HomeMy WebLinkAbout08-7919
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
7919
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
7919
FIRE PROTECTION MAINTENANC
FIRE-PROTECTION MAINTENAN E
NOT APPLICABLE
Address: 37301 HAPEL HILL LP
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: SILVER OAKS VILLAGE
Parcel Number: 03-26-21-0010-10200-0010
6/03/2008
25.00
25.00
6/03/2008 Phone:
FPM-SPRINKLER ANNUAL-YMCA -DONE 5-15-08
Name: EAST PASCO YMCA
Address: 37301 CHAPEL HILL LP
ZEPHYRHILLS, FL. 33542
~\Q,(jQ
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
STATE OF FLO~IDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF STATE FIRE MARSHAL
TALLAHASSEE, FLORIDA
CERTIFICATE OF COMPETENCY
THIS CERTIFIES THAT: ROBERT D MAYO
374 HOBBS ROAD
TAMPA, FL 33619-
BUSINESS ORGANIZATION: UNIVERSAL FIRE SYSTEMS INC.
CONTRACTOR II IS LIMITED TO THE EXECUTION OF CONTRACTS REQUIRING THE ABILITY TO LA YOUT, FABRICATE, INSTALL, INSPECT,
ALTER, OR SERVICE WATER SPRINKLER SYSTEMS, WATER SPRAY SYSTEMS, FOAM-WATER SPRINKLER SYSTEMS, FOAM-WATER
SPRAY SYSTEMS, ST ANDPIPES, COMBINATION STANDPIPES AND SPRINKLER RISERS, ALL PIPING THAT IS AN INTEGRAL PART OF THE
SYSTEM BEGINNING AT THE POINT OF SERVICE, SPRINKLER TANK HEATERS, AIR LINES, THERMAL SYSTEMS USED IN CONNECTION
WITH SPRINKLERS, AND TANKS AND PUMPS CONNECTED THERETO, EXCLUDING PRE-ENGINEERED SYSTEMS,
Chief Financial Officer
~' ClA// j
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07 01 2006 07 16 Hillsborough
Issue Date Type Class County
05517400011992
7596540001
150.00 06 30 2008
LicenselPermit Number
Application #
Taxes & Fees: Expire Date
'''\
t'....
OS/28/2008 03:35 FAX 8137837027
~ 002/004
MAY128/2007/1(ON rJ :01 AM
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OBOOZ99Et8 6€ISO 800~/6Z/g0
8136620080 OS/29/2008 15:45 RECEIVED FROM: 8137837027 #7136-002
May 28, 2008
City of Zephyrhills
UNIVERSAL
FIRE SYSTEMS INC.
374 Hobbs Road. Tampa, FL 33619
(813) 662-9200 . Fax 662-0080
LETTER OF AUTHORIZATION
Please accept this Letter of Authorization to allow the individuals listed below to sign
documents required to pull permits in City of Zephyrhills.
Robert D Mayo
Albert Mayo
Gary Flannery
Malissa Booth
Tim Kocher
Steve Shea
Kevin Hunt
Bob Rothman
R Brian Mayo
Rosa Sawicky
Nancy Safran
Doug Howe
Bart Trueblood
s.s. #
License #
S.S.#
S.S. #
S.S. #
S.S.#
S.S.#
S.S.#
S.S.#
S.S.#
S.S.#
S.S. #
S.S.#
S.S.#
Respectfully,
Qf:fQL /
Robert D MaycO
262-47-1144
05517400011992
261-19-3324
263-17-7404
378-68-5536
591-34-9026
590-44-3218
315-68-1804
267 -25-0509
589-66-7241
251-69-7341
263-79-3793
370-58-5805
261-92-9232
(Owner and Ucense Holder)
Notary Public:
'--~f/1YA7JIIM~
My Commission Expires:
SALES
.
SERVICE
.
INSPECTIONS
.
REPAIRS
2007-2008 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT
FACILITIES O~ MACHINES ROOMS SEATS EMPLOYEES
o 0 0
EXPIRES 9-30-2008 FOLIO NO
10
RENEWAL
17569.0000
OCC, CODE
090,015
BUSINESS TYPE
CONTRACTOR - FIRE PROTECTION"
H. WASTE
SURCHARGE
40,00
TAX
18,00
J- -'-..- --
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BOSIN'ES'S'TAX RECEIPT
HOBBS RD
MPA 33619
NAME
MAILING
ADDRESS
MAYO ROBERT D/UNIVERSAL FIRE SYSTEMS INC
374 HOBBS RD
TAMPA FL 33619-0000
HAS HEREBY PAID A PRIVILEGE TAX TO ENGA.QE
IN BUSINESS, PROFESSION, OR OCCUPATION SPECIFIED HEREON
DOUG BELDEN, TAX COLLECTOR
813-635-5200
THIS BECOMES A TAX RECEIPT WHEN VALIDATED.
PAID - 8102 - 85
08/10/2007 ... 58.00
'...
\',
.
May, 28, 2008 1:18PM
No. 7248
P.
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ACOBIt '.. I DATE IMIIIIIDCrfYYY)
CERTIFICATE OF LIABILITY INSURANCE OS/28/2008
PRODUCIiR (813)637-8877 FAX (813)637-8484 THIS CERTIFICATE I8I88UED AS A MAnER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
491S W. Cypress Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ,
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 100
T~a. FL 33607 INSURERS AFFORDING COVERAGE NAIC#
INSURED Uni versa' F, re Systems, Inc. INSURER k Travelers Indemity
374 Hobbs Road INSURER B: Travelers PIC Co. of America 25674
Ta~a, FL 33619 INSU~ER c: American Int'l Specialty Lines
I INSURER 0; Zenith Ins CO
INSURER E: St. Paul Surplus Lines Ins. Co.
ES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEIIIISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOlWlTHSTANDING
ANY' REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Al-l THE TERMS. EXCLUSIONS AND CONDITIONS' OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY tfAVE BEEN REDUCED BY PAID CLAIMS.
~ TYPE OF INSuRANCE JIOUC'f' NUMBER JIOUCY EFFEC11W POLICY EXPIRATION UMITI
GENERAL LIABIUTY DTC05372C723-IND-08 01/01/2008 01/01/2009 EACH OCCURRENCE $ 1.000.00~
~
X COMM~CIAL GENERAL ~IABILITY DAMAGa TO RENreO $ 300.OOIl
f--, CLAIMS MADE [!] OCCUR MED exp (Any ~~) S S.ooll
A X $10.000 PO ded. PERSONAL & ADV INJU~ S 1.000.0CNl
X Contactual liab GeNERAL AGGREGATE $ 2.000,000
GEN'L ACGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/O? N;J; S 2.000.001l
h POLICY m ~~S= n LOC
AUTOMOBILE UAIIIUTV DT810S372C723-TIl-08 01/01/2008 01/01/2009 COMBINED SINGLE LIMIT
f-- (lOa accklent) S 1.000.000
X ANY AUTO
f--
ALL OWNED AIlTOS BODILY INJURY
~ $
SCHEDULED AUTOS (Per pe.-,)
B -
X HIReD AfJTOS BODILY INJURY
T NON.QWNED AUTOS (Pl!~ 8CCklent) S
X Comp/Coll Oed $500 PROPERTY DAMAGE
(Per &c:Qd.nt) $
GARAGe LIABILITY AlITO ONLY. EA ACCIDENT $
=j ANY AlITO Oll4ER TliAH EA ACC $
AUTO ONLY: AGG S
EXCE$S/UIIIlRELLA LIAIIIUTY BE3956697 01/01/2008 01/01/2009 EACH OCCURRENCE S IS.000.000
Xl OCCUR D CLAIMS MACE UMBRELLA FOLLOWS AGGREGATE s 15.000,000
C FORM AND IS OVER $
~ DE:OUCTIBLE WORKERS COMP. s
X RETENTION $ 10.000 $
WORKliR8 COMPENSATION AND Z067973203 01/01/2008 01/01/2009 X I T"Xg9r~Wi I IOJ~.
EMPLOYER&' UASlUTY 1.000.000
D ANY P~OPRIETORIPARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFlCeRIMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE S 1.000.000
11 YIJ~ dl!sctibl! LIlder 1.000.000
SP~ IAL PROVISIONS bl!Iow E.L DISEME. POLICY LIMit $
f,r~EII QC05500567 01/01/2008 01/01/2009 $2.000,000 Each Act.
rrors & Omissions
E Liab $10,000 Deductible Each Act.
DIiSCRIP'llON OF OPeRATIONS I LOCATIONS' V2HICLES I EXCLUSIONIl ADDED BY D1IlORSEII&NT / SPECIAL PROVISIONS
City of Zephyrhi1ls
Building Department
5335 8th Street
Zephyrhil1s. FL 33542
CE
SHOULD Nf'( OF TIlE ABOve DESCRIBI!D POUCIES BIE CANCELLI!D "!FORE THE
I!XPIJlATION DATE THEREOF. THI! ISSUING INSURER WILL I!NDEAVDR TO MAlL
-1L DAYS WRlTTI!N NOTlCE TO THE CERTIFICATEi HOLDER NAMED TO THI! LEFT.
BUT FAIW~I! TO MAIL SUCH NOTICE SHALL IMPOSE NO O8LIOATlON OR LIABILITY
OF AtlY KIND UPON THE IHSU~ER.ITS AGeNTS Oft REPRESENTA'r'IW$.
AUl1IORIZED REPRUENTAllVE
--o.:a )1f.
RJOA ~I
@ACORD CORPORATION 1988
William Massaro Jr.
ACORD 25 (2001108)
8136620080
OS/28/2008 13:24
RECEIVED FROM:
#7108-001
May, 28. 2008 1: 18PM
No. 7248
p, 2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this fonn does not constitute a contract between
the issuing insurer(s), authorized representative or producer. and the certificate holder. nor does it
affirmatively or negatively amend. extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
8136620080
OS/28/2008 13:24
RECEIVED FROM:
#7108-002
OS/28/2008 03:35 FAX 8137837027
III 003/004
"-. ----. '-"_1..
MA~/28/2D07IVON t t ; 02 All
ZEPi~rLLS IlJILDIN;
.PAX No.'S13-780"':0021
P.004
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'N~ DF:DlSBD'RI!S'nUCT1OHS: 'The~ned ~'.chat_ ~1t.~.be'S~"~I~""'__u .
. .WhICh m~ be moM rvalrtoti". tMn County reQUI8IIor&S,t 'Thellln~_~.-8ume8 ~lib'lor~~~fth 'gnu, .'
~t.I_L..'_'''''~~J_~_' '" " , ' "-y . . '
'~gae~I"VCKI~_ . . '. OJ . . . .
,- 'UNuCENaeb:~ AND"'C'ON1RA.CToR ~1UtiEs: ".the ~ h8s'1Wed."m.dr~.'<<"" -::.-,
'contra0t0r81o undertitke work. they ~ I;te-:reqwlrld'to be Jk:enSieCt In aoaardance with ..ate and lOCaI'nOIIaiIons. It the. '
'conb"actw is not IIceDMcS _ ~ by baw. bo1h the j)WMrand 0Di"'4.-. may be cn.dfw-a m~vJat8tion
under state law. lf1he QWri.,. QI"'lnteaded~ are IJhC8rtlItn...1o what ~1'OQUirements.JNIY*PPIY for the'
" IntendtKf work. 'Ihey. are advta.a.1o cordact 1bs=Pasoo Count)' SuIIdlnu In&~ ~ SecUon.at 7ZT-a47-
8009, ~ore. ~ the _~. ~ hlred..a contntctor. or oonIr~. he _1$ lICMsed'to have 1he coNnIctor(~) sfgi'l . .
portions. of the ~CQnb1ac\a' SJook1I Of'" ~ 'for whlch-che)c wll be responsible, If you. as 1he"owner"Sigl:l as the
cOntractor. Chat m~ be ~ Ind1catfon 1hat he .. not ~,~ -.d 1& ~ot e~"to l-lIl1ttlng.prtvlegws 1ft Pasco.'
Co~.. ..' I . .. . I" . I . ".". .... _. ,- ,. .....
CONSTRUCTIONl..JI3N.LAW '(~'7's'.FIoiicIa S~"'~1 Jf valuidlOn of work .. $2.soo;oo or ~ I ~. ' ' .:
. certify that.., 1h8 appIleant. ha'VCJ .beet1 provjded ',With ~ <=op.y of 1he .-Ftarida Construc:Ion Uen 1..aYI--4t~$',
ProtectIon GuId; prapared by.the FIorJde ~ of.AgricuI....1II1d oen.umer'A&Jrs. If the appIoant ls'llOmeone. .
othw bin:the 'pwner", I certify Ihat I have obtiIIned a copy of the abaw destlrtbecl document, and promis'e In ~falth to - .
d~tlverlt1D~~prtor.tocarnnteQCli!!tm~ '... .,'. . "'_ '.' .... , . : '. ','. '-: . '.,
t;X)N'1'RACTORtSfOWN~""FFlDAVJT: J'~.1hatCIIl'the il'dbnnstiol',an 1hIs ~Is acWI'ata and
th.Id:..u work will be done In compllance,~ aII..ppllclebfe IIIW5 reauluting,~' zoning ~ land ."
dev8lopmeJlt."AppIIc:ation .. ~by ~ to obtain 8 permit 11> do woriC and. i~ - ~. I ceniIY '.
'. 1hat...., work Of 1nstaUatIon' has qgmm...... pl'ICIr tD IssUancle of a permit 8I'Jd thal.u work wm be perfonned'lo' .
, meet IitIIrKiards of all 1aWs.~.constIadIon. t:ounty and CRy 'CDderi. mnIng reguJatIons-. and Iiod _
. development'reg~ In ,1bD.'J~otton. .I'aao.~ that I undenstsnd that 1he.RllJUIeIIDM, at o1her
. gdl/emInEIntagenQes m8y apptyw the Intended,wor.rc" _that. Is rny.~tD idenIIfy1lVhatedlons t.
, mU8t ...'to btt In ~pllance. :.' . . "'. ' . - . " . . . .' ..' .
If I am tbe AGENT 'FOR 'THE 0WNItft. I promise...1I'I good..... ID infoim-1be owner of. penn~ ConcfIIons'set forth in '
ttde 8ftIidavIt prIojo 10 comm.nclng 'construCtIon. t u~ tMt . se~ pel'tI'lIt,.rnay be nIlifUIred far eIectI10aI ~
plumbing, aSans.'weIIs. pools, air cmu:IIIiOt1ir1g gee, CII' otbeI: Instdaftons not: ~pecifJcellY ~ in the appPeatfon.. A,
.permlt Jaeued 8haIl be consauod to b'o.. hcenee to ~~..l:t,wtth the WWk and not _ wtharltv ~ vf~. mn::eI.~, or.
. set aside B!1Y provisions of the 'bi1d1nical codes. nof 8haII18s~ Gf a permit preWni 1hft BUilding Oft'ldaIfrom ~ .
requiring. ~ of ~ In pa.., uonft1.lc:&Ji'l er vlalallOf'l8 of art"r codes. ,Ev..-y permit Issued shall begome invalid
'. ufltess the work authol1md by ~ permit is ~ wjthIn"sb( rnoriIhis',ofpenntt IesUanDe. or if work aufhorIzed'bV .,'
, the permit Is suspended or abandoned for a period bf ... (8) months __ tho tIrpe the WOlf( "'carnnwnQId, An ~
. may be requeited. in writing. from the BuDding ~ for 8 period not to ~aed nIriety (90) days and WID demoIlStrale .'
justifiable cause fDr the_ ~~n. .n: work pe~ t'o!" nlne\v (90) co~.da,y&. theJob is 'ca~ ~ndoned. ' . '.
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. 'WARNING TO OWNeR: YOliR.F~ TO RECoRD A 'Ncmce 'OF'COMIII8!IC&iM1INT llIAY"RESULT ," 'YOUR . · :.
PAYJNG TWICE J'OR IMP~NTS '1'0 YOUR MOPERlY. IF YOU INT&ND TO OBTAIN FWtANClNG, ~~T '
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OS/29/2008 15:46
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8137837027