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Home My WebLink About09-8745 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8745 ANNUAL FIRE PROTECTION MAINTENANCE - '--'- Permit Number: 8745 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: .. alt..: Date Issued: 1/20/2009 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 1/20/2009 Phone: Work Desc: FPM-ANNUAL FIRE ALARM FOR ZEPHY HAVEN NURSING HOME-BY JAN 31ST SIMPLEX GRINNELL LP FIRE PERMIT FEES 25.00 c ( I ,.. '� .:< v.4�:•"', '.. a aN ..... .... .. ., .... .. v,:;. , � ��'.... '` w:..,.: �� as r d'.��`� � ..?. 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 ZephyrhillsFire• Fax-813-780-0021 Permit Application Date Received r�o — (�`'(_l Phone Contact for Permit ( 3 Owner's Name Owners Phone Number Owners Address Fee Simple Titleholder Name Titleholder Phone Number CI C� C� Fee Simple Titleholder Address Job Address 3 asv Ze h Ifl5 FL 33S'-11 Lot# I Sub Division Parcel# Eli Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct [ ] Hazardous Material(Tier II or RQ Facility)ANNUAL._ Controlled Bum Hood Installation Emergency Generator<30 kw LP/Natural Gas-Installation Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale I J/ .7 ' Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL ry emi ®n er Sprinkler Eli . O ❑ O f [ J Recreational Bum Fire Alarm II [ ❑ ❑ u Sparklers Hood Cleaning LII O O O J Sprinkler System Installations Hood Suppression 11111 O O ❑ ILII Standpipes(Sprinkler Sys) 11111 Fire Alarm Installation a Torch Roofing/Tar Kettle JIll Fire Pumps [ Waste Tire Storage ANNUAL Eli Fire Works Eli Flammable Application-ANNUAL Valuation of Project aFuel Tanks Q Other_ Contractor Company �/n Cy Signature Registered Y/N Fee Current Y/N G. {� 336O _ License# ELECTRICIAN Company Signature Registered Y/N Fee Current L Y/N Address License# PLUMBER Company Signature Registered Y/N J Fee Current I Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current L7 N Address License# OTHER Company Signature Registered Y/N Fee Current 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 may be subject,to-"deed":restrictions 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~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 A NOTICE OF.COMMENCEMENT.MAY:RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTeTOOBIN FINANCING, CONSULT WITH YOUR LENDER OR AN A NEY BEFORE RECORDING YOUR NOMENCEMENT. FLORIDA JURAT(F.S.117.0 - OWNER OR AGEN CONTRACTOR Subscribed and sworn to(o before me this Subscribed and sworn ( . e this by by Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have 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 : Francis Lewis Mckinney Owner : Christopher R Brackett Task Number : 17271255 In Planning Scheduled Start Time Service Request Type : Inspection-Auto Gen Service Request Number : 11644278 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 Bil1To Name : Zephyr Haven Nursing Home BillTo Address: 38250 A Ave, City : Zephyrhills State : FL Zip 33541-5759 Contract Number: 139398 Inspections: Jul 2008, Jan 2009 Service Plan: FA-FULL Task Type : 2 Person Inspection Priority : Medium Task Name : FA-Jan 2009 Current Inspection: Jan 2009 Problem : Inspection System : SYSTEM-FA-SIMPLEX 4002 Serial: Simplex 4002 System Summary : Jan 2009 Created BY AutoGen Notes : LEGACY ACCOUNT NUMBER LEGACY CUSTOMER NUMBER - 01142858 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