HomeMy WebLinkAbout09-9229 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9229
ANNUAL ASSEMBLY PERMIT
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Permit Number: 9229 Address: 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 - 12100 -0252
Improv. Cost:° ' 7 r :11172.1): s.,
Date Issued: 6/10/2009 Name: SUB -WAY
Total Fees: 50.00 Address: 5406 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/10/2009 Phone:
Work Desc: PLACES OF ASSEMBLY PERMIT FOR SUBWAY
OWNER FIRE PERMIT FEES 50.00
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FIRE SITE INSPECTION -Final
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OCCU PANCY 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
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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
/ ye6 City ofZephyrhillsFire• Fax - 813 -780 -0021
81 3 - 780 -002
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Permit Application
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' . - Phone Contact for Permit
Date Received
Owner's Name �
V /NC. DBI4 3 uQ wA�l Owner's Phone Number
I S� %Th sq. P t Ft- 337 34
Owner's Address L V''9 - 7it 34 Ct. I 1
Titleholder Phone Number J
Fee Simple Titleholder Name
Fee Simple-Titleholder Address vim} _ "_A «..,s k •
.x,,,� .s ti' 3354'2.
S V-7(.... Lot f
Job Address 1 -- VVO Zep)'}'4IR -4%LA- f 1
5406 Cr -'t� Q 1 I Parcel #
Sub Division „�, -n�T,
Bio-Hazard Waste Storage - ANNUAL
Fumigation Tent
Comm Exhaust Kitchen Hood/Duct Hazardous Material (Tier II or RQ Facility) ANNUAL
n - Controlled Bum l I Hood Installation
f I
Emergency Generator < 30 kw 1 1 LP /Natural Gas - installation
J I LP /Natural Gas - ANNUAL Sale
Emergency Genetator> 30 kw
Places of Assembly- ANNUAL
Fire Protection Maintenance - ANNUAL ry�rr 74 ��
)utnyl Therm] f r IUtner ,� qi 5pr IQ ❑ ❑ 1 1 Recreational Bum /
Fire Alarm 1 1 ❑ ❑ ❑ 1 I 1 1 Sparklers
1
Hood Cleaning n ❑ ❑ ❑ 1 ( 1 1 Sprinkler System Installati --"` --
Hood Suppression ❑ ❑ ❑ 1 l 1 1 Standpipes (Sprinkler Sys)
1 1 Fire Alarm installation 1 1 Torch Roofing/Tar Kettle
I Fire Pumps 1 1 Waste Tire Storage ANNUAL
1 Fire Works
Flammable Application- ANNUAL . p Valuation of Project
Fuel Tanks
fl Other: 1
Contractor ' Company
ontractor Company L- P -r A- 1 N(L
Signature t, ' '._ ___ Registered Y / N I Fee Current 1 Y / N
Address a - -
License #
ELECTRICIAN Company L .
Signature Registered Y / N 1 Fee Current Y / N
Address License # 1
PLUMBER Company
Signature Registered Y / N 1 Fee Current Y / N
Address 1 License # 1
MECHANICAL Company
Signature Registered Y / N I Fee Current Y / N •Address License # 1
OTHER. Company
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Signature Registered Y / N Fee Current Y / N
Address! Lice s _.:, _......, .. .. _... _ ....._ ... ^
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 (httpj /appraiser.pascogov.com)
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permit 'NOTICE OF :DEED RESTRICTIONS: The and s ors. The'understands that a umes responsib Ibty.for compl a a with any
which may be more restrictive than County reg u
.applicable deed restrictions.
UNLICENSED 'CONTRACTORS AND "CONTRACTOR E RESPONSIBILITIES: ITIE : If with ow te and localner has
egulbons c If the
contractors o ndeenke work, they may be required
contractor is' not licensed as required by law, both the owner and contractor may be cited - for a misdemeanor violation for the
under state law. Iy are owner or intended con act the .Pasco C unty uncertain D v s on—L ceps ng ction:at 727-847 -
8009. a F urth e r they are ermore, if the oed t
8009. Furthermore, 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 - they 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. _ 500.D0 or more, I
CONSTRUCTION .LIEN LAW (Chapter713, Florida Statutes, of he d e undo va luation of r Lien $ Law— Homeowner's
certify that 1, the applicant, have .been provided with a copy
other than an t Gde"
"owner", I c c e by th rtify tha t t I have Department obtained c py f the above d scribed document and promise in faith to
other thh "oner", I ea
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 A stalla{ on commenced pri
or to issuance of a permit and that installation as indicated. I certify will be performed to that no work or install codes, zoning regulations, and land
meet standards of all laws regulating construction, County that nd l understand codes, that the regulations and
other
development regulations in the jurisdiction. I also certify
. 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. -1 understand i that
stallation of speci al y b req ire fo e r le ical work,
plu signs, wells, pools, air conditioning, gas, or other
set aside any p ny provisions io ns construed ch n i s a license
c odes, nor shall issuance a permit prevent the Building violate,
se al from thereafter
set asde aroviio of the technical permit invalid
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requiring a correction of errors in plans, construction or violations of any codes. e ry eemit rmit iss s ue e d shall bec if work au ome Inv by
unless the work authorized by such permit is commenced after time.the work is commenced. An extension
the perrnit is suspended or abandoned for a period of months six (6) (90) days and .11 demonstrate
may be ;requested, in writing, from the Building Official, for a0 consecutive days, the job is considered abandoned.
justifiable cause for the extension. If work ceases for ninety ( 9 )
'WARNING TO OWNER: YOUR FAILURE TO RECORD A'NOTICE YOU ' N OBTAIN F NANCING CIONSU 'YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDAIJURAT (F.S.117.03)
CONTRACTOR
OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this
Subscribed and swam to (or affirmed)•before me this by
by Who islare personally known to me or has/have produced
Who is/are personally known to me o 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
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