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Home My WebLink About18-20708 CITY OF ZEPHYRHILLS 5335-8TH STREET: (813)780-0020 20708 ANNUAL ASSEMBLY PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20708 Address: 5444 4TH ST 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: Parcel Number: 11-26-21-0010-06300-0110 Improv. Cost: OWNER INFORMATION Date Issued: 1/22/2019 Name: CHURCH OF CHRIST Total Fees: 50.00 Address: 5444 4TH ST Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 1/22/2019 Phone: (352)424-0144 Work Desc: PLACES OF ASSEMBY- CHURCH OF CHRIST- EXP 1/2020 CONTRACTORS APPLICATION FEES WNER FIRE PERMIT FEES 50.00 FIRE SITE INSPECTION-Final Ins ections Required 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 --------- _�_� Owners Name r� \ Owner's Phone Number Owners Address f'!'C`�/C Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address �,, •�, Job Address Lot# Sub Division Parcel# '----- Blo-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RO Facility)ANNUAL Controlled Bum Hood Installation Emergency Generator<30 kw LP/Natural Gas-Installation aEmergency Generator>30 kw LP/Natural Gas-ANNUAL Sale 0 Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL (� ❑ ❑ ❑ ❑ ®y 111 ® er t "U em Sprinkler Recreational Bum 0 Fire Alarm ❑ ❑ ❑ = Sparklers Hood Cleaning ❑ ❑ ❑ = Sprinkler System Installations Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) Fire Alarm Installation = Torch Roofingfrar Kettle Fire Pumps E-1 Waste Tire Storage ANNUAL Flammable Application-ANNUAL Valuation of Project Fuel Tanks 0 Other: 2-S / Contractor '///n Company C( Signature �G'' Registered Y/N Fee Current Address License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature F Registered I Y/N Fee Current Y/N Address License# MECHANICAL Company Signature F Registered Y/N Fee Current Y/N Address License# OTHER Company Signature- Registered Y/N Fee Current 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(httpl/appraiser.pascogov.com) I NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to'deed"restrictions' which 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 contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law,both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work,they are advised to contact the Pasco County Building Inspection Division-1 Licensing Section at 727-847- 8009. Furthermore, 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 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 IMPACT/UTILITIES 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 may be duel will 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 Paso County Water/Sewer Impact fees are due,they must be paid prior to permit issuance in accordance 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 applicant, have been provided with a copy of the 'Florida Construction Lien Law—Homeowners 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'SIOWNER'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 ia�d development. Application is hereby made to obtain a permit to do work and installation as indicated. I 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 Area and Environmentally Sensitive Lands,WaterlWastewaterTreatment. Southwest Florida Water Management District-Wells, Cypress Bayheads, Welland 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-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone"V'unless expressly permitted. If the fill material is to be used in Flood Zone'A', it is understood that a drainage plan addressing a 'compensating volume'will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone'A'in connection with a permitted building using stem wall construction,I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, 1 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 1 am the AGENT FOR THE OWNER,I promise in goad faith to inform the owner of the permitting conditions set forth in this affidavit 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 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 Building Official from thereafter requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such 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)consecutive days,the 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) OWNERORAGENT CONTRACTOR Subscribed and sworn to(or affirmed)before me this Subscribed and swom to(or affirmed)before me this by by I Who Islare personally known to me or hasfhave produced Who Islare personally known to me or haslhave produced as identification. I as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped i