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Home My WebLink About11-12538 _ � CITY OF ZEPHYRHILLS 5335 - STH STREET �. '"� �si3) �so-oo20 1253'8 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12538 Address: 38135 MARKET SQUARE DR 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: 02-26-21-0010-03900-0030 Improv. Cost: Date Issued: 11/16/2011 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38135 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540 Date Paid: 11/16/2011 Phone: (813)780-8440 Work Desc: FPM- FIRE ALARM ANNUAL- FLORIDA MEDICAL CLINIC 5. 1 � �,, • / f ! � ' l�� , �, ina Chapter 633, Fiorida 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 activiry 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 8't3= �80-0020 Ciry of.Zephyrhills�Fir:e• Fax-s�aasaoozi Permit Application Date Received - Phone ContacYfor Pertnit �] Q a� Owners Name O('� �� C. Owners Phone Number -� ��. �� Owner's Address 3 1 � � Fee Simple Titleholder Name Titlehoider Phone Number �� Fee Simple Titleholder Address Job Address � � IJ � � Lot# � Sub Division Paroel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kltchen Hood/Duct � Hazandous Material �er II or RQ Facility) ANNUAL � Controtled Bum � Hood Instaltatlon � Emergency Generator < 30 kw � LP/Naturel Gas-Installation � Emergency Generator > 30 kw � LP/Naturel Gas-ANNUAL 5afe � Fire Protection Maintenance - ANNUAL � Places of Assembly ANNUAL �y em� �n er 2 � Q 5prinkler � O O O � Recreational Bum �� f Z s�J U .� � � Fire Alartn � ❑ O �, � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � p ❑ ❑� � Standpipes (Sprinkler Sys) � Fire Alartn Installation � Toroh Roofingll'ar Kettle � Fire Pumps � Waste Tire Storage ANNUAL Fire Works Flammable Application-ANNUAL Valuation of Project Fuel Tanks � Othe ConVactor Company � Signature Registered Y/ N Fee Curren Y/ N F 3�y�y� Add�ess License # ELECTRICIAN Company Signature ` Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Signature Registered Y/ N Fee Current Y/ N Address License # MECHANICAL Company Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions: FII out application completely. Owner 8 Contractor sign back of application, notarized (Or, copy of signed conVact with owner) If over 52500, a Notice of Commencemerrt 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 Notice (http:/lappraiser_pascogov.com) �NOT�CE OF=DEEDRESTRICTIONS: The undersigned understands-that this permit may_be�subject:to�"de�d°��strictions" which may be more restrictive than Couniy�regulations. The.undersigned.assumes responsibility for:�ompliarnce�with any _appiicable deed restrictions. UNLICENSED CONTRACTORS AND `CONTRACTOR RESPONSIBILITIES: If the owner has 'hired �or - contractors to undertake work, they may be required to be licensed in accordance with state and local lf 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 portions of the "contractor Block" of this applica�ion�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 ficensed and is not entitled�ta permitting.privileges in Pasco County. CONSTRUCTION.LIEN�LAW (Chapter713, Florida Statutes,-as-amended): If valuation of work is $2;�00.00 or more, I certify that l, �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 compfiance with all appiicable 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. 1 also cer#ify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to idenYrfy what actions I must take to be in compliance. If I am the AGENT FORTHE 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 tMe work is commenced. An extension may be .requested, in writing, from the Building Official for a period not to exceed ninety (90) days and wili demonstrate just�able 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`NCI�'TTICE �OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO Y�UR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT W[TH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N ICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTO Subscribed and swom to (or affirtn�) before me this Subscribed an s m to (or a ) before me this by Who islare personally known to me or haslhave produced Who islare pe nally knovm e or has/ha�v n��tion. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed; printed or stamped Name of Notary typed. printed or stamped