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Home My WebLink About09-9237 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9237 ANNUAL FIRE PROTECTION MAINTENANCE '11M1717:7 Permit Number: 9237 Address: 38250 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 Im rov. Cost: Date Issued: 6/15/2009 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/15/2009 Phone: Work Desc: FPM - SPRINKLER QUARTERLY FOR ZEPHYR HAVEN NURSING HOME SIMPLEX GRINNELL LP FIRE PERMIT FEES 25.00�� i 1/0q (10 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." 0 : 111 7P P P T 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 ... Permit Application Fax -813- 780 -0021 Date Received rte` 7 � ` - h one Contact for Permit Owner's Name I ( en 91-e, )t G t o A-9,11 I Owner's Phone Number I S12) I ram 151 Owner's Address I { � C rt ` _ � �/ � 1c �\ 1 C ' ta � 9 � V -33� v Fee Simple Titleholder Name I "l Titleholder Phone Number 1 I1 1 1 I I Fee Simple Titleholder Address I F-• =s§. ,�; —. . „K , ... ,.r r-.M r A. u , :: t,- . --�.. - " ,, , ,, ,3..", , , ,,, :,,l, gi O 2—. � X , � ‘)\ NAM- ` ��s�a��> ,a;.�;.*:�” x :„mo Job Address - Z2 ?h iY ti L %941 1 1 I L ot # Sub Division I Parcel # I I I Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent Ii Comm Exhaust Kitchen Hood /Duct = Hazardous Material (Tier II or RQ Facility) ANNUAL I-I Controlled Bum I I Hood Installation I I Emergency Generator < 30 kw I ( Emergency Generator > 30 kw I I LP /Natural Gas - Installation LP /Natural Gas - ANNUAL Sale I — I Fire Protection Maintenance - ANNUAL r--7 Places of Assembly- ANNUAL IUtry (Semi I 'A71 Other �Y Sprinkler ❑ ❑ I I Recreational Bum r Fire Alarm I ❑ ❑ ❑ I I Fl Sparklers 7 Hood Cleaning I ❑ ❑ ❑ i :::::::: I 1 I I ons ood Suppression ❑ ❑ ❑ I I I ) �✓ ,,/ F Fire Alarm Installation I I Torch Roofing/Tar Kettle I Fire Pumps I I Waste Tire Storage ANNUAL I I Fire Works n Flammable Application- ANNUAL I ( Valuation of Project Fuel Tanks n Other: 1 Contractor Company 3 Cyn e � C( Signature Registered Y/ N J � Fee Current I Y/ N j Address I `l I I License # I ELECTRICIAN Company Signature I Registered I Y/ N j Fee Current I Y/ N Address I ( I License # PLUMBER I I Signature Company Registered Y N . 1 Fee Current I Y/ N J Address I I I J License # MECHANICAL' I Signature Company I Registered Y/ N ] Fee Current I Y / N J Address 1 J I I License # OTHER I I Company Signature Registered Y/ N I Fee Current I Y/ N I Address License # 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 htt //a ( p: ppraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersigned understands he undersigned as u assumes responsibility for:compl a e e with any which may be more restrictive than County regulations applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has - hired :a -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 -a p ply for the intended work, they are advised to contact the Pasco County Building Inspection Division — Licensing Section at 7.27 -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 permitting privileges in Pasco County. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, a s a d: I work is $2O 00 or more, I certify that I, the applicant, have been provided with a copy "Florida Construction Lien Law—Ho is so Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the app 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 consdi{ on I asn oe installations a r not may bncluded the application. n� A plumbing, signs, wells, pools, air co 9 9 se a s a any shall provisions constrd to be a license to proceed with technical codes, nor shall ss ance of a pe mitt prevent the Bu ding Official from thereafter r e q tr i n e any rectoof r the shall become invalid unless the a correction of errors in clan permit construction t commenced within six a months of permit permit ssuance, or work authorized by unless m e work suspended o b such p he wok is commenced. An extension m a pbe requested, is es ed, in d or g, from th period e Build ngOff cial forr a period not to exc ed nety days and will demonstrate may be requested, in writing, from justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO YOUR PROPERTY. NOTICE IF YOU INTEND TO OBT N CONSULT PAYING TWICE FOR IMPROVEMENTS WITH YOUR LENDER OR AN ATTO - - BEFORE RECORDING YOUR NOTICE • C � ENCEMENT. FLORIDA JURAT (F.S. 117. � � � / CONTRACTOR ; OWNER OR AGENT Subscribed and s om to or -" firmed) before me this Subscribed and sworn • (or - � ed) before me this by is/are personally known to me or has /have produced Who is /are personally known to me i has /have produced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped