HomeMy WebLinkAbout07-7225
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
7225
Permit Number: 7225
Permit Type: FIRE PLACE OF ASSEMBLY
Class of Work: FIRE-PLACES OF ASSEMBLY
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 11/21/2007 Name: OUR SAVIOUR LUTHERN CHURCH
Total Fees: 50.00 Address: 562620TH ST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 11/21/2007 Phone: 813782-1369
Work Desc: ASSEMBLY FOR OUR SAVIOUR LUTHERN CHURCH
Address: 5626 20TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s}: Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 12-26-21-0020-00400-0110
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, NFPA10l, Section 7.3.1.2
FIRE MARSHAL OFFICE: 813-780-0041
~&~ ~
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
Permit Application
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I Titleholder Phone Number I
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Fee Simple Titleholder Address I
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Job Address I 5 ~ .5 ?
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Owner's Name
Owner's Address
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Fee Simple Titleholder Name
Sub Division
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I Lot#
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Bio-Hazard Waste Storage - ANNUAL
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Comm Exhaust Kitchen Hood/Duct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
Sprinkler 0
Fire Alarm 0
Hood Clean/Suppression 0
Fire Alarm Installation
Fire Pumps
Fire Works
Flammable Appiication- ANNUAL
Fuel Tanks
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Fumigation Tent
Hazardous Material (Tier II or RQ Facility) ANNUAL
Hood Installation
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Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
License #
LP/Natural Gas-Installation
LP/Natural Gas-ANNUAL Sale
Places of Assembly-ANNUAL
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch Roofing
Waste Tire Storage ANNUAL
Valuation of Project
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Other:
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Recreational Bum
Contractor
Signature
Address I
OTHER
Signature
Address
Directions:
Company
Registered
License #
Company CI (' ~.s 't Q C2-
Registered IY I N I Fee Current
ELECTRICIAN
Signature I
Address I
I
PLUMBER
Signature
Address I
MECHANICA~
Signature
Address
Fee Current
Y/N
Y/N
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
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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 appiicable documentation
Allow 1D-14 days for review after submittal date.
-_......_....._~...._,.._--~._..,._.~~_..~.- .._._......_...-~ .-
NOT,ICE.QF.',DEED.RESTRICTIONS: The undersigned understands that this permit m~ybe subje.ct to ~deed" restrictions"
-which may be more restrictive than County regulations. The undersigned assumes responsibility 'for compliance with any
applicable deed restrictiens. ' '
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors. to und.ertake work, they may be required to be licensed in accordance with state and 10calregLilations. 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.
CONSTRUCTIONLlE'N'LAW (Chapter713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more;'1
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", J.certify thatt 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..constructioA,...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 pennitting 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
~imit'issueds:hClII"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
'requirirng.a correction of errors in pl~ns, construction or violations of any codes. Every permit issued shall become invalid
,unless'ihe:work'authorized'by such penn it is commenced within six months of permit issuance, or if work authorized by
tfte:pe'fiiiJt-'is"susperided or abandoned for a period of six (6) months after the time the work is commenced. An extension
ma)rbe requested, -in writing, from the Building Official ,for a period not to exceed ninety (90) days and will demonstrate
, j#~jfi,~le ca.iJse 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 IMPROVEMENT~ ~~ YC>.LJ~. r.~.q.~~!X~_"~)"BY1fjlF.""P.IP, 9;~JAlf'1I..glt'llA"'C,ING, CONSULT
Wl+H ~.(1UJR~L.ENJ).6R-OR,AN-At:rORN.~iSE' ,:..:RBOOR1i)lNG'YOtlR'NOTICE OF COMMENCEMENT.
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,OWNER OR AGENT
Subscribed and swom to {or a nned afore me this
/1-2/-07 by ~f'1 h' "'- AJ((fp
Whl?is/are personally known to me or has/have prodUced
Lr .' as identification.
CONTRACTOR
Subscribed and sworn to (or affinned) before me this
by
Who islare personally known to me or has/have produced
as identification.
Notary Public
Notary Public
mis .,Ill.9..
;~\o!'>v.fsf~ JACQUELINE BOGES
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Name 0 :.: '" ~ .. , 10
.'4rf..f""'" Bonded ThN T~F.1n k'IIuranoIeoo-aei-7019
,Commission No.
Name of Notary typed, printed or stamped