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Home My WebLink About13-14714 � CITY OF ZEPHYRHILLS 5335-8TH SIREET (si3)�so-oo20 14714 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 14714 Address: 38051 MARKET SQUARE DR 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: 02-26-21-0010-03900-0020 Improv. Cost: f��,r� Date Issued: �f~ Name: FMC MARKET SQUARE INC Total Fees: 25.00 Address: 38135 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 5. �.�,"� t 1 2 / ��j/ ina Chapter 633, Florida Statutes,authorizes the City to charge and aollect 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 RECORDING YOUR NOTICE OF COMMENCEMENT." _-, � � �:� , L•�'�-c. �_ `� ��c*�-�>�; PERMIT OFFICER��— PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 s»-�so-oo2o Ciry of Zephyrhiiis Fire Fax-813-780-0021 Permit Application Date Raceived ' � Phone Contad fa Pertnit 813 621 1357 Owners Name FLORIOA MEDICAL CLINIC Owner's Phone Numbar �� ow�er�ndd�ess 38135 MARKET SQUARE DR.,ZEPhIYRHILLS, FL 33542 Fee 3lmpie Tideholder Name Tideholder Phone Number �� C� Fee Simple Titleholder Address Jah Address 38051 MARKET SQUARE DR.,ZEPHYRHILLS, FL �oi� � sub Division C�TY OF ZEPHYRHILLS Parce�x 02-26-21-0010•03900-0020 OBio-Hezard Waste Siaage-ANNUAL � FumipaUnn Tent QComm Exhaust Kitchen Hood/Duct Q Hazatdous Materiai(Tier II or RQ Facility)ANNU�L._ Controlied Bum a Hood InsWllaUon QEmergency Generator<30 kw � LPMatural Gas-Inetallation QEmergency Generator>30 kw o lPMatu�ei Gas-ANNUAL Sa ppp�� QFire ProtecUon Maintenance-ANNIJAL O Places of AssemWyANMU 1l/'//� � �] erm �Tn er � 7 � Sprinkler � ❑ ❑ 0 � � RecreaGa�ai Bum — Fire Alertn � O ❑ ❑ � � SparWers Hood Cleaning � ❑ ❑ D � � Sprinkler System InstallaGons ,. Hood Suppression � p ❑ ❑ � � Standpipes(Sprinkier Sys) O Fire Alarm Instellation O Torch RoofinglTer Kettle Fire Pumps � Waste Tiro Storagc ANNUAL Fire WoHcs Flammable ApplicaUon-ANNUAL $25.00 , Valuation of Project QFuel Tanks � Other: CanUactw Company Signature Repistered Y(N Fee Cutrent Y/N Addrass License�f ELECTRICIAN � Campany Signawre Regis�ered Y!N Fee Currom Y!N Address Llcense q PLUM9Ef2 Compeny �'—" � SignaWre Registered Y/N Fee CuRent Y!N Address License# MECHANICAL C�p�Y � Signature Registered Y/N Fee Current Y/N Address licenae# OTHER JEFFERY D. BURNHAM �omveny RODAN FIRE SPRINKLERS,INC. � Signature Registered Y/N Fee Current Y!N Address 1 T T P F license# Directions: Fill out appllcadon completely. Oxmer 8 Contractor sign back af applicetion,notarized(Or,copy o!signed coniract with owner) If over 52500,e Notice ot Commencemenl is required(Mechanical wak over�5000� Supply 1wo(2)seta oI drawings with appiicabla dowmentation Allow f0-14 days for review aRer submittal date. Parcel#•obtained trom PropeRy Tax Notice(http:/lapp�aiser.pascogov.com) NOTICE OF DEED RESTRICTtONS: The u�dersigned understands that this permit may be subject to"deed"restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibiiity for compiiance with any appiicable deed restrictions. UNLtCENSED 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 locai regula6ons. If the contractor is nat licensed as requi�ed by law, both the owner and contractar may be cited for a misdemeanor violation under state iaw. If the owner or intended contractor are uncertain as to what licensi�g requirements may apply for the intended work, they are advised to contact the Pasca County Building i�spection Division—Licensing Section at 727-$47- 8009. Fu�thermore, 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 far which they wili be responsibie. If you, as the owner sign as the contrackar, that may be an indication that he is not properly licensed and is not enkitled to permitting privileges in Pasco County. CONSTRUCTION LIEN LAW(Chapter 713, Fiorida Statutes,as amended): If valuation of work is$2,500.00 or more, i certify that 1, the appiicant, have been provided with a copy of the "Flo�ida Construction Lien Law—Fiomeowne�'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'S/OWNER'S AFFIDAVtT: i certify that all the information in this application is accurate and that ail work will be done in compliance with ail appiicable laws regulating co�struction, zoning and land development. Application is hereby made to obtain a permit to do work and installaGon as indicated. 1 ceriify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the ju�isdiction. I also certify that I understand that the regulations of other govemment 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 conditians set forih 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 speci�cally included in the application. A permik 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 O�cial from thereafter requiri�g a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the worlc 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(9Q) days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned. WARNtNG TO OWNER: YOUR FAI�URE TO RECORO A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAlN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CQMMENCEMENT FLORIDA JURAT(F.S 117 03) OWNER OR AGENT CONTRACTOR�' —�____,_ - Subscribed end swom to(or affirtned)before me this �ubsc�b,eId+ swom o(o�r affirtned)h�fore his f bY It,�l!�—bY �2 i-��rV l�.�SA Y V16'1�1�'I Who islere persanally known to me or hasthave produced yyy,o.islare haslhave produced ,,� as identificatlon. as identification. ______.��____ Notary Public Notary Publit Comm�ss�on No_ Cc}mmission No �� t y o�y Name of Notary typed,printed or stamped Name of Notary typed,priMed or sta d��„v.7•o,� Nofary PuW�c State of Flortda _ ^ Gtueryl A DuffeU � o� My r�m�ssi�n E�tA0324 �r�0i n� Exprre5 11t12/2015