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Home My WebLink About08-8025 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 8025 Permit Number: 8025 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: CHURCH Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 6151 12TH ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 6/30/2008 25.00 25.00 6/30/2008 Phone: FPM-FIRE ALARM ANNUAL-FIRST CHURCH OF NAZARENE Name: CHURCH OF THE NAZARENE Address: 6151 12TH ST ZEPHYRHILLS, FL. 33542 ~ ~& ?J~ f\1j 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 $100.00, whichever is greater. All work shall be performed in accordance with City Codes and Ordinances. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." '-- P IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPEcnON CALL FOR INSPEcnON - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 JUN/25/2007/MCN I I: 12 AM 81,3:180.0020 Date ~eceived ZEPHYRHILLS BUILDING City of Zephyrhills 'FIFe Permit Application FAX No. 813-780-0021 # ro{)t~ P. 002 FBl<-813-780-0021 :1. Phone Conlacl for Permll ~.e Simple Titleholder Name Fee Simple Tllleholder Addro:i~ ::b A:::' - ," 1_ Owner's N8me Owner's AddresS Sub Division ~- ""$' Contractor SIgnature Addl1lss ELECTRICIAN Signature Addreee I PLUMBER Signature Adclre:ss I MECHANICALI Sienature Add~S3 I OTHER Slgnelure Addtwss L * ,... Diractions: Central Station Serv; "eR om l,llrlrO; rln I is same as . '~_.""W 1I.1Ulilllll.....--..-.'U<f "1 .L ""' - rl.1' I :;--:~ I I *-"" 1 'IICI 1 6151 12th Str~t Zephyrhills,'FL 33540 j Lot'" Parcel # . L '1 - '"""'\t'" o FumlglltionTent , D Ha'lluuoUS Mlllerial (TIer" or RQ Facility) ANNUAL D Hood Installlllil;Jr1 D LP/Ne\UrBl Gal;.lnstllllallon D lP/NlltuflIl Glls.ANNUAL. Sele D Places 01 Assembly-ANNUAL D Recraatlonel Bum D D D B II D D D B Cd . """'VT Blo-Hazerd Waste storage .'.ANNUAL. Comm Exhaust Kitchan Hood/Duct 'T P." SPl!rklers Sprinkler Syslam Installations Standpipes (Sprinkler Sy,) Torch ROoflngrrar Kellle Wa,leTI", StolllQe ANNUAL J Valuation of Project Contro!ltld BLm Emergency Generator < 30.kw Emll'gency Oenllnltor> SO kw Fire Protecllon Maintenance - ANNUAL ~.~.~~ Spr1nkler D Cl 0 0 ~ Fire Alllrm [2J Cl 0 rz( C:=J Do DOc.::J DoooCJ Hood CleanIng Hood Suppression ~ D Firs Alllrm Inslallallon Fire Pumps Fire Works Flammable Appllcation- AN~UAL. Fuel'rank:s Other~ '-~- Company Registered 6 Q9 L.icense'. Company RsglStered license # _., . ~J ~~~~:~.., ~r. ei., .I.. I Y I N I Fee cUlTsnll I L..r.lt!.J Fee Cu,",nt C' 1- Y I N I Fae CLJl'l'ent I I I Y IN L..~~I" r L I I I ~ l I I Y/N! I Company Registered license # Y/N --'("'vr r III "'\]7 T Company Registll....d . L1cenea #' Y/N I I ...... ..~~...., IT Fe& Current Y IN I ,.~._~.~- -...-...... Fill out eppUcatlon completsly. awner & COntractor &151'1 baol< of epplicatlon. nolarized (Or, copy of signed contract YIllh ownsr) If over 52500, a Notice of Commencement Is requlred.(Machanlclll WQrk ovsr $5000) Supply two (2) sets of drawings with applicable documenlallon Allow 10-14 deyr; for review after submlltel dale. Parcel # - obtained from Property Tal{ Notice (http://appralser.peBcogov.com) JUN/25/2807/MON 11: 12 AM ZEPHYRH1LLS BUILDING FAX No, 813-780-0021 p, 003 'NOTICE OF'DEED RESTRICTIONS: The undersigned understands that this permit may ,be'subjecf~to:"deed~lTestrictions." which may be more restrictive 'than County regulations. The'.underslgnedassumes responsibilityfor:compjlar.me1with any, ,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 l1layrapply 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 advl6ed to have 'the contractor(s) sign portions of the .contractor Block" of this application for whlch.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 UENLAW (Chapter713,Florida Statutes,.a8.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 Florid'a 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'SJOWNER'SAFFIDAVIT: 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, .zonlng 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 arid City codes, zoning regulations, and land development regulations in tl:1e 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 iri good faith to inform the owner of ~M 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 1 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 jU6t1f1able cause for the extension. If work ceases for ninety (90) consecutIve days. the Job is considered abandoned. OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this by , Who is/are personally known to me or has/have produced as Ide,nllficallon. CONTRACTOR ~~yomeottt~~' Who IsI~re personz;\ly I<:novm b me or l'.a&lhave produced as idenlificaUon. Notary PUblic 6w 1 ' 'Jr.nct No"'>'-- Commission No. J ClI i M !wi ,v- i'\- I l . . .. . J - Mv r-...........- ~ Name of Notary typed. printed or atllmpCld '\ -J:." ExpQs July 25. 2008 Commission No. Name of Notary typed, l'Jrlntedor stamped , ACORDN CERTIFICATE OF LIABILITY INSURANCE OPID AW J DATE (MM/DD1YYYY) . GUARD 1 06/24/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Best Insurors, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 31601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa FL 33631-3601 Phone: 813-871-4671 Fax:813-871-4099 INSURERS AFFORDING COVERAGE NAlC. INSURED INSURER A: COLONY INSURANCE COMPANY Central Station Services Inc INSURER B: dba Guardian All American INSURER C: Security Services 3300 Henderson Blvd. Suite 206 INSURER 0: Tampa FL 33609 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSRI POUCY NUMBER PD~1af~tWt P~ril M ON UMITS LTR TYPE OF INSURANCE GENERAL UABIUlY EACH OCCURRENCE $1,000,000 r-- A X COMMERCIAL GENERAL LIABILITY MP3620050 08/01/07 08/01/08 PREMISES (Ea occurence) $ 50,000 r-- tJ ClAIMS MADE ~ OCCUR ~ ~ EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 ~ ~ HIRED&NOA GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPJOP AGG $ 1,000,000 __ I POLICY n j~g: n LOC AUTOMOBILE UABlUTY COMBINED SINGLE LIMIT -~ $ ANY AUTO I (Ea accident) ~ -- ALL OWNED AUTOS BODILY INJURY ~ $ SCHEDULED AUTOS (Per person) ~ HIRED AUTOS BODILY INJURY ~ $ NON-0WNED AUTOS (Per accident) _. PROPERTY DAMAGE $ (Per accident) GARAGE UABLITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSJUMBRELLA UABIUTY EACH OCCURRENCE $ tJ OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND ITORy"LIMITS I !"ER- EMPLOYERS' UABIUTY ANY PROPRIETORIPARTNERlEXECUTlVE E.L EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEEI $ If yes, describe under E.L DISEASE - POLICY LIMIT I $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER City of Zephyrhills Building Dept 5335 8th St Zephyrhills FL 33542 CANCELLATION CITYZEP SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO OD SO SHALL IMPOSE NO OBUGATION OR UABIUlY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. REPRESENJollTIVE 't- @ACORDCORPORATlON 1988 ACORD 25 (2001/08) .---.______M__~_.__.____._____ AC# ,"', ;' ...... (1, r\ r: r, ,~~ :J {- _: t: t:_, ":: STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ#L06061600820 LICENSE NBR 06 16 2006 050821357 EF20000434 The ALARM SYSTEM CONTRACTOR I Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2008 ORENDORF, WILLIAM G CENTRAL STATION SVCS INC DBA GUARDIAN ALL AMERICAN SECURITY 3300 HENDERSON BLVD, SUITE 206 TAMPA FL 33609 JEB BUSH GOVERNOR DISPLAY AS REQUIRED BY LAW SIMONE MARSTILLER SECRETARY 2007-2008 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT FACILITIES OR MACHINES ROOMS SEATS EMPLOYEES o 0 0 1 EXPIRES 9-30-2008 FOLIO NO RENEWAL 135693.0000 OCC. CODE 090.000 BUSINESS TYPE CONTRACTOR-ALARM SYSTEM REPAIR/INSTALLATION H. WASTE SURCHARGE 40.00 TAX 18.00 HENDERSON BLVD 206 33609 NAME MAILING ADDRESS ORENDORF WilLIAM G GUARDIAN All AMERICAN SECURITY SERVICES 3300 HENDERSON BLVD STE 206 TAMPA FL 33609 BUSINESS TAX RECEIPT DOUG BELDEN, TAX COLLECTOR 813-635-5200 THIS BECOMES A TAX RECEIPT WHEN VALIDATED. PAID - 3306 - 85 08/07/2007 *** 58.00 HAS HEREBY PAID A PRIV'LEGE TAX TO ENGAGE .... Cot lCll.lCClC DCf'\I:"C::~~lnN OR OCCUPATION SPECIFIED HEREON