HomeMy WebLinkAbout09-8747 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8747
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 8747 Address: 38505 10TH AVE
Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost: .
Date Issued: 1/20/2009 Name: RAYMOND B STEWART MIDDLE SCHOO
Total Fees: 25.00 Address: 38505 10TH AVE
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/20/2009 Phone:
Work Desc: FPM-FIRE ALARM ANNUAL-RAYMOND STEWARD MD SCHOOL
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FIRE PERMIT FEES 25.00
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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."
a.,
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 (, ,7/-f,'7Fax-813-780-0021
yKPermit Application ! y0
Date Received 17oJy Phone Contact for Permit Ff/ (�0;3 9
Owner's Name Owner's Phone Number 1 I1 I
Owner's Address
Fee Simple Titleholder Name Titleholder Phone Number � II I
Fee Simple Titleholder Address
Job Address J U 9)5 Ave.fO Z- hyi11sIS, FL 335"! C) J Lot#
Sub Division Parcel#
LII Bio-Hazard Waste Storage-ANNUAL ElI Fumigation Tent
Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL
Controlled Bum Hood Installation
El Emergency Generator<30 kw jjJ LP/Natural Gas-Installation
LII Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
LIII Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL
®y emr er
Sprinkler ❑ ❑ ❑ B Recreational Bum
Fire Alarm V ❑ ❑ Sparklers
Hood Cleaning ❑ ❑ O J LJ Sprinkler System Installations
Hood Suppression ❑ ❑ ❑ J Standpipes(Sprinkler Sys)
LJFire Alarm Installation Torch Roofing/Tar Kettle
Fire Pumps LI Waste Tire Storage ANNUAL
LII Fire Works
LII Flammable Application-ANNUAL Valuation of Project
Fuel Tanks
Q Other:
Contractor Company �/n .Cy
Signature Registered Y/N Fee Current Y//N
Address U7 p G.I- j 336,0 License#
ELECTRICIAN Company
Signature Registered J Y/N I Fee Current J Y/N
Address
License#
PLUMBER Company
Signature Registered Y/N J Fee Current J Y/N
Address License#
MECHANICAL
Company
Signature Registered Y/N Fee Current I 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 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 INTEND TO OBT IN FINANCING, CONSULT
WITH YOUR LENDER OR AN A NEY BEFORE RECORDING YOUR NOTIC C MENCEMENT.
FLORIDA JURAT(F.S.117.03
OWNER OR AGEN CONTRACTOR
Subscribed and sworn to(or i before me this Subscribed and sworn ( . a 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 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 : 17277261 In Planning
Scheduled Start Time
Service Request Type : Inspection-Auto Gen
Service Request Number : 11656350
Customer Acct : 333104 Payment Terms: Immediate
Customer Name : Raymond B. Stewart Middle
Site Name
Contact Name : John Boucher Phone : 813-794-7961
Site Address : 38505 10th Ave, Pasco Co Schools
City : Zephyrhills
State : FL Zip 33540-4199
Bi11To Name : Pasco County School Board
Bil1To Address: 11835 Tree Breeze Dr, Maintenance Dept - John A Boucher
City : New Port Richey
State : FL Zip 34654-1808
Contract Number: 135993
Inspections: 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 4100U Serial:
Simplex 4100u System
Summary : Jan 2009 Created BY AutoGen
Notes : CONTRACT COVERAGE
***INSPECTION***
ANNUAL INSPECTION OF THE FIRE ALARM SYSTEM. CLEANING AND
SENSITIVITY TESTING OF SMOKE DETECTORS TO BE DONE AT 100% EVERY
OTHER YEAR (ODD YEARS) . AUDIBLE TESTING IS NOT ALLOWED DURING
SCHOOL HOURS. IF DEFICIENCIES CANNOT BE REPAIRED AT TIME OF
INSPECTION, IT MUST BE REPORTED TO THE PASCO CSB MAINTENANCE
DEPARTMENT (JOHN BOUCHER OR DON TORGE) .
LEGACY CUSTOMER NUMBER - 00734905