HomeMy WebLinkAbout16-17534 � CITY OF ZEPHYRHILLS
, 5335-8TH STREET
(sis)�so-oozo 17534
R . iANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION 1 LOCATION INFORMATION
� Permit Number: 17534 ! Address: 38543 4TH AVE
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: 11-26-21-0010-16800-0170
Improv. Cost: ' OWNER INFORMATION
Date Issued: 6/30/2016 ' Name: FIRST CHURCH OF CHRISTIAN SCIENT
Total Fees: 50.00 �� Address: 5239 9TH ST -HISTORIC
Amount Paid: 50.00 ; ZEPHYRHILLS, FL. 33542
Date Paid: 6/30/2016 Phone:
Work Desc: PLACES OF ASSEMBLY- FIRST CHURCH OF CHRIST SCIENTIST EXP 6/2017
CONTRACTOR S APPLICATION FEES
FIRE PERMIT FEES 50.00
�
b
� � ,�
; �.
r
.r��d t a.c�v�. �
� Ins ections Re uired �
FIRE SITE INSPECTION-Final
� ■
OCCU PAN CY LOAD.
Occupancy by more tha;n the number of persons above shall be considered
dangerous and unlawful. Occupant load determined by Florida Fire
Prevention Code, N FPA101, Section 7.3.1.2
�
i'
I
� 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 Zephyrhilis Fire Fax-813-780-OD21
�Permit Application
Date Received Phone Contact for Permit 1��,��w�
t�.:2�^�-:°!`k`..�Si..o.'.-..._��e:e:4�._ .,Me,...,N_,._R ,n..�-�..,nx�..,-m�c�¢C7.=,.___...-.w1:�.::af::.s=..�.'i�a=.e:7:i:.(*i.._'c.:�."�.-�,.`.�:.'}�3�3a'�':�.=;��:�,""_.�..-i� a s... as,
Qwner's Name'i� L �'�� dt" qs�` I �c����S' + Owner's Phone Number � � �
,
Owners Address� c3d'J � �, J u � � �
Fee Simple Titleholder Name Titleholder Phone Number � � �
Fee Simple Titleholder Address
.a:...-4n.^f ..R3f-t> __ ,^.-�vs�,:,^• n�....e '..�9A.V•���1:"..k .Y Ki�W? ii: ^'
F:°�"'�;'y2:'....__�.. `.'i�s:r
e.k. " .-`p� 3
NOTICE OF DEED RES7RICTIONS: The undersigned understands that this permit.may be subject to"deed"restrictions"
which-may,be more restrictive than Coun#y regulation's. The undersigned assumes responsibllity for campiiance vrith any
applicabie deed restdctlons. ' , _ ,
UNLICENSED`CON'rR1iCTOR$ AND CONTRACTOR RESPONS181Lit7ES: tf the awner fias hired a contraCtor or
contraciars to nnderfake work,they may be required to be itoensed ia accorcfance wlth state and Iocai regulat�ons. if the '
cantractor Is nof.licensed as.required by law;tioth the owner and contractor may be cited for a misdemeanor violatlon � 4
undar sta#e law,�if the owne�or iMerided�contractor are"uncertain as to-what licensing iequirements"may apply�for'the
intended wosk,they are advised to contact 2he Pasca Gounty Suiiding lnspection Divislon—l.fcensing Sectlan at 727-847-
8009.' Furthermore; ff the owner tias fiired a contrabto? or contractors,=he is advised to have the,cantractor(s) sign
portions of tiie"contractor Block"of tfiis apptica#ion for which they.will be responsibie. if you, as the owner sign as the r
contrac#or;tFiat�may be an indicat�on that he.ls riot propedy Itcensed and.is,not entltled to permti#ing privilsges,in Pasca •
cour�ry. � ... . , ..
TRANSPOi2TA1 iON tMPAC'f1UTILITfE$iMPACT i4ND RESOURCE'REfCOVEItY FEES: The undersPgned understands
that Transpotiatton Imgack Fees and Recourse Rec�very�ees tttay apply to th"e construciiuri of new duAdit�gs,change of
use in enfsting buildfngs, or expansion af existing buifdings,as specffied in Pasco County Ordinance number 89-07 and
90=0�,es'amendeil. The�undetslgriea atso understands,tha't such iees;asmay be diie;wiN be identlfied at•the fime o1
permltting. 1k Is further understoad that Tsansportation Impact.Fees and.Resour�ce Recovery Fees rr�ust be paid priar to
recei'ving a:"ceiiificate-of occuPancy"or,final power release. tf the project daes not involve a certificate of-oacupanay or
final pcwer retease,the fees mys#bs paEd prlor to perniif issuance. Furthetmote,H Pasco County WafertSewer Impact
fees are due,they must be pald priorlo permtt tssuance!n accordance wiih:applicable Pasco Gounty ordlnances..--.
CONSTRUCTION LIEN!LAW_(Chapter 713,�Florld.a Statutes,as.emended): (fivaluatian of work is$2,500.00 or.more,1
certify that 1, the applic�nt, have been pro'videtl witta'a'csipy at the "Florida GanshucHon Lien Law—Homeauvner's
Protection Guide°prepared by the Florida D�partment,of Agriculture and Consumer Affairs. tf the applicant is someone
other than the`ownar",i certity ihat I have obtained a copy of the abave described document and pmmise(n good fai#h ta '
detiver Et to the`owner"pdor to commencement'. `= ' � ` "
CONTRACTOR'S/OWNER'S AFFIDAVIT: I aer#ify_that all,the inforrnation In thls applicatlon Is accurate and that all work
wilt'be done in campliance with atl applicabte iaws regulating construbtion;zoning a�d iand development. Appticatton�is
hereby made to otifaEn a permlt !o da'tivoi�i�and Installatlan-as'lndlcated. I,+�rtPf}!,tt�at no work or'lrist�llation has ^�
cammenced prior to Issuance of a permlt and that all work wlll be.perlormed;io 'm'eet;stan'dards:of all lews regulaUng
• construciion, County and City codes, zoning regntafions, and landy�ievelopment regula#ions in the jurisd3ctlon. 1 also
certffy thak 1 tinderstand fhat the regulations a►attier govemment ageiictes may apply t"o',ihe intended work,a'nd.that it is
my responslbllity to identfiy what actlans I must iake to be In compliance. Suah agencfes Inctude but are not Ilmlted,to:
- Department af Environmenfai Pmfection-Cypress 8ayheads,`VNettar�d Areas and Environmentatly'SensHlve
l.ands,Water/Wastewater Treatinent.'`' � .
- SouihwesE Florlda Water Management Dfstrict-Wells; Cypress Bayheads, WeUand Areas, Altertng
Watercourses. 1 � . � r
- Army Gorps of Engineers-Seawalls;Docks,Navigable Waterways. '
- Department of Health & Rehabltttethre Services/Envtronmentat Nealth Unit-Welis, Wastewater Treatment,
Septtc Tanks. . � , _
- US E�vironmental Protectinn Agancy-Asbestos abatement. ,
Federat Aviation;Auth4rity-Runways. ""' '`
(vnderstand that the'totlawiiig iestr�ctions apply to the use of fill: __
- Use af.fill Is not allowed In Flaod Zone'V"unless expressly permltted,
- if itie'flii rtiate�ial-is fo=b�e-used in Ftood Zone `A°, ft is understood thafi a drainage ptan addressing a
- "compensating,votume"-vulll.be submttted af time nf petmilting whfch Is prepared by a professional engineer
• Iicensed:by:the,State'of Florida., • - � - � '
. ._ - lf,ihe.filt,material is fo,be used tn Ftood Zane"A;�in cannec�tion witfii a petmltted building us#ng stem walh , _
`canstnsatfori,l aectify.that�f!!I vir141 be_u'sed ority,;o tilLthe rarea wlfhln the stem wa!!.
- `If.:t1U_material is.,to�be,_used'In any,.area, I �ceitliy'that use.oF.,such.fitl�will,not,adv,ersely atfect,sdjacen#,
�properties...lfi use of fit#is fpunc!to advetseiy,affec#8d)acent properfles,the owner may be citecl far viotating
� �it►e:condltlons=of#he.bu]Id�rig�permlt I`ssued under the aHached,`perr'nft.application,for lots less.than.one(1)
_.acrevirht,ch.areeleyatedby,till,;an,engineereddralnageplanis;r'equired. ' " `"' �
_ . _. ;. _ .__.. ,
ff!am the AGEh1T FOR:TFIE=BWNEit;I pramise fin good3alth,to.,infotm t!i'e owner of the percnitting condit�ons set forth!n -
.z :.;,._,:_.,.r. ,;
thls aflidavft prior=to<commencing:construction. �!understand that�a separete,permit,may..be,,requfred for elechical,work,
., plumbing, signs,.we1ls,;poois, atr,candtiioning, pas,,or ather.�[nstalletions nof spediically indtuded in the applicafion. A
perml#issued�sfiatl be constived to 6e-a I�iisrtise to pioc�eed w�kh the work'and nof a§:suttio�ltjr.:to:violate,cancel,aKer,.or , •+.t
set�aside arry:provlsions�of the technical codes,nor shall(ssuence of a pertnit prevent fhe Bulldirig Official iroin tFiereafter
requtring a carr,ectior�,of eRorsin'plans;construction or violetions of any codes. Every permlt issued sha11 became invalid
uniess the work sufhoiized-by-such permlt is�ctimrc�enced wlttifn sbc mortttis of permft Issuanoe;or!f work authorized_by
_..
the permit is suspended.or abandoned.for a.perfod of�slx(6)months after tFie time the woik is`commencc�d. An extensian
may tie requesteii;in�irriting;from ttie 8nilding:0ificie!for a period not to�tceed ninety{90}days arid will demanstrate
Ju'sttftable cause tor the-�adensfot�. IE work.ceases for nlnety{90)consecutive days,th�job Is consfdered abandoned.
, ;:7. . � - . ,: '
WARNING�T.O OWNEft: YOUR FAILLIitE TO RECORD A NOT►CE OF,GOMMENCEMfNT.MAY.RESUI,T IN YOUl2
_ _ _
PAYING TWICE fQR;lMPROYEMENTS TO YOUR PROPERTY:-!F YOU INTEND TO OBTAIN�INANCING,CONSUL7
1lV1�T_H YCIUR LENDER�OR AN ATTdRNEY BEFORE RECO�tDING YOLtR NOTICE OF COMMENCEMENT
FLORIDAJURAT(F:'w�1i7.03)_ ' ...
OWtiER pR AtiENT.-.- "..... CONTRACiOR
Subealbed and swom to{or afflrmed)betore me thls Subsvlbed end swom to(or aHfrmedj betore tne thls .
�-:-:- ' _ bY
Who Is/ana personally knovm to me or hatJhave producred Who Islere per�onally Imown to ma or haslhave produCed
as tdenti�s�lion.. as ldenNfiwtlon.
Notary Publlc Nolary Publlc
Commisslon Na: Comm�stoa No.
Neme oi Notary lyped,printed or stemped �Neme of NoCary typed,printed or stamped
:�