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Home My WebLink About09-8983 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 8983 ANNUAL ASSEMBLY PERMIT a Permit Number: 8983 Address: 5 317 GALL BLVD Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE - PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-13300-0090 Improv. Cost: , Date Issued: 4/03/2009 Name: CLOCK FAMILY RESTAURANT Total Fees: 50.00 Address: 5317 GALL BLVD Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/03/2009 Phone: (813)788 -2511 Work Desc: PLACES OF ASSEMBLY- CLOCK RESTAURANT OWNER FIRE PERMIT FEES 50.00 (--(/ t/ FIRE SITE INSPECTION -Final OCCUPANCY LOAD: Occupancy by more than the number of persons above shall be considered dangerous and unlawful. Occupant Toad determined by Florida Fire Prevention Code, NFPA101, Section 7.3.1.2 FIRE MARSHAL OFFICE: 813- 780 -0041 ..fMli ra 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 ' / 8 (V Fax-813-780-0091 City of ZephyrhillsFire• a 81 7so -oo2o Permit Application 1 . - Phone Contact for Permit I 1 Dat.. Received — �� 1 1 � �,::.sr�._..._ .,,...�w...,� :.- .......,._ . .. axe C .._....._ Owners Phone Number , �g 1 - Owner's Name ®:` .r ' i,,�� j .2 _ Owner's Address Titleholder Phone Number 1 Fee Simple Titleholder Name Fee Simple Titleholder Address I Fr, w .,... ik ; � Y ��4 r°3s w ...x k.. . s :, x 1 . N..,... a .:. 61-12-Q- ` ) t T� L ot # 1 ` i _ . ( . Job Address Parcel #�. Sub Division -•° "'��°" Bio-Hazard Waste Storage - ANNUAL Fumigation Tent Hazardous Material (Tier II or RQ Facility) ANNUAL Comm Exhaust Kitchen Hood /Duct Hood installation - Controlled Sum 1. I 71 LP /Natural Gas - installation Emergency Generator < 30 kw I I LP/Natural Gas - ANNUAL Sale 1 1 Fire Generator 30 - - 1--- laces of Assembly- ANNUAL 1 Fire Protection tion Mainten enance = AN utrl � - v i Utner - J \/I Sprinkler 0 0 0 7 Recreational Burn Fire Alarm 0 0 0 1 1 1 Sparklers Hood Cleaning D 9 1 Sprinkler System Installations j 0 ED 0 Standpipes (Sprinkler Sys) Hood Suppression J 1 Fire Alarm Installation 1 Torch Roofing/Tar Kettle ( I Waste Tire Storage ANNUAL Fire Pumps � I i Fire Works Valuation of Project 1 Flammable Application- ANNUAL I I Fuel Tanks 1 Other: 1 Company Contractor � Signature ,C I Registered Y / N 1 Fee Current 1 Y / N I I License # Address 1 ' I ELECTRICIAN Company Registered Y / N 1 Fee Current 1 Y / N 1 Signature I Address I 1 License # l Company PLUMBER Registered Y/ N 1 Fee Current L Y / N Signature � Address 1 1 License # Company MECHANICAL 1 Fee Current 1 Y / N !I Registered Y / N Signature 1 Address 1 1 -License* OTHER 1 1 Company Registered Y / N 1 Fee Current I Y / N Signature License # Address FP:-< �r., ,: ,.m _.�.;: -;. Directions: 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 ybe subjectto "deed ":restrictions which may be more restrictive than County regulations. The..undersigned.assumes responsibility .for:compiiance• with, any .applicable deed restrictions. UNLICENSED 'CONTRACTORS AND - CONTRACTOR RESPONSIBILITIES: If the owner has - hired - :a - contractor or contractors 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 7.27 - 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 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 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 FORTHE 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 WITH PAYING YOUR LENDER OR AN BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FINANCING, CONSULT COMMENCEMENT. WITH FLORIDAJURAT (F.S. 117.03) DWNER OR AGENT CONTRACTOR Subscribed and swom to (or affirmed) before me this Subscribed and swom 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 otary Public Commission No. Commission No. Name of Notary typed, printed rinted or stamped Name of Notary typed, printed or stamped