HomeMy WebLinkAbout15-16376 CITY OF ZEPHYRHILLS
ti � ' S335-8TH STREET
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ANNUAL ASSEMBLY PEitMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Numbep: 16376 Address: 38300 11TH AVE
Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Biock: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-06600-0011
Improv. Cost: OWNER INFORMATION
Date Issued: 6/17/2015 Name: ARGIRIS CHRISTOS
Total Fees: 50.00 Address: PO BOX 224
Amount Paid: 50.00 MOOSE PASS AK 99631-0224
Date Paid: 6/17/2015 Phone: 813-479-3666
Work Desc: PLACES OF ASSEMBLY- LOS CHICO'S - EXP 6/2016
CONTRACTOR S APPLICATION FEES
FIRE PERMIT FEES 50.00
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Ins ections Re uired
FIRE SITE INSPEC ON-Final
OCCUPANCY LOAD: � � �
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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
a�3-7ao-oa2o City of Zephyrhills Fire Fax-s�3aso-ooz�
Permit Application
Date Recei'ved � � —� Phons Contact for Perrrtit � C�M��
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Owner's Name \ Y Owne�'s Phone Number �� [� C� '�
Owners Address �1 �
Fee Simple Titleholder Name Titleholder Phone Number [� � �
Fee Simple Tit(eholder Address '
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.lob Address lof# ��
Sub Division Parcel#
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� Biq-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Fxhaust K�tchen HoodlDuc# � Hazardous Material(Tier II or Rt2 Facilify}ANNUAl.
� Controlled Bum � Hood Installation
' � Emerge�cy Generatar<3d kw Q LPINatural Gas-Instaita#ion
� Emergency Generator>30 kw � LP a�-
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Fire Protectian Maintenance-AHNUAL 'Iaces of Assemb(y-ANEt�lAL
❑�y emi �n t er �
Sprinkler ❑ ❑ ❑ Recreatianal
Fire Alarm � ❑ O ❑ � � Sparklers �� ��
Nood Cleaning � ❑ � ❑ �� � Sprinkler System Installations j
Hood Su ression ❑ ❑ ❑ Standpipes(Sprinkler Sys) �
PP ❑ � � ,
� Fire Alarm Installation � Torch ftaofinglTar Kettle ��}�`
� Fire Pumps � Waste Tire Storage ANNUAL
� F(ammabie Application-ANFtUAL � ������� � Valuation of Project
� Fuel Tanks
[� Uther:
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Cantractor Company
Signature Registered Y/N Fee Current Y/N
Address �fcense#
ELECTRICIAN Company
Signature Registered Y 1 N Fee Current Y/1�
Address License#
P�Utv3BER Company
Signature Registered Y/N Fee Current Y/N
Address �icense#
MECHANICAL Company
, Signature Registered Y/N Fee Current Y/N
�i Address License#
Q7HER Company
Signature Registered Y/N Fee Current Y/N
Address License#
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Directions:
� FiI!out app(ication completely.
Owner&Cantractor sign back of application,notarized(Or,copy of signed contract with owner)
(f over$25Q0,a fVotice of Commencement is required(Mecha�icai work over$50Q0}
Suppiy iwo(2}sets of drawings with applicable documentation
Allaw 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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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 wlth 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 wark,they are advised to contact the Pasco County Building Inspection Division—Licensing-Sectfon at 727-847-
8009. Furthermore, ff the owner has hired a contractor or contractars, he is advised to have the contractor(s) sign
portions of the"contractor Block°of this application for which they wiil be responsible. If you, as the owner sign as the
contractor,that may be an indication that he Is not properiy licensed and is not entitled to permitting privileges in Pasco �
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands ,
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of ,
use in existing buildings,or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,will be idenfified at the time of
permlttfng. It(s further understood that Transportation Impact Fees and Resource Re�overy Fees must be paid prior to
receiving a'certificate of occupancy°or final power release. if the project does not involve a certificate of occupancy or
final power release,the fees must be paid prlor to permit issuance. Furthertnore, ff Pasco County WatedSewer Impact
fees are due,they must be pald prior to permit issuance in accordance with appiicable Pasco County ordinances. ,
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 wHh a copy of the °Florida Construction Lien Law—Homeowner's I
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 dacument and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I cerUfy that all the information in this appflcation is accurate and that all work
will be done in complfance 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 wark or installation has
commenced prior to issuance of a permit and that all work will be perFormed to meet standards of ail laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. i al"so
certify that I tinderstand that the regulaiions of otfier govemment agencies may apply to the intended work,and that it is
my responsibility to identity what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, VUeUand Areas and Environmentaliy Sensitive
Lands,Water/Wastewater Treatmenk '
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of EngineersSeawalls,Docks,Navigable Waterways.
- Department of Health & RehabilltaUve Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
1 understand that the following restrictions apply to the use of fill:�
- Use of fill is not allowed in Flood Zone°V°unless expressly permitted.
- If the flll materlal is ta be used in Flood Zone °A", ft fs understood that a drainage plan addressing a
°compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill materlal is to be used in Flood Zone°A° in connection with a permitted �uilding using stem wall
construction,I certify that fill wfll be used only to fill the area within the stem wali.
- If flll material is to be used in any area, I certffy that use of such fili wili not adversely affect adjacent
praperties. If use of fill is found to adversely affe�t adJacent properties,the owner may be cited for violating
the conditions.of the building permit issued under the attached permit application,for lots less than one(1)
acre which are elevated by flll,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permiHing conditions set forth in
this affldavit 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 specffically 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 pertnit prevent the 8uildirig Official from thereafter
requiring a correction of errors in plans,constructian 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 ff work authorized by
the permit ts suspended or abandoned for a period of six(6)months after the time the wark is commenced. M extension
may be requested,(n writing,from the Build(ng 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,th�Job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING 7WICE FOR IIVIPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WRH YOUR LENDER OR AN A7TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
FLORIDA JURAT(F:S.117.03) _
OWNER OR AGENT CONTRACTOR
r Subscrlbad end swom to(or affirtned)before me Ihis Subsclbed end swom to(or affirmed)before me this
by Y
Who is/are personalty knoxm to me or has/have produced Who Islare personally known to me or has/have produced
as identlficatlon. as identlfipdon.
Notary Public Notary Pu611c �
� Cammission No. Commission No.
Name oi Nolary typed,printed or stamped � Name of Nofary typed,printed or shamped
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