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Home My WebLink About10-11073 CITY OFZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 11073 ANNUAL FIRE PROTECTION 'MAINTENANCE Permit Number: 11073 Address: 38250 A AVE Permit Type: FIRE PROTECTION MAINTENANCE ZEPHYRHILLS, FL. Class of Work: FIRE- PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14-26-21-0010-01300-0010 Improv. Cost: r.;. .. , °, Date Issued: 10/22/2010 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 10/22/2010 Phone: (407)975 -3000 Work Desc FPM- SPRINKLER QUARTERLY- ZEPHYR HAVEN NURSING ru' ° C (:) 5Q- L A. w,�z�a`', - • oral 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." *VIP •" 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 813 =780 -0020 City ofZephyrhilis -Fire, '//°'13 Fax -813- 780-0021 Permit Application Date Recct u Phone Contact for Permit Owner's Name STMPT:FXGRTNNFLL Owner's Phone Number 813 626 5 4 8 2 Owner's Address 4701. Oak Fair Blvd TAMPA FL 33610 Fee Simple Name - • Titleholder Phone Number Fee Simpie Titleholder Address I € v � � - ,ac':,u.... ,_ .� - 0-.....,m.,, rx.._.��. �� _ ..... -�: -�:, •: ;.�.;�. 2 �•`Y" �.t � ..:,� .r: ... �"...__:. ��.,�as_� .,_,�:r. ,_.. ..��.�..,v •"�" -a ...,,. �.,...- _ `, ..�,w . -- .� .w Job Address �Sd p- 7? Q ( � avev `iocs•1 o Lot# # . Sub Division • I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent I I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier II or RQ Facility) ANNUAL Controlled Bum Hood installation L -- 1 Emergency Generator < 30 kw I LP /Natural Gas - Installation - - I I Emergency Generator > 30 -kw I LP /Natural Gas - ANNUAL Sale s Fire Protection Maintenance - ANNUAL . • Places ofAssembly- ANNUAL .. i ' L � - lAnl i Other • Sprinkler v ED DI • Recreational Burn te Fire Alarm I ( IA ID ❑ I , I, I Sparklers . 5 .W y rb IN Hood Cleaning In ❑ ❑ 1 Sprinkler' System Installations (.. fi Hood Suppression - I ❑ 0 -0 = 1 1 Standpipes (Sprinkler Sys): - I I Fire Alarm Installation Torch Roofing/Tar Kettle Fire Pumps r ----- 1 Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL ! , Valuation of Project I l' . , Fuel Tanks • • I Other .I am— " - - r t... r. :E ,>. • u . 7 mt9= `,. _ —7 -t Wa', e .4. . • = .ie !zrzs '..: e"svga.F 0-r -.I WZ ':er kae Contractor Company 3 (ti Ks-n•v't. �.( Signature Registered Y / N I Fee Current L Y / fit Address I `f I • • License # I • I . ELECTRICIAN Company . • Signature - - .. . - ' Registered ? Y 1.N I Fee Current I Y / N Address I . . . . I License # . PLUMBER Company Signature Registered Y / N ' I Fee Current I Y /- N. JJ Address 1 I License # . ' .. I MECHANICAL • Company Signature Registered Y/ N I Fee Current Y / N j . Address I. I License # I I OTHER - Company - - Signature Registered L Y / N I Fee Current Y / N Address .. .. - ...�.... >�..� ,,,�:.•__ - a . - �_._.,�r _. a:: =.= - .�.. '<°.._ ...asp 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 d - (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) • NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may_be subject =to "dead": estrctions" which may be more restrictive than County regulations. The.undersigned assumes responsibility for :Domplianc 'vYtb .ny _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 as 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 7.27-847 - 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 entitfed 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 f, 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:• 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 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. f 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 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:. -..[: understand_ that.a. separate maybe 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, after, 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. ff 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 ►' . Ce ENCEMENT. FLORIDA JURAT (F.S. 117.1 CONTRACTOR � CONTRA A OWNER OR AGENT Subscribed and. sworn . (or . r ed) before me this Subscribed and s om to or .`firmed) before me this by.., by Who is /are personally known to rite or 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 • •