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Home My WebLink About09-9000 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9000 ANNUAL ASSEMBLY PERMIT t "$ : I 7 .: Permit Number: 9000 Address: 37930 MEDICAL ARTS CT 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: 34- 25 -21- 0080 - 00000 -0010 Improv. Cost: €£..£.. Date Issued: 4/07/2009 Name: DAIRY QUEEN Total Fees: 50.00 Address: 37930 MEDICAL ARTS CT Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/07/2009 Phone: (813)780 -2826 Work Desc : PLACES OF ASSEMBLY- DAIRY QUEEN FIRE PERMIT FEES 50.00 C1 657----- 4 /1/14 (1% .s,'... 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 • 4 I 7 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 • 813-780-0020 City ofZephyrhills Fire Fax-813-780-0021 Permit Application Date Received I I _„ _:. .,., Phone Contact for Permit '� / ` / n ti 3 7S c [_(C' Owner's Name ��{ tt�. t ��t.r'!%.ii (.y� l'r r i ( i ( , ,1/ Owner's Phone Number ( IA �/ // I � 3 Owner's Address 1 ., / 13 G �� l e vC t r N , A 02' S C' > k, , �� L• I l k Name 1 Titleholder Phone Number Fee Simple Titleholder J Fee Simple Titleholder Address 1 xr x . •.az , ux ;i, , +.. ki :.: . . « ». ::v 4 r m +s, -;,m. s t .,; � .. �ss�:".., y. ,:.ffita. ..' ,Y Lot # Job Address Sub Division 1 Parcel 1 1 Bio- HazardWasteStorage - ANNUAL 1 Fumigation Tent I I Comm Exhaust Kitchen Hood /Duct 1 I Hazardous Material (Tier II or RQ Facility) ANNUAL n - Controlled Bum 1 1 Hood installation Emergency Generator < 30 kw 1 1 LP /Natural Gas - Installation I I Emergency Generator> 30 kw I ( LP /Natural Gas - ANNUAL Sale I Fire Protection Maintenance - ANNUAL Fri 1 X Places of Assembly- ANNUAL )utrly1 'Jsemij Ititner I I Sprinkler n ❑ ❑ ❑ 1 I 1 Recreational Bum Fire Alarm 70 0 ❑ I 1 1 I Sparklers Hood Cleaning El ❑ ❑ ❑ 1 I 1 I Sprinkler System installations Hood Suppression 7 ❑ ❑ ❑ J 1 I I Standpipes (Sprinkler Sys) Fire Alarm Installation 1 I Torch Roofing/Tar Kettle 1 I Fire Pumps I ( Waste Tire Storage ANNUAL n Fire Works I I Flammable Application- ANNUAL ! I Vaivation of Project Fuel Tanks 1 I Other: 1 .. „t.. Contractor Company . Signature : Registered ignature Registered Y / N Fee Current Y / N Address License # ELECTRICIAN Company • Signature Registered Y / N Fee Current Y / N Address License # I PLUMBER Company Signature Registered Y / N Fee Current Y / N Address 1 License # MECHANICAL Company Signature Registered _ Y / N Fee Current 1 Y / N Address I License # 1 OTHER Company Signature Registered Y / N Fee Current 1 Y / N Address license # 1 dam -------- 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 The u dersigned .as sitresponsibilbty fort ompl ance with any .which may be more restrictive than County regulation s applicable deed restrictions. UNLICENSED CONTRACoTORhep` may bOeNeq�red.0 beE ens dance with state and local Lionsc contractors s - to undertake they contractor is' not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation intended under state work, they If the are owner advised or co the contractor are County Buildings licensing D v s on—L cens ng at 7.27-847 - 0 09. Furthermore, if t e r they are he o to con 80. Furthermore, owner has hired .a contractor or contrwiiobe responsible. l lf youaas� the one as portions of the "contractor Block" of this application for which the r es in as t he contractor, that may be an indication that he is not properly licensed and is not entitled permitting .p 9 County. CONSTRUCTION -LIEN LAW ( Chapter713, Florida Statutes, -as: amended): If valuation of work is '$2;500.00 or more, I of 'the "Florida Construction Lien Law — Homeowner's certify that 1, the applicant, have been provided with a copy is someone other than G an the pre"owner ", Ice by th rtify tha t t I h Fl have obtained Department c py of the t above described document and promise in faith to other the ", I ceaa deliver it'to the "owner" prior to commencement. CONTRACTOR'SIOWNER'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 t op work Application is hereby m made to commenced pri or to issuance of a permit and.that installation work will be indicated. erformed certify to meet t no standards rd s installation fa l has mt adrd of all laws the jurisdiction. I also certify that understand that the regulations, regulations of other development government agencies eg tions in may apply to the intended work, and that it is my responsibility to identify what actions must take to be in compliance. ons set forth in If I affidavit commencing the AGENT FORTHE OWNER, i promise I in good derrstandhthatnaoseparat permit may be required for work, this affidavit prior to ommes air cond plumbing, signs, wells, pools, , air conditioning, gas, or other installations not specifically included in the application. set aside a an y py pro v i s io construed ns of the te co hn i s a li nor shall issuance of a permit prevent the Building violate, Official from thereafter set asde nroiioci requiring a correction of errors in plans, construction or violations of any codes. Every p ermit issued shall become invalid unless the work authorized by such permit is commenced within months months hs permit issuance, c , or if wor An exized by the permit is suspended or abandoned for a period of six (6) after ti days e n c will demonstrate nsby may be !requested, in writing, from the Building Official, for a90 t een ecutive days, the job is tiered abando justifiable cause for the extension. If work ceases for ninety ( ) WAR NING TO OWNER: YOUR FAILURE TO RECORD A'NOTICE'OF IC N OBTAIN FANANC NG CIONSU 'YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA'JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swum to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by by Who i s/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