HomeMy WebLinkAbout08-8069
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL ASSEMBLY PERMIT
8069
Permit Number: 8069
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: 5017 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot{s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-20800-0010
7/09/2008 Name: HUFFMAN CARLYLE & BARBARA
50.00 Address: PO BOX 251
50.00 CRYSTAL SPRINGS, FL 33524
7/09/2008 Phone: 813783-8098
PLACES OF ASSEMBLY BARB'S FAMILY DINNING
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
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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
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813-780-0'tl20
Date Received
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Owner's Name
Owner's Address
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Bio-Hazard Waste Storage - ANNUAL D Fumigation Tent
Comm Exhaust Kitchen Hood/Duct D Hazardous Material (Tier II or RQ Facility) ANNUAL
D Hood Installation
D LP/N~tural Gas-Installation
D- LP/Natural Gas-ANNUAL Sale
~ Places of Assembly-ANNUAL
City of Zephyrhills 'Fir-e
Permit Application
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Fee Simple Titleholder Name
Fee Simple Titleholder Address I
Job Add~" F ;;; "; fa~
Sub Division t
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Contractor
Signature
Address I
ELECTRICIANI
Signature
Address I
PLUMBER
Signature
Address I
MECHANICALl
Signature
Address I
OTHER
Signature
Address
Directions:
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
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. Sprinkler D 0 0 0 L-J
Doooc=J
DO ooc=J
Doooc=J
Fire Alarm
Hood Cleaning
Hood Suppression
Fire Alarm Installation
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Fuel Tanks
Other:
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Fax-813-780-0021
Phone Contact for Permit
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Recreational Bum
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch RoofingfTar Kettle
Waste Tire Storage ANNUAL
Valuation of Project
-'liili 1:1__
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
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W-~I.J
Y/N
Y/N
Fee Current
Y I N I
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Y/N
Fee Current
Y/N
Fee Current
Y/N
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)
NOTICE OF 'DEEDRESTRICTIONS: The undersigned understands that this permit may,besubjectto'''deed"rrestrictions''
which may be more restrictive than County regulations. The undersigned assumes responsibility for:compliar.1ce'with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND . CONTRACTOR RESPONSIBILITIES: If the owner hashired: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 (Chapter 713, 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as identification.
OWNER OR AGENT
Subscribed and sworn to (or affirmed) 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