HomeMy WebLinkAbout10-10289 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 10289
ANNUAL ASSEMBLY PERMIT
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Permit Number: 10289 Address: 38924 AVE
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: 14- 26 -21- 0100 - 03300 -0040
Improv. Cost: , .
Date Issued: 3/25/2010 Name: ZEPHYRHILLS WESLEYNN CHURCH
Total Fees: 50.00 Address: 38924 C AVE
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/25/2010 Phone:
Work Desc: PLACES OF ASSEMBLY- ZEPHYRHILLS WESLEYNN CHURCH
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IR IT IN P TIsN- inal
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, N FPA101, 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
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. 813 -780 -0020 • City ofZephyrhills'Fire,:
Fax -813 -780 -0021
Permit Application
Date Received - Phone Contact•for Penult
Owner's Name / EQONI 0 lt 1Q, `J LE`/AM CAUQ.Lt Owner's Phone Number C�
613 -1ENZ, IB
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Owner's Address 3 89Z4 C &\\E 7PPWriZ_LXa LLS FL 3354Z .
Fee Simple Titleholder Name Titleholder. Phone Number
Fee Simple Titleholder Address 1
Job Address • Lot#
Sub Division I • Parcel #
n Bio- Hazard Waste Storage - .ANNUAL n Fumigation Tent
- 1 1 Comm Exhaust Kitchen•Hood/Duct • n Hazardous Material (Tier 11 or RQ Facility) ANNUAL
n Controlled Burn n Hood Installation
• F Emergency Generator < 30 kw n LP /Natural Gas - Installation
n • Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
n Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL .
lLttrlyl •) Semi I Other
Sprinkler n ❑ ❑ ❑ n Recreational Burn
• Fire Alarm • E ❑ ❑ ❑ 1 1 n Sparklers
Hood Cleaning IT ❑ ❑ ❑ I I n Sprinkler 'System installations
• Hood Suppression El • ❑ ❑ ❑ .I ( n Standpipes (Sprinkler Sys) •
n Fire Alarm Installation n Torch Roofing/Tar Kettle
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL M I Valuation of Project
Fuel Tanks
Other:
) 6.3.1 Ai u t t- 6S Se►-•1 i3L.`j port t't 1 .
_ r Company ., ..,
Contractor t
Signature till' ,� ; L
Y /.N j Fee Current I Y / N
Address I License #
ELECTRICIAN Company .
Signature Registered Y / N Fee Current I Y / N I
Address 1 I License # I
PLUMBER Company
Signature Registered Y / N Fee Current Y / N I
Address 1 . I License # I
MECHANICAL • Company
Signature . Registered Y/ N 1 Fee Current I Y/ N I
Address ) 1 • License # I
OTHER Company
•
Signature
Registered Y/ N ,1 Fee Current 1 Y! N
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)
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'NOTICE OF:DEEDRESTRICTIONS: The.undersigned understands that this permit maybe• subject :to - "deed °Yrestrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility :for:compliance+with any
applicable deed restrictions.
`UNLICENSED CONTRACTORS AND - CONTRACTOR RESPONSIBILITIES: If - the owner has - hired - ra - contractor or -
contractors to undertake work, they may be required to 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 the 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 727 -847-
8009. Furthermore, if the owner has hired :a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application which 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.
CONSTRUCTION.LIEN.LAW (Chapter Florida Statutes,.as:amended): If valuation of work is •$2;500.00 or more, I
certify that I, - the applicant, have been provided with a copy. of the Florida Construction Lien Law— Homeowner's
Protection Guide" prepared by Florida Department of Agriculture and Consumer Affairs. If the applicant is . someone
other than the owner", 1 certify that l have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
- CONTRACTOR'S /OWNER'S AFFIDAVIT: 1 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. 1 certify
that no work or installation has commenced prior to issuance of a permit and all work will be performed to
meet standards of all laws regulating construction, County and City codes, .zoning regulations, and land
development regulations in the jurisdiction. I also certify that I understand that the regulations of other
. goverment agencies may apply to the intended work, and that it is my responsibility to identify what actions I
must take be in compliance.
If I am the AGENTFORTHE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. l understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically 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 of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of 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 TO OWNER: YOUR FAILURE TO. RECORD A 'NOTICE 'OF 'COMMENCEMENT MAY RESULT IN 'YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN - FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA J URAT: (F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swum to (or affirmed) before me this Subscribed and swom to (or affirmed) before me this
by b
Who is/are 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