HomeMy WebLinkAbout15-16523� CITY OF ZEPHYRHILLS
�� 5335-8TH STREET �
_ (si3)�so-oozo 16523
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_�:, � ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION � � LOCATION INFORMATION � •
I Permit Number: 16523 ! Address: 38303 NORTH AVE
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: TYSON
Est. Value: ; Parcel Number: 02-26-21-0080-OOA00-0080
Improv. Cost: OWNER INFORMATION
Date Issued: 8/18/2015 Name: SIX FEET UNDER LLC
Total Fees: 50.00 i Address: 31448 REED RD
Amount Paid: 50.00 DADE CITY FL 33523-7444
Date Paid: 8/18/2015 Phone: (440)520-3973
Work Desc: PLACES OF ASSEMBLY- LITTLE PEOPLE DAYCARE EXP 8/2016
CONTRACTOR S ` ' � APPLICATION FEES
FIRE PERMIT FEES 50.00
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' Ins ections!Re uired
FIRE SITE I PECTI N-Final I
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OCCUPANCY LOAD: �`�
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Occupancy by more than the numberiof persons above shall be considered
dangerous and unlawful. Occupant load determined by Florida Fire
Prevention Code, NFPA101, Section 7.3.1.2
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� 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
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813-780-0020 City of Zephyrhills Fire Fax-813-780-D021 �
Permit Application
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Date Received Phone�Contact for Permit �Y���
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�ner's Name L. � � �t� � Owner s Phone Number � � �
--�-OwnersAddress ��,�4�3 /" °`�� �/ G,� �
Fee Simple Titleholder Name j Titleholder Phone Number � � �
Fee Simple Titleholder Address
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Job Address � Lot# �
Sub Division i Parcel#
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� Bio-Hazard Waste Storage-ANNUAL I� � Fumigation Tent
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� Comm Exhaust Kitchen Hood/Duct ; � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Bum � � Hood Installation
� Emergency Generator<30 kw i � LP/Natural Gas-installation
� Emergency Generator>30 kw , � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � � Places of Assembly-ANNUAL
try emi �n t er `��
Sprinkler � ❑ ❑ ❑ B � Recreational Bum
� Fire Alarm � ❑ ❑ ❑ � � Sparklers ����
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
Hood Suppression � ❑ O ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� FlammableApplication-ANNUAL ! Valuation of Project
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� Fuel Tanks � I
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�tractor � � /� �� � Company �
i nature "�� � Registered Y/N Fee Current Y/N
Address License#
ELECTRICIAN I Company
Signature j Registered Y/N Fee Current Y/N
Address I License#
PLUMBER � Company
Signature Registered Y/N Fee Current Y/N
Address License#
MECHANICAL Company
Signature � Registered Y/N Fee Current Y/N
Address i License#
OTHER � Company
Signature i Registered Y/N Fee Current Y/N
Address License#
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�Directions:
Fill out application completely
Owner 8 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 Notice(http://appraiser.pascogov.com)
NOTICE OF DEED RESTRICTIOMS: 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 CONTRACYORS AND CONTRACTOR RESPONSIBILITIES: ff the owner has hired a contractor or
contractors to undertake wark,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 fs not properiy licensed and is not entiUed to permitting privileges in Pasco
County.
TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buiidings,change of
use in exfsting buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersfgned also understands,that such fees,as may be due,will be fdentified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
recelving a'certfficate af occupancy'or final power release. If the project does not involve a certificate of occupancy or
finai power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapte�713,Florlda 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 AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done In compifance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installatfon 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 ottier government agencies may apply to the intended work, and that it is
my responsibility to identtfy what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Vlletland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wetls, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalis,Docks,Navigable Waterways.
- Department of Health 8 Rehabilitative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:•
- - Use of fill is not allowed in Flood Zone"V°unless expressly pertnitted.
- If the flll materlal is to be used in Flood Zone "A", it is understaod that a drainage plan addressing a
°compensating volume"will be submitted at time of pertnitting which is prepared by a professional engineer
licensed by the State af Florida.
- If the fill material is to be used in Flood Zone "A° in connection with a permitted building using stem wall
canstruction,I certify that fill will be used only to fiil the area within the stem wall. ��-
- If iill material is to be used in any area, I certify ihat use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached pertnit application,for lots less than one(1)
acre whlch are elevated by flll,an engineered drainage plan is requfred.
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 instailations not specHically included in the application. A
pemtit issued shall be canstrued 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 Buildirig Official from thereafter
requiring a correction of errors in plans,constructlon 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 slx(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a perlod not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If wark ceases for ninety(90)consecutive days,th�job is considered abandoned.
PAYING TWICE ORE MPROV MEN'TS TO YOUR PROPERTI'.�IF YOU INT�NDETO OBTA N FI�N NC NG C'ON ULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR PIOTICE OF COMMENCEMENT
FLORIDA JURAT(F:S.117.03)
OWNER OR AGENT CONTRACTOR
Subsalbed and swom to(or afflrtned)befare me thfs Subsafbed end swom to(or afflrmed)before me thls
by by
Who Islare personally known to me or has/have produced lNho Is/are personally known ta me or hasas IdenBfication.
asidentlficatlon.
Nohary Pubilc Notary Public
Commisslon No. Commission No.
Name of Notary typed,printed or shamped � Name ot Nohary typed,printed or stamped