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Home My WebLink About09-9044 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9044 ANNUAL ASSEMBLY PERMIT Permit Number: 9044 Address: 5950 12TH ST 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: 11- 26 -21- 0010 - 01800 -0010 Improv. Cost: Date Issued: 4/21/2009 Name: ZEPHYRHILLS MASONIC LODGE Total Fees: Address: 5950 12TH ST Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: Phone: Work Desc: PLACES OF ASSEMBLY -FEE WAVIED PER FM °"t.. .# 2... r t „ i 2 �; �� a ? -: m ; � D v,6 �d rn' x �u :4 z ,'°� k : End 3 S 4 '. w FIRE PERMIT FEES 0.00 0j9 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, N FPA101, Section 7.3.1.2 FIRE MARSHAL OFFICE: 813 - 780 -0041 _,.ilYik _.� 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 of Zephyrhills Fire Fax- 813- 780 -0021 Permit Application Date Received Phone Contact for Permit Owner's Name I ,Z` /2 1 P kif4.edx// 4. 0 E I Owner's Phone Number I I I Owner's Address I TO ) A 7W 57 Fee Simple Titleholder Name I I Titleholder Phone Number I I Fee Simple Titleholder Address I Job Address Lot # I Sub Division I I Parcel # s E Bio-Hazard Waste Storage - ANNUAL El Hazardous Material (Tier II or RQ Facility) ANNUAL . E Comm Exhaust Kitchen Hood /Duct n Hood Installation Controlled Bum = LP /Natural Gas - Installation Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale El Emergency Generator> 30 kw n Places of Assembly-ANNUAL El Fire Protection Maintenance - ANNUAL = Recreational Bum Sprinkler 0 ❑ ❑ ❑ D Sparklers Fire Alami 0 ❑ ❑ ❑ I I [] Sprinkler System Installations Hood Cleaning El ❑ ❑ ❑ I I El Standpipes (Sprinkler Sys) Hood Suppression 0 ❑ ❑ ❑ I I = Torch Roofing/Tar Kettle Fire Alarm Installation = Waste Tire Storage ANNUAL Fire Pumps Fire Works Flammable Application- ANNUAL 1 Valuation of Project Fuel Tanks 0 Other: I I -&°� I�,:i is.*�.;�sFa£ .t;n„r.. , r:. r, ��tr^; ++a..wps ': ,.�s s%.":�*:&,ra. '#Y�a ±M2at,.= :�� :;r.,' Contractor Company I Signature ,„Q L i' 1( Registered Y/ N _1 Fee Current I Y/ N I Address I �� /J' I License # I ELECTRICIAN Company I Signature Registered Y / N I Fee Current 1 Y/ N I Address I I License # I I PLUMBER Company Signature Registered Y / N J Fee Current I Y/ Ni Address I I License # I I MECHANICAL Company I Signature Registered Y/ N 1 Fee Current I Y/ N Address I I License # I I OTHER Company I Signature Registered Y/ N I Fee Current I Y/ N I Address License # R0. i`;9;'�»r?a1:3` ,.A, ..:d+:�Yyna a ,..,, mz�'• xt 4w¢ �1F "P4€d ;' .':a..�R. `: ., r.tk!r'�- ., ,«:�.'fi«t`A.*h 3��""T?'.E' debt.' Fw# .'�4Ya>w�"3'�°+Jtulb&*eG:�c."r. ........ .daida.�ikd.�.'�,�..v.. .q. 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 - days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) • N OTICEI,OF:DEED-RESTRICTIONS: The undersigned u fhe undersigned i ssumes responsibility forrcompl 'a " t�e+wi i th any permit which may be more restrictive than County regulations .applicable; deed restrictions. UNLICENSED 'CONTRACTORS AND 'CONTRACTOR RESPONSIBILiT1ES: If 'the owner has -hired or contractors 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, t ate uncerta n .as to what iicens misdemeanor may apply violation the under state taw. If the owner or intended p intendedawork, they are advised to contact the Pasco County Building Inspection Division -- Licensing 5ection�t 727-847 - 8009. Rurthermore, if the owner has hired -a contractor or contractors, responsible. advised ha the e contractor(s) n s ign portions -,of the "contractor Block" of this application for which-they If yo .privileges t ass t he contractor, that may be an indication that he is not properly licensed and is not entitled permitting County. ; Florida Statutes, : amended): If valuation of work is"$2;500.00 or more, I certify that 1, the .LIEN LAW ( ave .b e n pr have .been provided -with a copy of the Florida Construction Lien Law— Homeowner s Pr oto that 1, - the ctidn Guide" prepared by Florida Department of Agriculture culture 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. CON-TRACTOR'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 r that no work or installation has commenced r stn°ctions County d City codes, .zoning regulations, and land a a will be ns permit and all work will be performe d t to meet standards of all laws 'regale ti g development regulations in the jurisdiction. 1 also certify {hat I understand that the regulations of other g ovemment agencies may apply tothe;.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 installations arate may erequired the application. leotrical r , phi included in violate, cancel, tin A plumbing, e i is- wins, wells, po air to be a or g codes, nor shall' issuance of a permit prevent the Building Official from thereafter permit issued -shall be construed to be a License to proceed with the work and not as authority shall become invalid or requiring aside any provisions oof r the technical permit i requiring a correction of errors in plans, construction or violations of. any codes. Every p the work authorized by such permit is commenced within. six after pe rm �WOTkar commenced. authorized iby unless (90) days and will An extension io the perthit is suspended ed, in or g, from the a period Official six ) Y may be ;requested, in writing, from the Building Official, for a p eriod not to exceed ninety ( justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. 'NOTICE 'OF 'COMMENCEMENT M74Y'RESULT IN 'YOUR WARNING TO OWNER: YOUR FAILURE 70 RECORD A PAYING TWICE FOR IMPROVEMENTS TD YOUR PROPERTY. IF YOU .INTEND TD OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY.BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDAii1URAT (F.S. 117.03) OWNER OR AGENT subscribed R swum to (or affirmed) before me this Subscribed and.swom to (or affirrred).before me this by by has/have roduc ed Who fist are personally Imown to me or haslhave produced as identification. Who is/are Personally known to m as dentification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed; printed or stamped Name of Notary typed, printed or stamped • •