HomeMy WebLinkAbout17-18978 :� _ /, �
CITY C1F ZEPHYRHILLS �'
5335-8TH STREET
_ (sis��so-oozo 1897�
�- � ANNUAL ASSEMBLY PERMIT �
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18978 Address: 38545 5TH AVE
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: � p Parcel Number: 11-26-21-0010-15100-0140
Improv. Cost: ty`� OWNER INFORMATION
,� Date Issued: 10/24/20 7 ^ Name: CITY OF ZEPHYRHILLS
\ Total Fees: 5 0 Address: 5335 8TH ST
Amount Paid: 50. � �� ZEPHYRHILLS, FL. 33542
Date Paid: 10/24/201 Phone: �
Work Desc: PLACES OF ASSEMBLY-WOMANS CLUB OF ZEPHYRHILLS - EXP 10/2018 FEE WAIVE
CONTRACTOR S , APPLICATION FEES
FIRE PERMIT FEES 50.00
<;�
� I
l � �
� �
', . Ins ections Re uired
FIRE ITE IN PECTION-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
8�3aso•oo2o City af ZephyrhiNs Fire > Fax-al�-7so-oo2� �
Permit Appi9ca#ion
ate Received� �� � Phane Contact for Permit ���
.v;..z��:�g.,;s:?.s;:z:-;an::�,.._. ,�_�.. _..f....,.e._..l.r�,.:__.;-:�.:�'„•pa��.ec;:�;G:,e,.�.:�'m...�s:��"�-".r.��'�:�y�:;LL4=:.:i.,�;�:�ss_,�::'�'.�.`�..+:rs,'�'i�.s-:?'�£�s�.�';"";a.�"<_c,-�€.�;.aw.:.�.� �'—�:ati.,;s�'-f:..xm��
�wners IVame x f{��'._ �cj .s � �Gl.j � C�I� fZ �4 Owner's Phon�TJumber e�t� 7�� '?
nvner's Address ���`'`� �� A,���, <'�%� �C/���-� S �� �'�`�`� .
ee Simpte Titlehoider Name Titleholder Phone Numbet �� � ��
ee Simple Titleholder Address '
..,�,.ar.; .-��.< .�� �:_.,-r>.��._�,,.��.>.�.--;.._:_„�- -���,�:,,,� ;<�.. _�<�tt-.��:z.--�- - - _ - -
��..w.�k�' �..._ , . .. _. �`r.�...r.�`-:zY:-,:_;;�,._'. ,e.a..`�as.._,.�_..�p,�.>.z-K.=�4�-adt:i1'"x�`=`�5`... �..:iz�_'=.'"�u:��;-��.�•�"'-�%:«�-'„�%�:'�ra�:�-F:.?�'X'f�'�::".,.`':_°a
��,.a.;.,,...:_�.._,.3_..x ..,.as.�:.x,4z.��<.�.z.x.....,,..P-....._..a. �-y'�..S.,•m-'
�b Address � Lot# C�
ub Division Parcel#
wc-w ;.2.�.. -x.,�.�. ;roxr»-r:— - �.,e;:a-�.,:.z+'-i..w-.enysr »_r,.-��'"�w'>,-_'::r"r;:.^ bs;-'yz"-i.�..2:?'.�"'�-+''�- i.:i��"":_..�:S.�.Y"'�`zi'`v.:£".=`"..,M`..w.....'"...;'.."=.�''-�i:-'..�.:.,,.=��i=SF';:�`�`�3:e:...v...
.,.....:r...�.ar„rs'i?:-`,...:...-..-.a.�"�.+"�.-�t,ia?..�!'si.�:r_""_'c-.-.>_"`.w`�.,.....'��e=i�..�._i.,.�.aefa.....»..n....�..,..�...�..� .s....-. ...G . ..���.._�... . ,. ;a'
:°� � Bio-Hazard W aste Storage-ANNUAL � Fumigation Tent
� Gomm F�rhaust Kitchen Hood/Duct � Hazardous Materiai{Tier)1 or RQ Facitity}ANNUAL
r o Controlled Bum _ � Hood tnstalletion _
� Emergency G�enerator<30 kw ,� LPINatural Gas-Instatiation
oEmergency Generator>30 kw � LP/Naturai Gas-ANMUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-AtdNUAt '
,, Chr y em� � er p
Sprinkter � ❑ ❑ O � � Recrearionai Bum `?.
Fire Aiarm � ❑ ❑ � � � Sparklers
Hood Cieaning � � ❑ , ❑ ❑ � � SpnnklerSystem instailations
Hood Suppression � ❑ ❑ ❑ � � Standpipes{Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing/Tar Kettie ' �
�� Fire Pumps Q Waste Tire Storage AtdNiJAL ,
� �lammable Application-ANNUAL �-- , Valuation of Froject
� Fuel Tanks �
Q Other:
r,:��; ;.^.�+��. �..,n'-- �,-.s+ r---� _ x.�n;-�,,.�w-� �„tir.^.r:-wY:-:..��-�...,. � r r.� � .-=".�"y,»�':.� - - s^'"-^,:�'..'�..:.�...�-. �;•_•�`:—�.'�:�' -��-q„"
. ,'"-5w.». ,...i�r:a-'�:Ka.E::.a a:.�i>a.�,:s�-��s.,..:.«._. ,..A..w.:� a :=.l.w-'w";a�«e .a`i:.€s= . .`i:.=..+..x.:.:,_'�.�s`i�."`A"".�";:- -'`�`'�"--�..-..:i�'.:-�.,....--.=._ ..._..__..�ids�.-`:p.•" �:.' �✓..:'z»..-nw. -[.�_ t.�
:ontraotor - Company
�ignature J���2��..���� Registered Y/N Fee Current Y/N
Address Liosnse#
:LECTRICIAN ' Company
�ignature Registered -Y i[�) fee Curreni Y/N
Address License#
'LUMBER Company '
tignaiure�` Registered Y I 1d Fes Gurrent Y/R)
Address License#
AECHANICAL Company
iignature • Registered Y/1!1 Fee Current Y I�1
Address � � Lioense#
�
}THEF2 . Company '
iignature Registered Y J N Fee Current Y/N
Address License# I
u,..,..��,.. .. . ,_�..-:...._ ..s: ... .. :..::....... - - --_�� . , � �. , , .� 5. , �: _x:J:.�;��e=��.�,.�;,�_,�.,�r�:�..-����w:�.. �
.�..�.a:vs.-...e,.ar,.,,._..:z:,:_�_.,K,.,..W�.,.. .... .__ �.,... ,-r- .,.,,,.:.._���.._....�-.. .H., .,,...�_ _ .._ ..,. ��_.
�.._..,.- ,. �.w�.,:..:_:-;�..;-.,x._.,,. ��._,��:r,:wx_.:_�»�_���, ��.-.. ;_,-,
,,....-. �:<_,�.T-.h...��--��-L
�..,�,�..ss,.�. _:�.�, ' ,. , r ....-:,<:._,�:>,<.z..,:�.-^ t�:,-
)irections:
Fill put application completely.
OJmer&Contraotor sign back of applicatipn,nofarized{Or,capy a#signed contract with awner}
" it over$250d,a Natice o!Commencement is required{fUlechanical wor4c over$5000)
� Supply two.(2)sets of drewings with appliaable documentation ' �
Allow 10-14 days for review after submittal date. Parcei#-obtained from Property Tax Flotice(httpJJappraiser.pascogov.com}
� �__.._. _ l���..� 1�,,�,, „ v".�, �-��'..9'- - _. __ �.� -
�� -- 1 �'�, ��' � .
N017CE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed°restrictfons'
which may be more restrict(ve than Caunty regulatlons. The undersfgned assumes responsib(lity for compliance with any
appiicabie deed restrictlons.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or a,
contractors to undertake work,they may be required to be Itcensed in accordance with state and local regulatlons. If the ' '
contractor is not licensed as requfred by law, both the ov►mer and contractor may be cited for a misdemeanor violaUon
under state law. If the owner or Irrtended contractor are uncerlafn as to what licensing[equirements may apply for the
intended work,ihey are advised to contact the Pasco County Buildln8 Inspection Divislon--Licensing Section at 727-847- • '
8009. �u►thermoie; if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block°of this application for which they will be responsible. if you,as the owner sfgn as the
contractor,that may be an IndicaBon that he Is not properly Iicensed and Is not enBtled to permiNing priv(leges In Pasco • .
County. • '
TRANSPORTATIOPI IMPACTNTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersfgned understands
that Transportetion Impact Fees and Recourse Recovery Fees may appiy to the construction of new bufldings,change of
use in exisring bufldings,or expansion of existing bufldings,as specified in Pasco Cot�nty Ordinance number 89-07 and
80-07,as amended. The understgned also understands,that such fees,as may be due,will be Identified at the 8me of
permitting. It is furlher understaod that TransportaUon Impact Fees and Resource Recovery Fees must be paid prior to
receiving a'certificate of occupancy"or flnal power release. If the project does not invoive a cert'rficate of occupancy or
final power release,the fees must be paid prior to permit Issuance. Furthermore,If Pasco County WatedSewer Impact
fees are due,they must be pald prior to permft Issuance In eccordance with applicable Pasco County ordfnances.
CONSTRUCTION LIEN LAW(Chepter 713,Florida Statutes,as amended): If valua8on of work Is$2,500.00 or more,I �
certifjr that I, the applicant, heve been provided wHh a cqpy of the 'Florida Constriicdon Lien Law—Homeowners �
Protection Guide'prepared by ihe Florida Departrnetrt of Agriculture and Consumer Aifairs. If the epplipnt is someone
other than the'owner°,I certify that 1 have obtained a copy of the above described document and promise in good fafth to '--
deliver ft to the'owner"prior to commencement. '
CONTRACTOR'S/OWPIER'S AFFIDAVIT: i certify that all the information In this application is accurate and that all work
�nn'll'be done fn compliance with all applicable laws regulating construction,zoning and lend development Appiicatlon ts
hereby made to obtafn a permit to do work and instellation�as indicated. I ceriffy that no work ar instsllatlon has
commenced prlor to issuance of a pertnit and that all work wlll be performed to meet�standards of all laws regulatlng
construction, County and City codes, zoning regulaUons, and land development reguladons in the jurisdfctlon. I aiso
certify that I dnderstend that the regulatlons of otFier govemment agencies may apply to the intended work,and that it is
my responslbllity to Identity what actions I must lake to be in compllance. Such agencies tnclude but are not IlmHed to:
- Department of Environmental Protection�ypress Bayheads, YVeUand Areas and Ern(ronmenteily Sens(Crve '
Lands,WatedWesiewaterTreatmenk '
- SouthwesE Florida Water Management District-Welis, Cypress Bayheads, WeUand Areas, Altering i
Watercourses. �
- Army Corps of Engineers-Seawalis,Docks,Navfgable Watervvays. I
- Department of Health & Rehabllitetive Servtc:es/Envtronmental Heaith Unft-Wells, Wastewater Treatment,
Septic Tanks. •
- US Envlronmental Protectlon Agency-Asbestos abatement
- Federal Aviation Authority-Rurnvays.
I understand thet the following resMctions appty to the use of flll:•
- Use of ftil is not aliowed in Flood Zone'V'unless expressly permitted.
- If the flll materlal (s to be usad in Flood Zane "A, it Is understood that a drainage plan address(ng a �
'compensating volurrie'will be submitted at dme of permitting wh(ch is prepared by e proFessional engineer . •
- 1(censed by the State of Florida.
- tf th�flll material is to be used in Flood Zone'A° In connec�tion wllh a perm�ted bullding usfng stem wail
� constrtiotfon,I certify that flll will be used only to flll the area wftitin the stem wall.
- If.flll material is to be used in any erea, I certify that use of such fill wlll not adversely affect adjacent
propertfes: If use of fill is found to edversely affect adjacent properties,the owner may be cfted far violetfng •
the conditions aF the butlding permit issued under 1he attached pertnft appllcatlon,for lots less than one(1)
acre whlch are elevatetl by flli,an engineered dralnaae plan is required.
If I am the AGENT FOR THE OWNER,I prbmfse in good fafth to inform the owner of.the permitting conditions set forth in
this effidavtt prior to commen�ing construction. I understsnd that a separate pertnit,may be requfred for electricel work,
plumbing, signs,v�rells, poois, afr cond�ioning;gas, or other InstallaBons not specffically induded in the application. A
permit issued shall be construed to be a license to proceed wRh the work and not es authority to,violate,cancel,alter,or
set eside arry provls(ons of the technical code's,nor shall Issuartce of a permlt preverrt the Bufldirig Official from thereaRer
requlring a correction of�rrors In plens,construction o�violaUons of arry codes. Every permft Issued shall become irnalid
unless the work euthorized by.su�h permit is commenoed vu(thin sbc mordhs of permtt Issuance,or ff work aulhorized by
the permit(s suspended or abandoned for a period of six(6)months after the Nme the work is commenced. M extension
may be requested, In wrfting,from the Building.Official for a perfod not to exceed ninety(90)days and wlll demonstrate
Justf�able cause for the extenston. if work ceases for ninety(9U)consecutive days,th\job is considered abandoned. •
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING 7WICE FOR IMPROVEMEM'S TO YOUR PROPERTY. IF YOU IfJTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
FLORIDA JURAT(F:S.117.03) •
ONINER OR AOENT CONiRACiOR
Subsalbed end exam to(or efHrtned)before me this Subavlbed end swm to(or eflirtned)befote me Cds
by by
Who Ware personefly ivwwn to me or hasThave produced Who Islate petsonally imovm to me or has/have produced
as identlficatlan. as Idendfi�a8on.
Notary Pubilc __ Notary Public
Commisslon No. Commissfon No.
Name ot Notary typed,pdnled or slamped �Name of Nolery p�pad,prirded or stemped
i