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Home My WebLink About10-10450 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 10450 ANNUAL FIRE PROTECTION MAINTENANCE ¢ , .> ,s u m a: 7 ¢, �er °° . �.°2.P as n( ,• s ° .. @ w. Permit Number: 10450 Address: 38233 DAUGHTERY RD Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL. Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35- 25 -21- 0010 - 12300 -0000 Improv. Cost: t.2-Pro: momE Date Issued: 5/11/2010 Name: ADVENTIST HEALTH SYSTEM Total Fees: 25.00 Address: 7050 GALL BLVD Amount Paid: 25.00 ZEPHYRHILL FL 33541 Date Paid: 5/11/2010 Phone: (813)783 -6189 Work Desc: FPM - QUARTERLY FIRE SPRINKLER FOR ADVENTIST HEALTH SYSTEMS C(04, IMPL X ` N LL L` IR P - M 25.00 10 r ) 04$ 1, J: FIR A - ANCE 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." k► .. 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 813780 -0020 City ofZephyrhills - Fire. Fax- 813 -780 -0021 /� t Permit Application Phone Received �u e CO Permit y .__. �� ::,�•- — .3 - _ v.... --' Contact for P erm Owner's Name STMPT,FXGRTNNELL Owner's Phone Number 813 1 626 5 4 8 2 Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 Fee Simple Titleholder Name - ' Titleholder Phone Number Fee SimpleTrtfeholderAddress I • pnn � Job Address S . g.:6 `Dctv3ri vot �� . Zeehirk1�IS TL 3 -±5 Lot# Sub Division Parcel # mow. te = . ..� . ; a== : .;s - - -z- �..... --tt v�.m - :— . =5,,:: %--, ' P - -- —' ,a - s: �- - a'c -,,,,,,a,e r ..s.. 1 • I :. Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent Comm Exhaust Hood /Duct I �l/� S Hazardous Material (Tier If or RQ Facility) ANNUAL I. Controlled Bum (7 1/ IJ 1* / , I Hood Installation / i •) Emergency < 30 kw 7 I LP /Natural Gas - Installation / 0 il 6 V E Generator > 30 kw I • LP /Natural Gas - ANNUAL Safe i I`. ( mergency 4 I " I' Fire Protection Maintenance - AnNUAL I Places of Assembly-ANNUAL IQ trly 'Semi IAni Other Sprinkler, ��f I I ❑ ❑. l ( Recreational Bum Fire Alarm I 1 ❑ ❑ ❑• 1 ' 1 1 I . Sparklers Hood Cleaning 1 ! El ❑ ❑ I I l I Sprinkler' System Installations Hood Suppression. I l CI ❑ ❑ ) I ._ I ( Standpipes (Sprinkler Sys);. t t I I Fire Alarm Installation L Torch Roofing/Tar Kettle • Fire Pumps Waste Tire Storage ANNUAL I Fire Works ,, I. Flammable Application- ANNUAL / Valuation of Project . Fuel Tanks • I I Other . . • F' ? Contractor � _ Company iKr.nv.t, t.( Signature Registered Y / N 1 Fee Current I• Y /'N _I ' Address I .. I License # ..I • L ELECTRICIAN , Company . . . , > , Signature :"f' - Registered Y 1 N I Fee Current I , / N'. I i . Address 1 I License # . . PLUMBER :. Company ' Signature Registered Y1 N ' Fee Current I Y / N Address I . . • I License # • I MECHANICAL Company Signature Registered Y/ N Fee Current I Y/ N Address I; . : -. I License # I OTHER • Company - Signature Registered L Y/ N I Fee Current I Y/ Ni 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 (httpJ /appraiser.pascogov.com) 'NOTICE OF :DEED RESTRICTIONS: The undersigned understands that this permit may_be subject to which may be more restrictive than County regulations. The:undersigned assumes responsibility for-:compliartce%with any _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 focal 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 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 entitfed permitting privileges in Pasco County. CONSTRUCTION N -LIEN LAW (Chapter713, 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 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 it to the "owner" prior to commencement. CONTRACTOR'SIOWNER'S- AFFIDAVIT: I certify that all the information in this application" is accurate and that all work will be done in compliance with ail 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 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 jurisdictioh. 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 l•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:.- L underatat d_ that.al5„oparate, permit may be requrred 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. shalt .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'NOTICE `OF `COMMENCEMENT MAY RESULT IN YOUR PAYING. TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBT N FINANCING, CONSULT WITH YOUR LENDER OR AN ATTO' - 'BEFORE RECORDING YOUR NOTICE C ENCEMENT. FLORIDA' AfRo(r.g 117.x- / OWNER OR AGENT CONTRACTOR S/ i . Subscribed and sworn • (or - 'r ed) before me this Subscribed and s om to or - 'rmed) before me this • by Who is /are personally known to me or has /have produced Who is /are personally known to me or has /have produced as identifcatior. • as identification. Notary Public - Notary Public Commission No. Commission No. - Name of Notary typed; printed or stamped Name of Notary typed, printed or stamped • • • • •