/2008 Phone: FPM-SUPPRESSION SEMI ANNUAL-ZEPHYR HAVEN NURSING Name: ZEPHYR HAVEN NURSING HOME Address: 38250 A AVE ZEPHYRHILLS, FL. 33542 0~yu~ 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 PERMn 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 Received Owner's Name Owner's Address tf11~5 "' frJ~ I Fax-813-780-0021 City of Zephyr hills Fire Permit Application J~~or.Y : .2f';~.-h; 147(f1"Vr: Phone Contact for Permit NIVS ~ ~I owne~s Phone Number LJ~.~ 7~ U~,t~-L"" II II I I IJS>d- 5U A-Auc- I Fee Simple Titleholder Name 1I'Jr;;J Fee Simple Titleholder Address Job Address Sub Division -El D D o @ o o o D o o Contractor Signature Address ELECTRICIAN Signature , Address I PLUMBER I Signature Address I MECHANIC' Signature . Address I olo-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 0 Hood Clean/Suppression 0 Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Other: OTHER Signature Address I Directions: - "'...&.~~ . II II I Titleholder Phone Number I I Lot# Parcel # I lUO IAII'II:.U r-~UM l"'~Ul"'I:.~ I Y 1Ar.I'IU 11'-'1:.) -, EI Fumiyoliull T .."t 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 Re~eationalBum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch Roofing D Waste Tire Storage ANNUAL .1 Valuation of Project Company I Registered License # I Company I Registered License # I Company I Registered License # Company Registered License # Company Registered License # 'sU'\"\ ~:;] k" G-, 111 {\.-e il Y I N' Fee Current I Y I N Y I N I Fee Current Y/N Y I N I Fee Current Y/N Y I N I Fee Current Y/N Y/N Fee Current Y/N I ~- ".,,-. . '~~ ~_'~"vm L 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 atter submittal date, .....---~..__..--~..._.~_..- ,'.--..---...- ... ,NOT~GE.QF,t)EED.RESTRICTIONS: The undersigned understands ,that this .permit m~ybe sl;lbject to "deed" restrictions" -which may be, more r-estrictivethan County regulations. The undersigned assumes responsibility 'for cDmpliance with any applicable deed restrictions. ' . . UNLICENSED CONTRACTORS AND ,CONTRACT-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 con~ctor 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 Pasc~ ,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 "contractDr 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 $2,500.00 or more;'1 certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide"'prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than. the "owner", I ,certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to ,commencement. . CONlRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and ,., ,'that' all ,work .will. be <lone in, compliance ,with., a1l-.applicable,.laws ,regulatiRg,-cOFlstruotion",zoFliAg,.and--land""",..-- development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work, or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating .construction, County and City codes, zoning regulations, and land developm~nt regulations in the jurisdiction. I also certify ,that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must,take to be in compliance. ' If lam the AGENT fO~ THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior ..tp. comlJ1~ncji1g construction. I understand that a separate pennit may be required for, electrical work, plumbing, signs; wells, :pools, air conditioning, gas, or other installations not specifically included in the application. A ~r.mitis$u~dstiall:be cons.trued 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 'requhing,a:.cmrection of errors in pl~ns, construction or violations of any codes. Every pennit issued shall become invalid ,unles.sitie:Work;aut.hprized''by suchpennit is commenced within six months of permit issuance, or if work authorized by .. ,tlie;:~ITiiiLisSU$'p~rided or abandoned for a period of six (6) months after the time the work is commenced. An extension 'may.-~ reqqested, tn writing, from the Building Official ,for a period not to exceed ninety (90) days and ,will demonstrate . j*~~(e ~ilse 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 -':'9 Y~~~_~~9,P.E~~~,.;.~f-,YQ.u.JN.J.I;l'!P,;J;.9,gp;r~lt!I-.~INAf'<ICJf'JG, CONSULT '':WMC..(!),~~N,;~~R~SSRjRE~R~.vc;m;mJTICE OF COMMENCEMENT. , :.::.:1. ~ . ~. , ' .(5) ". -' .', " ~,_,:::., ,; ~ ~;,!.~ ,:..,_.,....,:..,. .." ",_,..",," "" ,_" ''''',.,.....',,' ..,.....-....' ......'...:....n.--.-.......----..-..-..---......-'...-........' .",; .....~....... ...., .-... ,,' ' , .., , ":OWNeR OR AGI:NT CONTRACTOR Subsaibed and sworn to {or affirmed) before me this Subscribed and sworn to (or affirmed) before me this " ~. ~ Who lsI8J'e personally known to me or has/haVe produced Who is/are personally known to me or ~ve pmd~ , as Identification. as Identification. Notary PUblic Notary Public Commission No. ,Commission No. Name of Notary typed. printed or stamped Name of Notary typed. printed or stamped