HomeMy WebLinkAbout16-17998 . _ � CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 17998
ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit �elumber: 17998 Addres�: 7839 GALL BLVD
Perni 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:
Squ�ire Feet: Subdivision: CITY OF ZEPHYRHILLS
Es�t. Value: Parcel Number: 34-25-21-0010-01700-0010
Impr�v. Cost: OWNER INFORMATION
Date�� Issued: 12/14/2016 Name: NILKANTH HOTEL LLC
Totial Fees: 50.00 Address: 7839 GALL BLVD
Amoa�nt Paid: 50.00 ZEPHYRHILLS FL 33542
D�ite Paid: 12/14/2016 Phone:
W�,rk Desc: PLACES OF ASSEMBLEY MICRO HOTEL-EXP 12/2017
C � NTRACTOR S APPLICATION FEES
FIRE PERMIT FEES 50.00
. �
?V
Z �� ,
�
Ins ection Re ired
FIRE SIT INSPECTION-Final
OCCUPANCY LOAD:
Oc�upancy 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 Mls►IN ASSEMBLY AREA
ZEPHYRHILLS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FL 33542
aaa- sa-oo2a City of Zephyrhills Fre Fax 813-78Q-002'!
�, . Permit Application
Date Rec �— � Phone Cantacf far Permit ��j�� �n� �2-�-�
�'^' ...._. ->�,:,, .,_...... �..�.-_s.�-......,__...._.s...,.�.._�. ,��r.:�_.�...�__�.__s:�-�_:r�-....�..w.�_�rw..�.�..._..__�...x.....�...�-.�....s_=....._. �.. �
er's ame - 4�� ���'1 �� ., f�"��1��� �-�"'� Owner's Phone t3umber s�'+� �p� 0�'�'t
er's Addressl O� �W V� � G✓C. fl YVl, �� � 'T'�-- 3� S �'1 ( �
Fee Simple Title older Name Titleholder Phone Number [_�_� � �
Fee Simpte Tittel older Address
(i�-�,..'�.:....�_....,....:...�.:._ '"."'�`-,.."�...�a.�--- - .�`..;="n.^- '�..'"T'....:."".":.... w�':7U:w.>.'�"�.--._�".:''"'�-.-.,���-,.'�".L:....i�.:.,`'"":.�:�'.'�:.`?;�;�.."—�:,".��.x�._�����.'.:��».�."..�....�::::?..""","_�"--:......�o__ �. , ._;....,.
Job Address � 1 fJ� -} ��j�d�.—��. -� I �u�� ��Y 1'!Y 1�/��� � .�'�...�j.�'J�1l�r Lot# �
l...
f
Sub Division Parcel#
G:::.:..�._.�.,.-,..,. ___--.,_:k_�:..-_���,.�:...,_.��.....�j._�.�......�_.�_.,�.�..-�—��:...__r_o-.__�___�_..�.�..�._ .._._�,����.�...,�._.. , �.���...�_Y�.��..�.,_--
�� Bio-Hazard Waste Storage-ANNUAL Q Fumigation Tent
Q Comm Eathaust lfitchen NaodlDuct o Hazardous Material{Tier 1!ar RQ Facility}ANNUAL �C�
�� v
Q Controlled Bum Q Hood Installation `
� � Emergency Generator<30 kw o LPINatural�as-tnstallation � �
� �� Emergency Generator>30 kw /Nataral�Gas-ANNU�AL��Sale
Fire Protectian Maintenance-ANNUAL Piaces of Assem ly-ANNQAI [�
( �ry emi `A�n er e �� j J
Sprinkler � ❑ C� ❑ / ecreational Bum ��� ��
Fire Alarm � ❑ ❑ ❑ , � � Sparklers
Hoad Gleaning � ❑ ❑ ❑ � � Sgrinkler System tnstallations
Hood Suppression � ❑ ❑ ❑ C� � Standpipes(Sprinkler Sys)
QFire Alarm Insta{lation � Torch Raofing(Tar Kettie �
� Fire Pumps - Waste Tire Storage ANNUAL
� Flammable Appiicatian-APiNUAL �--� Valuation af Project
� Fuel Tanks
otn��:
_.,v ��.�.�._�w„e-..,.._,�,__n_..�...��r�.�-�::��.�.,. ..�r. . -.�,�� -� -
.._._. .. ...�.��.-_... -���..--��,.,��.
�^'>..�...�.�. ,,.�u,.�:�. _-__.�- �..���,.M�' . .�__.�,..�..._
�... ��.-..>.F.,,.-�>�-� .. -
�;. _._ .,.... ._...�.._.,... tz.,<,. ... _..� _�,x._.�_uw..w...�,_ ,u ,._.r. _ . _>.,.�,..._._. ...._,.....
ontractor Campany
Signature Registered Y/N Fee Current Y/N
ddress G License#
ELECTRICIAN Company
• Signature Registered Y/N Fee Gurrent Y!N
Address � License#
PLUMBER Company
3ignature Registered Y/N Fee Current Y/N
Address ( �icense#
MECHANICAL I Company
Signature Registered Y 1 N Fee Gurrent Y(N
Address License#
r
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
I'"",-'�'"ti..x'..�' :_._......_-�-__::n,.ti _,---.,a....w,.....__�.,......__,..._..,...._......ic�_,...._..._..,3_m<:.__,..,....�.r,..�....s.,...__.v�_....�...�...�._�...._.�-.�__„___,._.�-�....,.�,.�....-.,,.,wtr..»T.w.....,.,..._w.,.�........�.:t.s�:,...v,.,r:�...�._._-"`�..'""i
�. �_c.�.:.k..,.. .m. .:.. ,:,sar aa,. .,.; , . ;�..,.. ... ..... ... .
DIf8Ct1011S: +
FiII out applicatian compietely.
Owner&Contractor sign back of application,notarixed(Or,copy of signed contract with owner)
1f over$2544,a Notice of Commencement is required{Mechanical work over$5040)
Suppty two(2}sets of drawings with appticable dooumentation
Allow 1 D-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.00m)
i'
'_ -
PIOTICE OF DEED R�STRICTIONS: The undersigned understands that this permit may be subject to"deed°restrictions"
whlch may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed.restrictions.
UNLICENSED CONTRACTORS A4ND CONTRACTOR RESPOfdSIBILITIES: If the owner has hired a•contractor or
contractors to undertake work,they may be required to be ilcensed in accordance with state and local regulatfons: If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor yiolation
under state law. If the owner or intended contractor are uncertain as to what licensfng requirements may apply for the ,,
intended-work,ihey 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 contractbr(s) sign
porlfons of the"contractor Block"of this appl(cation for which they will be responsfble. If yau,as the owner sign as the
contractor,that may be an indication that he Is not properiy Ilcensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES:-The undersigned understands
ihat Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings,or expansion of existing buildings, as spec�ed in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,will be idenfrfied at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
recetving a°certificate of occupancy"or iinal power release. If the project does not invoive a certificate of occupancy or
final power release,the fees must be paid prfor to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance In accordance with applicable Pasco County ordinances.
CONSTRUCTIOPI LIEN LAW(Chapter 713,Florida StaYutes,as amended): if valuaGon df work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the °Florida Construction Lien Law—Homeowner's
Protection Guide°prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone __
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the°owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVI4: I certify that all the fnformation in this application is accurate and that all work
will be done in compliance with all applicable laws regulating consUucUon,zoning and land developmenL Application is
hereby made to obtain a permit to do work and installation as ind(cated. I certffy that no work or installatfon has
commenced prior to Issuance of a pem►it and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning,regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of ottier govemment agencies may apply to the intended work,and that it is
my responsibility to identify what actions I must take to be in compiiance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, VNetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment. '
- Southwest Florida Water Management District-Welis, Cypress 8ayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of EngineersSeawalls,Docks,Navigable Waterways.
- Department of Health,8� Rehabllitative Servfces/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental ProtecUon Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of flll:�
- Use of flil is not allowed in Flood Zone`V°unless expressly permifled. .
- if the fili material is to be used in Flood Zone "A", (t is understood that a drainage plan addressing a �
°compensating valume"will be submitted at time of pertnitting which is prepared by a professional engineer '
licensed by the State of Florida.
- If ihe fill material is to be used in Flood Zone°A° in connectian with a permitted building using stem wall �
construction,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 fill will not adversely affect adjacent
propertfes. If use of fill Is found to adversely affect adJacent properties,the owner may be cited for violating
the conditions of the building pertnit issued under the attached permit application,for lots less than orie(1)
acre which are elevated by flll,an engineered drainage plan is required.
� If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permltting conditions set forth in
this affidavR prior to commencing construction. I understand that a separate permit_may be required for electrical work,
plumbing, signs,welis, pools, air conditloning, gas, or other InstallaUons not spec�cally inctuded in the application. A
pertnit issued shali be construed to be a license to proceed wfth the work and not as authority to.violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall Issuance of a permit prevent the Buildirig Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit Issued shall become invaNd
unless the work authorized by such permlt is commenced within six months of pertnit issuance,or ff work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Build(ng Official for a period not to exceed ninety(90)days,and will demonstrate
justifiable cause for the extension. if work ceases for ninety(90)consecutive days,th,job 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F:S.117.03)
OYYNER OR AGENT CONTRACTOR •• `
Subsalbed and svuom to(or atflrmed)before me Ihis Subsalbed and swom to(or affirtned)before me this
by bY
Who Is/are personaily knovm to me or hasRiave produced Who Is/are personally Imown to me or has/have produced
asidentlficaBon. asidentificaBon.
Notary Public Notary Publlc
Commission No. Commisslon No.
Name of Notary typed,printed or stamped � Name of Nohary typed,printed or stamped
�