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HomeMy WebLinkAbout09-9030 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9030 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 9030 Address: 38250 A AVE Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL. Class of Work: FIRE - PROTECTION MAINTENANCE 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: 4/17/2009 Name: ZEPHYRHAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/17/2009 Phone: Work Desc: FPM - SUPPRESSION SEMI - ZEPHYR HAVEN- SCH WK OF 20TH FIREM■STER FIRE PERMIT FEES 25.00 0 (0 511--- 4,7? j l 3a F . ;,-=�: r zv: fPer6.. 14 ,.< : " e gam.... .. 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." 01P 1i 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 Fax -813 -780 -0021 Permit Application L , Date Received —/ 5'"-e, 5'"-e, / c Phone Contact for Permit �7 Z8 IMMO Owner's Name 1 �C pi.i.vr 1-1Ci...," — I Owner's Phone Number I Owner's Address I Fee Simple Titleholder Name I 1 Titleholder Phone Number 1 1 I Fee Simple Titleholder Address Gc P- X£`.«mn';H•"a� � / .v`� Job Address 3O.2 ✓ 0 4 Ave. Lot # Sub Division I Parcel # I ED Bio-Hazard Waste Storage - ANNUAL = Hazardous Material (Tier II or RQ Facility) ANNUAL E Comm Exhaust Kitchen Hood /Duct El Hood Installation Controlled Bum n LP /Natural Gas - Installation n Emergency Generator < 30 kw = LP /Natural Gas - ANNUAL Sale n Emergency Generator > 30 kw n Places of Assembly- ANNUAL Fire Protection Maintenance - ANNUAL = Recreational Bum InTail EMI) (j Other Sprinkler E ❑ ❑ ❑ n Sparklers Fire Alarm n ❑ ❑ ❑ I I CI Sprinkler System Installations Hood Cleaning Ei ❑ ❑ ❑ 1 1 0 Standpipes (Sprinkler Sys) Hood Suppression Et ❑ er ❑ I 1 n Torch Roofing/Tar Kettle El Fire Alarm Installation El Waste Tire Storage ANNUAL n Fire Pumps Fire Works Flammable Application- ANNUAL 1 ( Valuation of Project Fuel Tanks Q Other: I Contractor Company Fire 0X 71 - 11 /� cvl ot: C�` l Signature 7/116/ \ Registered Y / N I Fee Curren I Y / N Address I I License# 1 7AlSy8"6 la-ex I ELECTRICIAN Company I Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I PLUMBER Company I Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I MECHANICAL Company I Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I OTHER Company I Signature Registered Y/ N I Fee Current I Y/ N I Address License # �.3 >'.. cs,�{.. 3.v <::s.., n..�, `a:..�..•a•. ... c,uu .,...�. -- 'ran „ .s,a. ,. huxn+ sr�;.. aw '.=- .u .;m:w?.'r,:;iurssa2:xa ✓,- . °,., _,aiaar:.tassa.'.; .. 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;DF:DEED RESTRICTIONS: The undersigned understands that this permit maybe • subjectfto - " deed° :restrictions" .which may more restrictive than County regulations. The.undersigned.assumes responsibility .for:compliarice'with any .applicable deed restrictions. UNLICENSED 'CONTRACTORS AND "CONTRACTOR RESP.ONSIBILmES: If the owner has - hired - :a- contractor or • - contractors - to undertake work, they may be required 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 - fora misdemeanor violation iolation for the under state law. if -the advised o t intended contractor sco County licensing Division—Licensing l Section:at 727-847 - 8 009. a F advis he is advised to have the contractor(s) sign 8009.: Furthermore, if the owner has hired .a contractor or contractors, portions ;pf the "contractor Block" of this:application"for which - they will be responsible. If you, as owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled -permitting .privileges in Pasco County. CONSTRUCTION -LIEN LAW e Florida Statutes, as amgndedj If valuation of work 'B12500.00 or more I ( ave .b pr certify that 1, - the applicant, have .been n 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 1 have obtained a copy of the above described document and promise in good faith to deliver itlto the `owner" prior to commencement. CDNTRACTOR'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. l certify met ee t no wrk or st annd a rd s ofa all la n has co ws regulating on��oissuance , ounty .and City codes, .zoning regulations, performed d land m at adrd of ll la g development regulations in the jurisdiction. I also certify that 1 understand that the regulations of other . government agencies may apply to •intended work, and that it is my responsibility to identify what actions I must take to be in compliance. If 1 am the AGENT'FORTHE OWNER, I promise in -good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. 'trn understand or installations a separate to sspecifically may a req d uired n the electrical o , A pt m i t i signs welts on air conditioning, 9 a er, or permit issued shall be construed be a to be a � des shall proceed of a permit prevent the the ding i Offtcal c from thereafter set aside any provisions of the technical codes, etTriit issued shall become invalid requiring a correction of errors in plans, construction or violations of. any codes. Every p unless the work authorized by such permit is s9x (6 within onths aftenh e t me the�work issuance, 'IS commenced. An authorized extension the perriiit is suspended or abandoned for a p e riod of 90 days and will demonstrate may be requested, in writing, from the Building Official, for ag a consecutive a days, the job is considered abandoned. justifiable cause for the extension. if work ceases for ninety (90) MAY WARNING TO OWNER: YOUR FAILURE TO UR RECORD 'NOTICE PROPERTY. IF YOU INTEND TD OBT� FINANCING, T PAYING TWICE FOR IMPROVEMENTS TO YO + � M NCEMENT. WITH YOUR ENDER OR AN ATT = R EYBEFDRE RECORDING YOUR NOTICE OF FLDRIDAiJURAT (F.S. 117.0 / 411 CONTRA> DR (. a� ed) before me this Subscribed OR AGENT swum ' - ..before me this Subscribed and sworn to Subscribed and•swom to (or - � by --by isa personally known to me or has/have produced Who is/are personally known to me or ent f cats produced fre as identifcation . as idenUfrcation. Notary Public Notary Public ommission No. Commission No. c Name of Notary typed; printed or stamped Name of Notary typed, printed or stamped