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Home My WebLink About18-20528 CITY OF`ZEPHYRHILLS - 5335-8TH STREET (813)780-0020 20528 ANNUAL ASSEMBLY PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20528 Address: 5855 16TH ST Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: CHURCH Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-05000-0010 Improv. Cost: OWNER INFORMATION Date Issued: 11/29/2018 Name: ST. ELIZABETHS EPISCOPAL CHURCH Total Fees: 50.00 Address: 5855 16TH ST Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/29/2018 Phone: Work Desc: PLACES OF ASSEMBLY- ST ELIZABETH EPISCOPAL CHURCH EXP 11/2019 CONTRACTORS APPLICATION FEES NER FIRE PERMIT FEES 50.00 I i s FIRE SITE INSPECTION-Final Inspection Re ' e 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 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 * , Permit Application Date Received Phone Contact for Permit Owner's Name S l Owners Phone Number Owner's Address n 6T 511 , 1 1�� '7 Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address Job Address Lot# Sub Division Parcel# OBTA NED--ROM:PR-_P_ RTY F--;—N-TL•E----- Fj Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL Controlled Bum Hood Installation Emergency Generator<30 kw LP/Natural Gas-Installatior Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL Qtrl Semi Anl Other Sprinkler ❑ ❑ ❑ Recreational Burn Fire Alarm ❑ ❑ ❑ Sparklers Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) Fire Alarm Installation Torch Roofing/Tar Kettle Fire Pumps Waste Tire Storage ANNUAL H Flammable Application-ANNUAL Valuation of Project Fuel Tanks Other: Contractor Company Signature Registered Y/N Fee Current Y/N Address License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License# OTHER Company Signature Registered Y/N Fee Current Y/N Address License# Directions: Fill out application completely. Owner&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) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit maybe subject to"deed"restrictions" hic wh may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any,,, applicable deed-restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or conteactors'to undertake work;the ma:'be re uired`fo be licensed in accordance with state and local regulations:]f tFie"" _. Y Y , q contractor is not licensed as required by,law,_both the owner and contractor'may be cited fora misdemeanor violation under state law. If the owner or intended`contractor-are uncertain as..to.what licensing requirements may apply'fo'rthe' intended work,they are advised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847- 8009. Furthermore, if the owner has liir'ed'''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 sign as the contractor,that may be an indication that he is not properly licensed and is not entitled to permitting.,privileges,In,Pasco County. TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands- that 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 specified in Pasco County Ordinance number 89-07.and: 90-07,as amended. The undersigned;also-understands,-that such fees,as maybe due;vAl-be identified at the time of permitting. It is further understood that-Transportation Impact Fees and Resource Recovery Fees must be paid:prior.to receiving a"certificate of occupancy"or final power release. If the project does not involve a;certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, If Pasco County Water/Sewer Impact. fees are due,they mustbe paid prior to permit iissuance.in accordance with applicable Pasco County ordinances: CONSTRUCTION LIEN.LAW(Chapter.713,Florida Statutes,as'arrtended):'If valuation of work is$2,500:00 ormbre,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. otherfthan 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 AFFIDAVIT::•I certify that all the information in this;application is accurate and that all?work will be done in compliance with all applicable.laws regulating construction,zoning and land development. Application is he made to obtain a permit to do work and,installation as indicated. 1 certify that no work or installation has commenced prior to issuance of.a permit 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 other government agencies may apply to.the'intended work,and that it is my responsibility to identify what actions I must take to be in compliance. Such'agencies include but are not limited to: Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sen°sitive Lands,WaterMlastewater Treatment i Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,'Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency=Asbesto's abatement. Federal Aviation Authority-Runways. I understand that'the•following.restrictions apply.to-the use of'fll: - • Use of fill:is not.allowed in`Flood=Zone"V"unlesiexpressly permitted. If the fill material is!to,be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating.voium,e°vi41"1"be.,submitted.at time of permitting-which is.prepared by a professional engineer licensed by the State of Florida. - If the fill mat erialjss-to'be used 2in,,Flood Zone "A".in-'connection with a permitted building using stem wall construction;I certify that fill will'be used only to'fill.the -rea-within the.stem wall. - If fill material.is to be used,in any area, I certify that use,of such fill will not adversely affect adjacent properties: If use of fill is found-to-adversely affect adjacent properties,the owner may be cited for violating the,conditions,of,the building permit issued under;the,attached permit application,for lots less than one(1) acre Which:are elevated'by fill;An-engineered drainage;plan is required. If I at the AGENT FOR THE OWNER, I promise in good faith to inform-the owner of the permitting conditions•set forth in this affidavit it prior_to,commencing construction. I understand that a separate permit may be required for electrical work; plumbing, signs, wells, pools, air conditioning,-gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with tthe 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 Building Official fromthereafter requiring a correction of errors in plans,construction or violations of any codes: Every permit issued shall become invalid unless the.work authorized bysuch permit is commenced within six months.of permit issuance,or if 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..Building Official for a period not:to exceed ninety(90)days and will demonstrate justifiable.cause for the extension. If work ceases for ninety(90)'corisecutive days,the job is considered abandoned E WARNING TO,OWNER:.YOUR;FAILURE_TO RECORD A NOTICE OF.COMMENCEMENT MAY,RESULT IN YOUR PAYING.TWICE FOR=IMPROVEMENTS'TO,Y6UR'P.ROPEIkTY.AF1 YOU INTEND TO';OBTAIN;FINAIdCING;ON WITHYOUR LENDER-OR AN.ATTORNEY.BEFORE RECORDING�YOU OTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) OWNER OR AGENT CONTRACTO S6bsorIb6d and swum to,(or afiimied)before me this Subscribed and sworn to(or aiflnneii)b fore me this bV Who is/are personally known to me or has/have produced Who Is/are personally known tome or has/haye produced as Identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary,typed,printed or stamped C