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Home My WebLink About10-11210 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 11210 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 11210 Address: 38107 MARKET SQUARE DR 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: Improv. Cost: Date Issued: 11/29/2010 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38107 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/29/2010 Phone: Work Desc: FPM- SPRINKLER QUARTERLY- FLORIDA MEDICAL CLINIC • - -- 17- _ i- - € 5.16 V \ (1A5\° _ . • 1 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 $100.00, whichever is greater. All work shall be performed in accordance with City Codes and Ordinances. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." er! r P T IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041 813 - 780 -0020 City of Zephyrhlils Fire ra - a t 01.1-1l1.4 Permit Application . _ Date Received I Phone Contact for Permit g7 3 : . 1+`+± n'.,',£"'°+'„ r+ s`, �r.. .. >...z�«:.wa..,.u...«�..,,:w�- ..:.. ...e.x*rz,,,a:.a,.=..... .,.—._. r . ,, ..:. - : an ..��^.. .- -. asp. 357 .a.... Owner's Name Fux2t m(.-rttGA -t C,(,,1 rsK. Owner's Phone Number Owner's Address 3813 m A►Zx1.1 %MI-4 7(�>i +ed+1 .1...s, pc.. 333a v Fee Simple Titleholder Name Titleholder Phone Number Fee SimpleliitleholderAddress I I Job Address 38 10 1 AA fk(Z _ 1 )AR.$ Lot # Sub Division L r( OP jeTht'{JZ141U -3 Parcel # , pL • L(s , Z► • 0/7 1 o . 03S00• ] El Bio -Hazard Waste Storage - ANNUAL I Fumigation Tent n Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL n Controlled Bum I I Hood installation I I Emergency Generator < 30 kw I ( LP /Natural Gas - Installation - I I Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale r ( ( 1 U ( I Fire Protection Maintenance - ANNUAL I - I Places of Assembly - ANNUAL � f ry !semr1 FiTi I Uther Sprinkler I ` I ¢ ❑ ❑ ( Recreational Bum Fire Alarm ❑ ❑ ❑ I I I 1 Sparklers Hood Cleaning 17 ❑ ❑ ❑ I I I Sprinkler System Installations Hood Suppression u ❑ ❑ ❑ I 1 1 Standpipes (Sprinkler Sys) FT Fire Alarm Installation Ii Torch Roofing/Tar Kettle HI Fire Pumps I I Waste Tire Storage ANNUAL Fire Works I Flammable Application- ANNUAL 1 IS Js-, 1 Valuation of Project n Fuel Tanks 0 Other: I ;,:,s; x. a^ .x�ra;?c ,.. �.e, ,a +, , -.:,t- �-.c,. ,�eq;y .�.,,:v.rF . Kx,.rvw ,,. ...,.5...- ..,,- ......�-.�+. -�s.x� ,z;..- s..m,._: ...,..cs.. o-k , a,a:.�. t ;::<ta. . »-r. -.r _ - _czsFn.w,. •, Contractor 7r7 Company a t r-' JfZ1� 542.)►J.4....a., 1lx• • I Signature � Registered CO N I Fee Current I -r/ N 1 Address row I License # I (U e 4I3 Z.00011 c gS I ELECTRICIAN Company Signature Registered Y / N I Fee Current I Y / N Address I License # I 1 PLUMBER Company Signature Registered s Y / N I Fee Current I Y / N J Address I I License # I MECHANICAL Company Signature Registered Y / N I Fee Current 1 Y/ N I Address I I License # I OTHER Company Signature Registered Y / N I Fee Current I Y/ N J • Address I License I � 3. rriX�"'.$� # ,cF" 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) 'NOTICE OF'DEED RESTRICTIONS: The undersigned understands that this permit may .be subject'to "deed "restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for - compliance with any 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 local 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. 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 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: 1 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 must take to be in compliance. If I 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. I 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 construed to be a license to proceed with the work and not as authority to violate, cancel, alter,. or set aside any pro- - -vis ons -- visions of�1e �ecFinical cod - es, 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 shall 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 .' , 0 OBTAIN I FI , CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR 11 Su scnbed and swom to •efosre = this 0 V . Al Subscribed and sworn to (or affirmed) before me this �j ,, 10 by L r � . by Who is /are personally kno • • - has /have produced Who is /are personally known to me i has /have nroduced p as identification. as identification. i •• ,� ��! � . + Notary Public Notary Public /L — �� Commission No. Commission No. eHERYL A. DUFFEL. * MY COMMISSION if DD 7300St; Name of Notary typed, printed or stamped Name of Notary typed, printed or staml5 ii EXPIRES: November 12, 2011 vre of Ft �F Bonded Thm Budget Notary Services