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Home My WebLink About16-16889 CITY OF ZEPHYRHILLS 5335-8TH STREET � �sis��so-oo20 1 9 ANNUAL ASSEMBLY PERMIT PERMIT INFORMATION ` � - � LOCATION INFORMATION Permit Number: 16889 Address: 5444 4TH ST Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 1 1-26-21-001 0-06300-01 1 0 Improv. Cost: � - OWNER INFORMATION - Date Issued: 1/08/2016 Name: CHURCH OF CHRIST Total Fees: 50.00 Address: 5444 4TH ST Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 1/08/2016 Phone: Work Desc: PLACES OF ASSEMBLY- CHURCH OF CHRIST EXP 1/17 -CONTRACTOR S -= � - . " APPLICATION FEES: . � � - - � NER FIRE PERMIT FE 50.00 / � Z ' � ` � �In§ ections Re uired. . FI E TE I SPECTI -Final OCCUPANCY LOAD: �� 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 813-780-4420 City of Zephyrhilis Fire Fax-813-780-002't Permit Application Date i2eceived �— �� Phone Gantact for Permit � ta--:_...�=:�s;._<e•r;.�.....�.__..,... ..._...,� r_ ,.>.a.,., ._.-.�.,..:�a:.�:.�.��-•��—��.. ._...r.......--..�.__,.,.r�€:.:....m.'G�w-s_..-�^s:M�..�::�.�.a.,_�_,....�..__.,.s�.�.� .�ac.,.--�..,,�.,x.,,��...�s_ Owners Name ��' '�( t,5' t�wners Phone Number �__� [� �� 4wner's Address [ ' Fee Simple Titleholder Nama Titleholder Phone Number [� � �� Fee Simple Titleholder Address � _ ..-- .~�-�_ -_ - - - .,:�.�,.-:-��. ;,�.,.�„� - -- _ - -�..-,- - -- �.�:.-- -- - --�.m.7..,.,W,�....,�,.,,�.��.,.Y.� .� � ...�.� .,s.,,._� .�..:�;�:.: ._..��:.�._.a '°:�.:��_w . ,��:�<.� - wz�:i.h �__-.,_...-_,� ,�.__...-..�.y x.. Jab Addfess s lat# �� Sub Division Parcet# � .n.�.,..�>k.: �:�.�,-_.,..V...�ti�-�?��..�.,�-:.__ �f+»l.:45i'........rx�..�.'�.2'.:.+c.c..:.s...1.MJ....wu,..��eN:.�lxti:l�L+ayv�`��w,s.s.��ri.�::�..�t=c ..w ,....f.v.i�nx��'.i.?�:.,4.,..:�::A.:�,-...-,.,_. .'_=...-.....�i.:c:.h's;ti:�:�`.:J;v_.....,..c,.,......d ^'a � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � Camm Exhaust Kitchen HoodtDuct � Nazardous Material(Tier II or RQ Facility}ANNUIU. � Controlled Bum � � Haod Installation a � Emergency Generator<3d kw � LPJNaturat Gas-Instatiation � Emergency Generatar>30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protectlon Maintenance-ANFlUAL . Places af Assembly-ANTiUAI � � emi �n er �, Sprinkfer � � O II � Etecreational Bum � Fire Alarm � ❑ ❑ ❑ � � Sparklers �p�� Ca Hood CleanEng � ❑ ❑ ❑ �� Sprinkfer Sysfem tnstaliations � Hood Suppression � ❑ ❑ ❑ C7 � StgndpipeS(Spnnkler Sys) � Fire Aiarm Instal(ation Q Toroh Roofing/Tar Kettle � Fire Pumps • o Waste Tire Storage ANNUAL � Fiammabie Application-AFtNUAL �^—�� Valuation of Praject � Fuel Tanks ��•— Q C}ther. .....�.:�F�;._:�r�;µ-�....".�",.�--�.,��.;_.�._'-�::_...'�'--�.._�,.-:,.�.�� N��',�~-q=.��x,.;-.r:�::,::_�__. _,�� -- �---�a..� .._ �.W�'�""^�'-i.':� �_._:,�:."�—'""_"—:�...�...m"'t""...i-.,p�`w��'.M^'.�;.W. ;.�5..�•u•.�.:�.c Contractor } n �j� Company � � Signature �L��<<--�' �✓ Registered Y/N Fee Current Y/N Adt3ress �icense# , ELECTRICIAN Company Signature Registered Y I R3 Fee.Current Y 1�V Address License# P�UMBER Company Signature Registered Y/N Fee Current Y/N. Address License# MECHANICAL Company Signature Registered Y 1 R! Fee Current Y 1 tV Address License# � CITHER Company 5ignature Regis2ered Y!N �ee Curtent Y/N �� Address License# 6'�w--"..s...""".,..�.w�':G::,.,..r�.>.w,. �a..r...;:1.;..;.:�-...:�1�..�..+......._.:n._,-»._...s:.wchs:�.:.;..:,G:�._....w..:._.a�..�._ _ ..�...=:i;:�,-....�.�'�'�....�.....+...- -w.. ,._.........s_. .i �. s�r<a ,� ' '_ Directions: ^s..- _. . ,:x:��. ::�::��.;-��.::..:.:._�_.. .�t,�>-�::�:...:, FiI!out application comple2eiy. Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) K over$2540,a Notice of Comrner�cement is required(Mechanicai work over$5000) Supply two(2)sets af drawings v�nth applicabie documentation Allow 10-14 days for review after submittal date. Parcel#-obtained from Properry Tax Notice(http:!/appraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersfgned understands that this permit may be subject to"deed°restrictions" which may be more restrictive than County regulations. The undersigned assumes responsib(lity for compliance with any �• applicable deed restrictions. , ` UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contrector or contractors to urfdertake work,they may be required to be licensed in accordarice with state and local regulations. If the contractor is noClicensed as required by law, both the owner and contractor may be cited for a misdemeanor violatfon under state law. If the owner or intended contractar 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 ihis application for which they wili be responsible. If you,as the owner slgn as the , contractor,that may be an indication that he is not properly,licensed and is not entiUed.to.permitting privileges in Pasco County. TRANSPORTATION IMPACTNTILITIES 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 bufldings,.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,wlll be(dentified at the time of permitting. It is further understaod that Transportation Impact Fees arid Resource Recovery Fees must be pafd prior to receiving a'certificate of occupancy"or flnai power release. If the project does not involve a certificate of occupancy ar final power release,the fees must be paid prior to permit issuance. Furthermore, ff Pasco County Water/Sewer Impact fees are due,they must be paid prior to permft Issuance in accordance with appl(cable Pasco County ordinances. , CONSTRUCTION LIEN LAW(Chapter 713,Florlda Statules.as amended): if valuation of 5vork is$2,500.00 or more,I certify that I, the applicent, have been provided wrih a copy of the 'Florida Construction Lien Law—Homeowner's Protection Guide°prepared by the Florida Department of Agriculiure and Consumer Affairs. If the applicant is someone other than the°owner",I certify that 1 have obtained a copy of the above described document and promise in good faith to deliver it to the"owner°prior to commencement. CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information In this application is accurate and that all work will be done in compiiance with all applicable laws regulating constructlon,zoning and land development. Application is hereby made to abtaln a permft to do work and installation as fndicated: 1 cerlify that no.woMc or installatfon 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 regulatlons�in the jurisdiction. I al"so certify that I understand that the regulations of otNer govemment-agencies may apply to the intended work,and that it is my responsibility to identify what actions I must take to be in compUance. Such agencies include but are not limited to: - Department of Environmental Protection-Gypress BayFieads, V1letland Areas and Environmentaliy Sensitive Lands,WaterNVastewater Treatmenk ' � � - Southwest Fiorida Water Management Dlstrict-Wells, Cypress 8ayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalis,Docks,Navigable Watetways. - Department of Health & Reha6111tative Services/Environmental Health Unit Wells, Wastewater Treatment, Septic Tanks, : - US Envirorimental Protection Agency-Asbestos abatement' - Federal Aviation Authority-Runways. i understand that the following restrlctfons apply to the use of fiil:• - Use offll is not allowed in Flood Zone'V°unless expressly pertnitted. - if the flil materlal is to be used in Flood Zone 'A", it is understood that a drainage plan addressing a °compensating volume"will be submltted at time of pertniHing which is prepared by a prafessional engineer 1'icensed by tfie State`af Florida. � - If the fill,material is to be used_in.Flood Zone'A° in connection with a permitted buflding using stem wall con'struction,I certify that flll will be used only to fill the area within the stem wall. - If flll material is to be used In any area,_I certify that use of such flll will not adversely affect adJacent propertfes. If use of fill is found to adversety_affect adJacent properties,the owner may be cited for violating the co'nditions of the building permit�.issued under the attached pertnit appl(cation,for lots less than one(1) acre wfifch are elevated by.fill,an erigineered idrainage plan Is required. 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 affidavft prior to commencing construction. I understand that a separete 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 wark and not as authoriiy to violate,cancel,alter,or set aside arry provisions of the technical c�des,rior shail issuance of a permit prevent the Buildirig Official from thereafter � requiring a correction of errors in plans,construction or yiolations of any codes. Every permft Issued shali become invalid unless the work authorized by such permit is commenced withtn six months of permit issuance,or'rf�work authorized by the permit is suspended or abandoned for.a period of six(B)manths after the time the work is commenced. An extension may be requested,in writing,from the Building.Of�icfal for a period not to exceed ninety(90)days and will demonstrate just�able cause for the extension. If work ceases for nineiy(90)consecutive days,the�ob is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUI�LENDER OR AN ATI'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ' FLORIDA JURAT(F:5:117.03) OWNER OR AGENT CONTRACTOR Su6satbed and swom to(or afiirtned)before me this Subscribed and bswom to(or afiirmed)before me lhis b Who is/are pers naliy known to me or harJhave produced Who Islare pe�sonalry Imown ta me or has/h�n��tion. asidentlfiptlon. Notary Pubfic Notary Puhlic Commission No. Commission No. Name ot Notary typed,pdnted or stemped �Name of Notary typad,printed or stamped . � � . — �t1 � - � - �