HomeMy WebLinkAbout08-8243
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL ASSEMBLY PERMIT
8243
Permit Number: 8243
Permit Type: FIRE PLACE OF ASSEMBLY
Class of Work: FIRE-PLACES OF ASSEMBLY
Proposed Use: MOBILE HOME PARK
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 8/21/2008
Total Fees: 50.00
Amount Paid: 50.00
Date Paid: 8/21/2008 Phone:
Work Desc: ANNUAL PLACE OF ASSEMBLY - SIXTH AVE MOBILE HOME PARK
Address: 39345 6TH A E
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s}: Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 12-26-21-002B-00500-0000
Name: IXTH A UE LLC
Address: 39345 6TH AVE
ZEPHYRHILLS, FL. 33542
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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, ZephyrhiUs, FL 33542
813-780-0020 'f) 0<2 City of Zephyr hills .Fire Fax-813-780-0021
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I Titleholder Phone Number I
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Owner's Name
Owner's Address
Fee Simple Titleholder Name
Fee Simple Titleholder Address
Job Address
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Sub Division
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Bio-Hazard Waste Storage -ANNUAL
Comm Exhaust Kitchen HoodlDuct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
~~~~
Sprinkler 0 0 0 0 L-.J
Fire Alarm 0 0 0 0 c:=:I
Hood Cleaning 0 0 0 0 c:=:I
Hood Suppression 0 0 0 0 c:=:I
Fire Alarm Installation
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Fuel Tanks
Other:
D
D
D
D
D
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D
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D
D
D
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II
II
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Lot#
Fumigation Tent
Hazardous Material (Tier II or RQ Facility) ANNUAL
Hood Installation
LP/Natural Gas-Installation
LP/Natural Gas-ANNUAL Sale
Places of Assembly-ANNUAL
Recreational Bum
Sparklers
Sprinkler System Installati
Standpipes (Sprinkler Sys)
Torch Roofing/Tar Kettle
Waste Tire Storage ANNUAL
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Valuation of Project
Contractor
Signature
Address I
ELECTRICIAN]
Signature
Address I
PLUMBER
Signature
Address I
MECHANICAL]
Signature .
Address I
OTHER
Signature
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Directions:
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Company I
Registered
License # I
Company I
Registered
License # I
Company I
Registered
License # I
Company I
Registered
License # I
Company I
Registered
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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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
Aliow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com)
'NOTICE OF :DEED RESTRICTIONS: The undersigned understar..ds that this permit may.be'subject:to'"deed"rrestrictions"
which may be more restrictive than County-regulations. The ,undersigned assumes responsibilityfor:compliara:ce'with any
.applicable deed restrictions.
UNLICENSEDCONiRACTORS 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-r~gulations. 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 whichihey 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.
CONSTRUCTIONLIEN.LAW (Chapter713,Florida Statutes,.as:amended): 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'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 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 MA Y.RESUL T IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER R AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 11'Z,_3) ,j /J
OWNER OR AGE ~ ~ CONTRACTOR
Subscribed and s m (or affirmed) before me Subscribed and sworn to (or affirmed) before me this
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Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed; printed or stamped
CITY OF ZEPHYRHILLS
5335 8TH STREET
ZEPHYR HILLS FL 33542
Vendor 10 I Location
0000046879 - 001
Remittance Advice For:
08122008
08/12/2008
50.00
ZERO
ZERO
50.00
50.00