HomeMy WebLinkAbout17-18944 CITY OF ZEPHYRHILLS
5335-8TH STREET
,. • .ti tsis)�so-oa2o 18 4
ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18944 Address. 6251 FT KING RD
Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: F1RE-PLACES OF ASSEMBL.Y Township: Range: Boak:
Propased Use: CHURCH Lot(s): Block: Section:
Square Feet: Subdivisian: CITY OF ZEPHYRHILLS
Est. Vaiue: Parcei Number:
Imprav. Cost: OWNER INFORMATION
Date Issued: 1011712097 Name: THE ALLIANCE CHURCH
Total Fees: 50.00 Address: 6251 FT. KING RD
Amount Paid: 50.Q0 ZEPNYRNILLS, FL. 33542
Date Paid: 10/17/2017 Phone:
Work Desc: PLACES OF ASSEMBLY-THE ALLlANGE CHURCH - EXP 10/2018
CONTRACTGIR S APPLICATION FEES
O ER F E PE IT F S 50.00
�
_ �
��
�
i
Ins ectians Re uired '
FIR SIT NSPE ION- inal
CICCUPANCY LQAQ:
Occupancy I�y more than the number of persons above shatl be considered
dangerous and unlawful. Occupant load determined by Flarida Fire
Preventian Cade, NFPA10l, Section 7.3.i.2
PERMIT OFFIC
PERMIT EXPIRES IN QNE {1) YEAR FRaM DATE OF ISSUANCE
THIS PERMIT NEEDS TO BE POSTED IN VISIBLE LOCATION IN MAIN ASSEMBLY AREA
ZEPHYRHIL.lS FIRE RESCUE DEPT - G9a7 Dairy Rd, Zephyrhitts, FL 33542
$��-�aa-oo2a Cify of Zephyrhilis Fre Fa�c-813-780-4421
Permit Applicatian
s •
� Phone Contact for Permit
ate Received �
ti;'�t.`�_'"-:���-'.��:'s.�3�-x„3£.'.��:.s��--a�.;.�_...rn��.��1:::@:>'s:w'"-.''w��:�l,«.:;.=a-_"..,�nx'x..n�'.isL::�,a'._,,;x,:.:r'i.�..:.�'�^�.'�3.i7".`z;`�_d.Y.;s'v..°:�f.i.t".'•�.xa.�.�:rx's°::���•vx_,.��.-�..�»,�.rs+r.:s..K:..:xa-;'.,:.Y... ...,.a.� ...
,.... _�fr_. �..':�r^�_d-'x", :,s�
nvners Name (`r r� �,.�'t�� �.� z� .Z � Owner's Phane tdumber �� � ��
nnmer's Address �� 1 �'�- f�i n ,/'Q +ac� �
ee Simple Tittefiolder Name TiElehalder Phone Number �� �� �_�
ee Simple Titieholder Address '
„�_� -���� - �-.�r - ���...� _ - ,.x,-•��._ -��-,:,,�� ,-.�-:�..,,.�:�:.-=-�����_ ��.� R.:h��..�:
F�.'{'ii.,r.:_.-.:�Y-��°',c'y.1w`=t`s'.v. �<'_�%s:�-....�-=s.^"1.`s�:`�.'�'��.���:���..�:�-'»..%��w::F.:=s:��.e.: v.s,.;s-:,+'�`�.c. �..u:�".«.,-�i�x�.... - '�.'s�i�,.'^r,'��.=v r`'.�°i'�"-�`-".,_:.,.,.�� -z.rz. - ...:..,..'�"''...!'.ry*.'t�s.:;:.r,�s,N..,.�.;.t::-s_.s��_.a....:�='�i
�b Address � Lot# O
ub Division Parcel#
_ m�:K:_..,w,n;rw.::, _�..�,.-.t.. :r.� ,:s-�;�-^w.rFr.-,>d:.av..-�...-_r,.'^-Y. TM',�^r�-� _ �..,;.�., ':%�:d... �...,..'c•e'"�„f'?trx -:*,i.":..1'".,..--',^,-„„.x:��
;=iti:'<�i�'ai.w3�:�=.�.:.,..�,._...-n-9 a..:.K..,..,:.n..,...,._�ru_iw x..�"''•`.Y..-,t�.rw�,...::;�+.......,.�,.._-Wwa....x.,�.�..a,...,..�ik<»-.:"'...:a.-....,.:.�'��.._,..s��'�....,-.:i::r.v.:�:.�...�.._r�...�..'cB":.:�,,,.s.u.+_...,.v_..«.v.T^�'�?=� .,.a...........:.....y.`4.s�..--"`�i..;:
Q Bio-Hazard Waste Storage-A1dNUAL � Fumigation Tent
Q Comm Exhaust Kitcfien Hood/Duct � Ftazardous Material{Tief tt ar RQ Facili#y}ANRtUAL
„ � Control�ed Bum � Hood tnstatlation _
� Emergency Genarator<30 kw � LP/hlaturat Gas-installation
QEmergency Generator>30 kw � LP/Naturai Gas ANRiUAL Sale
Q Fire Protecttan Maintenance-ANNUAL � Places of Assembiy-AAITdUAI
� em� � er ����(��
Sprinkier � ❑ ❑ Q � � Reorea6onal Bum
Fire Alaarr � ❑ ❑ [3 C� � Sparklers
Hood Cieaning � LI , ❑ O � � Sprink(er System Instafiatians �1,-� j 1 t,r A��
lti,,. ��t���•
Hood Suppression � ❑ d ❑ � � S#andpipes(Sprinkter Sys)
Q Fire Alarm Instailation � Torcfi Roofing/Tar Kettte '
� Fire Pumps � Waste Tire Storage ANNll6lL ,
� Fiammable Application-ANIdUAL ��— � Valuation af Project
� Fuel Tanks
Q Other:
��'h,: �W.:..:J�' YCr`.i�.a.y�.. �.a•..4� s ^aYSY=s;�+*i.-sRW�s>...eF.�'F _ - vav,S.+., �—,-�r�yw'i-'�Jv.r.:..�-.r—M-a9:"�"a-�"'='[�='•-s` - - <.u^'y'. "siF{':
;',n.i-vx;:.t.3.,..,....:.r�=.t�.a:��e`ri.,_."..`�..r.r.,.,,:��.�`�:'.:. ..,.,..:..�;�!_a,Y..°..�:3-".n�`s`�.`.��.:::.ti�.;......u.t�,.»4,.s..«....,__ .kw`'"`'w..`�u's'w-....�.�.,.,�vzFa....,...,o..-.�...._.._.....,..}...-.. ,�...._.�,�. ..-....�.w"zi.'r`�.: . -.-„:.�"3::;3�=::......._..r�::�i,`.....»
:onVacfor / Campany
s'sgrrature ` `b y�""'" Registered Y/N Fee Current Y/IV
Address Lfosnse#
:LECTRiCiAN Gompany
4ignature Registered �Y/N Fee Gurrent Y/N
Address Llosnse#
'LUMBER Company
�ignature Registered Y 1 N Fee Cu�ent Y/N
Address License#
AECHANICAL Company
tignaiure • Registered Y/N Fee Current Y/(11
Address License#
)THER Company
iignature Registered Y 1 N Fee Current Y I fid
Address License#
"✓^.'X•. � __ - _ " _- •�':"... a4uY-, ___ - `.:K-'r _. .- .
x.`e.uzs�...Fr r.y,-.. . �� _ v - .� - 'i
.. asr�.�.,. .Ys"��a.:.F. -G:�;H'.•,,:�?:.*r�wa.�.'�R....�.,:��:rx...-..._,._.........,...__.....: __..a_..._b...__...-sa�:,z��.,�=...xr.�z�..,- .�...,-..._e..o.A_.,__ ._.:._,.. ..�.......,e ,.»�.-...�.,,..r..�i'.3.a.�-�.a;.,-.e�=G`3;.::'r.zits;eS-.....a3�':;��,4,s`�.rc.'ie�':...
)irections:
Fill out appticatian completeiy.
Owner&Contrac#or sign back of appticatian,natarized{Or,copy af s9gned cantract with ovmer)
!f over$250p,a Noiice of Commencement is required{Mechanical work over$5000)
Supply two(2)sets of draovings with applicable documentation
Atiow 90-14 days for review after submittal da#e. Parcei#-obtained trom Property Tax Notice(httpJtappraiser.pascogov.com}
NOTICE OF DEED RESTRICYIOMS: The undersigned understands that this permit may be subject to"deed'restrictions° �
which may be more restrict(ve than County regulaHons. The undersfgned assumes responsibllity for compliance with any
applicable deed restrictfons.
UNLICENSED CONTRACTORS AIdD COMTRACTOR RESPONSIBILIIIES: If the owner has hired a contractor or � " •�
contractors to undertake work,they may be required to be Iicensed in accordance with state and local regulations. If the
contractor Is not licensed as required by law, both the owner and contractor may be clted for a mfsdemeanor violatfon
under state law. If the owner or Intended contractor are uncertaln as to what Iicensing requirements may apply for the
lntended work,they are advised to contact the Pasco County Building Inspection Divislon—Licensing Section at 727-847- • ''
8009. Furthermo�e; if the owner has hired a contractor or contractors, he is advised to have the corrtractor(s) sign
portfons of the"contractor Block°of this application for which they w111 be responsible. if you,as the owner sign as the
contractor,that may be an indication that he Is not properly Ilcensed and Is not en8tled to permi�ing privlleges In Pasw • �
County. • '
TRANSPORTATIOf�IMP/RCTNTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation impact Fees and Recourse Recovery Fees may apply to ihe construction of new buildings,change of
use in exisHng buildings,or expanston of extsting bufldin8s,as specified 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 Identified et the time of
permitting. It fs further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a'certificate of occupancy"or f�rral power release. If ihe project does not involve a certiflcate of occupancy or
final power release,the fees must be paid prior to pertnit Issuance. Furthermore,if Pasco County Water/Sewer Impact
fees are due,they must be pald prior to permft issuance ln eccoNance with applicable Pasco County ordinances. ,
CONSTRUCTiON LIEN LAW(Chapter 713,Florida Statutes.as amended): If valuation of work is$2,500.00 or more,I
certify that I, the appilcant, have been provided with a copy of the 'Florida ConstrucNon Lien Law—Homeowner's
Protection Guide'prepared by the Florida Department of Agriculture and Consumer Aifairs. If the eppll�ant Is someone _
other than the'owner°,I certify that I have obtafned a copy of the above described document and promise in good faith to -�-
deliver tt to the'owner"prior to commencement. •
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certity that ail ihe Informatton In this application is accurate and that all wark
wn'll'be done in compliance wfth all applicable laws regulating construction,zonfng and lend development Application is
hereby made to obtafn a permlt to do work and Installation as Indicated. I certify that no work or Installation has
commenced prlor to issuance oF a permit and that all work will be perfortned to meet standards of all laws regulattng
• construction, County and City codes, zoning regulations, and land development regulations in the jurfsdiction. 1 also
certify that I dnderstand that the regulatfons of otHer govemment sgencies may apply to the intended work,and that it is
my responslbllity to identify what act(ons I must take to be in compliance. Such agencles tnclude but are not IlmRed to:
- Department of Environmental Protection-Cypress Bayheads, WeUand Areas and Environmentelly Sensitive
Lends,WaterNVestewater Treatment '
- Southwbs4 Florida Water Management District-Welis, Cypress Bayheads, WeUand Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalis,Docks,Nevtgable Watervuays.
- Department of Health & Rehabllitetive Servtc:es/Envirorilnental Heaith Unit Wells, Wastewater Treatrnent,
Septic Tanks. •
- US Environmental Proteclion Agency-Asbestos abatemenL
- Federal Aviation AutNority-Rurmrays.
I understand that the follouving resMcttons apply to the use of fill:•
- Use of flll is not allowed in Flood Zone'V'unless expressly permltted.
- If the flll material fs to be used in Flood Zane "A", it is understood that a drainage plan addressing a
'compensating volume"will be submitted at Hme of permitting which is prepared by a professional engineer . •
• iicensed by the Stete of Florida.
- If th�flll materfal is to be used in Flood Zone'A° in connecfion with a permitted building using stem wall
� construbtion,I certffy that fill will be used only to flll the area within the stem wall.
- If.fill material is io be used in any erea, I certffy that use of such flll wlll not adversely afFect adjacent
properties. if use of fll Is found to edversely affect ad)acent properties,the owner may be cRed for violating
lhe condiiions of the building pertnit issued under the attached pertnR appllcatlon,for lots less than one(1)
acre which are elevated by flll,an engineered drainage plan fs required.
If I am the AGEt�iTT FOR THE OWNER,I promise in good failh to inform the owner of tha pertnitting cond�ions set forth in
this effidavft prior to commancing construction. I understand:thet a separate permit.may be required for electricel work,
plumbing, signs,wells, pools, air conditioning,gas, or other Installations not specifically induded in the applicaUon. A
permft issued shall be construed to be a license to proceed v�ith the work and not as authority to,violate,cancel,alter,or
set aside arry provisions of the technical code's,nor shall issuar�ce of a permft prevent the Bulldirig Officlal irom thereafter
requiring a correotion of�rrors In plans,construction or vfolaUons of any codes. Every permit Issued shall become irnalid
uniess the work euthorized by.such permft is commenced withln six mordhs of permft issuence,or ff work authorized by
ihe permit is suspended or abandoned for a pariod of six(6)months after the time the work is commenced: M extension
may be requested, In writing,Trom the Building.Officlal for a period not to exceed ninety(90)deys and will demonstrate
Justifiable cause for the extension. if work ceases for ninety(9U)consecutive days,th�]ob is consfdered abandoned. •
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT NiAY RESULT IN YOUR
PAYIt�fG 7WiCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEHT.
FLORIDA JURAT(F:S.117.03)
OWNER OR AOENT ��A�TOR
Subscrlbed artd swom tn(or affirtned)before me this Subseibed snd s�wm 10(or atfirtnad)beTote me thLs .
�, by
Who IsYare perconaily krwwn to me or heNhave produced Who Is/are personally Imown to me or hasfieve produced
as iden9ficadon. es Identlfi�aBon.
Notsry Public Notary Pubtic
Commisslon No. Commission No.
Neme oi Notarylyped�Pdnted or stemped �Name of Notary typed,prirrted or stamped
i