HomeMy WebLinkAbout07-7090
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL ASSEMBLY PERMIT
7090
Permit Number: 7090
Permit Type: FIRE PLACE OF ASSEMBLY
Class of Work: FIRE-PLACES OF ASSEMBLY
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 10/12/2007
Total Fees: , ~
Amount Paid: vJ#
Date Paid:
Work Desc: ANNUAL - PLACES OF ASSEMBLY
Address: 5347 8TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-13400-0010
Phone:
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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
FIRE MARSHAL OFFICE: 813-780-0041
OWNER SIGNATURE ~
PERMIT EXPIRES IN ONE (1) YEAR FROM DATE OF ISSUANCE
THIS PERMIT NEEDS TO BE POSTED IN VISIBLE LOCAnON IN MAIN ASSEMBLY AREA
ZEPHYRHILLS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FL 33542
Fee Simple Titleholder Name
Fee Simple Titleholder Address
81 Jo. 780-0020
Date Received
Owner's Name
Owner's Address
Job Address
Sub Division
City of Zephyr hills Fire
Permit Application
Phone Contact for Permit
Fax-813-780-0021
ICity of Zephyrhills
I Owner's Phone Number
I 813
11780
II 0000
I
~n'
I Titleholder Phone Number I
II
II
Zephyrhills Public Library
5'3\..(/
I Parcel #
8+tl ~, I Lot#
1\ I-"Z(,q ..:1-1 - 061D.. '3'-\oO~60\O
\Ulj I AINl=U r-KUM I"'KUI"'l=K I Y I AA l'4U 11l'l=)
o
o
o
o
o
o
o
o
o
o
D
D
Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen Hood/Duct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
Sprinkler D
Fire Alarm D
Hood Clean/Suppression D
Fire Alarm Installation
D Fumigation Tent
D Hazardous Material (Tier II or RQ Facility) ANNUAL
D Hood Installation
D LP/Natural Gas-Installation
D LP/Natural Gas-ANNUAL Sale
D Places of Assembly-ANNUAL
D RecreationalBum
D Sparklers
D Sprinkler System Installations
o Standpipes (Sprinkler Sys)
D Torch Roofing
D Waste Tire Storage ANNUAL
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Fuel Tanks
Valuation of Project
Other:
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Contractor
Signature
Address I
ELECTRICIAN
Signature I
Address I
PLUMBER
Signature
Address I
MECHANICALj
Signature .
Address I
OTHER
Signature
I Company I
Registered
I License # I
I Company I
Registered
I License # I
I Company I
Registered
I License # I
I Company I
Registered
I License # I
Company I
Registered
License #
Y I N I Fee Current
Y/N
Y I N I Fee Current
Y/N
Y IN I
I
Y IN L
r
Y I N I Fee Current
Y I N I Fee Current
Y I N I Fee Current
Y IN I
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.
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NOTICE_OFDEED,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 may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW (Chapter713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more,"
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
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, withH all-applicable. laws ' regulatiRg.constructionj"zoning ,andH 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
musttake to be in compliance.
If lam 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. 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
setaside' anY provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
, requirirnga correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless'tlie::\O.iork'alJthoriZedby such permit is commenced within six months of permit issuance, or if work authorized by
the_periidt,jssusperided 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 PROPE~TY. If,YC/,U INlFNll,;rD,P!lJAI",.FINANCING. CONSULT
W1TH :Y:'(llURiL.ENDER.0RcAN.A+rORN~IBEFQRE~RBOdRDtNG'VOUFrf.iOfICEbF COMMENCEMENT.
: ;:::,1!F+iiJ.jR.!Btt:l1BAA'T'!-(ES'!11;1'7!03)'" ' ,,' , '
CONTRACTOR
Subscribed and swom to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as identification.
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Notary Public
Notary Public
Commission No.
Name of Notary typed. printed or stamped
Name of No