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Home My WebLink About09-9344 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9344 ANNUAL FIRE PROTECTION MAINTENANCE P v a A ddress: 3 8250 A AVE Number: 9344 �g = Permit N Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE - PROTECTION MAINTENAN •E 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: 7/14/2009 - <s Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.0 ^ • Address: 38250 A AVE Amount Paid: 25.0 ZEPHYRHILLS, FL. 3 Date Paid: 7/14/2009 v -' _ Phone: Iv Be= � I' 0 Y , - ' - - 1 \ II- N a . .s :€ " ' ", -I 1 1 ► (1 it c SIMPLEX GRINNELL 25 .00 LP FIRE PERMIT FEES [ Qd C efo 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 .1? 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 ZephyrhiUs Fire; q3 Fax -813 -780 -0021 Permit Application / Date Received J e Contact Permit ,.- - Phon on act r Owner's Name S TMPLRX(R I NNELL Owner's Phone Number 1813 1 626 1 1 5 4 8 2 Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 Fee Simple Titleholder Name Titleholder Phone Number I I J 1 Fee Simple Titleholder Address I --.. Job Address ,1 g 2 So \\4 , zeNv`' ( ,i1S L 335y 1 Lot# J Sub Division Parcel # I Bio- Hazard Waste Storage - ANNUAL Fumigation Tent I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier if or RQ Facility) ANNUAL I Controlled Bum Hood Installation I Emergency Generator < 30 kw LP /Natural Gas - Installation I Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale I . Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL 1 JU !Semi trlyl !Se''Anil Other Sprinkler ❑ ❑ ❑ I Recreational Burn r- Fire Alarm r I/ ❑ ❑. I I I I Sparklers /�/ Hood Cleaning 1 ❑ ❑ ❑ I I I I Sprinkler System Installations / n f f- k 9 Z 3 g Hood Suppression I I ❑ ❑ ❑ I I . J Standpipes (Sprinkler Sys) / //` j� I Fire Alarm Installation • I Torch Roofing/Tar Kettle p [ /— F— f Fire Pumps I I Waste Tire Storage ANNUAL �,/ O I ' Fire Works �I`Y I Flammable Application - ANNUAL ( Valuation of Project I Fuel Tanks I Other: '8,r3:N8 k ,8,- .8'888-- R 1 ,,,','''Y ^:. <`'- ` ',', _ " 2n8' i11 - :. iE8—,. , -A,G =,A.:3 AAA d 3er, ,, _,,, - ',,,x,.: ■ 'dd"4 p _,'._3 _ i 3 1 Y Contractor Company err tr■v .,� 1( Registered Y / N } I Fee Current I \ Y ill Address I `� I License # - ELECTRICIAN Company Signature Registered Y/ N I ' Fee Current I Y / N . . Address I I License # PLUMBER I Company Signature Registered Y/ N - . I Fee Current I Y 1 N J Address I License # _ MECHANICAL I Company Signature Registered Y/ N j Fee Current I Y/ N 1 Address I I License # I I OTHER Company _ Signature Registered Y / N I Fee Current 1 Y/ N 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 daps for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) NOTICE OF =DEED RESTRICTIONS: The undersigned understands tat assumes pe rmit m be ibilby for an pe e with any which may be more restrictive than County regulations. T undersigned _applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has - hired :a or - contractors to undertake work, they may be required to be licensed in accordance with state and local If the u nder t is not lic t h e o owner re or me intended both uncertain as to what licensing te cited misdemeanor violation may applyfothe under state law. If the owner intended 009. Furthwore, they are rmore, if the oow ner to contact as hired -a contractor County heois Division—Licensing dvi ed to have he contractor(s) sign 8009. ehe w 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, - a a e de ): I Construction of on r i $2;500.00 or more, I certify that I, the applicant, have been provided with a copy of other th an h ei o er", I onsumer Department deliver it to the "owner" prior to commencement. CONTRACTOR'S/OWNER'S 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 developme Application ihasecommen made ced prior to issuance of a permit ad that installation work will be performed certify to m no standards rd s installation fa l laws h and City codes, zoning regulations, and land mt adrd of all aws regulating construction, County tY development regulations in the jurisdiction. I also certify that 1 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 pemt may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A , cancel, alter, or permit issued shall be to be a license to shall ssualncehof e work a permitlprevent the ding Official from thereafter set aside any provisions of the technical codes, nor unless the work a a correcti t h of errors o s d such permit isrc violations of six a months of permit issuance, uordif shall become work authorized by the s erm ended or abandoned nch m a pbe a is es ed, in d or g, from e Build ng OfF Official (6) months after the time the work is commenced. An extension al for a period not to exceed days and will demonstrate may be requested, in writing, from 9 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 NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR BEFORE RECORDING YOUR NOTICE O O , : E N I , CONSULT WITH YOUR LENDER OR AN ATTO' FLORIDA JURAT (F.S. 117.1 • - �� OWNER OR AGENT CONTRACTOR Subscribed and s om to or -. imed) before me this Subscribed and sworn • (or - • ed) before me this by so Who is nally 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. Name of Notary typed; printed or stamped Name of Notary typed, printed or stamped