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Home My WebLink About12-12856 CITY OF ZEPHYRHILLS 5335-8TH STREET (si3)�so-oozo 12856 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12856 Address: 7910 GALL BLVD 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: 35-25-21-0010-00700-0000 Improv. Cost: Date Issued: 3/02/2012 Name: PRIMERICA GROUP ONE Total Fees: 25.00 Address: 3629 MADACA LANE Amount Paid: 25.00 TAMPA FL 33618 Date Paid: 3/02/2012 Phone: (813)933-0629 Work Desc: FPM-ANNUAL FIRE ALARM FOR STAPLES 5. � � � , r �. (��- ina Chapter 633, Florida Statutes,authorizes the City to charge and aollect 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." a.. P IT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal �ce- 813-780-0041 813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 Permit Application ate Received � O �Z--� Phone Contact for Pertnit � �_� C� wner's Name Owners Phone Number C� C� C� wner's Address 3e Simpie Titleholder Name Titleholder Phone Number C� C� C� 3e Simple Titleholder Address >b Address ...>1 �j # � p l 1 1 l(V �C}-�� '�_ _ Lot# �� b Division Paroel# � BiaHazard Waste Storage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Faciliry)ANNUAL � Controlled Bum � Hood Installation � Eme►gency Generator<30 kw � LP/Natural Gas-Installation f f � Emergency Generatar>30 kw � LP/Natural Gas-ANNUAL Sale ' aFire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �/, rTy emi �n er � Ga �+' . � ✓ Sprinkler � � Recreational Bum ❑ O ❑ �� I � � Fire Alarm � ❑ ❑ �� Sparklers �� Hood Cleaning ❑ ❑ ❑ � � Sprinkler System Installations � �� Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Installation � Torch RoofinglTar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL r � Valuation of Project � Fuel Tanks Q Other: �ntractor Company gnature Registered Y/N Fee Current Y/N Aidress License# ;-�CIAN Company gnature I Registered Y/N Fee Current Y/N Address License# _UMBER Company gnature Registered Y/N Fee Current Y/N Address License# :CHANICA Company �nature Registered Y/N Fee Current Y/N Address License# 'HER Company �L!/y��_ . �nature Registered Y/N Fee Current Y/N Address ��300 ac� g�� -��d� 32 License# �ctions: Fill 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 drewings with applicable documentation Allow 10-14 days for review after submittal date. Parcel#-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 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 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'SIOWNER'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 sworn to(or affirtned)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 typed,printed or stamped Name of Notary typed,printed or stamped � Page 1 of 4 3!!�a �'� �� 1-865-508-3721 �.100 Old Mwy 8 NUV Check In & Out New Brighton, �IIN 55112 �� #�'�� tVR �.ine 1-588-274-8595 General Information Date 2/17/2012 Work Order #: 20702 Status: Accepted Created• 12:14:49 PM ' (CST) Service Requestor Scheduled Site Request #: 9028 Name• Maintenance p: Contact ' 888-274-8595 Info: Priority: Scheduled Initial ETA: 3/31/2012 12:00:00 PM (CST) AnnualInspection Date 2/17/2012 Customer• Staples Cate 'or - Fire Alarm Date ated: 12:14:49 PM . 9 y' System (CST) Completed: Site: Staples 1899 Equipment: Building Interior Customer 7910 Gall Blvd PO#: Zephyrhills, FL 33542 AS 400#: 813-783-6026 Region Manager: Not To � Division Manager: Exceed: General Manager: Contractor: GRUNAU - ORLANDO Service - Alarm Requestor 11300 SPACE BLVD #4 & 5 From Scheduled Maintenance #534 ORLANDO. FL 32837 Scheduled Maint ID: 534 Contact: Mike Site: Staples 1899 Thomas, Service Service Category: Annual Inspection - Fire Alarm Manager System Phone: 407-857- Vendor: GRUNAU - ORLANDO - Alarm 1 00 Equipment: Building Interior Fax: 407-855-9064 Steps: Cell: 407-808-0993 1. Please schedule and perform the inspections listed above. 2. Work MUST be completed between the lst - 20th of the month. Service 3. Vendor Must Do The Following within 48HRS Requested: of receiving this work order: a. Accept the work order b. Enter the ETA for inspection within the above specified dates 4. If you cannot meet the ETA that you assigned during acceptance, please re-enter WorkOasis and use the SCHEDULE FOLLOW-UP DATE button at the bottom of the screen to update your ETA. 5. It is required that the site be called 3-5 days in advance to approve ETA. 6. Staples specifies that you notify mall management 24 hours prior to any inspections being completed that could set off alarms in other areas. http://api.workoasis.com/WorkOrders/WorkOrderPrint.aspx?WorkOrderld=20702&TechV... 2/22/2012 • Page 2 of 4 7. Technician MUST do the following while on- site: a. Check-In by calling the APi IVR phone number listed above b. Perform ONLY scope of work specifically listed on THIS work order c. Inform On-site authority of any deficiencies. d. All Documents must be COMPLETELY filled out. e. ALL documents must be signed / stamped by on-site authority f. Check-Out by calling the APi IVR phone number listed above 8. If any immediate repairs are needed during the inspection please contact Justin Holden at 888-274-8595 for further instructions. If the repairs require a return visit, please send Justin a complete quote within 5 days of the inspection date. 9. The Staples Field Survey must be completed (including site stamp and signature) and returned with your invoice and in-house inspection reports. a. Contact Justin if you do not have a copy of the survey. 10. If upon arrival you cannot complete the inspection as scheduled due to the customers request, please have the MOD sign the documents and detail the circumstances. li. Thank you for complying with all customer specific requirements! 12. Please make sure that you inspect the CORRECT Staples store. There are multiple locations in certain cities. 13. We cannot and will not process your invoice without an inspection report or Staples Field Survey. 14. Do not upload your invoice into the documents of the work order. 15. The following documents MUST be uploaded to the respective work order PRIOR to the work order being marked as completed: a. Extinguisher Inspection Report b. Extinguisher Service Summary Report (signed by store authority) 16. Invoices with complete and accurate paperwork, must be submitted to invoices@api-nsg.us within 30 days of job completion or contractor will not receive payment for work. By accepting this Work Order you agree to these terms. Notes: PLEASE NOTE THAT THESE INSPECTIONS ARE DUE IN MARCH Scheduled or UnScheduled: UnScheduled; Dispatch Method: AutoRegular Invoicing Method: Manual Unit Price: 400.00 http://api.workoasis.com/WorkOrders/WorkOrderPrint.aspx?WorkOrderld=20702&T'echV... 2/22/2012 • Page 3 of 4 Work Vendor On 00:00:00 Completed: -Site # of Hours• Documentation: History Date User Status Description 2/17/2012 12:14:49 Justin Holden APi-NSG Natl Scheduled Service Scheduled Maintenance Work PM (CST) Account Re� Created Order Created http://api.workoasis.com/WorkOrders/WorkOrderPrint.aspx?WorkOrderld=20702&TechV... 2/22/2012 ' Page 4 of 4 APi Work Qrder #: �Ca� ,�PI IYR 11n�e at 8�6�-bl�•3?21 �o Ch�ck In WQrk Pe�rfarmed /' Cvrnrnerats: 1s a �e�urn trip needed to co�nplete this jcrb� Yes[] No� Tech�iciar► is d�quired to meet with fhe customer's representati�e once the wc►tic is cv�npl�eted to di��uss rn�h�t was found vnd �orrected. Mater�a! C�uantity Labor: Name R�G OT OA1'E Travel Tim�: A�liieage: --- Technician Name: Dafie. Author�zed By: Technician Signo#ure: If a Syst�m Imp�m�nt ar I.�SrrfNy Isaw►h dl:eav�r�d,1'h�f�ollcwWng act�ons+��nqu��d ta taks plocs: 1. The ari-sfte s�n+fce technEcian 1s ta natifyr�,��y�r on sfle des��pnate of Mie prcblem fmmediate#y upan c�scouery adnd lhen e+�q 1he API Nc�Nona!S�rvie�C�aup a�{$$8)27�A-6595. 2. The technic�CSn sktaN�ao?kecr+e tl�facility until all parlies are notiAed of the sftucrtion an�i a r�sdhrfic�n is establisheel. Cal� APi IVR line crt 8b�6-+608-3?21 #o �Cl�eck �Ouf http:l/api.workoasis.com/WorkOrders/WorkOrderPrint.aspx?WorkOrderld=20702&TechV... 2/22/2012