HomeMy WebLinkAbout08-8600 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8600
ANNUAL ASSEMBLY PERMIT
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Permit Number: 8600 Address: 4917 GALL BLVD
Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26-21-0010-00900-0080
Improv. Cost: `" .,.,,� s<
Date Issued: 12/03/2008
Name: SHARONS PLACE
Total Fees: 50.00 Address: 4917 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/03/2008 Phone: (813)299-3729
Work Desc: PLACES OF ASSEMBLY-SHARON'S PLACE
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FIRE PERMIT FEES
50.00
_________ __ ( 217 ___________
FIRE SITE INSPECTION-Final
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 IC 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
313-780-0020 City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Date Received Ph ��
ta�for Permit
one Con
Owner's Name 1fliJ Owner's Phone Number L— L
3 I
Owner's Address IIi 7 G1L.L L
Fee Simple Titleholder Name Titleholder Phone Number L 1 L �
Fee Simple Titleholder Address
Job Address Lot# I
Sub Division Parcel#
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4':JJ
Bio-Hazard Waste Storage-ANNUAL Fumigation Tent
Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL
Controlled Bum jJ Hood Installation
Emergency Generator<30 kw LP/Natural Gas-Installation
Emergency Generator>30 kw �P/Natural Gas-ANNUAL Sale
Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL
r y emi her
❑Sprinkler O O ❑ Recreational Bum
Fire Alarm � ❑ ❑ ❑ L I Sparklers
Hood Cleaning ❑ ❑ ❑ L1 JJ Sprinkler System Installations
Hood Suppression ❑ ❑ ❑ EJ Standpipes(Sprinkler Sys)
Fire Alarm Installation [ ] Torch Roofing/Tar Kettle
Fire Pumps Waste Tire Storage ANNUAL
R Fire Works
Flammable Application-ANNUAL Valuation of Project
Fuel Tanks
Ot er: J 41f M t
Contractor Company
Signature Oi-vc_-. J Registered Y/N Fee Current Y/N
Address
License#
ELECTRICIAN
Company
Signature Registered Y/N Fee Current Y/N
Address
License#
PLUMBER
Company
Signature L Registered J Y/N Fee Current L Y/N
Address
License#
MECHANICAL
Company
Signature Registered Y/N Fee Current L Y/N
Address
License#
OTHER
Company
Signature Registered I Y/N Fee Current L Y/N
Address
License#
Directions: . u..
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 DEED RESTRICTIONS: The undersigned understands that this permit may-be subject'to-"deed",restrictions
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired-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(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 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,tions not plumbing, ed wells, str air to be a l license to proceed with the workand not specifically
cauthority to violate in s cancel, alon. A
ter, or
permit issued shall be construe
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 in six months of unless the work authorized r b ndon d forch permit
als pe od of six(6)ed months after the ti a thetwork is commenced An authorized
extension
the permit is suspended or abandoned
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 C OWNER: Y E FOR IMPROVEMENTS TO YOUR PROPERTY.OUR FAILURE TO RECORD A TIF YOU INTEND TO OBTAIN FINANCING, CONSULT
ICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWIC
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
CONTRACTOR
OWNER OR AGENT Subscribed and sworn to(or affirmed)before me this
Subscribed and sworn to(or affirmed)before me this by
by 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