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Home My WebLink About13-13999 CITY OF ZEPHYRHILLS � � 5335-8TH STREET ,/ �si3)�so-oo20 �,�ggg ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 13999 Address: 7050 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: 35-25-21-0010-10500-0000 Improv. Cost: Date Issued: 3/20/2013 Name: FL HOSPITAL ZEPHYRHILLS Total Fees: 25.00 Address: 7050 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 3/20/2013 Phone: (813)783-6189 Work Desc: FPM-SUPPRESSION SEMI- FLORIDA HOSPITAL - 5. , ' � \� �-16 � � � � , 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 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 Permit Application Date Received Phone Contact for Pertnit l 3 �t?� �� Owners Name L� y- S ��¢� �/-f.l� " Owners Phone Number �� -� / ��/� L---- Owners Address ��`L-L /�L /� / �� ls � � C'�-� V� Fee Simpie Titleholder Name Titleho(der Phone Number C� � �� 1 Fee Simpte TiUeholder Address �;s_�,. -dsa�am�zs+�.a�. ;r Job Address Lot# C� Sub Division Parcel# c?;�+� - - � :�,--'t�.��si:�s a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent a Comm Exhaust Kitchen Hood/Duct a Hazandous Material(Tier II or RQ Facility)ANNUAL aControlled Bum a Hood Installation � Emergency Generator<30 kw a LPlNat�ral Gas-Installation a Emerge�cy Gene2tor>30 kw a LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL � Places of Assembiy-ANNUAL � emi � er Sprinkler � p ❑ ❑ � � RecreaGonal Bum � 2 9G�C,� `� ✓ l ( � Fire Alarm � ❑ ❑ ❑ � � Spariclers Hood Cleaning O O ❑ � a Sprinkler System Installations Hood Suppression � t ❑ � p � � Standpipes(Sprinkler Sys) � Fire Alartn Installatio� � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL aFire Works aFlammable Application-ANNUAL Valuation of Project Fuel Tanks Q Other: �_+� ��-�:� Contractor �' Company m G - � /-}-F��f;V��j Signature Registered Y/I� Fee Cutrent Y/N Address y�("i/ �iG �-c�rr l�- - �" ( License# C7QC� ��C�C � /Y�3�1 ra � ELECTRICIAN Company Signature Registered Y/N Fee Current �'/N Address License# PLUMBER Company � Signature Registered � Y�N I Fee Current Y/►J Address License# MECHANICAL Company Signature Registered Y/N Fee Current Y/nl Address License# OTHER Company Signature Registered ( Y%fV I Fee CuRent Y/N Address License# y - ' - Directions: FII out applicaGon complete�y Owner&Contractor sign back of application,notariied(Or,copy of signed contract with ow�ev) H over$2500,a Notice of Commencement is required(Ntechanical woric over$5000) Supply two(2)sets of drawings with applicable documentatio� Allow 10-14 days for review afrer submittal date. Parcel#-obtained from Prvperty Tax Notice(http//appraiser.pascogov.com) Nu11C�. �.1F �)E�D RESTRICTIONS The undersigned understands that this permit may.be subject'to-�deed":restrictions" v�fiich m� ,� 1 � rnore restrictive than County regulations. The_undersigned assumes responsibility for:�ompliance ��ith any applicable �eed restrictions. t1N!_lC�E�SED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired :a contractor or contraciors 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) If valuation of work is $2,500.00 or more, certify that 1, 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'SlOWNER'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. Applicafion 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. 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 PAYlNG 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 MENCEMENT. FLORIDA JURAT(F S 117.0�,1 �l CONTRACTOR OWNER OR AGENT Subscribed and swom to( affirmed)before me this Subscribed and swom to(or a i ed)before me his bY bY Who is/are personally known to me or haslhave 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