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Home My WebLink About10-11211 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 4211 ANNUAL FIRE PROTECTION MAINTENANCE , Permit Number: 11211 Address: 38135 MARKET SQUARE DR Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE- PROTECTION MAINTENAN •E Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02- 26 -21- 0010 - 03900 -0030 Improv. Cost: Date Issued: 11/29/2010 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38135 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540 Date Paid: 11/29/2010 Phone: (813)780 -8440 Work Desc: FPM- SPRINKLER QUARTERLY- FLORIDA MEDICAL CLINIC -��•� �' - - -� 5.61 C7o - • - • 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." Or /• 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 of Zephyrhilis Fire rdx-. , o-, ov-vvc • Permit Application Date Received Phone Contact for Permit 9)3 (oz t 13s? Owner's Name lc( D QA tom- (n e:tweM _- & _) ki IC. Owner's Phone Number 1 Owners Address D. 13s m er mo v2. ZtrPf4•4R.t-ht.ts , PC- • 3 3 rya Fee Simple Titleholder Name Titleholder Phone Number , Fee Simple Titleholder Address Job Address 313 t 35 i(n('h".0 -t.'•r S @ ()AIM Zr4Pt+1- 'A.S. , PC- Lot # Sub Division 64 (,•( CV- x) id-S Parcel # ,,. 22, • L) • OD 10 •0 3900 • do bo Bio -Hazard Waste Storage - ANNUAL I Fumigation Tent I-I Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL El Controlled Burn n Hood Installation 0 Emergency Generator < 30 kw n LP /Natural Gas - Installation El Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL r y �/ 'berm � other / f Sprinkler Ib ❑ ❑ n Recreational Bum l Fire Alarm El ❑ ❑ ❑ 1 1 n Sparklers Hood Cleaning Ej ❑ ❑ ❑ 1 1 n Sprinkler System Installations H ood Suppression El ❑ ❑ ❑ 1 1 j Standpipes (Sprinkler Sys) Fire Alarm Installation I Torch Roofing/Tar Kettle Fire Pumps n Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL /4> Z 5 • •00 I Valuation of Project Fuel Tanks n Other: I I Contractor ''" T 71'; Company Rp>aAA-", pia)" ,spQjr1tC( S, lac . I Signature --- 'Regictered d7/ N I Fee Current I QS 1 N Address ( I License # I y(, e, Li _O 1)%g °° I ELECTRICIAN Company Signature Registered Y/ N I Fee Current I Y/ N_I Address ( I License # I I PLUMBER , Company Signature Registered Y/ N I Fee Current 1 Y/ N 1 Address I I License # I MECHANICAL Company Signature Registered Y/ N I Fee Current 1 Y / N I Address I I License # I I OTHER Company Signature Registered Y/ N 1 Fee Current 1 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 (httpilappraiser.pascogov.com) NOTICE OF'DEED RESTRICTIONS: The undersigned understands that this permit may be'subjectto "deed" (restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for rcomplia :rce 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 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 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 for which they will be responsible. If you, as the owner sign as the contractor, that maybe 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 Lai is someone Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant 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 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. 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. 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 construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions oTtl•ie cod - es; nor sttaltissuan-ce-of-a permit -preventthe- Buildtng- 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 IC OWNER: YOUR E FOR IMPROVEM ENTS TO YOUR PROPERTY. 'NOTICE IF YOU INTEND TO OBTAIN FINANCING, CONSULT PAYING TWIC WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE ._ COMMENCEMENT. FLORIDAJURAT (F.S. 117.03) . / i OWNER OR AGENT CONTRACTOR Su�s and swom • • r -41' - •) befor- e this , V _ Subscribed and swom to (or affirmed) before me this d� (0 by _ _ by Who is/are personall . • • •,• • or has/have produced Who is /are personally known to me i denti on. produced �--- as identification. as ifica ti �� . , Notary Public Notary Public L I >✓ �/ Commission No. ii1ERY1 A. DUFFEL_ j Commission No. A j%. * MY COMMISSION # DD 730956 I0i ' Q FXPIRFS Nnvamhar 19 ed, printed or stamped Name of Notary typed, printed or stare F Bonded Thru Budget Notary Services Name of Notary typ P •