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Home My WebLink About09-8853 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8853 ANNUAL FIRE PROTECTION MAINTENANCE Y E '.:1k � Permit Number: 8853 .„ Address: 5316 11TH ST Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Township: EPHYRHRan e:L Proposed Use: CHURCH9 Book: Square Feet: Lot(s): Block: Section: Est. Value: Subdivision: CITY OF ZEPHYRHILLS Improv. Cost: Parcel Number: 11-26-21-01OO-171OO-01OO Date Issued: 2/28/2009 Name: SAINT JOSEPH CATHOLIC CHURCH Total Fees: 25.00 Address: 5316 11TH ST Amount Paid: 25.00 Date Paid: 2/25/2OO9 Phone: 813 782-2813 ZEPHYRHILLS, FL. 33542 Work Desc: FPM-FIRE ALARM ANNUAL- ST JOSEPH CATHOLIC CHURCH SCH 2/25/09 RUSSELL ELECTRICAL CONSTRUCTORS FIRE PERMIT FEES ..25.00 FIRE ACCEPTANCE Final �F Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to prevention and protection related activities such as ins PaY for the costs of fire costs related to the aforementioned, pections,plan review,administrative fees,and other Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an a dfinal of inspection shall be charged double permit feeday operationapproved final per of rd co 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 OF COMMENCEMENT '. NOTICE PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION P IT OFFICER CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041 813-780-002n City of Zephyrhills Fire �') Permit Fax-813-780-0021 Application Date Received Phone Contact for Permit Owner's Name Owner's Phone Number $1 3 7$2 2 813 Owners Address 5316 11th St Ze h chill 1 Fee Simple Titleholder Name same Titleholder Phone N � r----� Fee Simple Titleholder Address umber IL- I _ Job Address Church bldg corner 5th Ave -11th st 16th st Sub Division Lot# e° Parcel# J Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct Controlled Bum Hazardous Material(Tier II or RO Facility)ANNUAL Emergency Generator<30 kw Hood Installation Emergency Generator>30 kw LP/Natural Gas-Installation Fire Protection Maintenance-ANNUAL LP/Natural Gas-ANNUAL Sale Places of Assembly-ANNUAL ❑ emi er Sprinkler 0 0 0 Recreational Bum ❑ Fire Alarm XC �� Sparklers Hood Cleaning ❑ Sprinkler System Installations Hood Suppression fI1J Standpipes(Sprinkler Sys) Fire Alarm Installation Torch RoofingfTar Kettle Fire Pumps JJ Waste Tire Storage ANNUAL Fire Works Flammable Application-ANNUAL Fuel Tanks $295. Valuation of Project [� Other: Contractor Signature _ Company Russell Electrical COnst LLC Address Registered EY/N Fee Current Y/N omas Boat Lnd Rd Umatilla F1 License# ELECTRICIAN 1111 Signature Company Address Registered Y/N Fee Current PLUMBER License# Signature Company Address Registered Y/N F�Curren�tY�lt MECHANICAL License# Signature Company LII 11111 Address Registered �NF.e Current Y/ OTHER License# fl Signature Company Address Registered Y/jN � Fee Current LY/N 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 //a htt ( P: ppraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersigned understands-The-unde undersigned at ned als s u es respons billy for permit maybe compliance any which may be more restrictive than County regulations. applicable deed restrictions. be licensed in accordance with state and local regiviolaton UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has -hired contractor be required t s. If the contractors to undertake work, they may both the owner and contractor may be cited for a misdemeanors may I for the under contractor is not licensed eowner required ned by law, County Building Inspection Division—Licensing Section at 7.27-847- un der state law. If the or intended contractor are uncertain as to what licensing requiremethe contractor(s) sign intended work, they are advised to contact thePasco application for which they will be responsible. If you, as the owner sign as the 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have privileges in Pasco portions of the "contractor Block thisof PP licensed and is not entitled to permitting contractor, that may be an indication that he is not properly If valuation of work is $2,500.00 or more, I County. Chapter 713, Florida Statutes, as- amended): _ CONSTRUCTION LIEN LAW( provided with a copy of the "Florida Construction Lien La canto e s someone certify that I, the applicant, have been re ared by the Florida Department of Agriculture and Consumer Affairs. If the app Protection Guide" P P other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to prior to commencement. that all the information in this application is accurate and deliver it to the"owner" construction, zoning and land CONTRACrk will be done S AFFIDAVIT: I certify h all applicable laws regulating that all work will done in compliance made to obtaina permit to do work and installation as indicated. I certify development. Application is herebyprior to issuance of a permit and that all work will be performed to that meetn work rord installation has commenced and City codes, zoning regulations, and land standards of all laws regulating construction, County certifythat I understand that the regulations of other apply to the intended work, and that it is my responsibility to identify what actions I development regulations in the jurisdiction. I also government agencies may pP Y conditions set forth in must take to be in compliance. promise in good faith to inform the owner of the permittingee required o i electrical nssetf work, If I am the AGENT FOR THE OWNER, I A this affidavit prior to commencing construction. I understand that a separate permit may plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. toissuance of a permit prevent the Building Official from theinaal d shall construed to n a license proceed with the work and not as authority to violate, cancel, alter, or permit issued permit issued shall become fter set aside any provisions of the technical codes, nor shall codes. Every requiring a correction authorized h of errors s clans,permitism or evidl within six after the time rmit issuance, k is commenced. An extension by such construction commenced wions o months of permit issuance, or if work authorized by unless the work g0 days and will demonstrate the permit is suspended or abandoned fora period of six (6) months iod not to exceed-ninety ( ) Y may be requested, in writing, from the Building Official for a9 consecutive days, the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety( ) once F COMMENCEMENT MAY RESULT IN YOUR A EWARNING TO OWNER: YOUR FAILURE TO RECORD PROPERTY. YOUR NOTICE OF COMMENCANCIN PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURT ENDEROR AN ATTORNEY BEFORE RECOR�1 FLORIDA JURA ( a CONTRALTO Subscribed and sworn o(or affirms )before me this OWNER OR AGENT before me this by Subscribed and sworn to(or affirmed) by ho is/are rsonal y known to me r ha ahePTuced Who is-'-personally known to mas identification denü roduced Notary Public Notary Public Commission No. M"'u4 * * My COMMISSION N DD O N173 Commission No. Name of Notary typed,p to BudDetNofary$0*0 Name of Notary typed,printed or stamped RLt.SSE5LL eLI✓CTRIC�4L aONTaTORBS LLC. 41220 Thomas Boat Landing Road Umatilla, Florida 32784 carolrussell@toast.net Rex: 352-636-5328 Carol:352-636-5316 Phone/Fax: 352-669-0131 February 21, 2009 City of Zephyrhills 5335 8th Street Zephyrhills, FL 33542 To Whom It May Concern: The following individuals are hereby authorized to sign for and pick up, any and all building permits, applications, local licensing forms, licenses, notice of commencement or any other required forms on behalf of Russell Electrical Constructors, LLC. David Radder William Radder This general power of attorney shall refer only to City of Zephyrhills, Florida. Signature of qualifier and license holder: Rex A. ussell License no. EC0002542 NOTARY STATE OF FLORIDA, COUNTY OF Sworn to and subscribed before me this 2/ day of 2009, by Rex A. Russell, who is personally known or has produced identificat NOTARY SIGNATURE SHARON M.RADDER My commission expires: * MY COMMISSION#00638273 EXPIRES:April 26,2011 'OF K a Notary services R ,ISSELL ELECTRICAL CONSTRCTDPS LLC 4122O Thomas Boat Landing Road Umatilla, Florida 32784 To: e-mail: carolrussell@toast.net Rex: 352-636-5328 Attn: Carol:352-636-5316 Fax: 352-669-0131 Fax: Phone: Insurance certificate(s) will be faxed directly from our insurance agent. Thank you. Carol AC# 3 9 4 2 8 5 5 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD - LICENSE NBR SEQ#L08082501478 1 0825 2008 078176000 EC0002542 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2010 RUSSELL, REX A RUSSELL ELECTRICAL CONSTRUCTORS LLC 41220 THOMAS BOAT LANDING, RD UMATILLA FL 32784 CHARLIE CRIST GOVERNOR CHARLES W. DRAGO DISPLAY AS REQUIRED BY LAW SECRETARY BOB McKEE 2008/2009 AKE COUNTY TAX COLLECTOR LAKE COUNTY BUSINESS TAX RECEIPT FACILITIES/ STATE OF FLORIDA RECEIPT NO. 2060000131 MACHINES ROOMS SEATS EMPLOYEES EXPIRES SEPTEMBER 30, 2009 TYPE OF 206 ELECTRICAL CONTRACTOR 4 RENEWAL $30.00 BUSINESS CERTIFIED BUSINESS 41220 THOMAS BOAT LANDING ADDRESS UMATILLA, FL 32784 ORIGINAL TAX Make checks payable to: $30.00 Bob McKee, Tax Collector AMOUNT PO Box 327 - Tavares, FL 32778-0327 $30.00 RUSSELL ELECTRIC CONSTRUCTORS LLC REX A RUSSELL 41220 THOMAS BOAT LANDING RD TOTAL $30.00 UMATILLA, FL 32784 X SIG AND DISPLAY AS ��- I SWEAR THAT THIS APPLICATION FOR RECEIPT IS MADE D FOR THE BUSINESS OR PROFESSION TRUE AND CORRECT THE APPLICATION MUST COMPLY WITH PAID-6003782 O7/25/2OO8 30 .00 STATE AND LOCAL ORDINANCE,INCLUDING ZONING. r tt'_ OL9y Ly : v FN Ft P_! 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