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Home My WebLink About08-7536 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL ASSEMBLY PERMIT 7536 7536 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: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 38620 LANSING A ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: SLEEPY HOLLOW MHSUB D1V Parcel Number: 02-26-21-0260-04500-0000 Name: SLEEPY HOLLOW Address: 38620 LANSING AVE ZEPHYRHILLS, FL. 33542 2/22/2008 50.00 50.00 2/22/2008 Phone: FPM-SLEEPY HOLLOW RECREATION HALL-PLACE OF ASSEMBLY cy~t{ 00 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 ~ I~ 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 81 ~780-0020 , [)a.'B~~~~i~~'"'''7'''''') Owner's Name Owner's Address City of Zephyrhills Firoe' Pennit Application ,.,..,.,.,~.~:,~'='"',j~~~;?~"."~~.".,~~'w"=~~z=,,..",-~~~,~~~~~~~~~~~f8nn~~J_~.P4"w,~"U.~,~~"~..,..,lL ;;r'~ Phone Num~;'_~] Fax-81~780-0021 .j Fee Simple Titieholder Name Fee Simple Titieholder Address I I ~'>AlY~/tJ.$ I Lot # I I +- ~A 7?Or4 H.4J../...- - Parcel # J {J"Z- ?,.(, U () 9->PO 4t:W I .....~_-:-:~:7.::-:-~.":'-'7':-::7;;-:~~::':'i::::':::.~_~:.i!JC;~~~_~::j:;:~'i<.!:~;'~!f~.;f!/:f.-"'~',,,.;J::<~::::;';?f=~~~~:-:J$1,~,,t,l2:~;.:;:';~7~:z;:r:~mr~:-:;:s:;,{(~;:l~~&"J;;;.#~,~~Ti!1iZ7~;':"~1'bZm;;:2~l1rt~:<-j-_..A"\k":lf<f~1$.';7:~:T:7~::.,tL:-:,';:;::;i:::t.~.~.,.~;,,~:<:-~.:t~::':,:~;'.~' Titieholder Phone Number I . ~.~_~~:;_;.'7.';~'::;'.:."~a.rL:r.::;Tt_.~:~.::~_,:_,:?:Z.:..:::>:r;"??1:~'ffi~<m'n.~~BitrrZ;:~T~,};5gt~~B~~~;:7:~~'m::~;~.:;X~I1F;r";iZ:r&~lK.z?rr[8;'!~f?~:~Zr.~:?~~si~~K:~~~:~R;Fj~'7'2t;:::F!:::;r::,: ~ "",,: ~~20 kt9N:$IN~ AVE, ~ ~~~~~-~'" D Other: ::::,,:'~-~';~'::;C:::::::::O::l;::~::,::2:t7:::Z:;~~'::~C:C3.':;S~1S!'i.cSiJ.NI51trfiy:;g:L'!?~~~~~-X:'~~;f~~~?X~~.:~~t:::rilij.:t}L~"iE.~''~~!if~~~ii-?Ji~:~~~rL=~:~~:'~:?Ziii{~:;::2D~~E~~'t"'f:S8.:J~~:1::::~:::J;Y~:Z:,: I Job Address Sub Division D D D D D D Contractor Signature Address I ELECTRICIANI Signature Address I I PLUMBER Signature Address I MECHANICALI Signature Address I OTHER Signature "'.'C',~ ,~~~res~J .,:,._,.;;.;s;'~",_~,_)","'.~';""""",.,.":,.,,,,:'.';;:'~',",,,. Directions: Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen HoodlDuct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL ~ l:sem'l ~ ~ Sprinkler 0 0 0 0 L-I DDDoC=:J ODOOc=J DDDDC=:J Fire Alann Hood Cleaning Hood Suppression Fire Pumps Fire Works Flammable Application- ANNUAL ';JJ2Z;;1::t2:J:::?:Y. ,~,. o D D D D S D D D D D D l Fumigation Tent Hazardous Material (Tier II or RQ Facility) ANNUAL Hood Installation LPlNatural Gas-Installation LPlNatural Gas-ANNUAL Sale Place,S of Assembly-ANNUAL Recreational Bum Sparklers Sprinkler System Installations Standpipes (Sprinkler Sys) Torch RoofinglTar Kettle Waste Tire Storage ANNUAL Valuation of Project Company Registered Fee Current I Y/N I I I I .1 ., ,4. ' I .- " .1 I I Y IN .1 License # Company Registered Y/N I Fee Current Y/N License # Company .. . ' Registered , YI-N J Fee Current ,Y IN License # Company Registered Y/N I Fee Current Y/N License # ; :. Company Registered Y IN' I ., F'ee~~.irrerit' I · "'( I N I ". ~L' # J ..'. . 'L lcense. '.' ,-......... - ,.." .; :;. , . :'"':-'-~~,;;:.;.,:.':;.;;.;::..;;.,:,~:.;.':oi..~~'.:'~:.~~~:c;;,:..~;.~ii,;,"'~_~".;,~:::;:...:.;;.:;.:..:.-~'i.l;-;:...:<~",/.cd::''''~::.>.;.::;.i.:<.;;.,c.~;.:::.<, "-". ."~,;;:.:.;~~.l,,ii..:-;;.J;;.-:~i.~""'~;:;.'"..:,.~~~;.O';'.O::';;~_.i;:;;;.~;.,,:<:.::,;;:;.;.;;~';";:_;'~;:c;:.:.,;.:~:...-;:..,-....,::",.;'~."':,;;'';':..;;.:';';',-''2:",~k..~~:.:~~;:'~. :':::c.":..;:~C:-;;';;'>..;;;: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 $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com)' .' ~ '. '. . , ....~'. ; ~': , .' . .~ \. -~-:-~!:-::: ;NO-r.ICE~rotEED'RESTRICTIONS: The undersigned understand~:t~@~elD'!itmay .be:subject;to'"deed~!T'estrictions"~'ic; whichma~~or.eor-estrictive than County regulations. The,undersi9'ile9i8~UJ;nes:responsibilityior:compliar.lce'with any'..;.,,', .applicable,deed:restrictions. " ' '.';" J~~,: '''''''' , I . ~ 'UNLlCENSenuoN"fRACTORS ,AND "CONTRACTOR:RESPDNSI~IL<lWI~he-uwner'has:-hired'~a ~contractor 'or"" ,." contractors jO unpertake wor~, the:y Jtlay b~ requ!req:to.~ Ii~nsed in accordance with ~tate arid local'r~ulations. If the contractor is 'not licensed as required by law, both the owner and contractor niay'b& cited for a-misdemeanor violation under state law. If the owner or intended contractor are uncertain ,as 'to what licensing 'requirements may :apply for the intended work, they are advised to contact the Pasco County Building Inspection Division-Licensing Section.at 727-847- 8009. Furthermore, if the owner has hired.a contractor or contractors, he .is advised to have -the contractor(s) sign portions of the "contractor Block" of this application 'for which 1hey \,/Viii be responsible. If you, as the owner 'sign as the contractor, that may be an indication'that h~ is.naf"properly IicensEidand isnot'.entUled;to.;permitti~g..privileges in Pasco COunty. '., ,-.: l , . CONSTRUCTION .LIEN LAW (Chapter 713, 'Florida Statutes"as:amenCied): If valuation 'of work is -$~;500.00 or more, I 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'SAFFIDAVIT: 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 maqe 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. 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 RECORD A 'NOTICE OF 'COMMENCEMENT MA YRESUL T 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. 1 7.03) . CONTRACTOR Subscribed and sworn to (or afflnned) before me this by Who is/are personally known to me or has/have produced as identification. ff'-~ /3~ Com[1:::;~' &'~;;. 9 Name of Notary typed, pnmed or stamped Notary Public Notary Public Commission No. Name of Notary typed, printed or stamped , 1O-..vIlllllllllCl'-N1I I _ . ,llOZlQ-t:snJdXB &.~ 9Mi699QQ#NOISSIJ'O'fO:)AW ~i;.'_:,l ~;, ,~ i.(VN)!l3:g ::m.u..,Tr:::-' .../. . '. ~ .'":;-.~~. ,~,,.,.. .. -~..~,."" .:- I~" -;". . ..-.,.--._~--<.,------_.......- .