HomeMy WebLinkAbout16-17646 i
CITY OF ZEPHYRHILLS
5335-8TH STREET
A _ _ (si3)�so-oo20 17646
ANNUAL ASSEMBLY PERMIT
� PERMIT INFORMATION . `� ` - � _ LOCATION INFORMATION
Permit�Vumber: 17646 Address: 38303 NORTH AVE
Per it Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class�of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book:
Propo�ed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: TYSON
Est. Value: Parcel Number: 02-26-21-0080-OOA00-0080
Impr'ov. Cost: ' OWNER INFORMATION _
Date Issued: 8/11/2016 Name: SIX FEET UNDER LLC
To�al Fees: 50.00 Address: 31448 REED RD
Amoi�nt Paid: 50.00 DADE CITY FL 33523-7444
D'ate Paid: 8/11/2016 Phone: (440)520-3973
W rk Desc: PLACES OF ASSEMBLY- LITTLE PEOPLE CHRISTIAN - EXP 8/17
C � NTRACTOR S '- � _ APPLICATION FEES
� FIRE PERMIT FEES 50.00
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! - � ` ns ections Re uired �
F R IT IN PE T ON-Fina
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i OCCUPANCY LOAD:
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Oc� upancy by more than the number of persons above shatl be considered
i 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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s�s- so-oo2o City af Zephyrhil(s Fire �ax-s�s-7saaa2�
fPermit•Application '
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Owner's Name ir� / LGJri L�fi L tl LJ< L� �/'f,(�(.S?f� Qwner's Phone Number U/ r�. �.r� �
Owne�s Address � � �j �� �t'�� �G t- �-"1 J �a3
Fee Simple Titleholder Name /,�p. � G � C. . Titlehoider Phone Number �� � �
Fee Simpie Titie 3older Address r r
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Sub Division � ' Qatcel# "
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� Bio-Hazard Waste 8torage-APINUAL Q Fumigation Tent
'� Comm Exhaust Kitcfien Hood/Duct Q JHazardous Matenat{�'ier!1 or RQ Facility)ANNUA� �
� Controlled Hum ' � Hobd Iristallation
�� Emergeney Generator<30 kw � LP/Naturai Gas-instaliatian ��
� Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
�{ Fire Protec6on Maintenance.-ANNUAL � Places rrf Assembly-ANNUAL ,
�`r'r`� try emi � t er,,- ,
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Sprinkier �' ❑ ❑ G3,t;� o �Recreational Bum
Fire Alarm � ❑ O ❑!}� � Sparklers � `�F�/ ���Y�
Hood G1eaning � ❑ Cl CI f� � Sprinkler System finstat}a6ons t
Hood Suppression �� O ❑ � � Q Standpipes(Spiinkler Sys)
If Fire Alarm insiailation Q Torch Roofing/Tar Kettie �
,� Fire Pumps `�' Q Waste T'ire Storage'ANNUAL
�� Fire Warks ,
� Flammable Applioation-AIdNUAL �—�r^� Valuation of ProJect
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, Fuei Tanks
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_ Contractor � _` ' Company ` - �
Signature Regis#ered Y�1 N Fee�Cu�rent Y7 N
Address � � Cicense# ' - � •
ECECTRICIAN� Cornpany ,s._� , ' ; .
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5ignature ! Registe"r"ed ' ' Y l N Fee Gurrent Y/'N �
Address ' � License'�f �
F'LUMBER � � ' Company
Signature Registeied Y 1 N. Fee current Y 1:N.
Address � "' - License#
MECHANiCAt Company
Signature Registered Y/N Fee Current Y/N �
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Address License# ` � �
OTHER Company , :
Signature � � Registered Y 1 N Fee Current Y I N
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Address� �O �� -
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aP. � ,G� C. 3 Ucense# �
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'R`��.-21 r'$::Y.:_-�:+ .+4s..^':...:tfim+.n�:i. �.<-���ti�i ._
directions: ,
� Fill out application completely. -
� Owner&Contractor sign back of appiication,notatized(Or,copy of signed contract with ovmer}
If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
� Supply two(2)sets of drawings with applicabte documentatio�
A1tow'f 0-14 days for review after suhmiBal date. Parcel#-obtained from Praperty Tax Natice{http:llappraiser,pascogov.cam}
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NOTICE OF DEED RESTRiCT10NS: The understgned understands that lhls permil;may be subject to"deed°restrictions"
which°may�be more resttiotive than Caunty regulation's. The undersigned assumes resporislbliity fiar compllance with any
applicatiig,deed restricttons. > , . . ., r ,. ;
UNLICENSED CONTRAG'PORS AND' CONTRAC70R RESPONSIBILITIES: !f the owner has hired a contractor or �
caritracfota.to undettake wark,the`y rriay be requlred#o be Ilcensed in acco'rdance w'ifh siate and local regu(attons. if the
con4ractor.is�not.�icensed as..required tiy law, both tfie oviiner and contractor may be ctted for a misdemeanor violatton '
under�state law. If tfie owrie�o�intended contracko�are uncertairr as'to wiiat licensing requlrements"may apply for�the I
intended work,they are advised to cantact the Pasao County Buiiding lnspection Divislort—Cicens�ng Sec#ion at 727-SA7- j
'� 8QU9.`Furthermore;i�the owner fias tiireii a cdnGaotor or cont'ractors,'he is advised ta have the contractor(s) slgn �
portions of tt►e"cantractor Block°of this application for„which they.wfll be responsible. If you, as the owner sfgn as the
contrac#ar,thaf may be.an Indlcation that tie Is'not praperly ticerised and.ls not ent(tied ta permltting privReges in Pasca �
, County. .
TFZANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE R�COVERY FEES: The undersigned understands
� that Transportatian impaot Fees arid Recourse R'scovery Fees may appiy#o the construotiosi of new bufldings,change of ,
use in exisiing buildings, or expansio�of e�cisfing buildings,as specifred in Pasco C�anty{}rdinance number 89-07 and
9U-07;as amended: The underslgned also understands,that such'fees;as may be diie;.will.be tdentffied at-the time.of ' '
, permltting. !t Is iurther anderstood that TsansportaHon Impact fees and.Resource Recovety Fees must be paid priar to �
� recelving a''ceitificate of occupancy"or;tinat power retease. !f the proje�t does not invotve a cert�oate�of occugancy oc '
final power release,the fees must be pald prior to permit issuanae. Furtliermore, ff Pasco County Water/Sewe�impact
lees are due,they ts�ust be paid pr{or ta permli fssusnce�in acxortlance wilh:epplicabls Pasco County ordinancEs.._
CONSTftUCTtOtd tiEN�LAW(Chepter 713,,Flarlda Sta'tui�s,as ameitded}: ff wafuation o#work is$2,50aA0 gr.more,i
certify that I, the applicant, have been pro'vided urifti a'copy"of the "Florida ConstruaHon Lien Law--HomeoiNner's
Prateatian Guide°prepared by the Florida Deparkment,.af Agriculture and Consumer Aftairs, H the applicant Is someone
i ather than#he"owner°,1 certify fhaf(haue gbtained a copy c�f#he abave'describeci document and prom3se in good faith fo ;'" � "
deliver ft lo the`owne�'p�ior to commencement. ' � •
CON7RACTOR'SfOWNER'S AFFIDAVIT: !cert(!y-that aU.,the,lnformetion ih thls applicatinn is accurate and that all.vuork
wiEl'be done in cornpttance with all applicabte laws reguta#tng constntctlan;zontng and iand devetoprr�en4 Application is
hereby made io obtain a permit to do wark and installation as'indicated. I ceritty.that no wnrk or'in's,tailattan has
, commenced prlor to issuance of a permit and ttiat all work will be perfarmed to meet.;stendards�of aii'laiivs regulaUng
• canstrucfion, County and Cify codes, zontng regalations, and land:�ievelopmen!tegulaBons tn the jurlsdlct(ori:�! a1"so
certify that I understand that the negulations of otFier govemment agencies may apply fo the intended woNi,a`nd�that it is
my responslbllity to identify what actions 1 must iake to be in compliance. Such agencies i'nclude but are not Iimtted'1o:
- Deparkmen#of Errviranmenfai ProtecfiotrCypress B�yhead's,`Vitettand Arees and Environmet�talEy`Sens{}�,$
Lands,Water/WaslewaterTreatmerit'.'"`" � " ' '� ' � `
- Southwest Flatida Water Management District-Wells, Cypress Bayheads, Wetland Areas, i4ltering
tNa#ercoucses. ., . . ; n
- Army Corps of Engineers-Seawalls,.Dacks,Navigable Watervvays.
- Depart'ment of Health 8� Rehabllltative ServiceslEn,v,ironimental Heafth Unit-Welis, Wastewater Treatment,
Sepflc Tanks. . . � � , ,
- US Environmental ProiecBon Agency-Asbestos abatement.
Federal;Aviallon;Authorky-Runways: ' `"`"" '"
1 understand tha{flie following iestrlctions appty ta the use of fil1:•
- Use af fili is nat allowed in Flaad Zone'V°onlass expressly permttted.
- N tfie"fl�l'mateiial (s to'be used-�in Flood Zone 'A°, It is understood ihat a drainage plan,addressing a
'compensating;�volume"wilt:�be subr►�ttted af ifine.of.permftking whfch is prepared by a professional engineer
- i'icenseil:.bythe-.Sfa#e.ofFiorid,'a:, � -- ` �' � _ �
)f th�f111 r,material_is to,be used (n Flood Zone'A;.,in.connectiori witli a permllted build'ing using stem wall
� saristnictlon;l certliy itiat fli vuill be used onty,to fll the,area wifhin the stem wait. , "
- 'ff�:fill°>ma#eriat;is-to„be,used`in�any•anea, 1 ceitify tfitat use.of such..ftl�wil}.not,.adversely aEtect ad)acent ,
�properties. if use of fi11 is found fo adversety,effect.adjacent propertjes;the owner may be cited for violaUng
- the�condlfioris�.+6f 4t'ie.builii�iig?pertnit,tssue¢under the attached�perinik_application,for(ots less than one{1)
acre.whtc,h:are,elevated_byftil,.an.engingeteddralnage.planis;reqii3red. � "� ' `
K I am the AGENTI'FOR THE�OWNER;I promise In good.faith;to;i.►�form.the owner of the pertnitting condftions set forth tn
thfs affidavtt,prior�ta.comritencing:constniction.. I und'e,rsterid thet a aepa'rate_permit,may,be required for electrical work, �
., ptumbing, signs,wetis„paats,,air._condilioning,gas, or other.=instaAafions nof`speciftcally iridcided`in the applicatlon. A
permit issued'sFiall'be`constnied to be•a Bcense fo prooeiad with the work�and noCes�authorftj!.to_violate;cancel,alter,or +,,
set•aside an}!:provtstons:ot_the technlca!_cades,nor shaA Issuance of a pemilt prevent#he Building Official ftom thereafter
reqytring a coifeciton vf errors�in-plans;cohstrtiction or-vtolatians of any codes. Every permlt lssued sha11 become Invaiid
unless the work aukhorized-by-such perrriitris:commenced within six moMlis of�permft issuence;oc,if work auihorized by
ihe perm!#{s.suspended or abandoned for a.period,oE stx(8)months after:the tf'me the work is commericed. An extension �
may iie req+uested;in vKiting;from the•Build3ng Oi�ciat for a period not tci,exceed,nlnety..(94}.days and wi!{demons#rafe
Ju'stHiable cause for the extension, If work ceases fo_r..ninefy(90)aotisecuttve days,fh,job Is considered abandonecl.
YVARNt�3�TO"OWFlER: YOUR FAILU3tE TO RECORD�A l�OT1GE{}F C4MMENGEMENT MA1C-RESULT 1N YQUR '
� Pla►1f1NG_T1MCE FOR+IMPROVEMENTS TO YOUR PROPERTY."IF YOG 1NTERID TO 08TAIN FIMAFfCING,Ct'�FISULT
' 116"TH YOURIENDER OR AN A ORNEY BEFQRE RECORDING YOUR NOTICE"OF C4MMENCEMENT •
FL:ORIDA JURA3{F:S.117.03} - . ` � � '
I OWNER ORAGENT��,- ':�... . CONTRACTOR
� Subsatbed and swnm to(or afllrmed)before me this Subsulbed and svuom to(or affirmed)before me.ttrls
� ��-��. .. ._. �. - � bY
( Who islare perso airy known io me or has/heve produced Wha is/are peisona�ty known to me or hasfiave prcduced
Iasidentlflcadon. asidentlflcadon.
Notary Pubilc Notary Pubflc
Gammission Na. Cammisslosr No.
Neme oi Notary typed,pdnted or sffimped �Neme oT Notary Q�ped,pdnted or stamped
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