HomeMy WebLinkAbout11-11645 . . CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020 � ��
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11645 Address: 7050 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 30-26-20-0000-00200-0010
Improv. Cost:
Date Issued: 3/15/2011 Name: FL HOSPITAL OF ZEPHYRHILLS
Total Fees: 50.00 Address: 7050 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/15/2011 Phone: (813)783-6189
Work Desc: FPM-SPRINKLER ANNUAUFIRE ALARM SEMI- FLORIDA 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 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 A7TORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
�
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
. 8� ;-,3o-co2o Ciiy of Zephyrhilfs �Fir:e: ��x-ais-7�o-o�zi
°ermit Appfica�ion
-
Dafe Flecz�ved ' Pf�one ConiacE for Permit
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O4vne�s Name ��MPT�EXC�RINNET�L -� Ownars Phone Number g� 3 G 2 G 5 4 8 2
owr,z,�s�dd;ess 4701 Oak Fair Blvd T�MPA FL 33610
Fe� Simple l I�tame - TiBeholdar Phon� Number �� �
Fee Simpfe
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Job Address � � s Y r .�. 5 _ v 3�5�.,.�.�L., -- P `"<."'="` �hy��l�j y Lot� �C
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Sub Division Parcel �
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� Bio-Hazard Waste Storage -ANhlUAL � Fum�gation 7enf
� Comm Exhaust Kifchen Hood/Duct � Hazardous Maferial (Tier If or RC2 Facilify) AhlNUAL
� Controlled Bum � Hood (nstalfation
� Emergency Generator < 30 kw � LP/t�latural Gas-Insfallafion
..� Emergency Generator > 30 kw � LP/Nafural Gas-AHNUAl� Sale
� Fire Protection Mainf -enan,r - ANI�1LlAL- - ----•._....__ Places of Assembly-ANNUAL
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, Sprinkler, � � Recreational Bum � � � I�Y �
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, e arm ❑ � ❑� � � Sparkfers
Hood Cieaning � p ❑ ❑�� � Sprinkler Sysfem Insfaftations
_ ._ _ Hood Suppressio� - � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
__ . ... ' • _
.. r . - FireAfarm Insfallation � ' To'rcf� Roofing/TarKetfle" '- • - �
_. . ,. _ ...
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�, Fire Pumps • � Wasfe Tire Sforage ANh1UAL
;:; � Fire Works • ,
, ,,, � ;� Ffammab[eAppficafion-ANNUAL. Valuation of Project .
' � �' Fuef Tanks � ' '
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Confractor � Company � �Y�"' � �n.,-�L L
Signature Registered Y/� Fee Current Y� I�
Add�ess License # •
ELECTRIC►AN` �.,''... ,"- . . - . " " - , Company
Signafure - •- ' - Registered Y/ N- Fee Current L Y/ I� ••
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Address License # -
PLUMBER . , Company � -
Signafure - FZeyistered Y( N � Fee Currenf Y/. �j' +
Address - License #
MECHAN(CAL Company
Signafure Registered Y/ N Fee Currenf Y��
. Address . License #
OTHER Company .
Signature Regisfered Y! N Fee Current Y/�
Address Licertse #
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Direcfions: ' -
. Fi[f ouf applicafion complefely. _
� Owner Y� Confracforsign back of appiication, notarized (Qr, copy of signed contracf with owner)
If over $ZS00, a riotice of Commencemenf rs required.(Mechanicat work over $5000)
-.- - Supp[y fwo (2) sefs of drawings wifh apPfcab[e documenfafion �
__ . _ Alfovw 1Q-14 days for revievr affer submiifaf dafe. Parcet �- obfained from Properiy T� t�ioiice (hifp:((appraiser.pascogav.com}
�1C3T(CE OF=€7EED E�ESTRECT[O�lS: f he.undersigned unders�ands-thai fnis permit may.be subj�ct°io
w(�icF� may oe more restrictive than Couny regulations. The-undersigned assumes respansibiliy for:�omplian�e witf� any
_appficable deed resfrictions.
Ut�L(CEPISED CQ�ITRACTOE�S A[�D COi�TRACTOR RESP.OI�S(B[L(T[ES: Ii the owner has �F�ired�_a �c�ncrac�or or -
confracfars fo under�ake work, f�tey may be required fo be licensed in accordance with s�afe and focal ff the
contracfor is not {icensed as required by (aw, ooth the owner.and coniracror may be cifed�for a misdemeanor v�ofa�ion
under sfafe faw. (f fhe awner or infended coniractor are uncer�ain.as fo what ficensing�requiremen�s may:apply for the
intended wor{c, tfiey are advised fo confacf �he Pasco Counfy Buifding [nspection Divis[on—Licensing Seciion.at 727-847-
8�Q9. Furfhermbre, iT the owner� has hired -a contractor or confractors, F�e is advisecf to have the confractor(s) sign
porEions of fhe "confracfor Bfock" af this appficafion�for wh�ch �they wiI[ be responsib(e. ff you, as the owner sign as the
contractor, fF�at may be an indicatian fhaf he is not properly licensed and is nof enEitled�to permif�ing privileges in Pasco
Counfy.
CONSTRUCT[OtV-L[EN l�AW (Cf�apter713, Floric[a S�atufes,_as.amended}: Ef vafuaEion of �nrork is �2;500.00 or more, I
cer�ify that [, the app[icant, ha�re been provided w�th a copy of 'fhe "Florida Consfrucfion Lien Law—Homeowner's
Protecfion Guide prepared by the Fforida DeparEment of Agriculture and Consumer Affafrs. If the app(icanf is someone
of(�er fhan the "owner", I cerEify fhat ! have obtained a copy of the above described document and promise in good faith to
deliver it fo fhe "owne�' prior to commencement.
CONTRACTOR'SIOWNEF�'S-AFF[DAVtT: f cerfify fhat a(I the information in fhis application is accurate and
fhat all work will be done in compliance wifh a[( applicab[e Iaws regu[ating consErucEion, zoning and [and
deve[opment. App(icafian is hereby� made to obtain a permit to do work and instaflation as indicated. .I cerEify
fhaf no work or �nstallation has commenced prior to issuance of a permit and�that al( work will be performed fo
meet standards of ali laws' regulating construction, County and City codes, zoning regulafions, and fand
development regulations in the jurisdiction. f also certify that l understand thaf the regulations of other
_ government agencies may applyto fhe intended work, and that it is my respons�bilify to idenfify what actions f
must take to be in comp(iance.
if I am fhe AGENT FQR�THE OWNER, I promise in good faith to inform fhe owner of the perrniffing.conditions sef forfh in
. _ __..; . .. _ .. . . �
– this�affidavit-prior-to commencing--construction�.._.Cundersfand_that.a separate far electrical wor ,__ ____
pfumbing, signs, welis, pools, air conditioning, gas, or ofher instal[afions not specifically �ncluded in fhe app[ication. A
permit issued shall be construed to be a license to proceed witfi the work and nof as authority fo violate, cancel, alter, or
set aside any pi'ovisions of the technical codes, nor shall issuance of a permit prevent the Building Officiaf from thereafEer
requiring a correction of errors in plans, cbnsfruction or violations of any codes. Every.permit �ssued sha�l becorne inva(id
unless the work authorized by such permit is commenced within six months of permit issuance, or if wark aufhorized by
the pe�mit is suspended or abandoned for a period of six (6) montf�s afEer the time the work is commenced. An exfension
may be requested, in wrifing, from the Building Official for a period not to exceed ninefy (90) days and wiE( demons�rate
jusfifiab(e cause for the extension. Cf work ceases for ninety (90) consecufive days, the job is considered abandoned.
- WARN[NG TO.OWNER: YOUR FA[LURE TO RECORD A'NOTICE OF' COMMENCEMENT' MlAY FZESULT [N YOUR "�
PAYtNG TWtC� FOR. (MPROVEMENTS T� YOUR PROPERTY. [F YOU INTEHD TO OBT N Fft�FING[HG, CONSULT
WITH YOUf2 LENDER OE2 AN ATTO BEFORE RECORD[NG YOUR NOTICE C ENCEMENT.
FLORIDA JURAT (F.S. 117.
OWNER_OR AGENT COhIFRACTOR
Subscribed and swom (or i ed) before me this Subscribed and s om fo or rmed) before me th�s —
. by b� --
Who is(are personaf[y known fo me or haslhave produced Who is/are personally known to me or hasfhave produced
as idenfification. as iden6ficafion.
Notary Public - Ngtary PubGc
Commission t�fo. Commission No. ,
ed; rintecl or stam ed t�ame of (�fatary fyped, printed ot sfamped
t�Iame of Notary typ p P