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HomeMy WebLinkAbout09-8833 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8833 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 8833 Address: 38250 A AVE W"u"' Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENANC E 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: 2/18/2009 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 2/18/2009 Phone: Work Desc: FPM-SPRINKLER ANNUAL BACK FLOW-ZEPHYR HAVEN NURSING SIMPLEX GRINNELL LP FIRE PERMIT FEES 25.00 c , I -27 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. )l Qt�33 �9' U Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit 49 Owner's Name Owners Phone Number Owners Address Fee Simple Titleholder Name Titleholder Phone Number L 1 L1 Fee Simple Titleholder Address LL�� Job Address 3 co__A A 2-L S fl.- 3_35 '11 Lot# C� Sub Division Parcel# Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL Controlled Bum JJ Hood Installation Emergency Generator<30 kw JJ LP/Natural Gas-Installation Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL r y emi er Sprinkler © O ❑ &, cK i)[ ] Recreational Bum Fire Alarm E ❑ ❑ Oj C1 E Sparklers Hood Cleaning ❑ ❑ ❑ C7 a Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ L1 LJ Standpipes(Sprinkler Sys) Fire Alarm Installation [ J Torch Roofing/Tar Kettle Fire Pumps Waste Tire Storage ANNUAL EFire Works R Flammable Application-ANNUAL Valuation of Project Fuel Tanks Q Other: Contractor Signature Company Registered L Y/NJ Fee Current Y/N Address License# ELECTRICIAN Signature Company Registered Y/N I Fee Current Y/ Address License# L PLUMBER Signature LCompany Registered L Y/N Fee Current [y/N Address License# MECHANICAL Signature Company Registered LY/N I Fee Current LY/NJ Address License# OTHER Signature Company L Ill Registered Y/N_J Fee Current Y/N Address Directions: 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 h J/a( ttp• ppraiser.pascogov.com) ne understands that ths permit may be NOTICE OF DEED RESTRICTIONS: The underg s The undersigned assume espons billy fortcompl a'ncetw'Ith any which may be more restrictive than County regulations applicable deed restrictions. the owner has UNLICENSED CONTRACTORS beNegRACTOR u!red to be RESPONSIBILITIES e ssed accordancef with state and locale regulations. Ifr or the contractors to undertake work, they may contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor lviy folationn r the under state law. If the owner or on contact the Pasco County Buildinged contractor are uncertain s to what Inspection Divis on-requirements s ngtSection at 727-847- intended work, they are advised to have the n 8009. Furthermore, if the owner has hired application forcontractor orh contractors, he is be responsible. af you, as the ownerrsctor(s)sign as the portions of the "contractor Block" of this privileges in Pasco contractor, that may be an indication that he is not properly licensed and is not entitled-to permitting p 9 County. CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, oamended): rthe e"FloridaConstruction Lien $2,500.00 ,500.0 or more, I own is certify that I, the applicant, have been provided with a copyapplicant is someone Protection Guide" prepared by the Florida Department of Aof ithetabove described document and promise in good faith to ure and Consumer Affairs. If the other than the "owner", I certify that I have obtained a copy deliver it to the"owner" prior to commencement. CONTRAC will be done iS compliance oAFFIDAVIT:lnce with all pplicablelawsr this application is construction, zoning uand land that all work nt willli done P 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 adpermit and that all regulations,work will be performedo to meet standards of all laws regulating construction, Countythat I understand ycodes, zoningthat the regulations n other development regulations in the jurisdiction. I also certify 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. forth in If I am the AGENT FOR THE OWNER, I promiseI lunderstan faith d that a inform seperate permit may be equ permitting ired for conditions electr electrical set I work, A this affidavit prior to commencing construction. Ilcation plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the app r, or permit issued shall be construed to be a lodges, to proceed nor shall ssualth ncehe work of a permit p event the not as hority to Bu ding Official from ther, cancel, eafter set aside any correction of rf the technical codes, requiring a correction of errors in plans, construction mencedlwithin six any codes. of permit permit lnce ordif woll become invalid rk authorized by unless the work authorized r b such d permit is the permit is suspended or abandoned for Building Of of for a period not the time ninety days and will demonstrate may be requested, in writing, from the Buildingconsecutive days, the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety(90) AY RESULT IN YOUR WARNING TO OWNER: YOUR FAILURE TO RR PROPERTY.NOTICE YOU INTEND TO OBTAINS PAYING TWICE FOR YOU FINANCING, CONSULT IMPROVEMENTS TO WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) CONTRACTOR OWNER OR AGENT Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this by by Who i— slare personally known to me or hasthave produced Who islare personally known to me or fiC ve produced as identification. as ideenntification. 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 : 18220309 Scheduled Start Time In Planning Service Request Type : Inspection-Auto Gen Service Request Number : 12222208 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 BiliTo Address: 38250 A Ave, City : Zephyrhills State FL Zip 33541-5759 Contract Number: 139394 Inspections: Feb 2009, Feb 2010, Feb 2011, Feb Service Plan: SP-TEST/INSP 2012, Feb 2013 Medium Task Type 1 Person Inspection Current Inspection: Feb 2009 Task Name SP-Feb 2009 Problem : Inspection System : SYSTEM-SP-BACKFLOW Serial: Backflow System Summary : Feb 2009 Created BY AutoGen Notes : 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 INSPECTION - 1-100% Inspection In January, Smoke Detector Cleaning As Needed, Ahca Inspection In July 100% Sensitivity Testing Required Every Even Year LEGACY ACCOUNT NUMBER LEGACY CUSTOMER NUMBER - 01142858 CONTRACT COVERAGE ANNUAL INSPECTION (FEB) OF THE BACKFLOW PREVENTOR.