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Home My WebLink About11-11852 - CITY OF ZEPHYRHILLS 5335 - 8TH STREET (si3) �so-oozo 11852 ANNUAL ASSEMBLY PERMIT Permit Number: 11852 Address: 38518 CR 54 EAST 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: 02-26-21-0060-O0000-0010 Improv. Cost: Date Issued: 5/09/2011 ��+�'� Name: LIBERTY PROFESSIONAL INC Total Fees: 50.0(�-� Address: 12603 LAKE HILLS DR Amount Paid: 50.00 (.-�� `� RIVERVIEW, FL Date Paid: 5/09/2011 Phone: Work Desc: PLACES OF ASSEMBLY- COUNSELING CENTER-FEE WAIVD PER FM-EXP 5/2012 5. ,� � ��I� � � - ina 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 s�aaso-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Appiication Date Received Phone Contact for Pertnit �� Owner's Name � Owners Phone Number �� Owner's Address Fee Simple Titleholder Name TiUeholder Phone Number �� Fee Simple Titleholder Address Job Address Lot # � Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility} ANNUAL � Controlled Bum � Hood Installation � Emergency Generator < 30 kw � LP/Natural Gas-Installation � Emergency Generator> 30 kw LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL Places of Assembly-ANNUAL �y emi �n er � Sprinkler � ❑ ❑ ❑ Recreational Bum ��' � � S Fire Alartn � ❑ ❑ ❑ � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Toroh RoofinglTar Kettle � Fire Pumps � Waste Tire Storage ANNUAL Fire Works � Flammable Application- ANNUAL Valuation of Project � Fuel Tanks Q Other. Contractor ,p � � � Company Signature C�(�, Registered Y/ N Fee Current Y/ N Address license # ELECTRICIAN Company Signature Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Signature Registered Y/ N Fee Current Y/ N Address License # MECHANICA Company Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions:� , . „,_�. .,. „. � �� . ... _,..,.. .. ., . ...�.,��... ..,�, .� .. ... . Fill out application completely Owner 8 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) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" 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 to undertake work, they may be required 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 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 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 to permitting privileges in Pasco County. CONSTRUCTION LIEN LAW (Chapter 713, 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 the 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 to the "owner� prior to commencement. - CONTRACTOR'S/OWNER'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 Ciry codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other 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 FOR THE 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 ninery (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 JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to (or affirtned) before me this Subscribed and swom to (or affirmed) before me this by by Who is/are perso�ally knovm to me or has/have produced Who islare personally known to me or haslhave produced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary ryped, printed or stamped