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Home My WebLink About11-12306 ' CITY OF ZEPHYRHILLS � 5335 - 8TH STREET � (si3) �so-oo20 12306 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12306 Address: 38300 5TH AVE Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book: Proposed Use: CHURCH Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-16500-0010 Improv. Cost: Date Issued: 8/29/2011 Name: TC FIRST BAPTIST CHURCH OF ZEPHY Total Fees: 25.00 Address: 38231 5TH AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 8/29/2011 Phone: (813)782-5574 Work Desc: FPM- FIRE ALARM ANNUAL- FIRST BAPTIST CHURCH �� , �",� �- 2 � � 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." � P IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Pire Marshal Office - 813-780-0041 1�`7 f ��T � C� r "� �� i�v� ci /"2�Y � 3�-�-- C�G,�� 1�' S �� - �� Q� � �f �� g!_3-6� C� ��'� � �� , - � „� [� � �-e� � �� z�� o �, �� .� �� -�,�, � � ��.� y � �� .: �� p��. � v ze� �7 -�-� � � l S 2� C( -r c. �, �t,.�r� b �.� t ��.. 7 6� F'-� � '�o/ �� r�� /� U,�,1'.e�- � � � � 2� 1 � ...> �` -, cere�s. �� -s" l �� R ��' � C / �� G�.-�.� STATE OF FLORIDA Dl3PARTMENT OF HIISINLSS AND PROFE3SIONAL REC�ULATION SL�CTRICAL CONTRACTOR3 LICSN3ING BOARD (850) 487-1395 .*°�..*� TALLAHAS3EE STR FL T 32399-0783 CBADi�TELL, DONALD ROSS FLORIDALARM COMPANY 322 CHADWELL DR SSFFNFR FL 335$4 . . ati►Rt�� #��3�1b�' . Congratulations! With this lic�nse you become one of the nearly one million ,�y�� C3p $IIr�� Floridians licensed by the Departmertt af Business and Professional Regulation �� Our professionals and businesses range from architects to yacht brokers, from ��7 boxers to barbeque restaurants, and they keep Fbrida's ec�nomy strong. =' ait�� -'�r 3iP'2��?�.t�f�##�,`" ' � 10?.�AfiS�S t Every day we work to improve the way we do business in order to serve you better. - �,;' ' ,'�,'% For informatian about our services, please log onto www.myfloridallcense.com. �� Z There you can find more information about our divisions and the regulations that � ' .� � impact you, subscribe to department newsletters and leam more about the �' ' 4 DepartmenY initiatives. �u • �,_,; f �- . .'�'�,,�Y Our mission at the Department is: Lic:ense EfficienUy, Regulate Fairly. We - ~.•, 1 . ; = constarrtly sVive to serve you better so that you can serve your a+stomers. '' '' ��'``r' �+ t`' a Thank you for doing business in Florida, and congratulations an your new license! �� `°"*��' w�"''��'�� " ��s�}+isYee est�, 11110' ,�`�, �'0�.� L3b@�;i111i��1ti DETACH HERE �c,� ��'�.��7 . � . .-:��►►��`�'��► , - . . . . ' ^ �� ; .. � -_ "�' �� ' . z ` _��`�;��'�". _ ' •x ' 7': - -_ � �f" ' ��I�M�V�iM.t{'�iV'� I _ x �[1YT� � Y1 . - � , _, .- . . . � i i j� 'a > r'..�.;::� i�, , ..i ' `:�:; z ' 'r ,- J --t: � .� �7 �ti � � .�K ; , y . ": � ' ^ � - � ri, :�.,. , � uiia , !i :7 , I �r�� ; � . . - . . , ��"i:��.''.�'!"�'�'. „ ' 8 - � '�.�� - _ - - � � Y±� � w -. +cl ;b��:�s'i� _� ;��t . ,�8��1��' ; �. , .,.., � , ��` � ��vie'�4�►�s �c� �_ .�.- r " ; : ��.�ai[��. �e311t'Ce��.w.��,,.�-r�.;_�� ,�-��;�; , , ' , . � � . < , , r _ �= ' � , �,,, : � r � �.4. � ' ,' - � y � - , . � � _ , .h # a , +:.�c �; , . ' '� ' �`�` �` , 1 � '� ' . '°' ,� '`"- Y •>.�= . ., . -�4t`-��•��4 . , - � j , � � A... _ ' +� �'�� ` q j . .�,_ ' "�' 'Y'�� 'i. �"� � � '_ . ' ' , _ "r.�. . _ . + �i - . . •- _ -. . �c.,,� , .r.�' . . . , _ ., r ✓ _ ' e L y `' M1 ' ; � ' : ' i . . -. ' n • ,. . , . � - ' , V° , .., w. „- , ,. �i�� ., . � ` r� � � -y: i, �. .-a '}i, ":.'.w,,, ,a.. a .. ...., w. ........ �...�: �a „�.: , - , � { , � . 813-780-0p20 Ciry of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Pertnit ��.� Owner's Name I < <�� - o �/' i Owner's Phone Number ��3 �� Owner'sAddress �,J� � `l L �� i ��S yZ Fee Simple Titleholder Name TiUeholder Phone Number �� Fee Simple Titlehoider Address . ,R., „ n-: :�.�rrix. �°��:��;�.. ,»,. »a • .. � �:-^'-�a�•�w� .s�?s��uC4da,>".e�» --:s>.�. . •- , Job Address 3 �-� � � � . S ' � �l � 2 Lot # � Sub Division Paroel # - .. .. .... . .D^h�. - ,. �v,•^ .....,.:te.�. .;i�..,_..., -�5:�. � , , .. .,. -�t�. ..+�F.-'-,r�iro.iw..+rz>.a:.. ,;.;a�s:.. �. .._t...� ° . n .. . � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Bum � Hood Installation � Emergency Generator < 30 kw Q LP/Natural Gas-Installation � Emergency Generator> 30 kw a LP/Naturel Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �y emi �n er Sprinkler � ❑ ❑ ❑ � RecreaGonal Bum Fire Alartn � ❑ � � � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps a Waste Tire Storage ANNUAL a Fire Works a Flammable Application- ANNUAL , Valuation of Project � Fuel Tanks Q Other: . . , . . ., .. ..... . . � � . ,. .. .. . , : M.. �.� . . : Contractor Company Signature Registered Y/ N Fee Current Y/ N Address License # ELECTRICIAN Company Signature Registered Y/ N Fee Current Y/ N Address � 'Z /' � i � �<I License # PLUMBER Company Signature Registered Y/ N Fee Current Y/ N Address License # MECHANICA Company Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions: , , . , ... . . .. . , : Fili out application completely Owner 8� 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 tk - 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 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 the intended work, they are advised to contact the Pasco County Buitding 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 (Chapter 713, 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: 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. 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 provisions of the technical codes, 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 TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to (o� affirmed) before me this Subscribed and swom to (or affirmed) before me this by by Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary ryped, printed or stamped Name of Notary typed, printed or stamped � DATE (MMIDDIVYVY) ACORO CERTIFICATE OF LIABILITY INSURANCE o8�25�20„ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT• If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policfes may require an endorsement. A statement on this certi£cate does not confer rights to the eerti£cate holder in lieu of such endorsement(s). cor+rncT aRODUCER phone� (813)988-123 Fax: (813)988-0989 NAt�tE_ MARY �Y PHONE S�3 9SB �ZS4 �a 813-988-0989 ASSOCIATES AGENCY, INC. �ac No E.��: �_ _L__ -' PO BOX 16190 E- �� ADORESS_ 11470 N. 53RD ST. vaooucea 2223 C_USTOMERID. __ __. -_ _ TEMPLE TERRACE FL 33687 Agency Lic# R001766 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA . SCOttSC�aI@ ADRC INC. & FLORIDALARM COMPANY INSURERB 322 CHADWELL DRIVE INSURERC SEFFNER FL 33584 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 228953 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CE�RT FICATE MAY BE ISSU�ED OR MAY PER A AFFORDED BY THE POLIC ES D SCRI ED REEN IS SUBJECT I TERMSS �ADOL�SUBR '� POLICYEFF POLICYE%P LIMITS INSR 7yPE OF INSURANCE INSR Wy0 POUCY NUMBER �MWDD/_YY'IV] �_lMM�DDIVYYYI �TR 1,000,000 A GENERAL LIABILRY CPS7320592 03113f11 03/13l12 EACH OCCURRENCE S DAMAGETORENTEO $ �O�OOO X COMMERCIAL CaENERAL LIABILITV 'I � i , PREMISES.�Ea_occurence) i MED EXP (Any one person) $ 5,�� CLAIMS-MADE X OCCUR � � i - i --� - "—" i ' ' PERSONAL&ADVINJURY $ 'I,OOO�OOO � '' GENERALAGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 'I,OOO,OOO GEN'L AGGREGATE LIMIT APPLIES PER' PRO- i ' $ POLICY j : �ECT ILOC _ _ _, — -- + - ' COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY '� $ � (Ea accidenq ANY AUTO ' ' � r BODILY INJURY (Per person) § ALL OWNED AUTOS � �� BODILY INJURV (Per accidenq $ SCHEOULED AUTOS , ! � PROPERTY DAMAGE $ � HIRED AUTOS i � , , (Per accident) , $ NON-OWNED AUTOS � � $ UMBRELU. uAB OCCUR , EACH OCCURRENCE � exce5s Lwe �CLAIMS-MAOE i , AGGREGATE $ ' �I $ DEDUCTIBLE ' , � . � RETENTION $ , , ' wC S7AiU- 07r+ WORKERS COMPENSATION � � TORVIiMITS ER $ pNO EMPLOVERS' 1U61LRV v i n ' E.L EACH ACCIDENT g ANV PROPfUETORIPARTNEWEXECUTIVE iNIA OFFICERIMEMBER Ezcwoeoa , E.L. DISEASE EMPLOYEE $ (Mandatory In NHj u yes, aesc�oe uneer E.L. DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS Eelow t -- -_ � ' � ', CPS1320592 03/13/11 � 03/13112 ' 2,000,000 AGGREGATE p �' Ertors or Omissions , '� � - 1----- -- -- -- ' - -- -�- - DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attaeh ACORD 101, Additfonal Ramarks Schedule, H more space fs required) Central Security Group is listed as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Zephyrhilis I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department �I ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8th Street Zephyrhills, FI SSS42 AUTHORIZED REPRESENTATIVE I I Attention: fx 813-780-0021 :� Mike R er — s ACORD 25 (2009/09) OO 1988-2009 ACORD CORPORATION. All rights reserved. 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