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Home My WebLink About11-12336 CITY OF ZEPHYRHILLS ' S335 - 8TH STREET . (si3) �so-oozo 12336 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12336 Address: 7350 DAIRY 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 -25-21-0010-06900-0020 Improv. Cost: Date Issued: 9/08/2011 Name: ADVENTIST HEALTH SYSTEM Total Fees: 25.00 Address: 7050 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 9/08/2011 Phone: (407)975-3000 Work Desc: FPM- SPRINKLER QUARTERLY- ADVENTIST HEALTH L � � 1.�, �. �— l lS� l l r � 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 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 ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 a��-�so-oozo City of Zephyrt�ills Fire - Fax-813-780-0021 Permit Application : Received ;� �j / Phone Contact for Pertnit � �p s 1j73 S iers Name ,Z �� ' ,gL �� r� � Owner's Phone Number C� U � ier'sAddress � �(S �'Q/K �CD14�( � �' 1� � ��S" Simple Titleholder Name Titleholder Phone Number � C� � Simple Titleholder Address L�l Address � Lot # Division Paroel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm F�chaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Bum � Hood Installation � Emergency Generator < 30 kw � LP/Natural Gas-Installation � Emergency Generator> 30 kw � LP/Naturel Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL _ [�' ' emi � er � Sprinkler �!�� {� U � � Recreational Bum Fire Alartn � ❑ ❑ ❑ �� Sparklers Hood Cleaning � p � � r� Q ❑ �� ❑ Sprinkier System Installations Hood Suppression ❑ ❑ ❑ Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch Roofinglfar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Fiammable Application- ANNUAL � Fuel Tanks �� Valuation of Project Q Other: ractor ature � Company %�t �C i � � Registered Y N Fee Cument Y/ N Address License # � :TRICIAN iture Company Registered Y/ N Fee Cument Y/ N Address License # �— IBER ture Company 4ddress Registered Y/ N Fee Cument Y/ N License # IANICAL :u2 Company lddress Registered Y/ N Fee Current Y/ N R License # ure Company ,ddress Registered Y/ N Fee Current Y/ N �ns: Lice�se # � Fill out appiication completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contrect with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drewings with appiicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice h //a � ttP: ppraiser.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 contrac or 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 under state law. If the owner or intended contractor are uncertain as to what licensing requirements may app y intended work, they are advised to contact the Pasco County Building 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 p�operly licensed and is not entitled to permitting privileges in Pasco County CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, of he a F o Construct on L en Law certify that I, the applicant, have been provided with a copy 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 NDER I O AN ATTOR EY�BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' CONSULT WITH Y�UR LE FLORIDA JURAT (F S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to (or affirmed) before me this Subscribed and swom to (or affirtned) before me this by b y Who is/are ersonall known to me or has/have produced Who is/are personally known to me or has/have produced p y as identiflcation. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped