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Home My WebLink About16-17365� �. CITY OF ZEPHYRHILLS 5335-8TH STREET : -- �sis>�so-oo20 7365 , ANNUAL ASSEMBLY PERMIT , PERMIT INFORMATION LOCATION INFORMATION Permit Number: 17365 Address: 5216 7TH ST HISTORIC Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: NOT APPCICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-16700-0180 Improv. Cost: � OWNER INFORMATION Date Issued: 5/19/2016 Name: HOUSING INDEPENDENCE INC Totai Fees: 50.00 Address: 5216 7TH ST. HISTORIC Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 5/19/2016 Phone: Work Desc: PLACES OF ASSEMBLY- UNITED CHURCH OF GOD- EXP 5/2017 CONTRACTOR S APPLICATION FEES OWNER FIRE PERMIT FEES 50.00 �Q�' ` � vv Ins ections Re uired FIRE SITE INSPECTION-Final � OCCUPANCY LOAD: 2 � S �� 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 ReceiYed ' Phone Contact for Permit �0.�� _'�.s. - - ------`.��--��..��.z, - �...z..�.�m. ...�_____ - — - Owner's Nam�� /�1 ,�� tl� Owner's Phone Number � � � Owner's Addre� �o�-./� � ,�r� Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titleholder Address � �:-�.�_......�,...�.,.a,..-��"'.,_�...-�... �"`.�"'_"'A.""'"'^._ .._,,....n.,.�.._...�..,,� ��_.�.__._.K "'-�.-....a,--�„ Job Address Lot# � Sub Division Parcel# �-,.:..-� ,�,.��_._... .,.�...._.,...�_.�,<.._..e.�.-._._.�_.�,.s._s._,w...,,�..._�---_ _---�-� -- - —:_�..__.__._._..�.�e.. -.v., - � 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 �i/�� Fire Protection Maintenance-ANNUAL � Piaces of Assembly-ANNUAL d� � tr y emi �n t er Sprinkler � ❑ ❑ ❑ B � 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 � Flammable Application-ANNUAL Valuation of Project � Fuel Tanks Q Other: �_�...,._� - - ..._._.._.�_..�... . - -------�-�_,r._.-:_�,.,.- - �, Contracto ✓ � Company Signatur� 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/N Fee Current Y/N Address License# e-=. .v_.._...__.:_,_;___e_.._..__.._.�._..V..�.__.._�_.�ti4�.:_,.<��...,....�..._.�_,a-..._K��___.�_,____..._...._.—�___.__._H......_.__-.:__v�_._s_..-_..__. ,a��_-----.:.�. 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) e N0710E OF pEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictlons° which may be more restrictive than County regulations. The undersigned assumes tesponsib3lity far comp3Rance with any appficable deed restrictions. : , 1 UNL.ICENSED CONTRAC70RS AND CONTR�4CTOR RESPONSIBILITIES: If the owner has hired a contractor or � contractors ta erndertake work,fhey may be required to be licensed in accardance w�th state and Iocal regulations. If fhe , oontractor is not licensed as required by law, both the owner and contractar may be clted for a misdemeanor vialation under state law. if the owner or intended cantractor are uncertain as to what licensing requirements may apply far the intended�watk,#hey ate adv3sed#o contact the Pasco County Building lnspection Division--Licensing Section at 727-&47- 80D9. Furthermore, ff the awner has hired a contractor ar contractors, he is advised ta have fhe contractor(s) sign portions of the"contractor Block"of ihis application for which they will be responsible. If you, as the owner sign as the con#racfor,fhaf may be an indicatian that he is naE prope�ly ficensed and is not entitled to permitting privileges 3n Pasca Counfy. TRANSPORTATIOhd IRAPACT/UTILITOES IMPi4CT AND RESOURCE RECOVERY FEES: The undersigned understands fhat Transporfation Impact Fees and Recourse Recovery�ess may appEy#o the consUuction of new bufidings,change of use in existing buiidings, or expansian of existing buildings, as specified in Pasco County Ordinance numbet 89-07 and 90-07, as amended. The undersigned also understands,that such fees,as may be due,wiil be identified at the time of permitking. St is furiher understood that Transpartation lmpact Fees and Resource Fteoovery Fees must be paid prior to receiving a°certifrcate of ocoapancy"or finaf power releasa. If the project does not invaive a certificate of occupancy or final power release,the fees must be paid prior to permit issuance. Furthermore, H Pasco County WatedSewer Impact fees are due,they must be paid prior fo permit issuance!n accordance with app(icable Pasco County ordlnances. CONSTRl1CTlOht LIEtd LAVN(Cfiapter 7i3,Florida Stafntes,as amendedy: tf vaEuation of work is$2,54Q00 or more,! certil'y that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Proteckian Guide°grepared tay the Florida Department ot Agriculture and Consumer Affairs. If the applicant is someone other#fian fhe"awner",1 certify fhat 1 have abtained a copy a#the abave described documenf and promise in goad faith fo deliver it to the"owner"prior to commencement. COt�TRACTOR'5101�►NER'S AFFIpAVIT: l certify that all the information in this applicatlon is accurate and that a!I work will be done in comptiance with ali appiicable laws regulating consfnaction,zaning and land developmenf. Applicafion'ss hereby made to ob#aln a permit to do work and installation as indicated. I certify that no work or instailation has commenced prior to issuance of a permit and that ail work wiil be performed to meet standards of all laws regulating constructian, County and Cify codes, zoning regulations, and [and develapment regulatPons in fhe jur3sdiotion. ( also certify ihat I tinderstand that the regulations of otiier govemment agencies may apply to the intended work, and that it is my resgonsibllity to identffy what actlons I must take to be In compliance. Such agencies include but are not limited to: - Departrnent of Environmentat Protection-Cypress 8ayheads, Vitetland Areas and Enuironmentatly Sensttive Lands,WatedWastewater Treatment - Southwest Florida Water Management Distrlct-Wells, Cypress Bayheads, Wetland Areas, Alkering , Watercaurses. - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. - department of Health & Rehabilitative 5ervices/Environmental Health Unit-Weils, Wastewater Treatment, � Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. 1 understand#hat the following restricflons apply fo the use of ffit.� � - Use of fill is not allowed in Flood Zane'V"unless expressiy permitted. - If the flil materlal is to 6e used in Flaod Zone "A", ft is understood that a drainage plan addressing a "compet�sating volnme"wiil be submltted at time af permit#ing which is pregared by a professionai enginesr licensed by the S#ate of Fiorida. - If the fill material is to be used In Flood Zone "A" in cannection with a permitted building using stem wall cons#ruct�on,i cettify fhat fi11 rv9ft be used onty to fill the area withln the stem wa1L -- - if flll material is to be used in any area, 1 certify ffiat use of such fltl wili not adversely affect adjacent propertfes. If use of fili is found to adversely affect ad)acent praperties,the owner may be cited for violating the cond3ttons of the butlding penn'st Issued under the attachsd permi#appiication,for lots tess tfian one{1} acre which are elevated by fiil,an engineered drainage plan is required. � � If I am the AGENT FOR THE OWNER,I promise in good faith to infarm the owner o#the permitting conditions set forth in i this af�davlt prior#o commencing oonshuction. (understand that a separate permit may be requlred far elechica!work, p(umbing, signs,welis, pools, air conditioning, gas, ar other installafions not specif3ca11y included in the applicafian. 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 pravisians o(the technlcai codes,nor shaii fssuance of a permit prevent the Bulldirig Official from thereafter requiring a correction of errors in plans,construction or vialations of any codes. Every permit issued shall became invalid ' unless the work authotized by such permit is commenced within six rnonths of permft issuance,or ff work authorized by ' ftle permif Is suspended or abandaned for a period of six{6j months after the time the work is commenced. An extension may be requested, in writfng,fram the 8uilding Offiicial for a period not to exceed ninety{90}days and witl demonstrafe � justifiable cause for the extension. If work ceases for ninety(90)consecutive days,th�job is considered abandoned. ( WRRNItdG TO OWNER: YOUR FAtLUftE T'O RECORD A NOTtCE OF CON9MENCEMENT N9AY RESU�fi tN Y011ft PAYING NVICE FQR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT ' YUtTFi YOUR i.ENDER OR AN ATTQRNEY BEFORE RECORDING YOUR NOTICE OF CdMMENCEMENT. i FLORtDAJURAT{FcS.it7.03) I OVIMER OR AGENT CONTRACTOR i II Subsalbed and swam to{or afttrtned}before me this Su6scribed and swom to(or affirtned)before me thls I by bY ' Who is/are personally known lo me or has/have produced Who Islare pe�&onally known ia me or heslhave produced ' asidentlficaHon. aslde�tlficaBon. Notaty Public Notary Puqlfc Commisslon No. Commtsslon No. Name at Na#ary typed,printed or stamped �t3ame of Notary typed,pHnted or stamped