The URL can be used to link to this page

Home My WebLink About14-15006 CITY OF ZEPHYRHILLS 5335-8TH STREET (sis)�so-oo20 15006 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 15006 Address: 38135 MARKET SQUARE DR 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: 02-26-21-0010-03900-0030 Improv. Cost: Date Issued: 2/25/2014 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38135 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540 Date Paid: 2/25/2014 Phone: (813)780-8440 Work Desc: FPM- SPRINKLER ANNUAL- FLORIDA MEDICAL CLINIC � 5. �� L�� , t � ' � inal 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 RECORDING YOUR NOTICE OF COMMENCEMENT." ---, � t � ,� I� � �J�� ; �J�,,��' �}_ � PERMIT OFFICE ` PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 813-�80-0020 City of Zephyrhills Fire Fax-813-780-0021 Perrnit Application Date Received r--� Phone Contact for Permit 813 621 1357 : _ owner's Name FLORIDA MEDICAL CLINIC owner's Pnone Number 813 780 8440 Owner's Address 38135 MARKET SQUARE DR.,ZEPHYRHILLS, FL 33540 Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titleholder Address .JobAddress 38135 MARKET SQUARE DR.,ZEPHYRHILLS, FL 33540 �a�p � sub oivision CITY OF ZEPHYRHILLS Parce�# 02-26-21-0010-03900-0030 � Bio-Hazard Waste 5torage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II ar R�Facility)ANNUAL aControlled Bum � Hood Installa[ion � Emergency Generator<30 kw a LP/Natural Gas-Instaliation Q Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale o Fire Protection Maintenance-ANNUAI a Places of Assembly-ANNUAL t y emi � er �i � ` Sprinkler � ❑ p �1 � Recreationel Burn / ��C/ Fire Alarm � ❑ ❑ ❑ � � Sparklers `f/ � Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installa[ions I Hood Suppression � p ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Inslaliation Q Torch Roofing/Tar Kettle //�V7'� � � Fire Pumps � Waste Tire Storege ANNUAL C�I � � '" � � Fire Works � Flammable Appiication-ANNUAL $25.00 � Valuation of Projeci FuelTanks QOther: Contrector Company Signature Registered Y/N Fee Current Y/N Address license# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# �- --� PLUMBER Company �� 5ignature Registered Y/N Fee Current Y 1 N Address License# MECHANICAL Company r Signature Regislered Y/N Fee Current Y!N Address license# OTHER JEFFERY D. BURNHAM ComPany RODAN FIRE SPRINKLERS, INC. Signelure Registered Y/N Fee Curcent Y/N Address license# 1 1 1 0 Directions Fill out application completely. Owner�Contractor sign back of application,notarized(Or,copy of signed contract with owner) If over$2500,a Notice of Commencement is required(Mechanical woiic over$5000) Supply two(2)sets of drawings with appkcable documentation Allow�0-14 days for review after submittal date. parcel#t-obtained from Property Tax Notice(http:{/appraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility For compliance with any applicable deed restrictions. UNLICENSED 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 contrackor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. CONSTRUCTION LIEN LAW(Chapter 713, 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 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'S/OWNER'S AFFfDAVIT: 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 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 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 separake permit may be required for e�ectrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not speci�cally 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 authori2ed 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 PAY(NG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANClNG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) OWNER OR AGENT CONTRACTORQ� �� -- Subscribed and sworn to(or affirmed)before me this Sk bs d nd rn lo�flrmed)before�g this by L ._ �� f bY . A—�i � �li:r Y1.�Q.M Who is/are personally known to me or has/have produced Who is/are personally nown to me or has/have produced as identification, as ident�cation. Notary Public Notary Public Commission No. Commission No. �� 3'�_ Name of Notary typed,printed or stamped �►1P nv � �}�- � (,�.�..ro ,` Name oi Notary yped,printed or stamped �"+stt�s^-'-"'+�^_��+`�-�li.+�/'"� dl�wor� hr,,,Ky PuL+lie S',�,e oi Roridd � ? : Che.rytA DutfeU M �-- ,�<a AAy Commiewion E�14C3�4 +C �orAa'" �A�111�2(10'IS #lPrs'��r-^��