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Home My WebLink About16-17830 �. � r CITY OF ZEPHYRHILLS 5335-8TH STt2EET . � r',Y (813)780-0020 83i� ;� ANNUAl.ASSEMBLY PERMIT ; i ' PERMIT lNFORMATION' - LOCATION INFORMATION '� Permi# Number: 17830 Address: 385�5 5TH AVE i ' Permit Type: �FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. i Class�e►f Work: F1RE-PLACES OF ASSEMB�Y Township: Range: Boolc. Proposed Use: NOT APPLICABLE Lot(s): Block: Section: ; S uare Eeet: Subdivision: CITY OF ZEPHYRHlLLS 9Est. Value: Parcel Number: 11-26-21-001Q-15100-0'140 lmprov. Cost: � 4WNER lNFORMATlON � Dat� Issued: 10/14/2016 Name: CITY OF ZEPHYRHI�LS � To�al Fees: � . Address: 5335 8TH �T � Amo�nt Paid: 50 ZEPHYRHI�LS, FL. 33542 � D�te Paid: 10/14/2Q1 Phane: i Wo,.rk Desc: PL.AGES OF ASSEMB�Y-WOMAN CLUB EXP 94/2417 WAIVED i C(�►NTRACTOR S APPLICATION FEES . � FI PERMIT FEES .00 i , � I - I � I i � n , 1 r /�� I �,�1/�r� '/� � x.�.� ?- � �� ,,� ; � � � Ins ectia Re uired �. " � FIR T NSPE 10 - inai � i i � , CICCUPAI�CY Lt�AD: � Qc�upancy by more than the number of persons above shall be considered dangerous and unlawful. Occupant toad determined by Florida Fire Prevention Cadej NFPA101, Section 7.3.1.2 � I PERMIT C7FFIG ' PERMIT EXPIRES IN ONE (1) YEAR FRBM DATE OF ISSUANCE � THIS PERMIT NEEDS TO BE PpSTE!') IN VISIBLE LOCATION IN MAIN ASSEMBLY AREA ! ZEPHYRHILCS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FI. 33542 � � � > > i s�s-I ao-oo2o City of Zephyrhilis Fire Fax-813-780-0021 � I ;Permit Applicat'ion Date Received � Phone Contact for Permit �� t:=:,�-gs'-r.:5:'f:-�.-r.ie�,.r .,.re.._�,�.,.....,sz.�....,wo, �+-i="F3t-.�'4:.R.- .'e.:-.�xr:�::�-�::i.;::-:3::T'.ts'a�..;'� ':.aL��S.:�'"s�.'��.-:._e.. . ..w-in;.�.::..�.� ,e �: _.a...,. � Owner's Name ��1 A N (5 L U g �'�� "r 2'� '�Phone Number � � � Owner's Address� � � ��`C V� �' � Fee Simple Titleholder Name Titleholder Phone Numbe� � � � Fee Simple Title lolder Address � _�., „y--.,-.�, „y:r---;'a• ..:�`'.3z�' �=�,;'.w..-..�.�',7„!,-�.�'-..'-�..sa....`-'-�'`-•°+�--�r:',:.,��:�'�,,..,:+�ht3:.-yr�^�y,,,.:. '.-�.>��c.� •-y r..r.y:.�.: �-�- `Y`5-.�.��.`�-.�ei•«.F'a.:.�,-'1`..�`.�,.j..r.-. ,yp t-,>_."t,.;.'.�--,".±.'F,-4-=�._, _.- >,�.., x.-.i�;... _ �£:,._ ,.r� - r�" -...,'"t`� f=.,:::..,.x.-..,3:.'�:;.i`."w....:::w:� ..r".m":'..,..��'�..'<�,a:�'s'.3 Job Address �`� � Lot# ,I Sub Division � Pa�cel# ` ' ! ,.,r�,-..�.;:..,�.. ,,.,,.,._..t......� . �.-.....,�...iM-c.. -r..:r•�-_,;:;=;"'�,":;+,::_'-,,,`"T`_..r�'��...:v,':`�'_��',.4."'�.:_."`i"�:;_-.a:.._ar3s::.«.Y,�.a�-'�'.�,_�>-,�.�.r.�-...�-M'?�ssr�.�?f�..'.r>;,,"r.;aTt�s`Y�a`i�..e�:,:'�,r.4,.;��a+.'°"`.-,'}.°zi".._`'Z [z1-.�_,.�...,.��;�,....:e iN....;<:._-�"�i�i-:..�.w^�i....3w.;'�,.;..--w��'.a.^"...�".�'"Y:�.,:.aa.�..�.:�.... . � , � �� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent i �I Comm Exhaust Kitchen Hood/Duct � tHaiardous Material(Tier II or RQ Facility)ANNUAL ' �I Controlled Bum � Hood Installation � ; Emergency Generator<30 kw � LP/Natural Gas-Installafion � j Emergency Generator>30 kw � CP/Natural Gas=ANNUAL Sale �� Fire Protection Maintenance.-ANNUAL . . � Places of Assembly-ANNUAL �� try emi �n t er ,- - n Sprinkler - �'` ❑ ❑ �;*;B � Recreational Bum � � ," - � Fire Alartn � ❑ ❑ ❑:�� ❑ Sparklers , Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes(SprinklerSys) � I � �� Fire Alarm Installation Torch Roofing/Tar Kettle ' � ''' Waste Tire Stora e i4NNUAL �� Fire Pumps � 9 �� Fire Warks �; Flammable Application-AtdNUAL ValUetlO�Of PfOJeCt '� Fuel Tanks • ; Other: � _. - - [:.s:�.l,"a'.'ti':i':..z,..,...:L�"�..__.v.".�'�':tr,''.u:�::.'.:S3:r.t ;t_iT'.�'-.�::.,'�';•,�'•:.:J"+�x-,'��„�.-"m..'TS',''`.�.3.TT'v:.,'u"`t:..'.3...a.,.'R"a.�.w"°.y,"a`i-:.:',�a......,.�"v�?�.�:W.i:'?gi^.�'�`�"'^�"'�'""'r,__ _..,a..'r'i--.....'�.,-'�"`.�.�:.'�.'::�'.'•�...,"'.'°.:";.'::�ZT_-^,>,...."".' Contractor � � ' Company Signature Registe�ed Y'/''N ` �Fee CuRenf� Y/N Address � � ` " � �L'icense# • - � ELECTRICIAN Coinpany - Signature 'Registe�etl" �°Y l N Fee'Gurrent` Y/N � • i Address � Cicense# � ' , „ � �,-_ PLUMBER • ' Company , .�� . �,`:, Signature Registe�ed Y b N, Fee Current Y/N.. ' i Address ' License# ' MECHANICAL - Company ' � � Signature Registered Y/N Fee Current Y/N ` ' � - • , i Address License# - , � OTHER Company � ' Signature Registered Y/N Fee Current Y/N , Address License# ' � E'ti��,: :�?.:�'."iti" _..,:..:.,c.�..nr�. ..__....,:.., t�..✓-_...:...r..,_...��,v.r_�.r_�;R.-.,_.k>:....-,..� �-�..._,:�.<:.,_....::.....:.�_-....,.-:_�.f.;,:�, �.. ...xt z,.._.=�a:s,_,....ra._.,,z>,,,._:,a,..-.,z.�..._.,..�`2::'��:.;::;�,:.x_i�;:: Direciions: f l^� � � � .. �'� 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) i i I, � ,�, s , NOTICE OF DEED RESTRICTIONS: The understgned understands that:this permil;may,be subject to"deed'restrictions" which-may,be more restrictive than County regulatfons. The undersigned assumes responsibility for complianee with_any _ applicable deed restricdons. ;t ' ' � UNC.ICENSED'CONTRACTORS AND�CONTRACTOR RESPONSIBILITIES: Jf the owner has hired a contractor or contrac'tors to undertake work,they may be required to be licensed in�accordance with state and local regulations. If the contractor:fs not.�icensed:as..required 6y law;bbth the ouiiner and cohtractor mey be cited for a misdemeanor violation under state law.�H the owne�oY iritended"contraetor are uncertain'as'to vvfiat licensing�equl�errienfs may appiy'for�the intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- 8009: �Furthermore; if the owne� fias Fiired a contreoto�`or-contractors,=he is advise8 to,have the cantractor(s) sign portions of the"contractor Block"of this appllcation fo[.which they will be responsible. if you,as the owner s(gn as the - contractor,tliat�may be.an ind9cation that Fie.ls not prope_rly licensed and is-not-entitled to permitting privileges in Pasco Counly.l. - - _ . TRANSRORTATION IMPACT/UTILITIES IAAPACT 14ND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impaof Fees and Recourse Recovery" Fees may apply to the�construciion of new bufidings,change of use in existing buildings, or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and 90=07;as'amended. The`undersigneii "also understands,that such'fees;as maybe d'ue;will.be Identifled at-the time of � permitling. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to ,-.. �ceiving a:'ceitifi,cate of occuqancy"or,firnat power release. if the project does not involve a certificate of occupancy or final power release,the fees must be paid prior to pe'rmit issuance. FurtFieRnore,�ff Pasco County Wate�%Sewer impact fees are due,they must be pald prior to permit issuance�in eccordance with:appiicable Pasco County ordlnances.. CONS�RUCTION LIEN;LAW,(Chapter 713,,Florida Statule5,as�mended): If valua6on of work is$2,500.00 or more,I ceriify that 1, the applicant,"have been pro'vided wRfi a iropy of tFie 'Florida Construcfton Lien Law—Homeowner's Protection Guide"prepared by the Florida Department,of.Agricullure and Consumer Aifairs. If the applicant is someone other than the'owner",I certify that I have qbtained a copy of the above"described document and promise in good faith to �.'' deliver it to the"owner"prior to cammencement. � � � � CONTRACTOR'S/OWNER'S AFFIDAVIT: I cerfify-that all.the:informalion in this applicatlon is accurate and that all work will'be done in complfance with all appli�ble laws regulating construction;zoning and land development. Application is hereby made to o6taln a permit to do wo�k and Ins4allation'�as"Indicated. i ccerUfy that no work or-�i�i'stallation�has ,y,.,.,.. commenced prior to issuance of a permit and that all work will be,performed,to meet;stand"arda:of all'leiivs regulaUng • construciion, County and City codes, zoning regulations,,and.;la.nd��levelopment regulatlons in the jurisdiction. I aiso certffy that I understand that the regulatfons oF otHer govemment agencies may apply to,the intertded worlc,a`nd•that it is my responsibility to tdentffy what actions I must iake to be in'compliance. Such agencles Include but are not Iimited ia: - � Department of Environmental Protection-Cypress Bayheads;VI►edand Area's and Environmentally'Sensftive Lands,WaiedWastewater Treatmerif:'" ' " ' �• ' - ' Souihwes! Florida Water Management -District-Welis; Gypress Bayheads, Wetland Areas, Altering - � Watercourses. , � Army Corps of EngineersSeawalls;Uocks,Navigable Waterways. ' - iDepartment of Health 8 Rehabflitetive Services/Environinental Health Unit-Welis, Wastewater Treatrnent, Septic Tanks. � � ' - US Environmental Protection Agency Asbestos abatement. �� Federal,Aviation;Authority;Runuways. '''�``=' t I understand that#Fie Tollowing restiictions<apply to the use of fill:• - - � Use of fill is not allowed in Fiood Zone N"unless expressty pertnitted. - , if tfie"flil rtiateiial is�to�be`used in Flood Zone 'A", ft is understood that a drainage Plen,addressing a ; 'compensating-volume"_will,�be submltted at time of.permitting which is prepared by a professional engineer - , i licensed by=the State,of Flontla. �� .'',,,. E - , .;.. ' . - ,IJf!he fill material is to be used in Flood Zone r A°.in connecttdn wftli a permitted build'ing using stem wall constructfon;:I c�_', .that�tll iivill be used only{o fll the,area wilhin the stem wall. , �Y.�..,.. - �, .If:-fllifma#etial__i_szto>�be.used�in`.any-area, 1 certify'that use:of.such._fill•wtll not:adve[sely affect adJacent , "properlies,...If use,of fll Is tound to adverseFy affect adjacent propertles,`the owner may be cited for vlolating �� the-conditions�of.the.tiuilding'pertnit:lssueil under the attached::permit-appllcation,for lots less than one(1) ' - acre.which,are..elevated byfill,:an,englneered dralnage.plan Is;requlred.� �"`` ` � �- ' 7' '";.. f�_ If 1 am the AGENT FOR:T_H'E�OWNER;I,proml'se,in good#aith,to lnform ttie awner of the permitting condRions set forth In this effldavft,pno�"to�commencing:construotion..�l understand�theCa separate:permlt.may..be;cequf[ed for electrical work, � _, plumbing, signs„wells,,po,ols, alr_.condltipning, gas, or other.:installaHons:nof'spedfiballyln`oluiled in the application. A . permlt issued"�tia'll be-constnied to be=a license to proceed with the work�and nof.as'authorltj�.to.violate,cancel,alter,or _ t� set aside any piovisions of ihe technical codes,nor shall Issuance of a permlt prevenf ihe Bulldirig OFfic(al from thereafter ' requlring a coirection of errors=ln plans;co'nstructlon or vlolaHons of any codes. Every permft Issued shall become Invalid ' unless the work eiitfiorized by such perrnit is;.00rtimenced within slx moMFis of pertnK Issuence,or.tF work auihorized by • � the permit is suspended or,abandoned.for_a_perio.d ot slx(6)�months after the time the work is'commenced. M extension - may 6e�r"equested,in viiriting;�ir'om the Buflding Ofliclal for a period,not to exceed nlnety.(90)days and will demonstrate justHiable cause for the extenslon. If work ceases for ninety(90)consecutfve days,�the job is consfdered abandoned: WARNING�TO'OIPVNER:-YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENTeMAY RESULT IN YOUR • PAYING TWICE FOR•IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT - WtTH YOUR CENDER�OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. F,L'ORIDAIJURAT(F:S::117.03)� . ' " .,� OWNER OR AOENT-�_.-�..... ." CONiRACTOR Subsalbed and swom to(or aftirtned)be(ore me thls Subavibed end swom to(or afttrmetl)6eiore me.thls ' bY,.,_. , . '` bY Who Islare personally knovm to me or haslhade produced Who Islere petsonally Imoum to me or hasThave produced as identlfioadon. as Ident�iwtlon. I ` il , � Notary Publlc NOTary Publlc , Commisslon No. Commisslon No. , _ . I _ Neme of Notary typed,printed or afsmped �Name oi NoNdry q�ped,pdnted or sfamped � I I