HomeMy WebLinkAbout18-20132 CITY OF ZEPHYRHILLS
w 5335-8TH STREET
(813)780-0020 20132
ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION = LOCATION INFORMATION
Permit Number: 20132 Address: 38634 CR 54
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: 02-26-21-0000-01400-0000
Improv. Cost: OWNER INFORMATION
Date Issued: 8/20/2018 Name: FAITH BAPTIST CHURCH INC
Total Fees: 50.00 Address: 38634 CR 54
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/20/2018 Phone:
Work Desc: PLACES OF ASSEMBY- SANTUARY AREA-EXP 8/2019
CONTRACTORS APPLICATION FEES
OWNER FIRE PERMIT FEES 50.00
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FIRE SITE INSPECTION-Final Ins ections Re uid d
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 OFFICOY
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
913-780-0020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received Phone Contact for Permit E=_=.E�
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Owners Name ��T _ BA p /�% a,j G fLOwners Phone}Numbe2r c �/� U gSU
Owners Address 33694 `.A S Lam✓ S ✓ 7&— A 1�S �Ll J3,'J ^/
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
Job Address Lot#
Sub Division Parcel#
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-Installation
Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
Fire Protection Maintenance-ANNUAL Jr,- Places of Assembly-ANNUAL
tryl Pemlil ®n FEE]
Sprinkler ❑ ❑ ❑ Recreational Bum
Fire Alarm ❑ ❑ ❑ Sparklers �v
Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations
Hood Suppression El ❑ ❑ ❑ Standpipes(Sprinkler Sys)
Fire Alarm Installation Torch Roofing/Tar Kettle
Fire Pumps Waste Tire Storage ANNUAL
Flammable Application-ANNUAL Valuation of Project
Fuel Tanks
0 Other:
Contractor Company
Signature Registered Y/N Fee Current Y/N
Address License#
ELECTRICIAN Company
Signature Registered Y/N_j Fee Current Y/N
Address License#
PLUMBER Company
Signature Registered Y/N Fee Current
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: d
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)
as
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—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 maybe an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is$2,500.00 or more, I
certify that 1, 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 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 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.
If I am the AGENT FOR THE OWNER, I promise in good faith to',inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. it 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 Ilcense�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)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
by by
Who is/are personalty known to me or has/have produced Who is/are'personally known to me or has/have 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
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