HomeMy WebLinkAbout10-10927 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10927
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 10927 Address: 7340 GALL BLVD
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 - 0880 -0000
Improv. Cost:
Date Issued: 9/15/2010 Name: TOWNVIEW RETAIL LLC
Total Fees: 25.00 Address: 725 CONSHOHOCKEN SR
Amount Paid: 25.00 BALA CYNWYD PA 19004
Date Paid: 9/15/2010 Phone:
Work Desc: FPM -FIRE ALARM ANNUAL- FL HOSPITAL
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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."
Ai 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
3137,9C:0020 City of Zephyrhills - Fire , ( Ct 11 Fax -3 730 -0021
Permit Application 4.,
Date Received , : - r Phone Con, for Permit
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Owner's Name I S TMPT,FXGR T NNFJ,L Owner's Phone Number 813 626 5 4 8 2
Owner's Address 4701 Oak Fair Blvd TAMPA FL 33610
Fee Simple Titleholder Name 1 - ' Titleholder Phone Number
Fee Simple Titleholder Address .
Job Address - -i•- � `>Pl 1 7--( hATk•.111i — 7J9 Ta ,i`( T---,- 335 fo Lot
Sub Division Parcel #
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...:a -v .^.,. t.._> -- wT. cz.a -.emu.. n:.e4... . > .....,� ._......� .�._ -�..m ,. - �. >M___. -,... .
• Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent
Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Ter If or RQ Facility) ANNUAL
Controlled Bum I Hood installation
I Emergency . Generator < 30 kw n LP /Natural Gas - Installation
_ - I Emergency Generator > 30 kw ' I I LP /Natural Gas - ANNUAL Sale
I. Fire Protection Maintenance - ANNUA • - - I I Places of Assembly ANNUAL
+Qtrly ISemiI IAnII pa=
Sprinkler. ❑ ❑ ❑. • I 1 Recreational Bum
Fire Alarm I VI ❑ ❑ r • , I 1 Sparklers ,
Hood Cleaning 1 ❑ ❑ ❑ I I I Sprinkler System Installations
_. . , , Hood - Suppression _ I ❑ ❑ p I7 I I Standpipes (Sprinkler Sys):..
I I• Fire Alarm Installation 1
1 Torch Roofing/Tar Kettle -
Fire Pumps Waste Tire Storage ANNUAL
I , .. - I Fire Works , .
fl I• Flammable Application- ANNUAL f Valuation of Project
Fuel Tanks
I..,. ( ..Other: . I
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Contractor / Company 3 CHti . C (�Firn i C(
Signature Registered Y / N Fee urrent Y/ N I
• Address I ._ . . , `S
(: License # I
ELECTRICIAN
Signature -' '- , Registered Y / N I ' Fee Current I . r:Y / N
Ic
Address I , - . .. License # I I
PLUMBER _ Company <,
Signature _ Registered Y / N I Fee Current Y / Ili -
Address I License # • I ' I
MECHANICAL Company
Signature - Registered Y / N I Fee Current Y / N 1
. Address J ... • I License # I
OTHER - Company . - .
Signature Registered Y / N I Fee Current Y / N
Address j (
L
License #
ae W_ > -:-
- - 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 4- obtained from Property Tax Notice (http: / /appraiser.pascogov.com)
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NOTICE OF =DEED RESTRICTIONS: The undersigned understands that this permit may_be subject to "dead ": 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 - hired - :a - contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and focal regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited :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 will be responsible. If you, as 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 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law— Homeowner's
Protection Guide" prepared by the 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 promise in good faith to
deliver it to the "owner' prior to commencement.
CONTRACTOR'S/OWNER'S - AFFIDAVIT: 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 perrnit to do work and installation as indicated.. 1 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 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 1
must take to be in compliance.
If 1' 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 .:,.1- understand: that .a,separate permit may, be 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 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 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 JURAT (F S: 117. • _
OWNER oRAGENT �/ CONTRACTOR
Subscribed and om to or 'firmed) before me this
Subscribed and sworn • (or - i• ed) before me this by
by Who is /are personally known to me or has /have produced
Who is/are personally known to ma i denfiticahas /have produced p y as identification.
as identification.
Notary Public • Notary Public
Commission No. - Commission No.
Name of Notary typed; printed rinted or stamped Name of Notary typed, printed or stamped
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SEP -15 -2010 12:13 From:SIMPLEXGRINNELL 8136641731 To:813 780 0021 P.1'2
SimplexGnnnell LP
4701 Oak Fet rfilv�l.
Fire & Tampa, Fl. 33610
Security PHONE: 813 - 626 -5482
FAX: 813 - 664.1731
Sim p/exGrinne//
www.simolexaJjnttel1. corn
TeleFax Transmission
This farsrmtlo transmission may contain c nfidential andfor attomey/ctent privileged information
belonging to the sonder.This Information is Intended only for gm use of the IndMdual or entity named
on this transmission sheet. [(you are not the intended recipient, or the employee or agent responsible to
tho Intended recipient, you should retum to sender immediately. you are tw. by notified that any
daclosure. copying, distibution or the taking of any action in rellanco on the contents of this k:hxapied
Information is strictly prohibited.
24/7 Emergency Service
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• Fire Sprinkler Systems .
Date 9b s/w
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• Fire Detection & Alarm
Company ` /� 2 O� - `', /g
• Fire Extinguishers
/T !T I r
Attention
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•• flange Hood Systems - kCIC ( e
Fax No.
• Special Hazard Systems g- 13 - 7 fro —00 3-
Z
• Integrated Security Applications From
Subject
• Healthcare Systems
No. of pages
• Sound & Communications (including this one)
• lime & Workforce Managernent Messago: •
• Emergency Lighting ? 1t ilk CA-1 W e`} R1nk f •
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• ,System Design & Installation • QVde S 11 C it- S
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' Project Management a 3 Co 9/ 3
• Inspection & Testing
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• Preventive Maintenance
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Over 150 offices in principal cities
throughout North Anierim.
For marketing brochures regarding
SimprexGrinnell systems and
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services; caI11- 800 - 746 =7530. _.- . ..
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SEP -15 -2010 12:13 From: SIMPLEXGRINNELL 8136641731 To:813 780 0021 P.2'2
1 , :2 -T STATE OF FLORIDA
ti , ' 4 '� •.. DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
' ' ,� f ,• ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487 - 1395
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TALLAHASSEE FL T STREE •
KLINGENSMITH, WILLIAM JAY 1I
SIMPLEXGRINNELL LP
1929 OAK STREET NORTH
CLEARWATER FL 33760
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Congratulations! With this license you become one of the nearly one million • , `.� r - , " } " BGR - „
$P =
Floridians licensed by the Department of Business and Professional Regulation. 9 yacht • , ., R . . U 3loll S. -
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Our professionals and businesses rang from architects to acht brokers, from `4A ' y . ,- L ' <• k t}, � ° -;
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boxers to barbeque restaurants, and they keep Florida's economy strong_ ,... i , . � :; /f� i . -k C� . ; .: _.. " . :: � ' N ,; , f t
;i l*t_ :• + - .':i!i ;j` ? S TS ' . -.. rri . �'2�.
Every day we work to improve the way we do business in order to serve you better. . .;U?' ;,; ,, %: - f; ? y _ . • : : _r' • , ,.
For information about our services, please log onto www.myforldalicense.com- 7..., , ;: - .4;..:::: , % , :- . . .t
42 > ' y , M ", « .r a 'x 'S
There you can find more information about our divisions and the r egulations that x (? .7'' G W , t� 1 P.
impact you, subscribe to department newsletters and learn more about the •' 1. e ) . . °•.;+ r • .. .,
Departments initiatives- � C }. _e).•, _ ,,!,
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Our mission at the Department is License Efficiently, Regulate Fairly_ We ._ n • .:,., . , - �. � ',�
constantly strive to serve you better so that you can serve your customers_ I ) v we s,, '�";•:�c�' .sw + rsiF;,r F
Thank you for doing business in Florida, and congratulations on your new license) -.� i4 '° ° :°�'
DETACH HERE
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