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Home My WebLink About12-13512 �� CITY OF ZEPHYRHILLS 5335-8TH STREET �sis)�so-oo20 13512 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 13512 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: 1426-21-0010-01300-0010 Improv. Cost: Date Issued: 10/04/2012 Name: ZEPHYR HAVEN NURSING HOME Total Fees: 25.00 Address: 38250 A AVE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 10/04/2012 Phone: (407)975-3000 Work Desc: FPM-SEMI HOOD SUPPRESSION FOR ZEPHYR HAVEN NURSING HOME " v , � .2�( G � , t� ,. � _ E� ina Chapter 633, Florida Statutes,authorizes the City to charge and wllect 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 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 f�ermit Application Date Received � � � � Phone Contact for Permit l 3 ��7� _ ... .._.�.:�:� . ��G Owners Name � `c°,� v „� Ownefs Phone Number �I,3 �� i CT—� 'J � Owners Address ,3d �� /t � �� S �, 33� Fee Simple Titleholder Name Titleholder Phone Number �� I I �—._—J Fee Simple TiUeholder Address �'"��1T' �i?'�s ��a:"��:y�'""" Job Address Lot# �� Sub Division Parcel# l?�i�. -—'�S"°—Cu'�,e`�'6`°ie,.""� � . :��'�<�c-�'•' ."'��:d.�c"" a Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent ~ a Comm Exhaust Kitchen Hood/Duct a Hazardous Materiai(Tier II or RQ Facility)ANNUAL � Controlled Bum a Hood Installation � aEmergency Generator<30 kw a LP/Natural Gas-Installation � �� aEmergency Generetor>30 kw a LP/Natural Gas-ANNUAL Sale �(J Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � � [� �y em� �n er � � � Sprinkler � O 0 ❑ � � Recreational Bum Fire Alarm � ❑ ❑ ❑ � a Spariclers '� .� � Hood Cleaning � ❑ O O � a Spri�kler System Installations /�� Hood Suppression �'f r p � ❑ � a Siandpipes(Sprinkler Sys) l l � aFire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL aFire Works aFlammable Application-ANNUAL Valuation of Project Fuel Tanks � Other: �._.F . �.. Contractor � Company � G - �• /-1--��r��f;1'�� Signature Registered Y/N Fee Current Y/N Address �-/7�/ .�iG �=�rr L4" - --� � License# �Q� �� lY��1 1�. � ELECTRICIAN Company Signature Registered Y/N Fee Current Y/nJ Address License# PLUMBER Company 5ignature Registered Y/N Fee Current Y/N Address License# MECHANICAL Company 5ignature Registered Y/N Fee Current Y/N Address License# OTHER Company Signature Registered Y/N Fee Current Y/N Address License# Uirecttons ' "'_ FII out applicaGon completely Owner&Contractor sign back of applicatio�,notarized(Or,copy of signed contract with ow�er) if over$2500,a Notice of Comme�cement is required(Mechanical work over$5000) Supply two(2)sets of drawings with applicable documentation Allow'10-14 days for review afrer submittal date. Parcel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS. The undersigned understands that this permit may.be subjecYto-"dee:d':restricfions" whi ' r�,}� h� rn��' �estrictive than County regulations. The_undersigned assumes responsibility for:complian�e with any appi��.a��e -«��:d resu�ictions UNL6CENSED 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 Counry. CONSTRUCTION LIEN LAW(Chapter713, Florida Statutes, as amended): (f valuation of work is $2;500.00 or more, 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 thai no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet sfandards 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. l 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 TT RNEY BEFORE RECORDING YOUR NOTICE OF MENCEMEAIT. FLORIDA JURAT(F.S 117.0 - /� . CONTRACTOR � ' OWNER OR AGENT Subscribed and swom to( affirmed)before me�th�is— Subscribed and swom to(or a ed)before me his bY bY Who is/are personally known to me or has/have produced Who is%are personally known to me or haslhave produced as ident�cation. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped