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HomeMy WebLinkAbout12-13353 � CITY OF ZEPHYRHILLS � 5335-8TH STREET (sis)�so-oozo 13353 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 13353 Address: 38107 MARKET SQUARE DR Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book: Proposed Use: MEDICAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: improv. Cost: Date Issued: 8/20/2012 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38107 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 8/16/2012 Phone: Work Desc: FPM-QUARTERLY FIRE SPRINKLER � ' � z' ,_,2�J �� ma 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 Pians, Specifications and Fee Must Aaompany Application. Commencement of work without written approval of the Fire Department's Fire Marshai 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 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 � 813 780-0020 C�cy or Zephyrhills F��� Fa.-813-780-0021 � Pe�m��Applicatwn ��«Re�P,�od - Pno�e co��a«.o�Pa�m,� 813 V 621 1357 ow�o�,rv„m� FLORIDA MEDICAL CLINIC ow�a��s P„o�e N�mea� � � � ow���,Add�P=, 38107 MARKET SQUARE DR., ZEPHYRHI�LS, FL 33542 FP.,S, �,e T���a�,o�de�Na,.,., L���ho�de.P„o.,�N�mea� � � � F��5�.,��a T,�iehoiae�Add��,,. �oe Ann�,,,, 38107 MARKET SQUARE DR., ZEPHYRHILLS, FL 33542 �o # � s�h o,��,�o� CITY OF ZEPHYRHILLS PF o,# � B�o-Haza�d W„s�e S�o��96 -ANNUAL � F„m�9a.�o„Ta,.� � Comm E.ha,,,�K�«ne.,Hooa/D„<< � Ha�a�do,..Ma�o��a�(T���II o�RQ Fe,����v)ANNUAL � C�„«o��ed B,,,,, � Hood I„�«��a��o., � Emb�9a.,�, G,,.,o.��o�< 30 kw � LP/Ne�,.�a�Ga� I.,,�a��a��o., � fi �� i � E�.,��96.,�y Go�o�a�o�>30.w � LP/Na�,,.a�Ga�ANNUALSaIe l � � F„� P,o««,�„Ma�.,�o„a.,�a-ANNUAL � P�a�a, o,A,some�,.-ANNUAL �.�Y 0 �� ❑ ��-----.. SP��.,k��. � � ❑ ❑ Rd«aar�o„��B,.�� F��.,A�T.m � ❑ ❑ ❑ � � S�a�k�e�� H���,C�ea.,,,,� � ❑ ❑ ❑ � � SP.�„k�a�SYZ�om I,.��������o„� Hood S�PP.o.,,o„ � ❑ ❑ ❑ � � a„ P.. �..k�e St Npi •��Spr r Sys� � F��E A��.�m I,,,�..�����o„ � To.�h Roo.�„9/T��Kaa�e � F,�e P„mPS � We,�o T�.a S�o�fl90 ANNUAL � F.e Wo�., � Fia,.,..,ahi„Anai�<a.�o�-ANNUAL $Z�J.00 Vai�acio� orP�o�e�i � F,.��Ta„k� � Dinor Contraceor Company —� s,9�a���� Re9�=«�ad Y/N Fea C��,d�� Y/N Add��,� L�e„�a # ELECTRICIAN Compa„y � s,g����.� R�9�,�d�eN Y/N Far Cu��o�� Y/N Aen��,_ L�e,,,e ri PLUMBER Compa„Y s��,.�,� Re9,=�o.od Y/N Fea C���d�� Y/N A�d.,,,� L��a.,�a# MECHANICAL Co�,pa�Y s,9�����o Ra9�=�a�ed Y/N F�e C��.a�� Y/N ANd.�=, L��o„�a# oTHER JEFFERY D. BURNHAM comp��y RODAN FIRE SPRINKLERS, INC. s,g„a���� R�9�=�A�od Y/N Fao c���a�� Y/N AddfeSS 2 01 N. 70TH ST. TAMPA FL 619 ��=a�=�# 31531 12006 D��E<<,�,,, F�n o,.c�noi,���io� �omPio��.iy Ow.,�,�&Co.,«A«o�„�„ ea�k or a�w�����o,,, „o�..��:.�n (O� � , ed�o„«a«w��n ow�„�) PY o ci9n I,o„<<$2500 � N�,.�� o�Co�,m�.,�P,,,a„� ,�eq��.od(Me�na���e�w�.k o„e�$5000) S�pply rwo�z� s��s of tlrawings w�th applicnb�a tlo.um�ncation Aliow�O-�Q a y �nr review�/cor subm�ttnl a�te Parcel#-ob�ainotl from Proparcy TaH Notice �nc[p�Iapp niser pascogov com� NOTICE OF DEED RESTRICTIONS• The undersigned understands that this permit may be subject to"deed" restrictions" w h i c h m a y b e m o r e r e s t r i c t i v e 2 h a n C o u n t y r e g u I a i i o n s I h e u n d e r s i g n e tl a s s u m e s r e s p o n s i b r I i i y f o r c o m p I�a n c e w i 2 h a n y a p p I I C a b l e tl e e d r s C r i c 2 i o n 5 UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES• If the owner has hiretl a coniractor o� con[rac[ors io undertake work, they may be required to be licensed in accordance with state and local regulations �fihe con2rac[or i� not licensed as required by law, both the owner and contractor may be cited for �i mistlemeanor violation under scate law �f tne owner or inten�ed contractor are uncertain as to whac licensing requirements may apply for che intended work, chey are advised to con[act the Pasco County Uuilding �nspec[ion �ivision-Licen�sing Section at 727-847- 8009 Furthermore, if che owner has hired a contractor contrac[ors, he �s advised To have the contractor�s) sign portions of the "contractor Block" of this application for which they w��� be �eSPonsible If yo�, as �he owner s�g„ as the contractor, that may be an ind�cation that he is not properly licensetl and is not entitled 2o permicting privileges in Pasco County CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended) If „a�„a��o„ o.wo�k ,s $2,500 00 o� m o�e, 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 ofAgriculture and ConsumerAffairs. Ifthe applicanc �s so,„eone 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 a�� the informa��o„ �„ th�s aP,����at�o„ ,s accurate a�d [hat all work will be tlone in compliance with all applicable laws regulating constr�c2ion, zoning and lantl developmen[, Application is hereby made to obtain a permitto do wo�k and insialla[ion as indica[ed � certify chat no work or ins[allation has commenced priorto issuance of a permit and 2hat all �niork will be performed to meec sxandards of all laws regulaang conscruction, County and City codes, zoning re9ulation , antl land development regulacions in the �urisdiccion � also certify that � understand tha[ ihe regula[ions of other g o v e r n m e n t a g e n c i e s m a y a p p I y c o 2 h e m t e n d e d w o r k, a n d t h a t i t i s m y r e s p o n s i b i I rc y [o i d e n n f y w h a t a c t i o n s � m u s t t a k e t o b e i c o m p I i a n c e If I am the AGENT FOR THE OWNER, I Prom�=e �„ good faith �o ��fo�m Che ow�e� of[he Pe�m�tt�„9 �o�d�t,o„s se�fo�t„ ,,, ihis affitlavi[ prior [o commencing construction, I understand that a separate permi[ may be required for electrical work, plumbing, signs, wells, pools, a�r conditioning, gas, or other insiallai�ons nox specifically included in the applica[ion /"� p e r m I T i s s u e d s Ft a I I b e c o n s t r u e d t o b e a I i c e n s e i o p r o c e e d w i T Ft [h e w o r k a n d n o t a s a u t h o r i t y i o o I a c e, c a n c e I, a I[e�, o r set aside any provisions of[he technical codes, nor shall issuance of a permit preven[the UuildingV�fficial from thereafter requiring a correc[ion of errors in plans, construccion or violacions of any codes Every permic iss�ed shall become �nvalid unless the work au[horized by such permic is commenced within six monchs of permic issuanc , or if work auchorized by t h e p e r m i t i s s u s p e n d e h o r a b a n d o n e d f o r a p e r i o d o f s i x �6� m o n 2 h s a f t e r 2 h e c i m e i h e w o r k i s c o m m e n c e d A n e x[e n s i o n m a y b e r e q u e s t e d, i n w r i[i n g, f r o m 2 h e U u i I d i n g O f f i c i a l f o r p e r i o d n o t 2 o e x c e e d n i n e t y (�O) d a y s a n d w i I I d e m o n s t r a t e �u s i i f i a b l e c a u s e f o r t h e e x e e n s i o n �f w o r k c e a s e s f o r n i n e t y �9�) c o n s e c u t�v e d a y s, t h e�o h i s c o n s i d e r e d a b a n d o n e tl 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 � � �— Subscr�bc+h And sworn S (or .�Ifirmetl' befo�e ma this �ubsc�,be, ntl swo� f(�rmetl) f `in.�ef�trM1 �/�y y�J�W hY o �/•1���pY n�o���Z1 b �Kl ■{. •Nl-�r1 Who is���e �ersonally known[o me or hes�hav protlucetl W=o isla� pe allv_Y�i r M1ns�hav protlucetl s �ae.,uncac�o., s �nennf�„ano� No� �„ P„e�,� No�a�y P„e��� Comm���,o., N� Comm ==�o., No • o�a+^o� Notary PuWic State of Floride N�..�e orNo�a�y�Yped, �,�,,,�ee o� s�a,,,pea Na,.,e orNo�a�Yrypetl, prmied �a, g . MyCommiss�onEE140324 �'orr�� Expires 11112�2015