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Home My WebLink About13-14712 CITY OF ZEPHYRHILLS 5335-8TH STREET (si3)�so-oo20 14712 ANNUAL FIRE PROTECTION MAINTENANCE , Permit Number: 14712 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: 11/14/2013 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38107 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/14/2013 Phone: Work Desc: FPM-ANNUAL FIRE SPRINKLER FOR FLORIDA MEDICAL CLINIC ~� '� �; f � �� , ina Chapter 633, Fiorida 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 shail 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 RECORDING YOUR NOTICE OF COMMENCEMENT." _- ., -J . c" (, , �y 1 �a l��",.�-L, `- 'f�'' ��y'_; PERMIT OFFICE " PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION -8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 e�saao-oo2o City of Zephyrhilis Fire Fax-8�3-780-002t Permit Application Date Received �� Phone Contact tw Permit 813 621 1357 wmer's tvame FLORIDA MEDICAL CLINIC Ow�efs Phone Numbet � � � owners address 1� 3�10?MARKET SQUARE DR.,ZEPHYRHILLS,�L 33542 Fee Simple Tttletwider Name 7itleholder Phone Number � � �� Fee Simple Tiqeholder Address Job Address 38107 MARKET SQUARE DR.,ZEPHYRHILLS, FL 33542 �ot t1 sut Division CITY OF ZEPHYRHIILS p�� — _� � Bio-Hazerd Wesie Storaga•ANNUAL a Fumigetlon Tent � Comm Exhausl Kitchen HoodlDuct � Hazardous Materiat(Tier 11 or RQ Facility)/WNUAL � Controlled Bum a Hood Installetion QEmergency Generetor<30 kw a LP/Natural Gas-Insta�latlon � J��/� � Emargency Generator>30 kw � LPMatural Gas-ANNUAL Ss // a Fire Protection Ma+ntenance-ANNUAL � Plaees o(Assembly-ANNUAI !/ � em � er � Sprinkler � Q O �➢ � RecreaUonal Bum Fire Alartn � ❑ p ❑ � � Sparklers Hood Cleaning � O ❑ ❑ � � Sprinkler System Installations Hood Suppression � ❑ O ❑ � � Sta�dpipes(Sprinkier Sys) oFire Alartn Installation Q Torch RooCngRar KetUe � Fire Pumps � Waste Tire Storage ANNUAL Fire Worlcs � Fiammable Appilcation-ANNUAI. $2�,pp Valuation of Project Fuei Tanks QOther: Coniractor Company �—� SignaWre Registared _Y/N Fee Curcent Y 1 N Address license# E�ECTRIClAN Company �— Signature Registered Y/N Fee Cunenl Y/N Addrass License tl PLUMBER Campsriy �— Signature Reglsiercd Y/�1 Fee Gunent Y/N Address license# MECHANICAL Company r— Signature Registered Y/N Fee CuRent Y t N Address License# OTHER �EFFERY D. BURNHAM ComRany RODAN FIRE SPR NKLE S, INC. � Slqnamre Regisured Y/N Fee Curcent Y/N Addresa 1 N 7 T T. F License# 1 1 oi.ecuons: Flll out appUcaUon wmpietely. Owner 8 ConVacWr sign badt of appliceUon,nolarized(Or,copy of signed conUact with owner) If over 5250�,a Notice of Commencement is required(Mechanical work over 55000) Suppty two�2)seis of drawings with appllcaMe documentation Allow 10•14 deys for rev(ew arier submittal date. Parcel#-obteined 6om Properiy Tax Notice{http:/lappraiser.pascagov.com) NOTlCE OF DEED RESTRtCTIONS: The undersigned understands that this permit may be subject to"deed"restricbons" which may be more restrictive than County regulations. The undersigned assumes responsibility for compiiance with any appiicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a conuactor or contractors to undertake work, they may be required to be licensed in accordance with state and Iocal 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 a�e advised to contact the Pascfl Cou�ty Building Inspection Division—licensing Section at 727-847- SQ09. Fu�thermore, if the owner has hired a contracto� or contractors, he is advised to have the contractor(s) sign portions of the "conVactor Block" of this application fo� which they wiA be responsible. If you, as the owner sign as the co�tractor, that may be an indication that he is not properly licensed and is not e�titled to permitting privileges in Pasco County. CONSTRUCT(ON LtEN LAW{Chapter 715, Florida Statutes,as amended): If valuation of work is$2,500.00 or more, i certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien �aw—Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consume�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 co�struction, zaning and land development. Application is hereby made to obtaln a permit to do work and installa6on as indicated. I certify that no work or installation has commenced prior to i5suance of a permit and that all work will be performed to meet standards of a11 laws regulating construction, County and City codes, Zoning regulations, and land deveiopment regulatians in the jurisdiction. I also certify that I understand that the regulatio�s 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. 1 understand that a separate permit may be required for elecVical 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 s lice�se to proceed with the work and not as authorfiy to violate, cancel, alter, or set aside any provisions of the technical codes, no�shall issuance of a permit prevent the Building Official from thereafter requiring a correction of er�ors in plans,construction or violatlons of any codes. Every permit issued shall become invalid uniess 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 O�cial 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 FAlLURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT lN YOUR PAYING TWICE FOR tMPROVEMENTS TO YOUR PROPERTY. tF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTQRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT FLORIDA JURAT(F.S. 117.03) OWNER OR AGENT CONTRACTOR_�'" — --'—"""^ Subscribed and swom to(or affirmed)betore me this S}�sc►ibed and to(or atfirmedj b ore rr� this by !,'"(�bY��G�'r,� � v�}1.�.t�. Who is/are personally known to me or haslhave produced W6n1g(are pe_rsona know�to me hasfhave p uced as identificaUo�, as identificatio�. Natery Publ�c Notary Public Commiss�on Na. , Commission No. ��- !�d ��'r"�i Notary Publ�c StatE of Ffonda Name of Notary rypad,p�inted or slamped Name of Notary typed,printed or st ��e � My Gommiss�on EEtaD�24 ,�r ^��QF4t�+� E,cp�reslV�2r2415