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Home My WebLink About08-8249 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 8249 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: 8249 FIRE PROTECTION MAINTENANC FIRE-PROTECTION MAINTENAN E COMMERCIAL 8/25/2008 Name: FLORIDA MEDICAL CLINIC 25.00 Address: 38135 MARKET SQUARE 25.00 ZEPHYRHILLS, FL. 33540 8/25/2008 Phone: 813780-8440 FPM-SPRINKLER QUARTERLY -FLORIDA MEDICAL CLINIC 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 t: ro2Jff Fax-813-780-0021 City of Zephyr hills Fire. Permit Application ~:=---1-~__fflj'" J I Fee Simple Titleholder Address I _Wi r"': Job Address I 38 \~S n'lAQ r::FT I Owner's Name Owner's Address Fee Simple Titleholder Name Sub Division -[ D D D D D o Contractor Signature Address ELECTRICIANI Signature . Address I PLUMBER I Signature Address I MECHANICALI Signature Address I OTHER Signature _ ....~dressJ, Directions: 5()"'-lf-~ (2 E I Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL ,~ l:seomq IAon11 ~ Sprinkler ~ l!1' L-J Fire Alarm 0 0 0 0 r==I Hood Cleaning 0 0 0 0 r==I Hood Suppression 0 0 0 0 r==I Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Pho~e Contact for Permit ] ~ \ ~ . _lit'-llli -' "ii' - Owner's Phone Number Titleholder Phone Number I I d~~~~~1 hlHtqi] "_~ I Lot # I I I Parcel # IIlJ!r!flIll _1Wll II~" D Fumigation Tent 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 Recreational Bum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch RoofinglTar Kettle D Waste Tire Storage ANNUAL Valuation of Project License # I~~\ F~~~~nt rF0~flF(~~ L~I1bLl 'r)'t.tCO\ (t /((({ Company Registered License # Y/N Y/N Fee Current Company Registered License # Y/N Fee Current Y/N I Y/N I Fee Current Y/N I I Y/N I Fee Current Y/N l "r r ' ',......t' C' , ~"...=",..,,,,...,"""l. _~1lI Company Registered License # Company Registered "'1-...,,~-~,,-.J ~ License # 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://appralser.pascogov.com) ",- ",." 'i"'""'~'^ T .^~, '>>'M""^'~ \"'i1 'NOTICE OF:DEED RESTRICTIONS: The undersigned understands that this permit may _besubject'to'~deed"rrestrictions" 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:a-contractoror 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 'fora 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 permjt 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 cif tflelecnhicaf codes, nor shall issuance of a permit prevent the Building Gfficialfrom 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. _':..........____ __,,"(7" IP- "Il II~", .. Notary Public ~~taryPUbIiC .~l'lf'Wli~.4tc;, c/trt/-~ , 7:;)fC4- (&u,Aat1 LETTER OF TRANSMITTAL TO: CITY OF ZEPHYRHILLS 5335 8TH ST. ZEPHYRHILLS. FL. 33540 DATE: 08/22/08 ATTENTION: INSPECTIONS RE: FLORIDA MEDICAL CLINIC ISC 284 WE ARE SENDING YOU THE ATTACHED ITEM (S) : COPIES DESCRIPTION 1 ORIGINAL EA 1 ORIGINAL EA' APPLICATION FOR OTLY INSPECTION S25.00 CHECK #9550 (FOR INSPECTION) THESE ARE TRANSMITTED FOR YOUR USE AS REQUESTED. THANK YOU. COPY TO: File SIGNED. Q :~Q 6o~ CRYST V. BARROW Horne Office 2501 N. 70th Street Tampa. Florida 33619 (813) 621-1357 (813) 628-0143 Fax FED ID # 59-1716869 E-mail: rodanfire@aol.com Sales . Desian b Installation . Repairs . Service Brancll Office 6650 E. Rogers Circle BOCi1 RcltOIl. Florida 33487 (561) 241-9411 Fax (561) 241-2972 E-mail: rodanfireboca@aol.com