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Home My WebLink About08-8535 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8535 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 8535 Address: 38250 A AVE Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14-26-21-0010-01300-0010 Improv. Cost: Date Issued: 11/14/2008 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/14/2008 Phone: Work Desc: FPM-SPRINKLER QUARTERLY-ZEPHYR HAVEN SIMPLEX GRINNELL LP FIRE PERMIT FEES 25.00 FIRE ACCEPTANCE Final 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 City of Zephyrhills Fire• 'f 'O5 ' ` Fax-813-780-0021 t Permit ApplicationJ Date Received J -3 O p Phone Contact for Permit g i13 �p„5 2vf Owners Name f) Owners Phone Number I 1 1 � Owners Address Fee Simple Titleholder Name Titleholder Phone Number CI C1 I1 Fee Simple Titleholder Address Job Address v S® A A , -. Z e h r h i it 5 ç 1 Lot# I1 Sub Division Parcel# Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct [ ] Hazardous Material(Tier II or RQ Facility)ANNUAL LIJ Controlled Bum Hood Installation Emergency Generator<30 kw El LP/Natural Gas-Installation Eli Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL El Places of Assembly-ANNUAL emi E er Sprinkler ❑ O Recreational Bum Fire Alarm El ❑ ❑ ❑ II El Sparklers Hood Cleaning LII O O O [IIIJ Sprinkler System Installations Hood Suppression ❑ ❑ ❑ II LIII Standpipes(Sprinkler Sys) Fire Alarm Installation El Torch Roofing/Tar Kettle El Fire Pumps El Waste Tire Storage ANNUAL El Fire Works El Flammable Application-ANNUAL Valuation of Project El Fuel Tanks Q Other: Contractor Company ��►+ ,cy Signature Registered Y/N Fee Current Y/N Address 7 C 4 i .�,a.,r �3( C"n 33610 License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current J Y/N Address License# OTHER Company Signature Registered Y/N Fee Current I Y/N Address License# Directions: 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 maybe subjectto-"deed":restrjctions which may be more restrictive than County regulations. The-.undersigned assumes responsibility for:compliancewith 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 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 4%NOTICE-OF-COMMENCEMENT-MAY RESULT IN'YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBT IN FINANCING, CONSULT WITH YOUR LENDER OR AN A NEY BEFORE RECORDING YOUR NOTIC C MENCEMENT. FLORIDA JURAT(F.S.117.0 OWNER OR AGEN CONTRACTOR Subscribed and sworn to(or b fore me this Subscribed and sworn ( . aff ed)before me this by by Who is/are personally known to me or has/have produced Who is/are personally known to me or hasthave produced 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 Technician Work Report Date of Work: Not Scheduled District : 292 Technician : Miguel A Rivera Owner : Christopher R Brackett Task Number : 16464218 In Planning Scheduled Start Time Service Request Type : Inspection-Auto Gen Service Request Number : 11144976 Customer Acct : 21390 Payment Terms: Immediate Customer Name : Zephyr Haven Nursing Home Site Name Contact Name : Neal Frasier Phone : 813-7825508 Site Address : 38250 A Ave, City : Zephyrhills State : FL Zip 33541-5759 BiliTo Name : Zephyr Haven Nursing Home BillTo Address: 38250 A Ave, City : Zephyrhills State : FL Zip 33541-5759 Contract Number: 139394 Inspections: Feb 2008, May 2008, Aug 2008, Nov 2008 Service Plan: SP-TEST/INSP Task Type : 1 Person Inspection Priority : Medium Task Name : SP-Nov 2008 Current Inspection: Nov 2008 Problem : Inspection System : SYSTEM-SP-WET SPRINKLER Serial: Wet Sprinkler System Summary : Nov 2008 Created BY AutoGen Notes : LEGACY ACCOUNT NUMBER LEGACY CUSTOMER NUMBER - 01142858 INSPECTION INSPECTION - 1-100% Inspection In January, Smoke Detector Cleaning As Needed, Ahca Inspection In July 100% Sensitivity Testing Required Every Even Year GENERAL SERVICE SERVICE - Inspection Comments - KITCHEN PART - 360d FUSIBLE LINKS -- Quantity: 2 -- Interval : Semi-Annually do not charge service call, $85 plus parts 125.00 a hood cleaning no service call DETACH BEFORE DEPOSITING NO. 3035521 INVOICE DISCOUNT AMOUNT DATE NUMBER 11112008 • PERMIT111108 0.00 50.00 056313 0.00 50.00