HomeMy WebLinkAbout07-7265
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL ASSEMBLY PERMIT
7265
Permit Number: 7265
Permit Type: FIRE PLACE OF ASSEMBLY
Class of Work: FIRE-PLACES OF ASSEMBLY
Proposed Use: COMMERCIAL
Square Feet:
Est, Value:
Improv, Cost:
Date Issued: .12/17/2007
Total Fees: 50.00
Amount Paid: 50.00
Date Paid: 12/03/2007 Phone:
Work Desc: ASSEMBLY PERMIT- COUNTRY KITCHEN ON 301
Address: 5327 G L LVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-13300-0010
Name: THE COUNTRY KITCHEN ON 301
Address: 5327 GALL BLVD
ZEPHYRHILLS, FL. 33542
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12 h7107
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OCCUPANCY LOAD:
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OCCUp cy by more than the number of persons above shall be considered
dangero and unlawful. Occupant load determined by Florida Fire
Prevention ode, NFPA101, Section 7.3.1.2
FIRE MARSHAL OFFICE: 813-780-0041
~
NER SIGNA RE -1- ~I~ R
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
Date Received
Owner's Name
Owner's Address
Fax-813-780-0021
City of.Zephyrhills Fire
,Permit Application
Phone Contact for Permit
Owner's Phone Number
~13
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Fee Simple Titleholder Name
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Fee Simple Titleholder Address
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Sub Division
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D
D
D
D
D
D
D
D
D
D
D
D
Contractor
Signature
Address I
ELECTRICIAN
Signature I
Address I
PLUMBEE
Signature
Address I
MECHANICALj
Signature ' I
Address I
OTHER
Signature
o Fumigation Tent
o Hazardous Material (Tier II or RQ Facility) ANNUAL
o Hood Installation
o LP/Natural Gas-Installation
DY/Natura, Gas-ANNUAL Sale
~Iaces of Assembly-ANNUAL
o Recreational Bum
o Sparklers
o Sprinkler System Installations
o Standpipes (Sprinkler Sys)
o Torch Roofing
o Waste Tire Storage ANNUAL
I
~\\J 0
I
Parcel #
Bic-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
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Company I
Registered
I
I
I
I
I
I
I
I
License #
Company
Registered
-~
License #
Company
Registered
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License #
Company
Registered
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License #
Company
Registered
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License # ',),
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I Lot# I
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Valuation of Project
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
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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_
..__....__...._....._...._.~_.._.~-~..- .~_...' .-...'
'. .
..NOT,ICE;QF.~DEED:.RESTRICTIONS: The undersigned understands.that this permitm~y'be sl:lbject to ~deed" restrictions"
.whichmaybe. more restrictive.than County regulations, The .undersigned .aSSl:lmes 'responsibility 'for compliance with any
applicable deed restrictions. . '. .
'UNLlCENSED CONTRACTORS AND 'CO~C"f.OR ~SPONS.IBILmES: If the owner has hired a contractor or
contractors. to und.ertake work, they may be reqUired to be hcensed m accordanCe with 'stateand locaL regUlations. If the
contractor IS' not licensed as reqUired by law, both the owner and contractor may be ,cited for a ',misdemeanor violation
~nder state law. If the o~er or intended contractor are unce~i~ as to .wh":1t Iic~n~ing 'requirements may apply for the
mtended work, they are advised to contact the Pasc~ ,County BUilding Inspection DIvision-licensing Section at 727-847-
800~. 'Further,!lOre,if the own;r has. hired. a ~ontractor ,orcontra~tors, he is advised to have the contractor(s) sign
portlons.or-the contractor ~Io~k ?f this 'apph.cationfor whlC~ they will be ,responsi~le, .Ifyou, as the owner sign as the
contractor, that may be an mdlcation that he IS not properly llcensed.and IS not entitled to permitting privileges in Pasco
County .
CONSTRUCTION'LlEN'LAW (Chapter713, Florida Statutes, as amended): If-valuation of work is $2,500.00 or more'"
certifY that I, the applicant, have been provided with a copy ofthe"FloridaConstruction Lien Law--Homeowne~'s
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs, If the applicant is someone
other than' the "owner", I.certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to .commencement. .
. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
... ..... ... "that.. all.work . will. be -.done in. compliance.-with"all..applicable--Iaws .regl:llatiRg..cOAStruotioA,...zoAiAg.:and..land...........
development. Applic~tion is hereby made to obtain a permit to do work and installation as indicated. I certify
that no work or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of all laws regulating ,construction, County and City codes, zoning regulations, and land
develop'm~nt regulations in the jurisdiction. I also certify .that I understand that the regulations of other
government agencies may apply to the intended work, and that it is my responsibility to. identify what actions I
mustiake to be in compliance, . .
If I.am the AGENT fOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affi.davit prior.~o.comf:T1Elncii:1g construction. I understand that a separate permit may be required for.electricarwork,
plumbing, signs; wells, :pools, air conditioning, gas, or other installations not !?pecifically. included in the application, A
~rmiti~$uedS:hall:b~ construed to be a 'license to proceed with the work and not as aLithority to violate, cancel, alter, or
setaside aniprOvisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
. requiring.acGlTection of errors in pl~ns, construction or violations of any codes. Every permit issued shall become invalid
. .i.inless'i1ie:j.Vork'aulhqrized'"by such ,permit is' commenced Within six months ~f permit issuance, or if work authorized by
.' .tii~:pi:iITiift.:js'susperid~d or abandoned for a period ~ six (6) mo~ths after the time th~ work is commenced: An extension
may.-.pe requested. ~n writing, from the Building Officla~ .for a pened not t~ exceed nln~ty ~90) .da~s and'wllI demonstrate
. j#~~le ~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 IMPROVE?NiENT~ ~? YOLJ~J'~q,P.E~TX': .IF~~t!P";rB .B~Jftlf'll.gl"'ANCJNG,. CONSULT
.. WI+H :V..(JWR.L:EIlIDSR..,(l)R"AN,.A;:rDRNB~1"sEJ;f!jRS:~' . .!WOTlCE OF COMMENCEMENT.
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".OWNeR OR AGENT CONTRACTOR
Subscribed and sworn to {or aflinned) before me this Subscribed and ~m to (or affirmed) before me this
woo' 'isJare p~~naIlY known to me or haS/haVe produced Who is/are personally known to me or hasJhave produced
. as idenllfication. as idenllfication.
Notary PubRc
Notary Public
.Commission No.
Commission No.
Name of Notary typed. printed or stamped
Name of Notary typed. printed or stamped