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Home My WebLink About11-12417 CITY OF ZEPHYRHILLS ' S335 - 8TH STREET (si3) �so-oo20 12417 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12417 Address: 38250 A AVE Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14-26-21-0010-01300-0010 Improv. Cost: Date Issued: 10/06/2011 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 10/06/2011 Phone: (407)975-3000 Work Desc: FPM-SEMI HOOD SUPPRESSION FOR ZEPHYR HAVEN NURSING HOME - 5. �; C � — / � % .�,.J ina 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 - Fire Marshal Office - 813-780-0041 a� s�so-oo2o City of Zephyrhills Fire Fax-ai �-�ao-oo2� Permit Application Date Rewiw::d ` �`� � Phone Contact for Pertnit � 3 1 t 7� �C� . �: Owners Name Owners Phone Number �� C� Owners Address Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address Job Address �� /`'�' ,i'�t!'C/�'+'e— e � /'�r�'� l'�� 3 �� Lot # � Sub Division Parcel # � Bio-Hazard Waste Siorage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct Q Hazardous Mate�al (Tier II or RQ Faciliry) ANNUAL a Controlled Bum Q Hood Installation _ a Emergency Generator < 30 kw a LP/Natural Gas-Installation a Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Sal +. � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNU L 1� �y emi �n er / � � � Sprinkler � ❑ ❑ ❑ � a RecreaUonal Bum Fire Alarm � ❑ O ❑� a Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � t ❑ X O� a Standpipes (Sp�nkler Sys) �� Fire Alartn Installation Q Toroh RoofingfTar Kettle ,)y �� Fire Pumps � Waste Tire Storage ANNUAL l/" � � Fire Worics � � Flammable Application- ANNUAL Valuation of Projec a Fuel Tanks Q Other: Contractor �' Company }�Yj G - /-1 - �. � /:Yl.c,.s� Signature Registered Y/ N Fee CuRent Y/ N Address y?�/ .l�iG �-4rr �4'" - 'T � License# � �y�3�� dc�r�.��f ELECTRICIAN Company Signature Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Signature Registered Y/ N Fee Cument Y/ N Address License # MECHANICAL Company Signature Registered Y/ N Fee CuRent Y/ N . Address License # �THER Company Sig�ature Registered Y/ N Fee Current Y/ N Address License # Directions: Fill out application completely. Owner & Contractor sign back of application, �ota�zed (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 #- obtained from Property Tax NoGce (httpJ/appraiser.pascogov.com) /�1�� S�c" ,�.� �'s�.3 � ��/- �r9�� NOTICE OF.DEED RESTRICTIONS: The undersigned understands that this permit may_be subject'to�"deed"��stri.tir�ns" which may be more restrictive than County regulations. The.undersigned assumes responsibilityfor:complian�e with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESP.ONSIBILITIES: ff the owner has hired :a 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 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 po�tions 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 (Chapter713, Florida Statutes,.as amended): If valuation of work is $2;500.00 or more, 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 ce�tify 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 iss�ance of a permit and that all work will be performed to meet sfandards 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 govemment 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 fhis affidavit prior to commencing construction. I understand that a separate pe�mit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifica�ly included in the application. A permit issued shall be construecl 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 author'¢ed 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, ftom 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 TT RNEY BEFORE RECORDING YOUR NOTICE OF MENCEMEAIT. FLORIDA JURAT (F.S. 117.0 � CONTRACTOR OWNER OR AGENT Subscribed and swom to ( affirmed) before me this Subscribed and swom to (or a ed) before m his bY by Who is/are ersonall known to me or has/have produced Who i s/are personally known to me or has/have produced P y as identification. as identffication. Notary Public Notary Public Commission No. Commission No. ed, rinted or stamped Name of Notary typed, printed or stamped Name of Notary typ P