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Home My WebLink About10-10575 CITY OF ZEPHYRHILLS 5335 - 8TH STREET 10575 (813) 780 -0020 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 10575 Address: 705 GALL BLVD Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL. Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: MEDICAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 30 26 - 0000 - 00200 - 0010 Improv. Cost: E ;. a : 7> Date Issued: 6/11/2010 Na e: FL HOSPITAL OF ZEPH Total Fees: 50.00 Addr- s: 7050 GALL BLVD Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/11/2010 ' • ' Work Desc: FPM- SPRINKLER QUAR 'LW S r - RESSIO SEMI- FL HOSPITAL 01777 11 LL LP s��y -MI J 50.x0 0 (C)-52— F` PA E ina 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." �1r� 1i 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 Zephyrhills'Firz 44 ( Vt9 1 Fax- 313-780 -0021 Permit Application Date Received _ ._ _ K ... a. �x mss.. Phon Contact for Permit � - =�`�" ° -��-.� . �-- -.,.�_ �w �:.� .�,�.:� -- _ L �.�Q l� ( !fi ►'�� ✓�ilt'Owne�s Phone Number I X 81 3 H � 6 2 6 5482 Owner's Name 1 STMPT,RXGRTNNELL Owner's Address ( 4701 Oak Fair Blvd TAMPA FL 33610 - 1 Titleholder Phone Number Fee Simple Titleholder Name Fee SimpleritleholderAddress ` • �? d Job Address -- 7()5 t? l ".tril \t 1?- \QA. • 7 P 9voA rin ►i1 S I- 3 c� + Lot f# I Parcel # 1 Sub Division 1 1 1 Bio- Hazard Waste Storage - ANNUAL Fumigation Tent 1 1 Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier 1I or RQ Facility) ANNUAL Controlled Bum Hood Installation . 1 1 Emergency Generator < 30 kw LP /Natural Gas - Installation LP/Natural Gas - ANNUAL Sale 1 . 1- Emergency Generator > 30 kw Fire Protection Maintenance - ANNUAL - ' . Places of Assembly - ANNUAL . 1. 1 Lim Isemil 'Anil !Other Sprinkler, IM ❑ ❑. 1 f 1 ` Recreational Burn Fire Alarm ■ ❑ ❑• (• , 1 1 1 Sparklers • Hood Cleaning 0 '! ❑ ❑ I ( 1 ( Sprinkler System Installation f Standpipes (Sprinkler Sys); Hood Suppression - 0 / I, . -� 1 ` • ( Torch Roofing/Tar Kettle -.•__ - -- 1�_ Fire Alarm Installation ! _ _ P Waste Tire Storage ANNUAL - ` 1 ; (. Fire Pumps __ • 1..1„ I • Fire Works • ' . . Flammable Application- ANNUAL Valuation of Project Li y� . ' Fuel Tanks f / I �- v ^7 ` r Other rh I r►.v c� f , • 'J • � � I r tt 1 , yP�n�.,..{ �- �:: 3a. :uSz�S�?.��;� Company 3 fyrl -r �,•Frrr� -e. t( Contractor _ ' Signature Registered Y / N Fee Current 1' Y / N 1 . , 1 License # ELECTRIC Compan y Signature . _ Registered • Y/ N 1 Fee urren 1 -- : Y/ N .1 Address 1 1 License # 1 ,. l , PLUMBER Company . •.. Registered L Y/ N' 1 Fee Current 1 Y1.1.1 . • Signature I • Address 1 • 1 License # , 1 ` t MECHANICAL Company Signature Registered L Y/ N Current Fee Cuent L Y/ N 1 • . Address 1, -. _. 1 License # 1 1 • • OTHER Company . Registered Y/ N 1 Fee Current 1 Y / N i Signature License # dress 1 $'�'�11"f Ad �hYSn�r�u• ' 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.pascogay.com) • NOTICE OF.DEED "RESTRICTIONS: - The undersigned understands that this permit may_be•subjecf to ":restrictions which may be more restrictive than County regulations. - the _undersigned assumes responsibility for -:compliance with any _applicable deed restrictions. UNLICENSED `CONTRACTORS AND CONTRACTOR RESP If the owner has - hireha contractor or - contractors to undertake work, they may be required 'to be licensed in accordance with state and iocal 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 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,_as.amended): If valuation of work is $2;500.00 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 I have obtained a copy of the above described document and prdmise 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 applicationis 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 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 l understand that the regulations of other government agencies may applyto 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.. 11 understand that.•a.,separate p rmit imaybe required.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 ORAN ATTO' 'BEFORE RECORDING YOUR NOTICE e' C ENCEMENT. , / FLORIDA 41 RAT (F S 117. OWNER OR AGENT CONTRACTOR / ■ • Subscribed and sw om • (or . r ed) before me this Subscribed and s • m to or . - imed) before me this • by ... by Who is /are personally known to me dr 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 • •