HomeMy WebLinkAbout09-9115 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9115
ANNUAL ASSEMBLY PERMIT
Permit Number: 9115 Address: 5118 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: 11-26-21-0010-07000-0011
Improv. Cost:
Date Issued: 5/08/2009 Name: FUNG GARDENS
Total Fees: 50.00 Address: 5118 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/08/2009 Phone: (813)788 -4586
Work Desc: PLACES OF ASSEMBLY FUNG GARDENS
. ' ° i s ..,. 6 .... 3 >4 . n
FIRE PERMIT FEES 50.00
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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
813 - 780 -0020 Ci ty p h of Ze rhills Fire Fax - 813 -780 -0021
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Permit Application
C24. Phone Contact for Permit
Date Received
�.. d�
• Owners Phone Number �� ��(� 1 Owners Name �,,/� f //�� ry/ _
Owner's Address 1 ,..5 s7 64 / 1 fi L Y " " • 7 �iiJ i� 1 / r
��
I Titleholder Phone Number ( 1 1 I
Fee Simple Titleholder Name I
Fee Simple Titleholder Address -. .. r_ _, � - �. .
Lot #
Job Address ( I
Sub Division 1 Parcel #
CI Bio-Hazard Waste Storage - ANNUAL Hazardous Material (Tier II or RQ Facility) ANNUAL
Comm Exhaust Kitchen Hood /Duct ED Hood Installation
ED Controlled Bum a LP /Natural Gas - Installation
Emergency Generator < 30 kw LP /Natural Gas - ANNUAL Sale
El Emergency Generator > 30 kw ED Places of Assembly- ANNUAL
Fire Protection Maintenance - ANNUAL I-1 Recreational Bum
r y 'Semi' Eall 'Other I ❑
Sprinkler 0 ❑ ❑ ❑ Sparklers
Fire Alarm ❑ ❑ ❑ I I I Sprinkler System Installations
Hood Cleaning 0 ❑ ❑ ❑ I 1 El Standpipes (Sprinkler Sys)
Hood Suppression 0 ❑ ❑ ❑ I I E Torch Roofing/Tar Kettle
Fire Alarm Installation 0 Waste Tire Storage ANNUAL
Fire Pumps
Fire Works I
Flammable Application- ANNUAL Valuation of Project
Fuel Tanks I
0 Other
..� .:4d.�S.x VIZ. »-,,.�.✓r'Td ..:��S.w. 3��- �. rC w'- �t, ��+ ?" F5& 1�rR•. ceN? �, .?Y_iXfW><.�+3t= RP,�.k'?..�3�SY ,, ' �. mcfx.. eb'.L.:' 3 '� - �R€ _. e s�. PiH - F•*'*Sw� -"
/ Company
Registered I
Contractor I /J I
Signature X r d Y/ N I Fee Current I Y/ N I
Address I I License* I
ELECTRICIAN Company I
Signature Registered Y/ N I Fee Current I Y/ N
Address 1 I License # ( I
PLUMBER Company
Signature Registered l Y/ N � Fee Current I Y/ N I
Address I I License # I I
MECHANICAL Company I
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License # ( I
OTHER Company I
Signature Registered Y/ N 1 Fee Current I Y/ N I
Address License #
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)
;ND T iCEPFDEED RESTRICTIONS: The undersigned understands that this permit may.be•subjectito"deed° restrictions" -
which may be more restrictive than County regulations. The..undersigned.assumes responsibility.for complianne +with any
.applicable deed restrictions.
UNLICENSED 'CONTRACTORS AND 'CONTRACTOR RESPONSIBILITIES: If . the owner has -hired-a- contractor or - -
contractors to•undertake work, they maybe required-to be licensed in accordance wtth state and local regulations. If the
contractor is• not licensed as required by law, bothi;the owner .and contractor may be cited for misdemeanor violation
under state law. If 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 777 -847-
8009. Zurthernore, if the *owner has hired .2 contractor or contractors, he is advised to have the contractor(s) sign
portions . ;:if the "contractor Block" of application for which will be responsible. if you as 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. r7K3, Florida StaturEes,asm
. aended): If valuation of work is or more, I
certify that t 1 ,
C
.LIEN LAW ( b provided -with .a copy of the "Florida Construction Lien Law— Homeowner's
1 - the he applicant, have .been .be en p e
nt is - someone
Protection Guide" prepared by Florida Department of Agriculture above �� cubed do ument and promPsean goo iatth to
other than the "owner", I certify that' have obtained a copy Of
deliver it!to the `owner" prior to commencement.
te and
CONTRACTOR'S/OWNER'S-AFFIDAVIT: I certify that all the ei info
r on in c onstruction, ' is
s c A l and
t all work will be done in compliance with all . app
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 lions, and land
o
meet standards of all laws regulating construction, County and City t hat the regulations of other
development regulations in the jurisdiction. I also certify
- govemment agencies may apply to Intended work, and that it is my responsibility to identify what actions I
must take to be in compliance. -
tf 1 am the AGENT'FORTHE DWN promise
ctroi ds f i understand that a pe may h required for�elG�l� cal
this i"idavit prior to commencing c as, .or other installations not specifically included in the application. A
plumbbing, signs, welts, pools, , air conditioning, g
the work and not as authority permit issued -shall i construed to c des, nor shall ssuance of a permit Prevent the B ding (Official cancel,
rom thereafter aside any provisioio ns of the technical permit issued shall become invalid
requiring a correction of errors in plans, construction or violations of.any codes. Every
unless the work authorized by such permit r a�enod of six (6 within. or>t'hs after the time�the�workas commenced. An extension
may pb r is sus or abandons P
may be ;red, in writing, from the Building Ofirictal, for a consecutive days, the job (90) days and
tiered aba
d neddemonstrate
justifiable cause for the extension. If work ceases for ninety ( 90 )
■
WARNING TO OWNER: YOUR FAILURE O YOUR
PRDPERTI'• IF YOU -COMMENCEMENT
OBTAIN' FINANCtNG,
PAYINGTWICE FOR IMPROVEMENTS
WITH YOUR. LENDER OR AN ATTDRNEY-BEFDRE RECORDING YOUR NOTICE` OF COMMENCEMENT.
FLDR1DAiJURAT (F.S.117.03)
OWNER DR AGENT fii CON and swum to (or affirmed) before me this and .sworn to (or amied).before me fttis swom
by
by
Who istare personally (mown to me Who rsJarepersorralb' Iutown 10 me or has/have produced
identification. has/have on. produced as identification.
as ienttfiii
Notary Public
Notary Public
Commission No. .
Commission No. -
Name of Notary typed: printed or stamped
Name of Notary typed, printed or stamped
•