HomeMy WebLinkAbout21-3061Name: ALLIANCE CHURCH OF
ZEPHYRHILLS
Address: 6251 Ft King Rd
ZEPHYRHILLS, FL
Phone:
City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
FIRE-003061-2021
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 10/2112021
Permit Type: Fire
Class of Work: Places of Assembly
Building Valuation: $0.00
Electrical Valuation:
Mechanical Valuation:
Plumbing Valuation:
Total Valuation: $0.00
Total Fees: $50.00
Amount Paid: $%00
Date Paid: 10/21/2021 11:23:22AM
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REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O. I
CONTRACTOR SIGNATURE
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813-780-0020
Date Received
Owner's Name
Owner's Address I k e 0
Fee Simple Titleholder Name
Fee Simple Titleholder Address
Job Address
Sub Division
Contractor
Signature
Address
ELECTRICIAl
Signature
Address
PLUMBER
Signature
Address
MECHANICA
Signature
Address
OTHER
Signature
Address
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Directions:
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Phone Contact for Permit I F) I I
tr( k I Owner's Phone Number
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Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen Hood/Duct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator > 30 kw
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Fire Protection Maintenance - ANNUAL
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Sprinkler
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0
0 0
Fire Alarm
0
0 0
Hood Cleaning
0
0 0
Hood Suppression
0
0 0
EDFire
Alarm Installation
Fire Pumps
Flammable Application- ANNUAL
Fuel Tanks
ED
Other:
Fax-813-780-0021
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Lot # L
Parcel #
Fumigation Tent
Hazardous Material (Tier 11 or RQ Facility) ANNUAL
Hood Installation
LP/Natural Gas-Installatior
LP/Natural Gas -ANNUAL Sale
Places of Assembly -ANNUAL
ElRecreational Burn
ElSparklers
EJSprinkler System Installations
Standpipes (Sprinkler Sys)
Torch Roofing/Tar Kettle
Waste Tire Storage ANNUAL Valu rt(nof Project
Company
Registered
LY / N J
Fee Current
L_Z / N J
License #
Company
Registered
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Fee
Y ! N��
License #
Company
EE=F.,
Registered
Current
License #
Company
E0=F.eCuirrent
Registered
License #
Company
Registered [—Y
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Fee Current
Y/N
License #
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 $50001,
Supply two (2) sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (hftp://appraiser.pascogov.com)
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. 4 A.
UNLICENSED T T CONTRACTOR I B ILITI : 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 may be 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.
CONT T , A I ' 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 , I promise in good 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 C NOTICE F COMMENCEMENT RESULT IN YOUR
PAYING IC FOR IMPROVEMENTS TO . IF YOU INTEND TO T FINANCING,CONSULT
lT Y L TT Y F I Y TlC F COMMENCEMENT,
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 personally 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