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Home My WebLink About12-12961 � CITY OF ZEPHYRHILLS � 5335-8TH STREET (si3)�so-oozo 129�1 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 12961 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: 4/10/2012 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 20.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/10/2012 Phone: (407)975-3000 Work Desc: FPM-SUPPRESSION SEMI-ZEPHYR HAVEN � �� - � ; _ 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 aosts 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 RECO IN Y R NOTICE OF COMMENCEMENT." ' PERMIT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 ��y v LGF/IIr111111J� ��c raX-tS1,S-780-0021 Permit Application Date Received — - 3 t 7� - c � ? Phone Contact for Pertnit ! 1 �� -�:-.>�:;...n.� .. . � . Owners Name Owners Phone Number Owners Address �� Fee Simple Titleholder Name Titleholder Phone Number [� �� Fee Simple Titleholder Address —� =�`� �` -=�s....:aci-. ,P��y_D^"��r�'-'r:t++'�-":^�'a�E3`�?��s / .w'c:�-s�`�"•c,.-:.c:',:� .�a. Job Address �� /� �- ��,,� �a� � �vc��``� Lot# Sub Drvision �� Parcei# � � ..u.�z��°.Y°.�°�.-�'�.��.-�-___.....__.�� - - - �.;,,.��:--- .�.�...,.,,,,� .��.:_�.�..?��s��;�.^., ��.�. a Bio-Hazard Waste Storage-ANNUAL � � Fumigation Te�t m aComm Exhaust Kitchen Hood/Duct a Hazardous Matenal(Tier II or RQ Facility)qNNUAL aControlled Bum a Hood Installation aEmergency Generator<30 kw � LP/Natural Gas-Installation a Emergency Gene�ator>30 kw � LPlNatural Gas-ANNUAL Sale aFire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL ❑� emi �n er � Sprinkler ❑ ❑ ❑ Recreational Bum � � � j Fire Alarm � ❑ ❑ ❑ � � Spariclers �� Hood Cleaning � ❑ p p �� a Sprinkler System Installations Hood Suppression � r ❑ � ❑ � � Standpipes(Sprinkier Sys) a Fire Alarm Installatio� � Torch Roofing/Tar Ketlle a Fire Pumps a Waste Tire Storage ANNUAL aFire Works aFlammable Application-ANNUAL � � Valuation of Project Fuel Tanks � Other: Contractor �- Com an Signature P Y � � - � �"'��/�'�4--� Registered Y/N Fee Current Y/N Address y��( �`�G �«� �4_ _ T ELECTRICIAN � License# � fY�3.�z1 �oe�f��o�� Company Signature Registered Y/1� Fee Current Y 1 N Address License# PLUMBER Signature Company Registered �'/(v Fee Current Y/(� Address License# MECHANICAL Signature Company Registered Y/N Fee Current Y/N Address - License# OTHER � Signature Company Registered Y/N Fee Current Y/N Address n License# uu ca,uv�u. .._- Fiil out applicaGon completely Owner&Co�tractor sign back of application,notarized(Or,copy of signed contract with owner) H 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 Notice h J/a i ( ttp' ppraaser.pascogov.com) �NOTICE OF DEED RESTRICTIONS: The unde�sig�n�ed �he undersigned a'ss�umes�espons bilbry fort�mpl a�e w th any which may be more restrictive than County regulat applicable deed restrictions. UNLICENSED CONTRACTORS AND bONeRAe�T.o be E enOedSiBac'coEdance wth s ate and locale egulationrsc Ifrthe cont�actors to undertake work, they may q contractor is not licensed as required by law, both the owner and contractor may be cited for a misdem�an�oP vio ation under state law. If the owner or intended contract o Count cBu Idingslnspectionl Div s on feL cens'mgtS ction at 727-847- intended work, they are advised to contact the Pasc Y 8009. Furthermore, if the owner has hiredl'cationtfor which�theyrwill be esponsbleetlftyouaas the ownteasign asstge portions of the "contractor Block" of this app erl licensed and is not entitled to permitting privileges in Pasco contractor, that may be an indication that he is not prop y Counry. CONSTRUCTION LIEN LAW (Chapter 713 ovided wSh a tcopy of rthen�F o)ridla Clonstructio� L en L aw00Hom owne's certify that I, the applicant, have been p licant is someone Protection Guide" prepared by the Florida Depa�tment of Aof thetabove des�ribed documlent and prompse in good faith to other than the"owner", I certify that I have obtained a copy deliver it to the"owner" prior to commencement. that all the information in this application is accurate and CONTRACTOR'SIOWNER'S AFFIDAVIT: I cettify �icable laws regulating construction, zoning and land that all work will be done in compliance with all app� development. Application is hereby eneed� �orto s uancle of a p t and'that lalltwork wiNdbe performed'to that no work or instaltation has comm P meet sfandards of all laws regulating' {o�nstr icaiis �°��thatdl ulnde saand that heeregulatonsaof oths I development regulations in the �unsd government agencies may apply to the intended work, and that it is my responsibility to identify what action must take to be in compliance. ood faith to inform the owner of the permitting conditions set forth in If I am the AGENT FOR THE OWNER, I promise in g this affidavit prior to commencing construction. I sn oerothe�r inst I�lat op sr not specifical�ly bnc�dedred he alppli ati eor�, plumbing, signs, wells, pools, ai� conditionmg, ga , permit issued shall be construed to be a liceeSenor shall is�sua'ncehof a pe mitprevent thehBu ding Offi eal from the eafter set aside any provisions of the technical cod , ermit issued shall become invalid requiring a correction of errors in plans, construction or violations of any codes. Every p such ermit is commf six 6Wmhonths after�the fimPe thetworkasCCOmmenced. Anhextension unless the work authorized by P the permit is suspe�ded or abandoned for a period o ( ) for ninet (90)consecutive days, the job is considered abandoned. ma be requested, in writing, from the Building Official fo ya period not to exceed ninety (90) days and will demonstra e Y justifiable cause for the extension. If work cease W ARNING TO OWNER: YOUR FAILURE TO RECOROPE TM TIF YOU INTOE DETO OBTA NnFI�NANCSNG,rCONSULT PAYING TWICE FOR IMPROVEMENTS TO YOUR P WITH YOUR LENDER OR AN TT RNEY BEFORE RECORDING YOUR NOTICE OF MENCEMENT. 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 me his bY by Who is p tsonally known to me or haslhave produced Who is%are personally known to mas dentificaU'oProduced as identfication. Notary Public Notary Public Commission No. Commission No. Name of Notary lyped,printed or stamped Name of Notary tyPed,printed or stamped