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Home My WebLink About14-15296 ; ; ' CITY OF ZEPHYRHILLS 5335-8TH STREET �ais)�so-oo20 15296 ANNUAL FIRE PROTECTION MAINTENANCE � e., : PERMIT INFORMATION LOCATION INFORMATION Permit Number: 15296 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: :OWNER INFORMATION Date Issued: 5/21/2014 Name: FLORIDA MEDICAL CLINIC Total Fees: 25.00 Address: 38135 MARKET SQUARE Amount Paid: 25.00 ZEPHYRHILLS, FL. 33540 Date Paid: 5/21/2014 Phone: (813)780-8440 Work Desc: FPM- SPRINKLER ANNUAL HEALTH CARE CONTRACTOR S APPLICATION FEES RODAN FIRE SPRINKLERS N FIRE PERMIT FEES 25.00 i ` f�i � �.� /�� o�� J' Ins ections Re uired FIRE ACCEPTANCE Final 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. "WARIVING 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." � � , �� , , p �� )��-�-�. �,� PERMIT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 sis-�ao-oozo � City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit 813 621 1357 �_.._ .......................:..:...._,_...........,...:...:,:......,.,:.:.:::::.....,..;:.:: ...,�:.:,::.::�::..... -- ;�, ..�,. ..�:........, ..... . ... �,.,. ,..................... ... ,. ...�� ...�..............,......,._,......__..�,......:..............-�._.,..._..........,.. ._ . . .. .._.. ., ,.:_.........._.. ........... ..:..�.. . ... ... :._:,<:.:::.:..:.:::..::::.::.-;:::,::.;:_:-<;::.::.,:,:::,.::::..:.:_,_.�..::,:..:.:.:.::.:.::..:.:::;>;-:-:_:::,.::<.:>:.::::,:::..::::�:::::.-::::..::<:�,:...:_:�,.::.....::.,.:::_.::...,.::.,. _ _...,.. owners Name FLORIDA MEDICAL CLINIC owner's Phone Number � � � owner's Address 38135 MARKET SG�UARE DR., ZEPHYRHILLS, FL 33542 Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address . .. ,.........., .. .. .;...;...........,.. -- - - - - - ,,:.. :.:.:::.: .... _- - - - ..... .�. _ , ..:: ,:.:>: _.-:........:::..:. - - - ' - ....,;,, . .�.... .,_...... ...- :. . .. , .. ..:,�:..:.:. .: � __;,;.,,...r-r�.:.:-r-a�:z::-._.:�.-,:<-._..�. :. � .. . : ..r.., �" �:. ..,.,,:'�.::,...... _;.r... ....:....:.:.;...<.....z. � J. � ... . . :. ..:..:.:. . . ...�::�:...:.... . .... ...:�:r:..'.:.:�. �.. .' ... �.. . . . . .� Job Address 38051 MARKET SQUARE DR., ZEPHYRHILLS,'FL , ' �ot# � sub Division CITY OF ZEPHYRHILLS Parce�# 02-26-21-0010-03900-0020 .. ..<:....:..... �.;.,::.::::;::.:::..:..: .. : ..:��..:;.,:.::,:,;��. :: :_.:..::.;:.,:::.... . .:::::...:,. : ...................... , . . . .......�.. .. ... . ... . .. _ . � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen HaodlDuct � Hazardous Material(Tier II or R�Facility)ANNUAL � Controlled Bum a Hood Installation � Emergency Generator<3D kw � LP/Nalural Gas-Installation • � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL /1� �y emi �n er �V Sprinkler � � O ❑ � � Recreational Burn �\ Fire Alarm � ❑ ❑ � � � Sparklers Hood Cleaning � ❑ ❑ ❑ �� ' � Sprinkler System Installations liood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Inslallalion � Torch RoofinglTar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL $25.00 Valuation of Project � Fuel Tariks Q Other: ....__..._ .. .......,....,.. .:...::.....::..._:.:.,... ......_:.:..,.,.r_.:...v,:.,::...........,...,_ _ .....,... _ � �,: ._�. , ..K:. .., .. ..,. ._ � �..,.._ ,....:::� , ,.�... ..:... ,:. ...., x.r;,.;.r � .. ...�.. .. .... . .... ....... ..�. ..�... . ......... Contractor Company Signature Registered Y/N Fee Current Y/N Address License# ELECTRICIAN Company �- __ Signature Registered l�/N Fee Current Y/�I Address License# PLUMBER Company _ __ � Sfgnature Registered Y/N Fee Current Y/N Address License# MECHANICAL Company _ � Signature Registered Y/N Fee Current Y/IV Address License# OTHER JEFFERY D. BURNHAM �ompany RODAN FIRE SPRINKLERS, INC. Sig�ature Registered Y/N Fee Current Y/N Address E. WAY AV I A M L �icense# 8 15 10 012 6 _�.:..: .::..... ...: . _ ..:.:..x.. . :, ......_...: .. ..._ ........, _. _. ..,.......,... Directions: Fiil out application completely. Owner&Coniractor sign back of application,notarized(Or,copy of signed contract with owner) If over 52500,a Notice of Commencemenl is required(Mechanical work over S5000) Supply two(2)sets of drawings with applicable documentation Allow 10-14 days for review after submitial date. Parcel#-obtained from PropeAy Tax Nolice(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 contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. CONSTRUCTION UEN 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'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. Application is hereby made to obtain a permit to do work and instaUation 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 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 Iicense 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 OBTAIfV FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR fVOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) � OWNER OR AGEN7 CONTRACTOR� ' -z— — Subscribed and sworn to(or affirmed)before me this S bs,c,n�be�af�d s rplo( rmed)be re m is , s by "��Zby ..�G•��1��.i' �t �ik'`l1 YI�Z'� Who is/are personally known to me or has/have produced �c�js/are personally known to me o has/have produced as identification. as identification. Notary Public �� . Notary Public;�; Commission No. Commission No. `��'� ' ` � � �lo�ryPubMc8lsqoPFlO�IdO '` Name of Nota ed, rinted or stam ed Name of Notary typed,pn edlo arg`�e�h�'�B'n,�^"�o,�--- � �Y tYP P P � *�,,��dF E�res�i/��g 140324 f ' .t.,.ni�,r:,r„:,�';,f,�icF�:;J�.�'-��cs� . . , . , .. :�`�