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Home My WebLink About08-7559 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL ASSEMBLY PERMIT 7559 Permit Number: 7559 Permit Type: FIRE PLACE OF ASSEMBLY Class of Work: FIRE-PLACES OF ASSEMBLY Proposed Use: CHURCH Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: 50.00 Amount Paid: 50.00 Date Paid: Work Desc: Address: 551019 H ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-14300-0000 r;,J ,8 r' (l/ (1r ) 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..... Ie 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,~78~-0020 {F 1557 Fax-813-780-0021 City of Zephyrhills Fir,a. Permit Application [)~~e~ec:~i_ve.~. . _ .J . ... . J .. i1b~iMJ:~):t*"nm:~I~~~~~~~<>i,OO$1%~ .i,~;~.,~~,''''',:t.,';<~;i~,o>.:lW~b;';:~<;<'~~'~''''''~~~~ . Owner's Name- Owner's Address Fee Simple Titleholder Name Phone Contact fur pe=>\!!fl_.-~_lL",_,Jl"w_"",,"M' Owner's Phone Number ] '1L3 II 7~'%. 114~ II II I Lot# I 5"~) 0 +i It.S'T 'P~S B" TC" 41 MJ Cu."U-Jr/ "n! ~. 'ZJ!!pJ.Y~~'L-<5 ~ .p... 335"42 . I ~ Titleholder Phone Number Fee Simple Titleholder Address I I I !)5J. 0 I ~f~J~~~~~_~~~l.lBam~~a\lI. ~1 Job Address Sub Division D D D D D D D D D B D ftfu~Wwf.m~m'i.~m~t1tmJlll 11""/1 S, dEs r- Parcel # ~~~f~f.i?:~~~~3 ~ IUltJ1~llll1t ~~M~m~~~* 11 Bio-Hazard Waste Storage - ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL ~I::;emll~~ Sprinkler D 0 0 0 L-.J Fire Alarm D 0 0 0 c=J Hood Cleaning D 0 0 0 c=J Hood Suppression D 0 0 0 c=J Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Contractor Signature Address ELECTRICIANI Signature Address I PLUMBER Signature Address I MECHANICALI Signature . Address I OTHER Signature ~~:L....,__,-, .., Directions: D Fumigation Tent D Hazardous Material (Tier II or RQ Facility) ANNUAL D Hood Installation D LP/N~tural Gas-Installation : ~atural Gas-ANNUAL Sale Places of Assembly-ANNUAL D Recreational Bum D Sparklers D Sprinkler System Installations D Standpipes (Sprinkler Sys) D Torch RoofingfTar Kettle D Waste Tire Storage ANNUAL Valuation of Project ~~~~~~~~~~2~l~.~~~~:~~jt2 Company I Registered License # I Company Registered License # Company Registered License # Company Registered License # Company Registered Fee Current Y/N Y/N Y/N Y/N Fee Current .._'w....""" .. . m....._-.'.".''''-'..''''.............v:v-7 n1 n"'"" ,-~' 'w Fee Current Y/N - Y/N Y/N Y/N Fee Current Y/N Y/N Fee Current "...L~~';~~~w.."'~""""~..,,"",..."..~"..,,_~,..._...~,,__~,~~..,~<WJ.......~... ._- 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 (htlp://appraiser_pascogov.com) 'NOTICE OF :DEED RESTRICTIONS: The undersigned understands that this permit may _besubjectto-"deed~<restrictions" which may be more restrictive than County regulations. The ,undersigned assumes responsibility for:compliar:tce,with any _applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has -hired-~a-'contractoror 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,_asamended): If valuation of work is $2,500.00 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'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 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 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 MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER AN AlT NEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 11 .0 OWNER OR AGENT Subscribed and swo to r f1inned) be e this by Who is/are personally known to me or has/have produced as identification. CONTRACTOR Subscribed and sworn to (or aflinned) before me this by Who is/are personally known to me or has/have produced as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed; printed or stamped .,.,,"-----"'......."'~."'.,'_..~ .,.<-,,"'~"~.,"'"".",.,~.'--"'..,;..-->,,'