HomeMy WebLinkAbout09-9235 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9235
ANNUAL ASSEMBLY PERMIT
Permit Number: 9235 Address: 5963 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: 10- 26 -21- 0020 - 00000 -0021
Improv. Cost: A,
Date Issued: 6/12/2009 Name: ABC RESTAURANT
Total Fees: 50.00 Address: 5963 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/12/2009 Phone:
Work Desc: FPM - PLACES OF ASSEMBLY -ABC PIZZA
FIRE PERMIT FEES 50.00
C ( 152°)
q if
Ry 5,
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
City ofZephyrhillsFire• Fax- 813-780 -0021
Permit Application
Phone Contact for Permit
Date Received 6'/2 , � P „ .,__ M _cW...
Owner's Phone Number 1
Owner's Name � - -
Owner's Address .9CP3' Z#'49--e--e---- ! '
Titleholder Phone Number
Fee Simple Titleholder Name
1
F
Simple 717:M 111, Address t ,t �,,,, ,_ 1_ .., Drys omo
.. � ��r.�.. "" rW+.}. r.L,x ...; � i .r
.: A ... -y �:. i w,.... � :rx�...,,�.A�w`�� �.. ��. r. .+e...�..J�''.r��Y4M�4�tE.'x�t� '+'c"i /� / .. ...� —� J Lot # 1 � ..
� . -- ,e; 1---- ( / �� 7 "!mil
Job Address 1 � 6 3
Parcel # �
Sub Division f
,.=,a rse, rv.. .
1 Fumigation Tent
Bio-Hazard Waste Storage - ANNUAL
1 I Comm Exhaust Kitchen Hood/Duct 1 Hazardous Material (Tier II or RQ Facility) ANNUAL
I - Controlled Bum I Hood Installation
1 LP /Natural Gas - Installation
Emergency Generator < 30 kw
1 Emergency Generator> 30 kw ,�. 1 LP/Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL � 1 "' maces of Assembly-ANNUAL
)UtnyJ 1semi ! " rtner 1
Sprinkler ❑ ❑ ❑ 1J Recreational Bum
Fire Alarm I I . ❑ ❑ ❑ 1 1 I Sparklers
Hood Cleaning n ❑ ❑ ❑ I I I Sprinkler System Installations
Hood Suppression LJ ❑ ❑ ❑ j I 1 Standpipes (Sprinkler Sys)
1 Fire Alarm Installation I Torch Roofing/Tar Kettle
Fire Pumps J Waste Tire Storage ANNUAL
I Fire Works
1 Flammable Application- ANNUAL . ` f Valuation of Project
, .1 1 Fuel Tanks
1 Other: 1
Contractor - ` 7 7 ,„•--- 7 ,„•--- „. S • -��tj, Company . / 5 -
Signature
: 3 Registered Y / N Fee Current Y / N
Address 111W 9f- iri/ /" / / . . License #
ELECTRICIAN Company - Signature • Registered _ Y / N Fee Current Y / N
Address License #
PLUMBER Company
Signature Registered Y / N Fee Current 1 Y / N
Address License #
MECHANICAL Company
Signature Registered Y / N Fee Current 1 Y / N 1
Address -License # _
OTHER. Company
Signature Registered Y / N Fee Current Y / N
Address. ( L i. nse
Lice
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)
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i m �;OF:DEED RESTRICTIONS: The undersigned lersigned this permit
responsibility .for:compi antetwt
which 'th any
which may be more restrictive than County regulations. The und
.applicable deed restrictions.
UNLICENSED 'CONTRACTORS ertawork, ey may be required ed'O be licensed n accordance with state and localr egula ons -contractor If the
contractors so not is not licensed as required by law, both the owner .and contractor may be cited - for a misdemeanor violation
under state law. Iy are owner or i contact contractor h sco County Buulllding Inspection Division—Licensing l S ction -at 727-847 - for the
8009. a Furtheermor e, if t are he owner to c
8009. Furthermore, owner has hired .a contractor or contractors, ilbe responsible. advised If you, as t owned sign as
portions of the "contractor Block" of this application for which -they rile 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.
2;500.00 or more, I
CONSTRUCTION .LIEN LAW (Chapter713, Florida Statutes, of a d F ' ) i f C luation oton r en is $ Law— Homeowner's
certify that 1, the applicant, have .bean provided with a copy
Protection Guide" prepared by Florida Department of Agriculture etb ve
and Consumer Affairs. If the described document and prom faith to
other than the "owner", I certify that 1 have obtained a copy
deliver itfo the "owner" prior to commencement. that all the information in this application is accurate and
_ CONTRACTOR'SlOWNER �S AFFIDAVIT: I certify !able laws regulating construction, zoning and land
that all work will be done in compliance with all applicable
development. Application n i has com p�or�to issuance of a permit and�that�lalaltwork indicated. I certify to
that no work or installatto codes, .zoning regulations, anod land
meet standards of all laws regulating construction, County and Ci reg f other
development regulations in the jurisdiction. I also certify that I understand that the
. 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.
ons set forth in
If i am the AGENT •F OWNER, I prom ise iU good h that a separate permit may be required for t electri al work,
this affidavit prior to commencing construction.
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall construed to a lodes, nor shall issuance of a permitp event the Building violate,
Official from thereafter
work an not as auority to set aside any provisions of the technical codes, ermit issued shall become invalid
requiring a correction of errors in plans, construction or violations of any codes. Every p
unless the work authorized by such permit is commenced within nths after the e r
of permit issuance,
commenced. authorized
by
the pern$it is suspended or abandoned for a period of six (6) 9 days commnc will demonstrate
An extension
io
may be requested, in writing, from the Building Official, for a9per %des cutive days, the job is considered abandoned.
justifiable cause for the extension. If work ceases for ninety ( 0 )
'WARNING TO OWNER: YOUR FAILURE TO RECORD A 'OF N OBTAIN F NANO NG C
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDAJURAT (F.S. 117.03)
CONTRACTOR
OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this
Subscribed and sworn to (or affirtned).befnre me this by
by Who i 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
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