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HomeMy WebLinkAbout10-10825 f CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 10825 ANNUAL FIRE PROTECTION MAINTENANCE a S :4..::... 11;114' °� _ 8 7717:: 7 7S `�'' E` ....E Et� ' �' E' �'v - ;.''& .4s a %. - .:' 1 ' °` ,,,', g I . Permit Number: 10825 Address: 7050 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 -20- 0000 - 00200 -0010 Improv. Cost: '� AMC "`TT e 73:7 s=ets Date Issued: 8/12/2010 Name: FL HOSPITAL OF2EPHYRHILLS Total Fees: 25.00 Address: 7050 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 8/12/2010 Phone: (813)783 -6189 Work Desc: FPM- SUPPRESSION SEMI- FLORIDA HOSPITAL FIR A _ � A a - ' I•N - P = F -E 25.00 : ES f. C (0 32 / F A - AN inal 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." 111 �i Aar 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 DETACH BEFORE DEPOSITING No. 3083658 INVOICE DISCOUNT AMOUNT DATE NUMBER 08092010 PERMIT 709 080910 0.00 25.00 056313 0.00 25.00 813- 780 -0020 City of Zephyrhills Fire. Fax - 813 -780 -0021 Permit Application Date Received 1 0 Phone Contact for Permit Mg. Lt Owner's Name f �/ © 4 ciC, / �r X� Owner's Phone Number ( 1 1 1 1 I Owners Address Fee Simple Titleholder Name Titleholder Phone Number 1 1 1 1 Fee Simple Titleholder Address I Job Address - 70,5 — ° 6'W2// 306d . Lot # I Lot # � Sub Division Parcel # - - - - . , _at; -, .- - - - _,�L" a s_�.; .rc r:� , !3�'39b et. °�ri e.�'u 7.. r1<.r , - .E��gl4� Y ✓> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL n Controlled Bum I I Hood Installation n Emergency Generator < 30 kw n LP /Natural Gas - Installation El Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL IUtnyl 'Semi I (A�rI Other Sprinkler n ❑ ❑ ❑ n Recreational Bum Fire Alarm n ❑ ❑ ❑ I I I I Sparklers Hood Cleaning n ❑ 13 CI Sprinkler System Installations Hood Suppression V t ❑ X ❑ I I I I Standpipes (Sprinkler Sys) n Fire Alarm Installation n Torch Roofing/Tar Kettle n Fire Pumps I I Waste Tire Storage ANNUAL I I Fire Works I1 Flammable Application- ANNUAL I I Valuation of Project I - 1 Fuel Tanks I Other I Contractor ..„77 411WPOr �� P454 Pi rt #41..e...4 i-er 1 Signature Registered Y / N I Fee Current 1 Y/ N Address I 1 1701 £ G- -4 — 6 - 6 Lw6.- -T _ .1 1 License # ELECTRICIAN Company Signature Registered Y/ N I Fee Current I Y / N Address I I License # I PLUMBER Company I Signature Registered Y/ N j Fee Current I Y/ N Address I f I License # MECHANICAL Company I Signature Registered Y / N I Fee Current 1 Y / N J _ Address ( I License # I I OTHER Jar Company Signature Registered Y/ N . 1 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 (http:/ /appraiser.pascogov.com) =DEED RESTRICTIONS: The undersigned The . undersigned this ssumes responsibility for: mpl an e t which may any which may y be more restrictive than County regulations. applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired :a - -contrac or 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 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 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. 50 CONSTRUCTION. LIEN LAW (Chapter 713,.Florida Statutes, _asfinend ): If aluati ouct i on Lien $ ,50 0.00 or more, Homeowner's certify that 1, the applicant, have been provided with a copy o is someone other thou th an the owner", 1 certi y that I obtained a of the t above described docum and promise in faith to other the "oner ", I tY 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. tf i his affidavit AGENT FOR THE OWNER, construction. I in understand that a separate permit may be required conditions set forth in work, t aidavit prior to commencing plumbing, d shall be , on be a 9 license gas, or to proceed ewith installations not specifically and not as authority to violate, cancel, lter, or set aside an y provisions io con st set asde nroviions of the technical codes, nor shall issuance of a permit prevent the t issued shall become invalid requiring a correction of errors in plans, construction or violations of any codes. Every p unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by may permit is suspended or g, from abandoned e Buildng al for period not to exceed t n ninety 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. PAYING OWNER: YOUR FAITS TO YOUR PROPERTY. T IF YOU INTTEND NCEMENT OBTA N NANC NG, CONSULAY RESULT IN PAY TWICIC E FOR IMPROVEMENT • MENCEMENT. WITH YOUR LENDER OR AN TTY RNEY BEFORE RECORDING YOUR NOTICE OF FLORIDA JURAT (F .S. 117.0 / / CONTRACTOR R Ar OWNER OR AGENT �" o re m is Subscribed and sworn to (, affirmed) before me this Subscribed and sworn to (or a'T ed) befo by by Who is /are personally known to me or has /have produced Who is �a p ovally 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