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Home My WebLink About09-9085 CITY OF ZEPHYRHILLS 5335 - 8T1 STREET 9085 (813) 780 -0020 ANNUAL ASSEMBLY PERMIT Permit Number: 9085 Address: 5855 16TH ST Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE - PLACES OF ASSEMBLY Township: Range: Book: Proposed Use: CHURCH Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11- 26 -21- 0010 - 05000 -0010 Improv. Cost: : Date Issued: 5/04/2009 Name: S T ELIZABETHS EPISCOPAL CHURCH Total Fees: 50.00 Address: 5855 16TH ST Amount Paid: 50.00 ZEPHYRHILLS Date Paid: 5/04/2009 Phone: Work Desc: PLACES OF ASSEMBLY- ST ELIZABETH EPISCOPAL CHURCH OWNER FIRE PERMIT FEES 50.00 OStd o 9 Lam: + � � _, � ,� ... V, _ FIRE SITE I■SPECTION -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 gr3j 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 IIISFire Fax-813-780-0021 City ofZephyrh' s1378o o0zo Permit Application • Phone Contact for Permit Date Received w o I 1 1 i` S • S 0 4 4 di Owner's Phone Number - Owner's Name �� ' 3 ��'L Owner's Address t Titleholder Phone Number Fee Simple Titiehoider Name Fee SimpleTitleholder Address ,<:�.�w�,. «�: -,, ..,�., - ,..«._ . ,•,.�.�. � �, •...� Lot# Job Address parcel # Sub Division • . .• _: Fumigation Tent Bro-Hazard Waste Storage - ANNUAL 1-1 Hazardous Material (Tier II or RQ Facility) ANNUAL E Comm Exhaust Kitchen Hood/Duct I I Hood installation 7 -Controlled Burn l i--'1 i LP/Natural Gas..lnstaliation Emergency Generator < 30 kw l r — j /Natural Gas - ANNUAL Sale Li Emergency Generator> 30 kw 11 )�I p laces of Assembly- ANNUAL n Fire Protection Maintenance - ANNUAL ii rr rr E=1 [w • J ner Recreational Bum Sprinkler � 0 0 Fire Alarm C j�'� rkl ❑ ❑ 0 0 u Spaers H C A D 0 0 C Sprinkler System Installations Hood leaning ❑ � � 0 Standpipes (Sprinkler Sys) Hood Suppression Torch Roofing/Tar Kettle Fire Alarm Installation I Waste Tire Storage ANNUAL FR Fire Pumps Fire Works 1111111111111111111111111 Valuation of Project Flammable Application- ANNUAL Fuel Tanks = Other: ;� f s�• -t.: -.;.,..�, N :... -.,:,v - Company Signature Contractor Registered Y/ N 1 Fee Current 1 Y/ N 1 • ' � License # I Address _.. Company ELECTRICIAN Registered Y/ N I Fee Current I Y/ N Signature License # Address l Company Signature J PLUMBER l Registered Y/ N Fee Current 1 Y/ N Address 1 f J License # Company , MEnatUre I ALI Registered Y / N I Fee Current Y / N Signature JI • License # l Address • Company OTHER • I Registered i Y/ N 1 Fee Current 1 Y/ N Signature • License I.w� =H:. Address Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract wtth owner) If over $2500, a Notice of Commencement is required.(Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Parcel #- obtained from Property Tax Notice (http:!lappraiser.pascogov.com) Allow 10 - days for review after submittal date. . _ 'NOTICEPF:DD 'RESTRICTIONS: The undersigned understands that this permit may.be•subjectfto ". - which may be more restrictive than County regulations. Theu.mdersigned.assumes responsibility.forrcompliarmetwft any _applicable deed restrictions. UNLICENSED 'CON AND "CONTRACTOR RESPONSIBILMF-S: If the owner has - hired - za -contractor or • - contractors to work, they may be required be licensed in accordance with state and local 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 owner or intended contractor uncertain .as - to what licensing - requirements may :apply for the intendedmork, they are advised to contact the:Pasco County Building inspection Division—Licensing Sectionat 727-847- 8009 EUrthermore, if the 'owner has hired .a contractor or contractors, he is advised to have the contractor(s) sign portions the "contractor Block" of :application which will be responsible. If you as the owner sign as the contractir, 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,.asamended): If valuation of work is$2;500.00 or I certify that 1, - the applicant have been provided .with a copy of the - Fiorida Construction Lien Law—Homeowner's Protection Guide" prepared by the Florida 'Department Of Agriculthre and Consumer Affairs If the applicant is someone other than the "owner I certify that I have.obtained a copy cif the above described document and promise to deliver &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 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 all work will be performed to meet standards or all laws regulating construction, County and City codes, ..zoning regulations, and land • development regulations in the jurisdiction. 1 also certify - that I understand that the regulations of other govemment agencies may apply to extended work, and that it is my responsibility to identify what actions I must take to be in compliance.. If I am the AGENTFORTHE DWNER, I promise in good fait:h.to inform the owner of the permttting conditions set forth in this affidavit prior to commencing construction. -1 understand that a separate permit may be required for electrical or plumbing, signs, wells, pools, air conditioning, gas, or other installations not specincally 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 crf permit issuance, or if work authored by the perri is suspended or abandoned for a period crf 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 TD DWNER: YOUR FAILURE TO RECORD A 'NOTICE'OF - COMMENCEMENT MAY'RESULT IN 'YOUR PAYING1WICE FOR IMPROVEMENTS TD YOUR PROPERTY. IF YOU INTENDTD OBTAIN' FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFDRE RECORDING YOUR NOTICE OF COMMENCEIVIENT. FLORIDAILIURAT (F.S. 117.03) . • OWNER DR AGENT CONTRACTOR Subscribed and -sworn tD (or affnmed).before me this Subscrthed and swom to (or affirmed) before me It !is bY by Who isiars personally known to MB or has/have produced Who istare personally known in me or has/have produced • as idenifficalion. as identification. Notary Public Notary Public commission No. • Commission No. Name of Notary typed; printed or stamped Name of Notary typed, printed or stamped - • • • •