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Home My WebLink About10-11121 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 11121 ANNUAL ASSEMBLY PERMIT Permit Number: 11121 Address: 5327 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 - 13300 -0010 Improv. Cost: Date Issued: 11/04/2010 Name: THE COUNTRY KITCHEN ON 301 Total Fees: 50.00 Address: 5327 GALL BLVD Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/04/2010 Phone: Work Desc: PLACE OF ASSEMBLY PERMIT FOR THE COUNTRY KITCHEN ON 301 P 1 50.00 / C.C.. __ I V \ I 111 1 • N- 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 j .. �.�►z� 3 j I : 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 of.Zephyrhills Fire Fax - 813 - 780 -0021 Permit Application Date Received �. , _ . __.,,.• _...,,,.,- ... _:.- .,..,., ,•_a >,,. ,. .:.... ,.. .,,.; Phone Contact for Permit ,.. _ K ■ �� /W CV &O �3 � 5 1 9-6 � Owner's Name I �V� C-1 , Owner's Phone Number C_ � Owner's Address ��rlii`_ -,_ `% \ \I ' Cad 7q - 3 3 (-I Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Address I (� , ` Lob Address ) ' 3 �� mss- \ �� vi & z {��t i t \r\ , \\s 1 (� -- L 3 3 5 yr) Lot # Sub Division Parcel # n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL Controlled Bum = Hood Installation 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 -AN AL IriFyl !Semi! Ma Other A � t CI ❑ ❑ = Recreational Bum 1 / ,� Fire Alarm ❑ ❑ ❑ I n Sparklers Hood Cleaning ❑ ❑ ❑ ❑ I n . Sprinkler Syste Installed Hood Suppression ❑ ❑ ❑ Standpipes (Sprinkler Sys) Fire Alarm Installation n Torch Roofing/Tar Kettle Fire Pumps Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL ' I Valuation of Project n Fuel Tanks ❑ Other. Contractor Company Signature Registered Y / N J Fee Current Y / N j Address I License # ELECTRICIAN Company Signature I Registered Y / N 1 Fee Current I Y / N j Address I License #. PLUMBER Company Signature Registered Y / N _ Fee Current I Y / N j Address I ' License # MECHANICAL . Company Signature Registered Y / N Fee Current I Y / N I Address I I License # I OTHER \�--t ,) Company Signature .�_ Registered Y/ N 1 Fee Current I Y/ N j Address \O S' Wk. r> 2 t . \\ - 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 (littp: / /appraiser.pascogov.com) NOTICE OF DEED,RESTRICTIONS: The undersigned understands that this permit maybe :subjectto "deed " 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 .a contractor or contractors undertake work, may be to be licensed in accordance with state and local regulations. 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 are uncertain as to what licensing requirements may apply for the intended work, 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 for which they will be responsible. If you, .as the owner sign as the contractor, that may be an indication he is not properly licensed and is not entitled permitting privileges in Pasco County. CONSTRUCTION LIEN LAW (Chapter713, 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", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it 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 development. Application is hereby made to 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 that 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 govemment 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. I 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 PAYINGTWICE 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 JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by by 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