Loading...
HomeMy WebLinkAbout08-8475 CITY OF ZEPHYRHILLS • 5335-8TH STREET (813)780-0020 8475 FIRE ALARM SYSTEM PERMIT Permit Number: 8475 Address: 38453 5TH AVE Permit-Type: FIRE ALARM SYSTEM ZEPHYRHILLS, FL. Class of Work: FIRE ALARM SYSTEM Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-15300-0070 Improv. Cost: 3,594.00 Date Issued: 11/03/2008 Name: HUDGINS, DREW Total Fees: 150.00 Address: 38453 5TH AVE Amount Paid: 150.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/03/2008 Phone: (813)788-5534 Work Desc: ADDITION TO FIRE ALARM SYSTEM ADT SECURITY SERVICE,INC FIRE ALARM 50.00 FIRE INSPECTION FEES 50.00 FIRE PLAN REVIEW FEES 50.00 FIRE ACCEPTANCE Final FIRE ELEVATOR RECALL 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 COMMENCEMENT 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." CONTRACTOR SIGNATURE I IC R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office-813-780-0041 CERTIFICATE OF INSURANCE CERTIFICATE NUMBER PRODUCER 521439 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Marsh,Inc. POLICIES DESCRIBED HEREIN. 1166 Avenue of the Americas COMPANIES AFFORDING COVERAGE New York,NY 10036 COMPANY A: New Hampshire Ins. Co. Telephone(212)345-5000 COMPANY B: New York Marine & General Insurance Co. (Lead) INSURED COMPANY C: White Mountain Insurance Co. COMPANY D: Nat'l Union Fire Ins Co of Pittsburgh, PA COMPANY E: Illinois National Insurance Co. ADT Security Services,Inc. COMPANY F: Commerce & Industry Ins Co 32100 US Hwy19 N COMPANY G: AlSouth Insurance Co. COMPANY H: Insurance Company of the State of PA Palm Harbor,FL 34684-3727 United States COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRMENTS,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER LTR POLICY EFFECTIVE POLICY LIMITS DATE(MM/DD/YY) EXPIRATION A GENERAL LIABILITY GL 1871924(Primary X COMMERCIAL GENERAL GL) 10/1/2008 10/1/2009 GENERAL AGGREGATE $4,000,000.00 CLAIMS MADE PRODUCTS-COMP/OP AGG $4 000 000.00 X OCCU OWNER'S&CONTRACTOR'S PERSONAL&ADV INJURY 2 000 000.00 EACH OCCURRENCE $2,000,000.00 FIRE DAMAGE(Any one fire) $1,000,000.00 D AUTOMOBILE LIABILITY MED EXP(Any one person) $10,000.00 D X ANY AUTO CA 1607774(MA) 10/1/2008 10/1/2009 COMBINED SINGLE LIMIT CA 1607775(VA) 10/1/2008 10/1/2009 $7,500,000.00 D X HIRED AUTOS CA 1607776(AOS) 10/1/2008 10/1/2009 X NON-OWNED AUTOS D WORKERS COMPENSATION AND WC 1872471(CA) D EMPLOYERS'LIABILITY 10/1/2008 10/1/2009 Xwcsururoar orHe WC 3754201(AOS) 10/1/2008 10/1/2009 E THE PROPRIETOR/ WC 1872475�M[J.._..._._ EL EACH ACCIDENT F PARTNERS/EXECUTIVE 10/1/2008- -_-- 1Q(1/2009 $2,000,000.00 OFFICERS ARE: C WC'187247 /1/2008 10/1/200g..� EL DISEASE-POLICY LIMIT G WC 1872478(CT,GA,PA,SC) 10/1/2008 10/1/2009 $2,000,000.00 A WC 1872477(NY,OH,WI) 10/1/2008 10/1/2009 EL DISEASE-EACH $2,000,000.00 D WC 1872473(OR) 10/1/2008 10/1/2009 H WC 1872476(AR,MA,VA) 10/1/2008 10/1/2009 A WC 1872474(TX) 10/1/2008 10/1/2009 EXCESS LIABILITY A X OTHER THAN UMBRELLA FORM GL 1871990(Excess GL) GENERAL AGGREGATE $11,000 000.00 10/1/2008 10/1/2009 PRODUCTS-COMP/OP AGG $11 000 000.00 UMBRELLA FORM EACH OCCURRENCE $5,500,000.00 C PROPERTY 'All Risk'of direct n WM-ARP-05-01-08 5/1/2008 5/1/2010 AMT OF INSURANCE VALUE OF REAL Earthquake,Flood,Personal roperty?ge. PROPERTY INVOLVED IN Business Income,Building, Property, erty,Expense, CONTRACT BETWEEN Rental Value and Boiler and Machinery NAMED INSURED AND OTHER CERTIFICATE HOLDER B Builder's Risklnstallabon/Contract Works JP-TI-20072 B Rental Equipment/Contractor's Equipment JP-TI-20072 5/1/2008 5/1/2009 USD$10,000,000.00 B Blanket Transit JP-TI-20072 5/1/2008 5/1/2009 USD$10,000,000,00 perlobsite 5/1/2008 5/1/2009 USD$10,000,000.00 perjo nve DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS per conveyance Job Number.town 174 Customer Number:town 174 Town Number:town 174 LICENSE HOLDER: MARK C PENZATO EF0001123 CERTIFICATE HOLDER City of Zephyrhills CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE 5335 Eighth Street INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER 5335 Shills,FL 33542 NAMED HEREIN.BUT FAILURE TO MAIL SUCH NOTICE SH OBLIGATION OR LIABILITY OF ANY KIND UPON ZephTHE INSURER AFFORDING COVERAGE.ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. United States MARSH USA INC,BY: Sarah Karg,Properly Program David Kong,Casualty Program ro9 Franklin i Program ,Global Marine Transit VALID AS OF:9/28/2008 11111111111111111111111111101110111011101110111 I I I I I I I I 2008159188 Rcpt:1211370 Rec: 10.00 Permit No. Tax Folio No. DS: 0.00 IT: 0.00 -- 11/03/08 Dpty Clerk NOTICE OF COMMENCEMENT JED PITTMAN PASCO COUNTY CLERK STATE OF FLORIDA, COUNTY OF PASCO 11/03/08 11':19am 1 Of 1 OR BK 7958 PG 1866 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property: (legal description and street address if available) :11-26-21-0010-15300-0070 38453 5th AVE, ZEPHYRHILLS, FL 33542 General description of improvement: EXPAND EXISTING FIRE ALARM SYSTEM TO NEW AREA / 3. Owner information: HUDGENS DREW BEN a. Owner address: 38453 5 AVE, ZEPHYRHILLS, FL 33542-4328 b. Interest in property: OWNER c. Name and address of fee simple titleholder: (if other than owner) 4. Contractor: v a. Name and address: ADT Security Services Inc _ 5471 W Waters Ave. Tampa, FL 33634 b. Phone number: 813-806-7000 c. Fax number: 813-806-7191 (optional,if service by fax is acceptable) 5. Surety: a. Name and address: b. Pmount of bond $ c. Phone number: d. Fax number: (optional ,if service by fax is acceptable) 6. Lender: a. Name and address: h. Phone number: c. Fax number (optional, if service by fax is acceptable) : 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(l) (a)7. , Florida Statutes: a. Name and address: b. Phone number: c. Fax number (optional, if service by fax is acceptable) : 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Leinors Notice as provided in Section 713.13 (1) (b) ,Florida Statutes: a. Name and address: b. Phone number: c. Fax number (optional, if service by fax is acceptable) : 9. (Expiration date of notice of commencement (the expiration date is one year from the date of recording unless a different date is specified) . Date: ? Signature of Owner x , Printed Name x $—L T `3 (•�rVc C� State of x RCric11 CU County of x PCB<,AC Sworn to and subscribed before me thisday of ( 20 c L . ff--L is( )personally known to me or( Produced _—_as identification. Notary: Seal: PIR,ES:MAy17,2012 Nohry pig feu STATF OF FLORIDA COUNTY OF'PAS DA TRUE AND C IS TO CERTIFY THAI THE FOR C OF RECORD Ofd RECO'COPY THE DOCUMENTOING IS A OF F'USLI, 1. HAND AN OFF/ N THIS OFFICE, �,, TN ES FILE CIAL SEAL THIS S MY QED PITTIVI©(/ DAY OF CLE 2 op BY F CIR COURT Y CLERK cwx-1 813-780-0020 j CitY of Zephyrhills rhills Fire / �� . P Y Fax-813-780-0021 Permit Application -/jt Date Received -- — Phone Contact for Permit S'/� j�� $ �$ ^caner s Name (/ n r e 4/ Bfl Owner's Phone Number J I I I "vners Address I33 5t z ,�/s Pz. 3 8 Fee Simple Titleholder Name Titleholder Phone Number I L1 C Fee Simple Titleholder Address ``�� e� Job Address S7�� _ 24 vei, ' Lot# — Sub Division Parcel# 1 v�4' Z.-( -01)10 !53od .0076 Rio-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 a LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL JJ Places of Assembly-ANNUAL emi er Sprinkler ❑ O O ® Recreational Bum Fire Alarm ❑ O O 1 Sparklers Hood Cleaning O ❑ ❑ I Sprinkler System Installations Hood Suppression ❑ ❑ ❑ II 1J Standpipes(Sprinkler Sys) Fire Alarm Installation [ ] Torch Roofing/Tar Kettle Fire Pumps [ J Waste Tire Storage ANNUAL Fire Works Flammable Application-ANNUAL (�T '3 „f-9 Valuation of Project Fuel Tanks �dLC Z ' Ire a /' Ste.j Other: / Contractor Company Signature Registered Y/N Fee Current I Y I N Address License# ELECTRICIAN Company Signature Registered I Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered l Y/N I Fee Current J Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current L Y/N Address f License# OTHER Company ci tyq5e C✓�Gej Signature Registered Y/N Fee Currer L Y/N Address �- License# �dQ 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(httpJ/appralser.pascogov.com) NOTICE OF*DEED RESTRICTIONS: The undersigned understands.thatthis permit maybe subject'to-"deed",restrictions" which may be more restrictive than County regulations. Thee-undersigned assumes responsibility forccompliancewith any .applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired-ha--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, 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 the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety(90)consecutive days, WARNING TO OWNER: YOUR FAILURE TO RECORD A'NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS AN ATTORNEYO YOUR PROPERTY. IF YOU INTEND TO OBTAIN BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.FINANCING, CONSULT WITH YOUR LENDER FLORIDA JURAT(F.S.117.03) OWNER OR AGENT CONTRACTOR Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)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. ed, rinted or stamped Name of Notary typed,printed or stamped Name of Notary typ p ZEPHYK LLs5 Ii'itKr- DEa kn i 1hliEl i agn7 nnjrn, Dn�rj 7nnhvrhffls FL 33542 i-�;v ,....c. ..�.... P r41 '7un_lulA•! F lft13170.!nA4 awt it\i. V`i i�ivr Vvr:i i raw business rvarne: tafa t-; ;Yt s r -ii u. ..."v.s�: d of C Business Address: Business Phone No -• •, - t3iiiiFig Phone ivi,._ �"F -, rv;.�, ,� R _.t«._._inpcc Fr No Bil i3i1Un Fax No.. flfiWt -`- ----_- -" purr FEE FASSE ALARM FEE =z. ,- 1J tr.et6rra.Td.ye�riaTnTtc.i eoi _W.a. Li S ::y.w,.i :i :m- -__ _-- `�--- _-- ers+ (Minimum C nsr �fJ.W ! i 2nd RAN I:a}J�{%tp;y t �i iti j j i n:.• w:y; 55.. } I Plan Revtsmns OBI Fri $5 1 I�Re-inspection bLJl1 xi, Re-irtsnectktn 5500 Alarm 1 1 ttiarmEn sVCTFM «2. tr! c 116th Alarm ..*ii( _.. '50 I Iswx rrosa paerx $t 5iS I ri r - wax w FIRE PUMP 1 (Acceptance Test $45 pe.system . F - 1 IeP-ire v`=' U 1 Li E Fbw S75 f k or tm i Bum $iOO cif !AP 1; STEM 1 IH!)rk t/r�t $ 50 tY/ r'-. _ ._ ._thh - g+x• is i v i C (Li ==-„ , 9w i T�FE= - :: Li Wet $50lJ OTHER N:- s�:c ait- Siie sitii d�c $50 II Div $50$50 1 i Fire WaWsm Wail $95 per wad jl�jGweneraior<Ki- $100 I I rn? $50 I IP c 125 eertatic I (Generator>30 KW 150 0 ._ !`tn I I ini Azmgr�t. a4S a irHEN EXHAUST @��c Tr:.tj�.� Q�C.rt $50 Hooc Yucts Te. 1(YXl0'Or $15 per ie!!t S 61i:�a PuUApp iad $ 0 OTHER Fie� er $45 UHaz. $100 A Li LP rWaralian per ta.t 350U File S*Pn sicn $30 Fu d Tank Uida/eiion $50 Sy en (Par Tank) $50 8 Eidiatist Hod $30 Ui iewi.ed.,�es $50 Roklalmd n oG (Per System) (firer f a Timm) ❑SFW A 150 []ka 5l1e �ad DOL aid Cw xied bw fm 24 taus __� HCa Ndrucem impL iwc ► A0 FALSE ALARM PLANS TOTAL <,//T PdSP �BCj TOTAL] P1i T TAL[ T.T.L�� AN GR TOTAL , i<7J — Caianisais� Date: 2s d - Inso 1I7 ,�___