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
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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
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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
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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
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Who is���e �ersonally known[o me or hes�hav protlucetl W=o isla� pe allv_Y�i r M1ns�hav protlucetl
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