HomeMy WebLinkAbout15-16658 CITY OF ZEPHYRHILLS
r�; '�`" 5335-8TH STREET
(si3)�so-oo20 16658
ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION - � - - � LOCATION.INFORMATION � �
Permit Number: 16658 Address: 6251 FT KING RD
Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book:
Proposed Use: CHURCH Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost: " ' . OWNER INFORMATION - �
Date Issued: 10/12/2015 Name: THE ALLIANCE CHURCH
Total Fees: 50.00 Address: 6251 FT. KING RD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/12/2015 Phone:
Work Desc: PLACES OF ASSEMBLY-ALLIANCE CHURCH OF ZH -EXP 10/2016
CONTRAC.TOR S � � � � APPLICATION FEES
OWNER FIRE PE MIT FEES 50.00
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FIRE SITE INSPECT N-Final ,
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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
813-780-0020 City Of Zephychills Fire Fax-813-�80-0021 —
' Permit Application
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Fee Simple Titleholder Name Titleholder Phone Number C-� [� ��
Fee Simple Titleholdet Address
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� Bio-Hazard Waste Storage-ANNUAL � � Fumigation Tent »�-k.
Q Comm F�chaus#Kitchen HoodlDttc# � Hazardous Material(Tier tl ar F{Q Facility}Jtt+iNtlAL
� Controlled Bum a Hood Installation
� Emergency Generator e 30 kw � LPINatural�as-Installatian
Q Emergency Generator}30 kw � LP/Natural Gas-ANNUAL Sale
o ,Fre Protection Maintenance-ANNUA! �Places of Assembly-APiNUAL , `��
❑� emi �Tn er �,�j'�/�
3prinkler L7 L7 ❑ � Recreationa!Bum �� �
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Nood Gleaning � ❑ ❑ ❑ C� � Sprinkler Sys#em Insta!►a6ons
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
o Fire Aiarm Installation � Tarch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Starage ANNUAL
� F3ammableApplication-ANNUA� �—r � Valuation of Project
� Fuel Tanks
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Gonlsactar / Company . �
Signature �o�-r--- ' Registered Y/N Fee Current Y/N '
Address license#
ELECTRICIAN Company ,
Signature Registered Y 1 N Fee Current Y 1 N
Address License#
PLUMBER Gompany -
Signature Regis#ered Y/N Fee Current Y/N
Address
Cicense#
MECHANICAL Company
Signature Registered Y I►U Fee CuRent Y 1 N
Address � License#
OTHER -
Company
Signature Registered Y/N Fee Current Y/N
Address
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Fit!out application comp3etely.
CMmer&Contractor sign back of applicatian,notarized(Or,copy of signed contract with owner)
tf over$2500,a Notice af Commencement!s required(Mechanicai work over$5400)
Suppty two(2}sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-abtained from Property Tax Notice(http://appraiser.pascogov.com)
NOTICE QF DE6D RESTR[GTtONS: The underslgned understands khat this permif may be subject to"deed°restrictions"
whioh may be more restrictive#han County regulations. The undersigned assumes responsibAity for compiiance with any
appficable deed restrictions.
UNLtCENS�D G4NTRACTORS Atdp CONTRACTOR RE�P4NISi81LtTiES: If the owner has h'sred a aonMactar or
contractors tp undertake wotk,they may be required to be 13censed in accordance wtth state and iocal reguEatians. !f fhe
contractor is not licensed as required by law, both the owner and conVactor may be cited for a misdemeanor violatlon
under state law. tf the ow�er nr intended cantractor are unoertaln as to whak lEcensing requlrements may apply for the
intended wnrEc,they are advised to conta�f the Pasco Caunty Suiiding lnspeotion Division—LEcensing SeatEon a#727-847-
8009. Furthermore, ff the awner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"corttractor Block"of this applicatlon far which they will be responsible. .If you,as the owner s{gn as the
conftac#or,tha#may 6e an Endicatian that he Is nof property ilcensed and is nof en�tled fo permitting priv�leges In Pasco
County.
TRANSPQRTATlON IMPACTlUTILlTIES lMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transpartation lmpact Fees and Recourse Recavery Fees may apply to fhe canstrucfion of new bui3dings,change of
use in existing buildings,or expansion of existing buildings,as specffied in Pasco County Ordinance num6er 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,wlll be identified at the time of
permlf#ng. lt Is iurther understood thaf Transportatlan lmpact Fees and Resource_Recovery Fees must be paid psiar fa
' receiving a'certificate of accupancy"'a�flnal power"release. If the project daes not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit Issuance. Furthermore,If Pasco County Water/Sewer Impact
� fees Sre due,they must be pald prlar ta permtt lssuarsce�n accordance wiEh appticable Pasc�County ordinances.
� CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,5oR.00 or more,i
ce�tify that I, the applicant, have been provided with-a copy of the 'Florida Construction Lien Law—Homeowner's
Proteot�on Gu1de°prepared by the Ffortda Qepartment of Agric�lture and Consumer Atfairs. EF!he appiicanf is someone
other than the°owner",i certify that I have obtairied a copy bf the above desaribed dacument and promise in good faith to
deliver it to the"owner°prior to commencement. �
CONITRAGTOR'SlOWNER'5 AFFIDAVIT; 1 certl�y that a1i the Iriformation in this appticatlon is acxurate and that ail work
wil(be done in comptiarice with a0 appiicable laws regutaGng construction,zoning and tand deveiopmenl Apptication is
hereby made to obtain a permlt to do work and InsNallatlon as indfcated. I ceHify thak no work or installation has
commenced prior fo{ssuance af a pe[mit and fhat a(t_work w]it_be.performed to meet standards af at!laws regulaEing
construcfion, County and City codes, zoning regulations, and tand development regulations m the jurisdic#ion. I al"sa
certify that I Understand that the regulations of otFier govemment agencies may apply to the intended work,�nd that it is
my respansibitity to identify what actEorts i must take to be in compllance. Such agenctes iriclude but are no#ifmited!o:
- Department of Environmentat Protection=Cypre'ss Bayheads, VlleNand Areas and Environmentaily Sensifive
Lands,WatedWastewater Treatmenk '
- Southwest RorEda Water Management Dlstrict-Wefis, Cypress Sayheads, WeUand Areas, AtteNng ,
Watercourses.
- Army Corps of Engineer,�-Seawalis,Docks,Navig�ble Waterways.
- Depa�tment o( Flealth & Rehatilittatfve°SeiviceslEnvironmental Health tlnit-Wells, Wastewater Treatment,
Septic Tanks. ��
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation�uthority-RurnMays.
1 undets#and that the follffwing restrictions appty to fhe use of fiEl:
- llse offili is not allowed in Flood Zone'V"unless expressly permikted.
- !f the flll fnaterla! (s to be used in Flood Zone °A", It is understood that a drainage plan addressing a
°compensating volume"wil!be svbmifted at time of percnttting whEch is prepared by a professiona4 engineer
licensed by the State of Florida.
- tf the flIR.materlal is to be used in:Flood Zone°A°in connecUon wfth a permitted building using stem wall
' canstrucfian,l certify ff�at fli1 w{t!be used only ta fill the area wtthin fhe sfem walt.
- If flll material is #o be used in any area,-1 certify that use af such fill will not adversely affect adjacent
properkies. !f use of flll is found to adversely affect adJacent pmperties,the owner may be cited for violaQng
the contiltions af fhe building psrmi#Issued under the aitached perm�f applic�tfion,for iots less than ane{1}
acre which are elevated by fill,an engineered drainage plan is required..
If I am the AGENT FOR THE OWNER,I promise tn good faith to:inform the owner of the permitting conditions set forth in
fh€s afffdav;t prlar to cocnmencing consfructiart. !undershand thaf a separate permit may be required for etechical work,
plumbing, signs,weils, pools,_afr canditioning, gas, or other InstatlaGons not specificaliy induded in the applicafian. A
permit issued shall be consdved to be a license to proceed with the work and not as authority to vivlate,cancel,alte�,or
se#aside any prov3slons of the technical codes,nor shall issuance of a permEt prevent the Bulid"srig Ofliciat t�i"tn thersafter _
requiring a aorrection of errors in ptans,construcfion or viotatfons of any codes. Every permtf tssued shal(become invatid -
unless tha work authorized by such permit Is commenced wlthfn six months of permit fssuance,or ff virork auihorized by
fhe perm'st is suspended or abando�atf for a period af sl�c{B}trianths aftes the tirne the work is commenced. Art extension
may be requested, In writing,irom the Building_Oflicfei for a period nof to exceed nineiy(90}days and wili demonstrafe
justf�abie cause for the extension. If work ceases for ninety(90)consecutive days,the�ob is considered abandoned.
WARNtNG TO OWNER: YOUR FAlLURE TO RECORD A NOTiCE OF COMMENCEMENT MAY RESULT 1N YOUR
PAYING TWIGE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
YitITF#YOtlR LENDER Oit AFt ATTORHEY BEFORE REGORDING Y'OUR NOTIGE OF GOMMENGEMENfi. '
FLOF2IDA JURAT(F.S.117.03j
OWNER OR AQENT CONTRACTOR
gvbsqlbed and swom ta(ar a#Elrtned)betore ma�Is Subsatbed and svuom fo(or affirmed}betore me ffits
qy by
Who islare personaliy known to me or harJhave produced Who Islare personaily Imown to me or haslhave produced
as fdentlficadon. as IdentlticaHon.
Notary Public Nptary Public
Commission No. ' Commisston No.
Name of Naiary typed.PHnted or stsmped �Name af.Noiary iyped:Pdnted ar stamped
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