HomeMy WebLinkAbout11-11643 . CITY OF ZEPHYRHILLS ✓-'
- ' S335 - 8TH STREET'
(si3) �so-oozo 11643
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11643 Address: 38240 DAUGHTERY RD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0010-00600-0010
Improv. Cost:
Date Issued: 3/15/2011 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33541
Date Paid: 3/15/2011 Phone: (813)783-6189
Work Desc: FPM- FIRE ALARM ANNUAL- ADVENTIST HEALTH SYSTEM
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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 otl�er
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 pertormed 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."
�
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
2EPHYRHILLS FiRE RESCUE DEPT - Fire Marshal Otfice - 813-780-0041
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� Permii Applica�ion
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ow�? 4701 Oak Fair Blvd TfiMPA FL 33610
Fee Simple Titfei�ofder I�ame � Titleholder Phon� Number �� �
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� Bio-Hazard Waste Storege - ANFtUAL � Fumigation 7enf
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier I[ or RQ Facilify) ANNUAL
� Controfled Bum � Hood fnsfalfafion
� Emergency Generator < 30 kw � LP/Natural Gas-Instaflafion
Emergency Generator � 30 kw � LP/Nafural Gas-ANHUAL Safe
� Fire Pratection Maintenance - ANhIUAL � Places of Assembly-AP(DtUAL
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, Sprinkfer. � ❑ ❑ ❑ � � Recreafional Bum /„
, Fire Alarm � d ❑ �� � Sparkfers '1� I � � �!
Hood Cleaning � p ❑ ❑� � Sprinkler Sysfem Insfafla4ions `
_. _ , Hood Suppressio� � ❑ ❑ ❑ � � Standpipes (Sprinkier Sys)
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, ,;: � Fire Pumps Wasfe Tire Storage AHNUAL
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Fire Works
� -,-,,; � ; FlamriiabfeApplication-ANNUAL Valuation of Project
' ^ �� Fuel Tanks � ' '
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Signafure ' Registered Y/ IV Fee .CuRent Y/ N
Addres§ License # •
ELECTRICfAN `--.` ' .,' . - " - • ` . -- Company -
Signafure - " ftegisfered �: Y/ N . Fee Current Y/ N �•
Address License # � - .
PLUMBER . _ ` , Company • -
Signafure Regisfe ed Y/ I� � Fee Currenf 1' /. �j'
Address License # �
MECHANfCAL Company
Signafure Registered Y/ N Fee Currenf Y/�I
Address . ' License #
OTHER Company .
Signature Registered Y/ N Fee Current �( /�(
Address Licerts #
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. Filf out applicafion compfefely_ ,
_: Owner 8� Contcacfor sign back of applicaiion, nofarized (Or, copy of signed cantracf with owner) .
(f over $Z500, a Notic= of Comrnencement is required_(Mechanieaf wor{c over $500Q) .
-_ - Supply fwo (2) sefs of dcawings w[fh applicab[e documenfafion �
___ . _ Altod�t 10-f4 days for review at�er submitFaf date. Parcef �#- obfained frnm ProPa�}r Tax t�iofic2 (F��fp://appraiser.pascogav.com}
�1CTT(CE �F-[7EED �RESTREC i IO(�S. k he undersigned understands.fha� �his permit maybe subjeci°�o `dee`d':reszric�.�ons'
wl�ich may oe more restric't[ve than Couny regulat[ons. Th°-undersigned assumes raspansibiliy for:�omplian�� with any
.appl�cabte deed resfrict[ons.
U�IL[CEhtSED CQ�ITRACTORS A�iD COt�lTRACTOR R�SP.O�ISIBIL(T[ES: fi the owner has - hired�:a°cDnuacior or -
confrac�ors to underfake 4vork, they may be required �o be [icensed in accordance wifh state and focaf�regufations. If r«°
confracfor is not ficensed as required 6y (a4v, both the awner .and con�ractor may be cited �for a�misdemeanor viola�ion
under sfafe law. (f fhe owner or infended contracfor are uncerEain.as fo what Iicensing �requiremenis may:apply ror the
infended work, t(iey are advised fo contact fhe Pasco County Buifding [nspection Dlvision—Licensing Section_a� 727-847-
8Q09. Furfhermore, i� fhe owner� [�as hired _a contracfor or con�ractars, f�e is advised fo have fhe confracfor(s) sign
por�ions of the "contractor BfocK' af this appfication for which will be responsible. [f you, as Ehe owner sign as fhe
confractor, fhat may be an indication that he [s not properly ficensed and is not enEiffed�to permifting pr[vileges in Pasco
Caunfy.
CONSTRUCTION.L[EN �AW (Chapfer713, Florida S�afufes,,as.amended}: ff valuation of �nrork is $2;50Q.00 or mare, I
cerfify thaf E, fhe appiicant, hatre been provided with a copy of the "Florida Construct�on Lien Law—Homeov�rner's
Profecfion Guide" prepared by the Fforida DeparEment of Agricufture and Consumer Affa[rs. if the appficant is someone
other fhan the "owner", ( certify fhat I have abtained a copy of the above described document and promise in good faith to
defiver [t to the "awne�' prior fo commencement.
CONTRACTOR'S/OWNER'S-AFFIDAV[T: I cer�if}r that afi the information in this applicafion is accurate and
that all work wifl be done in complianc.e wifh a[i applicab(e I.aws regu[ating construcfion, zoning and land
deve(opment. App(icafian is hereby made to obfain a permit to do work and insfallation as indicated. ( certify
fhat no work or instal[atian has comrnenced prior ta issuance of a permit and�thaf al( work wifl be perf�ormed fo
meet sfandards of all (aws regulating construction, Counfy and Cify codes, zoning regulafions, and [and
development regulations in the }urisdiction. f als.o certify fl�at I understand thaf fhe regulafions of other
_ government agencies may applyfo fhe intended wark, and that it is my responsibilify to identify whaf acfions i
must take to be in compliance.
ff I'am the AGENT FQR�THE OWNER, [ promise in good faifh to inform the owner af the permiffing.conditions sef forEf� in
-__ ... . .. _ . -
-- this-affidavit prior-to comme�cing--consfruction�.._ [: unde"rs.faqd_ �ha� a se.parate _perm,it.,may, be reguired for elecfrica wor ,_ __
plumbing, signs, wells, pools, air conditioning, gas, or other instalfaEions not specifically included in the appfication. A
permit issued shafl be�construed to be a license to proceed with the work and not as authority to viofate, cancel, afte�, or
set aside any pi'ovisions of the technical codes, nor shall issuance of a permit prevent the Building Official from fhereaffer
requ�ring a correction of errors in plans, consfruction or violatio�s of any codes. E�ery.pe.rmit �ssued shal[ become inva(id
unless the work authorized by such permif is commenced within six months of permit issuance, or if wark aufhorized by
the permit is suspended or abandoned for a period of six (6) montF�s affer the time the work is cQmmenced. An extensiori
may be requested, in wrifing, from the Buifding Official for a period not fo exceed ninefy (90) days and wi[l demonsfrate
justifiab(e cause for the extension. ff work ceases for ninefy (90) consecutive days, fhe job is considered abandoned.
- WARt�[NG'TO. OWNER.: Y�UEZ FA[LURE TO RECORD A N�T[CE O� COMMENCEMENT� Mt�Y F2ESliLT W YOIJR '
PAYtNG TWtC� FOR. (MPROVEMENTS T� YOUR FROPERTY. [F YOU INTEHD TO OBT h[ FENAPiGI(�G, CONSUl..'T -�
W(TH �YOUR LENDER OR AN ATf'O BEFORE RECORD[NG YOlJR hIOTICE C ENCEMENT. .
FLORiDA JURAT (F.S: 117.
OWt�tER AGENT CONTRACTOR
Subscribed and swom (or i ed) before me fhis Subscribed and s om to or icrned) before me th�s
. by bY
Wf�o is/are personally known to me or haslhave produced Who is/are personally known to me or has(have produced
as iden6ficabon. as iden6ficafion.
Notary Public Notary Pub(ic
Commission l�to. Commission No. ,
ed; nnted or sfam ed Name of [�tofary typed, printed or sfamped
I�tame af Notary typ R P