HomeMy WebLinkAbout11-11794 CITY OF ZEPHYRHILLS ,
- 5335 - 8TH STREET
�si3) �so-oozo 11794
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 11794 Address: 38233 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: 35-25-21-0010-12300-0000
Improv. Cost:
Date Issued: 4/19/2011 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 25.00 Address: 7050 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILL FL 33541
Date Paid: 4/19/2011 Phone: (813)783-6189
Work Desc: FPM- SPRINKLER QUARTERLY- 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 other
costs related to the aforementioned.
Compiete 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."
�
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=r80-0O20 City ofZephyrhilfs'Fire� F�x-aj�-7ao-oo21
Pzrmii Applicaiion
Dats Ezeceived - Pho Coniact for Permit
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O,n��ts Name Owners Phone Numb�r g:� 3 6 2 6 5 4 8 2
OwnersAdd-ess 4701 Oak Fair B1vd T�MPA FL 33610
Fea Simple ,Tif(eholder hlams " - T�leholdar Phone hlumber ���
Fee SirnpfeTifleholderAddress
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JobAddress J� L-33�G-v i'1�'e'" � - �eQh�fkIIIS -�� 33SN �L �SO '�� ��ny� Lot# �
Sub Division Paroef �
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� 8io-Fiazard Wasfe Storage - AHNUAL � Fumigafion Tenf
� Comm Extiaust'Ffitcfien Hood/Duct � Hazardous Material (Tier If or RQ Facifify) ANNUAL
� Controlled Bum � Hood (nstal(afion
,� Emergency Generator < 30 kw � LP/t�fatural Gas-Instaflafion
� ° �Emergency Generetor> 30 �kw � LP/f�latural Gas-ANPtUAL Sa[e
�. �
.. , _�' Fire Protection Maintenance - ANPIUAL Places of Assembiy Ah(NUAL �� �
y emi An er ,� II
, , , Sprinkfer. � ❑ � � ' � Recreafional Bum ,�,
- � � , Fire Alartn � ❑ ❑ ❑� � � Sparkfers ` .
f . ,��� � Hood Cleanir�g � � ❑ ❑ � � SprinklerSystem Iresfa(fa6ons
_ _ _ . - - , .. Hood Suppression. - .❑ q O _O � � Sfandpipes (Sprinkler Sys)_ _
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- = =�° - Fire/Xlamt Inslaflafion • ' �
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oofinglT'ar Kettle � '`
� �. ��~,, �. Fire Pumps � ( Waste Tire Storage AMNUAL -
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,- � ` Fire Works � ``
. � �;, �� ,� FlammabfeApp[icafion-ANNUAI� , , ValU3floit of PfojeCt ,
' � � �`' Fuef - Fanks
� ' � �, .Other: •
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Confractor � Company � �N`' tiwr'-c. �
Signafure ' Registered Y/ N Fee �urrertt l� / I�
Add�ess _ _ " _ A License # '
ELECTRtCtAN ; .- , ' . , . _ • ° .. �, • - , Company , ' ��.. • � . :�. '
Signature • � -- ' - � � ' • - ` Registered < Y / N � Fea,Currgnte , Y / N � ; •
, Address License # ' ,
PLUMBER , . ' . . Company � :� . � ':"•
Signature ' Regisfered Y(� Fee Current Y��;�
Address • License #� `
MECHANfCAL Company
Signafure Regisfered Y/ N Fee Currenf Y/ I�l
Address . License #
OTHER Company -
S[gnatu2 Registered Y/ N Fee Current Y��
Address Licerese #
Direc6ons: - �
" , FF[( out appficafion compfefely_ '
' Owner � Contr�tcforsign back of applicafiort, nofarized (Or, copy of signed confracf with owner) -
ff over $Z500, a I�Iofice of Commencement is required_(M1rE_chanica( work aver $50D0� . .
'� ''_ - Suppty two (2) sefs of drawings with appficabfe doc�menfation -
-�.. - _ AlfoHr 10-14 days for revlew ai�er submi�Fa[ da4e_ Parcet �- obfair�ed from Pmperfy Tax Hofice (hifp'l(appraiser.pascogav.cnm)
`�lf3T[CE QF=DEED "RESTRIGT[Ot�S: i he.undersigned understands.fhat this permit may_be•subject=io
which rriay be mare restriciive than Couny regulations. The_undersigned assumes responsibiliy for-:�ompliaR�e�with any
_applicabfe deed resfrictions.
LlI�IL(CE(�lSED'COt�TR:4CTE3RS AI�1D CO�ITRACTOR RESP.ONS[BILIT[ES: lf�fi�e o�vner has or �-
confracfors �to undertake work, ti�ey may be required be Iicensed in accordance wit{� sfate and Ioca( If fhe
confracfor is nat [icensed as required by faw, bofh the owner .and con�ractor may be cited �for :a �misdemeanor vlo[ation
under sfate faw. [f the owner or infended contractor are uncer�ain.as�fo what ficensing�requiremen�s may.app[y �or �he
intended work, tfiey are advised�fo contact fhe�Pasco County Buifding [nspection Division—Licens[ng Section_at 727-847-
80Q9. Fur�hermore, if the owner� has hired _a contracfor or confractors, he is advised to have �fhe confractor(s) sign
porfions of fhe "contracfor Bfock" of fhis applica�ion which'they wi[f be responsible. [f you, as awner sign as the
contracfor, thaf may be an inc(icatian'�haf he is not properly ficensed and is nat enfiffed permit�ing pr[vifeges in Pasco
Counfy.
COIVSTRUCT[OIV_L[EN LAW (Chapter7�f3, �(aricla S�afufes,_as.amendecl}: If vafuation of �nrork is $2;500.00 or more, I
cerfify tf�af [, �fhe applicant, have been provided w�th a copy of �the "Florida Construefion Lien Law—Homeowner's
Protecfion Guide" prepared by Florida Depar�ment af Agricu(ture and Consumer Affa€rs. [f the app[ieanf is someone
ofher fhan the "owner", ( cerEify that I have obtained a copy of the above described document and pramise in good faifh to
de(iver [t fa tf�e "owne�' prior to commencement.
- CONTRl�CTOF�'SlOWNER'S-AFFtDAVfT: f cerEify fhat afl the informafion in fhis appiicafion is accurafe and
fhat all ar✓or[c wiff be done in compfianc.e wifh afi applicable laws regu[ating construcfion, zoning and [and
_ devefopment. ApplicafEan is hereb}� made to obfain a permit fo do work and installa6on as indicafed. .f cerfify
fhaf no work or �nstalEatian has commenced prior to issuance of a pe�in�it and alf work wi(! be performed fo
meet sfandards of all (aws � regu(afing construction, County and Cify codes, .zoning r�gitlafions, and (and
development regufafions in the jurisdiction. f a[s.a cer�ify f�at l understand thaf fhe regulations of other
. government agencies may app(yto fhe intended work, and that it is my respans[biiify to idenfify what acfions f
must take to be �n compfiance. �
Ef f�am #he AGENT FORTHE OWNER; I prornis�-in good faifh Eo inform the owner. of the perrrT[ffing,.conditions sef forEh_ in_ .
_.. _... _.
-� - - - -- .� _ . _ � �._ _...; .. ._. ;.:_.._. .. __. �-
--this commE�c��g may required_for_e(ectrical.r�ork, _. ,
pfumbfig, signs, welis, pools, air conditioning gas, .or other instal[afions not specifically [ncluded in the applicatioti. A
permit issued sha(f 6e construed to be a license to proceed wiffi fhe work and not as aufhorify to vio{afe, cancel, a(ter, or
sef aside any p'rov�sions of the technical codes, nor sha(I iss�ance of a permif prevent fFie Building Officia[ from fihereafter
_requ�ring a correctian oF errors in p(ans, consfrucfion or viofafions of any codes. Every.pe.rmit.issued. sha((,beco.rite inva(id ,
unless t(ie work authorized by such permit is commenced w�fhin s�x mont[�s of permit issuance, or if wark authorized by
the perm�t is suspended or abandoned for a period of six (6) montF�s af�er the fime the work is commenced. An e�ension
may be requested, in wrifEng, from the Building Officiaf for a period not fo exceed ninety (90) days and wif( demons�rate
jus�ifiab(e cause for the extension. [f wo�k ceases for ninety (90) consecutive days, fhe job is considered abandoned. .
WARI�CNG'1'O. OWNER: YOUR FA[LURE TO RECORD A`NOTtCE "OF'��COlif[MENCEMENT MAY"RESULT (N YOUR ''
PAl(tNG,TWtC� FOR. [MPROVEMENTS TQ YOUR FROPERTY. [F YOU [HT��D TO OBT N FENA[�ICIhIG, CONSULT�-"--'� �'-
WITH�YQUR LENDER DF�AH ATTO �BEFORE RECORDWG YOUR�HOT(GE C � EHCEMENT. ..
FLORIDA JURAT (F.S: 117. -
OWNERORAGENT l CO�iT'RACTOR � -_,
T�r...� .
Subscri�bed• arid swom ,(o� � ed) before me fhis Subscribed and s m fo o� irmed) before me th�s -_
. by - . by
Wt�o is/are persona(Iy knawn to me or has/have produced Virho is(are personally known to me o� haslhave produced
� as idenfifica6ori. as idenfificafion.
� Notary Pub[ic - Notary Pub�ic
Commission E�to_ Commissian Na. -
f�iame af Nofary typed; printed or sfamped t�ame Qf t�fofary typed, printed or sfam}ied