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Home My WebLink About15-16254 CITY OF ZEPHYRHILLS 5335-8TH STREEf � C" (sis)�so-oo20 254 :� ANNUAL ASSEMBLY PERMIT � PERMIT INFORMATION LOCATION INFORMATION Permit Number: 16254 Address: 5538 GALL BLVD Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-05700-0250 Improv. Cost: OWNER INFORMATION Date Issued: 5/07/2015 Name: WELLESLEY DEVELOPMENT CORP Total Fees: 50.00 Address: 34619 SR 54 W Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 5/07/2015 Phone: Work Desc: PLACES OF ASSEMBLY- LITTLE CEASARS- EXP (RENEW) 5/2016 CONTRACTOR S APPLICATION FEES OWNER FIRE PERMIT FEES 50.00 II � � � ��— � � Ins ec ' e uired � FIRE S TE INSPECTION-Final OCCUPANCY LOAD: ��,�(��,,, l� �f Occupancy by more than the number of persons above shall be considered dangerous and unlawful. Occupant load determined by Florida Fire Prevention Code, NFPA101, Section 7.3.1.2 PERMIT OFFIC PERMIT EXPIRES IN ONE (1) YEAR FROM DATE OF ISSUANCE THIS PERMIT NEEDS TO BE POSTED IN VISIBLE LOCATION IN MAIN ASSEMBLY AREA ZEPHYRHILLS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FL 33542 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Recei;,�d Phone Contact for Permit��,�_� I, �3�'-":C..:. Owner's Name �:"�� Z C ✓�-e 7 y.}r 5 Owner's Phone Number � � 3 � ��j �V I� �Owner's Address � 3� � �� I� 1 U t�• ��Q h ( h . ��S F � , � S�( 2 Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titleholder Address �'s"`,,.�.'°��,`...�_.�._.., - - - - __..,..zw.�..�...-"p'°'.P.:�..�a..�-`� Job Address s �� Lot# Sub Division Parcel# �.`W-.,'°� - .__...<_...,.._.....�._..��___.��.,_-...�..._....,.��...��...�<.�.....�.�.��-- _...,_,..._ _.._....,.��.��...__.�___._.._..__.4._.._.�..�... � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL � Controlled Bum � Hood Installation � Emergency Generator<30 kw � LP/Natural Gas-Installation � � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL tr y emi �n t er Sprinkler � ❑ ❑ � � � Recreational Bum Fire Alarm � ❑ ❑ ❑ � � Sparklers � Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � FlammableApplication-ANNUAL Valuation of Project � Fuel Tanks Q Other: ' :�_°w-�..- r_.,..�� ...__.�...a.M_,.Y�_._._._.,._�..��.T.�.�____. _�..�._.A..�....v._� —�:.�.�_�__�.,�._��_....�___:_,,:,..�_�__m...,_._..�� ,�JContractor ,�/� �� `� � Company f�\Signature U ��y�"� /�vr'�""Y ` Registered Y/N Fee Current Y/N Address License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License# OTHER Company Signature Registered Y 1 N Fee CuRent Y/N Address ' License# ', ru...--.��.�..._.._.a____._..,�...,»....._...__..�:._._..�._.,.#�_..__-u.._..�__.�..........__�_:_.,._...�..�.__._�._.�.....,.�......,n._._._.a.-.e�.n�.__._„_._.,�_-:..,.._._„__...:._b_.�a�,�_...._.._N.._�_e.,�,�-�..,_...�;:� � 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 work over$5000) Supply two(2)sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Nolice(http://appraiser.pascogov.com) N0710E OF bEED RESTRICTIONS: The undersigned understands that fhis permit may be subject to"deed"restrictions° I which'may be more restrlctfve than Gounty regufat3ons. The undersigne��assnmes responsibility#ar compliance with any applicable deed restricftons. ` �'�� _, UNLICENSED CONTRAC70RS AND CONTRAG70R RESPONSIBILITIES: If the owner has hired a contractor or � contractors to undertake wotk,they may be required ta be licensed in acccordance wfth state and kocaS regaRations. !f the contracfor is nof ticensed as required by taw, both the owner and cont�actor may be cited for a misdemeanor violafion 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 Buliding fnspection Dlvision—�#censing Sectfon at 727-847- 5009. Furthermore, ii the owner has hfred a contractor or contractors, he +s adv(sed ta have tfie confractor(s} sign port(ons of the"cantractor Block"of this application for whlch they will b�e responsible. IP you, as the owner sign as the contractar,that may be an'sndEcatlon that he is nak properiy ticensed an�ts not entided to permitting pdvlleges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACI"AND RESOURCE REECOVERY FEES; The undersigned understands that Transportation lmpact Fees and Recaurse Recovery Fees may appiy to the constnsotion of new buifdings,change of use in exisfing buildings, or expansion of exisfing buildings, as spec�eal in Pasco Caunty Ordinance number 89-07 and 90-07, as amended, The undersigned also understands,that such fees,as may be due,will be identified at the time of permltting. tt!s futther understood that Transpartefion lmpact Fees and Resaurce Recovery Fees must be pald prior to receiving a'cert�cate of occupancy"or ftnat power reiease. if the project does not invoive a certificate of occvpancy or finai power release,the fees must be paid prior to permit issuance. Furthermore, ff Pasco Caunty Water/5ewer Impact fees are due,they musk be paRd prtor to perm4t lssuance En accordance with appllcatile Pasca Caunty ordinances. CONSTRUCTION LIEtV LAW{Chapter 713,Flarlda Stata#es:as amen�ded}: !f valUation of work Is$2,60QAd or mare,t certify that I, the applicant, have been provided with a copy of the "Florida Conshuction Lien Law—Homeawner's Protection Guide°prepared by the Florida Departmeat of Agriculture anc!Consumer Affairs. !f!he applicant is someone other fhan the°owner",1 certlfy tha#1 have abfained a copy of the abave described docament and promise 3n goad faith to deliver it ta the"owne�"prior to commencement. ' CONTRACTOR'S/OWNER'S AFFlDAVIT: 1 certffy that all the information!n this application is accurate and that all work � wiE1'be done In comptlance with a!t appllcable laws regulating cansfnsatit�n,zoning and land developmsnt. Application is hereby made to obtain a permit to do work and installatfon as indlc�ited. I certify that no work or installation has commen�ed prlor to issuance of a permlt and that all work wlll be perl'ormed to meet skandards of all laws regulating • cansfrucfian, Counfy and Cify codes, zonEng regulaGons, and (and devetopment regutatloRS In the jur�sdic#'son. i a4"so certify that I understand that the regulations of otFier govemment agenciies may apply to the inte�ded work, and thet it is my responsibility to ide�ttfy what actlons I must take to be In compllence. Such agencies inalude but are not limited to: - Department of Environmentat Ptotection-Gypress Sayheads, Wetland Areas and Environmentafly Sensitive Lands,WaterlWastewaterTreatment. - Southwest Florida Water Management District-Wells, C;ypress Bayheads, Wetland Areas, Aitering Watercourses. - Army Corps of Engineers-Seawalis,Dacks,Navigable Watervvays. - Department of Health & Rehabilitative Services/Environmental Health Unit-Welis, Wastewater Treatment, Sep#ic Tanks. - US Environmental ProtecUon Agency-Asbestos abatement. - Federal Aviation Authority-Runways. 1 understand fhat fhe follawing resUlctians apply to the use of fiii:� - Use of fill is nat atlowed in Fiood Zone'V"untess expressly pi�tmitted. � - - If the flll material is ta be used in Flaod Zone "A", (t is i�nderstood that a drainage plan addressing a °compensating volume"wi!!be submitted at time of permitkirig which is prepared by a professiana4 engineer licensed by the Stafe of Florida. - If the fili material is to be used in Ffood Zone `A° in cannecEion with a permitted building using stem wall constructton,l certiiy that fitl witl be usec!anty to fili ttie area w�th3n the stem wait. - If flli material is ta be used in any area, t t;ertlfy that usa� of such fill wi{( not adverseiy affect adjacent praperties. If use of flll Is found to adversely affect adjacent properties,the awner may be cited for violating the conditions pf fhe buitding permit issued under the attactied permit appiication,for lots isss than one(1} acre which are elevated by fltt,an engineered drainage plan i:s required. If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting condikions set forth in th€s aflldavlt prior to cammencing construatlon. !unders#and that a sep�irate permtt may be required for electrical work, plumbing, signs,wel(s, poots, air conditioning, gas, or other instaliation:� not specMcally included in the appticafEon. A permit issued shall be construed ta be a license ta proceed with the worlc and not as authority to,violate,cancel,al#er,or set aside any provisfons of the teehnicaE cades,nar shatt issuance of a permft prevent the Buildirig Officia!from thereafter requlring a correctian of errors in pians,construetlan or violations of any c:ades. Every permtt(ssued shall become invaiid unless the work authorized by such permit is commenced within six months of permlt issuance,or'rf work authorized by the permit Es suspended or abandaned for a period of six{6j months after the t+me the work is commenced. An extension may be requested, in writing,from the Build€ng Ctfficiat for a period not to exceed ninety{90}days and wilt demonstrate justiflable cause for the extension. If work ceases for ninety(90)consecutive days,th�Job is considered abandoned. WARNING TO OWNER: YOUR FAtl.URE TO RECORD A NOl'ICE OF COMMENCEMENT MAY REStJLT IN YQUR PAYING 7"WICE FdR IMPROVEMENTS TO YOUR PROPERTY. IF YOIJ INTEND TO OBTAIN FINANCING,CONSULT Wil'H YOtlR LEt+IDER OR AN ATTORNEY BEFORE RECORDING Y011l$,NOTIGE OF CdMMENCEMENT. Fl.ORtDA 3URAT(F:S.117.Q3} OVYNER OR AGENT CONTRACTOR Subscr[bed end swom to(ar afiirmed}beFore me this Suhsal6ed and swo��n to(or a(flrmed)beiare ma fhis by Y— Who is/are petsonalty known to me or has/heve produced Who islare petsonaliy known to me or hasfhave produced as identlBcatlon. as IdenBfication. Notary Public Notary Public Cpmmisston No. Gommtssion No. Name af Notary iyped,Pdntad ar stamped IVame af Notary typed,printed or stamped I