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Home My WebLink About10-10571 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 10571 ANNUAL FIRE PROTECTION MAINTENANCE : . --., 's• I fs u Permit Number: 10571 Address: 6610 STADIUM DR 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: 02- 26- 21 -001B- 00000 -0010 Improv. Cost: r i _ s' igairrIE7777:71777 7; Date Issued: 6/11/2010 Name: DA VITA INC Total Fees: 25.00 Address: 6610 STADIUM DR Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/11/2010 Phone: (813)788 -4887 Work Desc: FPM - ANNUAL FIRE ALARM FOR RENAL HEALTHCARE ` ,' : #' r a e � i ($ 4 a,+''s:33L�`, f.* a a '..a �.x. � .:�:;rt � r >a�'a,°,l�;axj'a,'�: ,., � r �� e t., ,, . . a ,s „� 1�oa.e� - ”. `s,.� fix, PATTI LE . & R FRI E „ RAT ON FIRE P RM T FEES 25.00 6n1 � ro ea d � If, A EP AN E 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." eaPPP P � IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - Q HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041 a1'3- 780 -0020 City of.Zephyrhills - Fire• Fax- 813-780 -0021 /0 Permit Application Date ReReceived - /r'-- /0 Phone Contact for Permit • / 3 7'2 j 3 3 1 9 , r :. �>" �. fi.' �aYa:, x„ d:` ",�i:52hu- s++ &5�.......,.«xt:sb Owner's Name b A Ur4-,4 IJ•' - R r riAI /4r J 3 *.ra Owner's Phone Number g 3 ?RS 4 7 Owner's Address 44 to v.-Ad 1 t yr, )r. Zr,ek..erA Ns F1- 33. Fee Simple Titleholder Name Titleholder Phone Number Fee SimpteTitleholder Address I Job Address 5frftvt e Lot # Sub Division Parcel # U A ,24 ,i ._.. -� � 3 Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL Controlled Bum I I Hood Installation Emergency Generator < 30 kw LP /Natural Gas - Installation I Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale I Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL ILItriy1 lbemiI Other Sprinkler I ❑ ❑ n Recreational Bum .1 1 I Fire Alarm ❑ ❑ •K 1 Sparklers J` 1 V Hood Cleaning 71 ❑ ❑ ❑ f I Sprinkler System Installations Hood Suppression I I ❑ ❑ ❑ I 1 Standpipes (Sprinkler Sys) I — I Fire Alarm Installation I Torch Roofing/Tar Kettle I Fire Pumps I I Waste Tire Storage ANNUAL I Fire Works Flammable Application- ANNUAL I I Valuation of Project Fuel Tanks I Other: I d c+ FD-e Abt-rw S c4,-.n - 4 nn tual � _x >� a ,�x- �..:.zG.._., - ::�Fi:"•'- u�"€llUa`"x,F,_ Mai.FMaz `''"��S'�* iairattWal'4 ti lU._..:.¢3«°" >Mc..m,.ik&t'. a. tsu :_..sE,Wi...a .vwa..,�.-1c1 _ _.,:.a1 . 4&Z..,, ....m.Gal;......M,... Contractor Company Signature Registered Y / N Fee Current I Y / N Address I License # I ELECTRICIAN // , Company / • r C iYC -/-v- I C Signature Azad !z( Registered - N F ee Current Y / N Address 3 9 /// j _ Q _ - 7 7 5 r e i z j A Y / s f' 1 33 5'V O I License # I EC- DOO/ 268 W137 PLUMBER Company Signature Registered Y / N Fee Current 1 Y / N Address I I License # I MECHANICAL Company Signature Registered Y / N Fee Current Y / N Address I License # OTHER Company Signature Registered Y / N 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 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascoaov.com) • NOTICE OF DEED RESTRICTIONS: The undersigned understands undersigned a responsib Ity for•compl an jectito which may be more restrictive than County regulations. Th .applicable deed restrictions. UNLICENSED CONTRACTORh , AND � CONTRACTOR to be RESPONSIBILITIES: esed acco dance with state and local regulations. If contractors to undertake work, they may contractor is s not licensed as nsed as required by law, both the owner and contractor may be cited for 'a misdemeanor violation othe under state law. If the owner or intended contractor are uncertain eln o as l t what licens D n s og req i rem nt S ma y :ap f 7-847- th intended work, they are advised to contact the Pasco County 9 P 8009. Furthermore, if the owner has hired lication contractor for which -they esponstlbleelftyou have as - the own as the sign portions of the "contractor Block" of this pp rivile es in Pasco contractor, that may be an indication that he is not properly licensed and is not entitled permitting p 9 County. Florida Statutes,.as: amended): If valuation of work is $2,500.00 or more, I CONSTRUCTION .LIEN LAW (Chapter713, of 'the "Florida Construction Lien Law— Homeowner's certify that I, the applicant, have been provided with a copy Protection Guide" prepared by the Florida Department of Agricure and Consumer above described Affairs. and prompse faith to other than the "owner", I certify that I have obtained a copy of th 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 that op work Application is heremymm�ced pr obtain ior to issuanc permit e of a per t and i that al will be performed to m et t a n d rd or in l has go construction, County and City codes, zoning regulations, and land meet standards of all laws regulating that I understand that the regulations of other development regulations in the jurisdiction. I also certify 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. forth in If I am the AGENT FOR OWNER, I proise in a permit may b rm the owner of the requg ed for l electr c I work, this affidavit prior to commencing construction. plumbing, signs, wells, pools, air conditioning, cense os other installations not and not as authority to violatee anp or permit a s issued an p provisions construed to is a I P r e g h i d e any rectof r the in plans, construction s or a violations of any codes. Every t perm t issued shall become invalid unless the a correcti t h of errors such plans, unless the work authorized abandoned for a per such permit is c od of six (6) within six months of after the time the work is commenced An h extension the permit is suspended or ab days and will demonstrate may be requested, in writing, from the Building Official for a period ecutive days, the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety ( ) WARNING TO OWNER: YOUR FAILURE TO RECORD A'NOTICEOU INTEND TO COMMENCEMENT M FA Y RE U T IN YOUR CONSULT TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) CONTRACTOR RA A OWNER OR AGENT CONT CONT and swum to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by by by Who is/are personally known to me or has /have produced Who is /are personally known to me identification. ation. ve produced as identification. as ientific Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped