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HomeMy WebLinkAbout08-8391 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8391 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 8391 Address: 38220 HENRY DR Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Township:ZEPHYRHILLS g e:L Proposed Use: COMMERCIAL9 Book: Square Feet: Lot(s): Block: Section: Est. Value: Subdivision: CITY OF ZEPHYRHILLS Improv. Cost: Parcel Number: Date Issued: 10/03/2008 Name: HCR MANOR CARE Total Fees: 25.00 Address: 38220 HENRY DR Amount Paid: 25.00 Date Paid: 1O/O3/2OO8 Phone: ZEPHYRHILLS, FL. 33542 Work Desc: FPM-SPRINKLER QUARTERLY- HCR MANOR CARE A TOTAL SOLUTION, INC FIRE PERMIT FEES •• . . .`zA � �� 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 PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION OFFICER CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041 00T/?2/2037/TUE 11 :27 AM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P. 001 613-7.80-0020 City of2ephyrhills Fins . 4 (b ,/t I Fax-813-780-0021 Permit Application Date Received tt In Phone Contact for Permit Owner's Name - LM HcJ Y/^1 Owner's Phone Number 913 I 1 i OwnersAddress L3 22O. IL C,2 Fee Simple Titleholder Name Titleholder Phone Number Fee.Simple Titleholder Address Job Address . . Lot# Sub Division Parcel# Blo-Hezard Waste Storage-ANNUAL [ Fumigation Tent — © Comm Fxhaust Kitchen Hood/Duct Hazardous Material(Tier 11 or RQ Facility)ANNUAL Controlled Bum . Hood Inatallatlon Emergency Generator{30 kw [ ] 1-151 ural Gas-Installation • Emergency Generator>30 kw ED I.P/Natursl Gas-ANNUAL.Sale FIre.Protection Maintenance-ANNUAL • Places of Aesembty-ANNUAL • I® y a er f" � • Sprinkler yQ• O ❑ Recreational Bum tire Alarm 17 IEl Sparklers Hood Cleaning ❑ O ❑ Sprinkler System Installations, Hood Suppression 17 .O O I tandpipes.(Sprinkler Sys) • Fire Alarm Installation' Torch Roofing/Tar Kettle fl Fire Pumps Waste Tre Storage ANNUAL fl Fire Works Flammable Application-ANNUAL Va}Uation of Project >uel Tanka . Other. . Contractor company A O G.T. Signature L Registared N J Fee Current . /N Address 3 E License# ELECTRICIAN Company Signature Registered Y/ J Fee Current L Y/N Address ucensa# SI PLUMBER Company Signature I Registered IY/NJ Fee Current YIN Address License#. MECHANICAL Company signature Registered I Y/N I, Fee Current Y/N Address License# OTHER Company L Signature Registered rY/N j Fee Current J YJLj N Address • ' License#k . 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 40-14 days for review after submittal date. Parcel#-.obtained from Property Tax Notice(hbpJ/appraiser pascogov.com) SST/712/27107/TUE 1 ': : 27 AM ZEPHYRHILLS BUILDING FAX No, 813-780-0021 F7fl2 'NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may_be•subject'to'"deed":restrictions" which maybe more restrictive than County regulations. 'The-undersigned assumes responsibility'for:compiiacce+with any .applicable deed restrictions.. .UNLICENSED'CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: if the owner has hired-ta~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 maybe cited'for a-misdemeanor violation under state law. If the owner or intended contractor are uncertain as'to what licensing-requirements may rapply 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 coritractor(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.privile'ges in Pasco County. CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes,.as-amended): If valuation of work is'$2500.00 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 obtaip 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 musttake-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'WOTICE-OF-COMMENCEMENT MAY'RESULT IN'YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LEND OR'AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F-S.117.03) OWNER OR AGENT, 2V9 ' CONTRACTOR Subscribed and swum (o affirmed)be me � Subscribed and swum (or affirmed)bgfore s by �, b o islets personally Kno to me or has/have produced Who is/are personally known to me or has/have produced as identlf cation. as identification.. 3 otary Public' L Notary Public. Commission No. ► t Commission No. e 3 `I Name of Notary typed,printed or stamped . . Name of Notary typed,printed or stamped °vo Notary Public State of Florida ,tt"�. dotary� =Wiic State of Florida Elizabeth De Jesus r° cF Elizabeth De Jesus e My Commission DD639910 My Commission DD639910 0 °4 E Tres�' i '�°r M1° Ex ices 02/13/2011 xP .