HomeMy WebLinkAbout11-12270 ,i ---
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(si3) �so-oozo 12270
ANNUAL ASSEMBLY PERMIT
Permit Number: 12270 Address: 5855 16TH ST
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: 11-26-21-0010-05000-0010
Improv. Cost:
Date Issued: 8/18/2011 Name: ST. ELIZABETHS EPISCOPAL CHURCH
Total Fees: 50.00 �-�� ^'
Address: 5855 16TH ST
Amount Paid: �� � ZEPHYRHILLS
Date Paid: 8/18/2011 Phone:
Work Desc: PLACES OF ASSEMBLY FOR ST ELIZABETH CHURCH-FEE WAIVED PER K BARNETT
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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
8'I`.l-780-0020 City of Zephyrhilis Fire Fax-813-780-0021
Permit Application
Date Received Phone Contact for Pertnit
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Owner's Name ,-�/" Owners Phone Number �,� �Z 2 d Z
Owner's Address s � �f s, T �� S �
Fee Simple Titleholder Name Titleholder Phone Number � C� ��
Fee Simple Titleholder Address
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Job Address �� s h . / ! � ,3� Z Lot # ��
Sub Division Parcel #
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a Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Tier II or RQ Facility) ANNUAL
a Controlled Bum � Hood Installation
� Emergency Generator < 30 kw a LP/Natural Gas-Installation
� Emergency Generator> 30 kw a LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL Places of Assembly-ANNUAL _ B �
❑ �y emi �n er � �/`� /
Sprinkler ❑ ❑ ❑ Recreational Bum �-
Fire Alartn � ❑ ❑ ❑ � � Sparklers �
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations �
Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
� Fire Alarm installation � Torch RoofingRar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application- ANNUAL �1 Valuation of Project
� Fuel Tanks
Q Other:
. . . .,. . .,,.. . >. ..�: � .� ,�_ -� . �
Contractor � . ,... - 4, �:y�:sr.... .... �..�.. �.��a ... . .
Company
Signature ,� �, Registered Y/ N Fee Current Y/ N
Address License #
ELECTRICIAN Company
Signature � Registered Y/ N Fee Curtent Y/ N
Address License #
PLUMBER Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
MECHANICAL 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 & Contractor sign back of application, notarized (Or, copy of signed contract with ovmer)
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 City 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 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 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 b Y
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 ryped, printed or stamped
'�� �,�~�� ,� InSpQCt��r1 R@pQ� �- .. Print Date: 8/15/2011 10�03 07AM
y �:"t ;� Annual � � " b
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� zephyrhills Fire Rescue Activity Date: $/�5/2p11 � nt n
Fire Prevention Bureau 9 '32:26qR/�
6907 Dairy Rd Activity Number I-171-10-0430
Zephyrhilis, FL 33542 Activity Cause: Periodic
Phone 813-7 80-0041 �nspector Name: Kerry garnett
Fax 813- 780-0044 Inspector Phone•
Status: Fail
Pa rt}�
ST ELIZqgETH CHURCH
(000563) Occupancy Type. Assembly
5855 16TH ST Property Use: Places of Worship
ZEPHYRHILLS, FL 33542 Total Violation. 6
813-782-12p2 Corrected Violation• p
Hours: 0 50
Total Fees $ 0 00
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1 Ref Number NFPA 1 (2006) Florida Fire Prevention (2007) 11 1.2 Electrical Fire Safety `
All electrica' appliances, fixtures, equipment, or wiring shall be installed and maintained in ac
�Comment Iv GARAGE _ REpLqCE LIGHT SWITCH F cordance with NFPq 7p, National Electrical Code.
2 Ref Nu�nber NFPA � _ ACE PLqTE COVER THAT IS BROKEN (LOCATED BY DOOR)
(2006) Florida Fire Prevention (2pp7� 13 g � 1 General Requirements. ---�-- �
The installat on, maintenance, selection, and distribution of
Fire Extinguishers, and Section 13.6 Portable fire extinguishers shall be in accordance with NFP
Comment: RELOCATE FIRE EXTINGUISHER ON NORTH WALL IN SANCTUARY - IT IS OBSTRUCTE A 10, Standard for Portable
3 Ref. Nur,iber NFPA 1 (2006) Florida Fire Prevention (2007) 11 1 5 1 �
Multiplug adapters, such as multipiug extension cords, cube adapters, strip plugs, and other devi D � -- -
Multiplug Adapters
their listing. -
ces, shall be listed and used in accordance with
omment: rernove multi piug adapter plugged into surge strip on north wall IN SANCTUARY , ry
4 Ref Number NFPA101 (2006) Florida Fire Prevention (2007) 7 g � �* v �
Emergency lighting facilities for means of egress shall be provided in accordance with Section 7.g for th
where required in Chapter 11 through Chapter 42 2 General. _ _ --
() Underground and limited access structures as address in Section 11 7
5uildings as reauired by other sections of this Code 4
�nclosures, for which the following also a �• 9 ��� guildings or structures
() Doors equipped �,,ith delayed-egress locks (5) Stair shaft and vestibule of smokeproof
or the smokep •oof enclosure mechanical ventilation equipment. (b) The standb ( High-rise
PP y(a) The stair shaft and vestibule shall be permitted to include a standb
�estibule emerqency lighting power supply (6) New access-controlled egress doors in accordance with 7 Y 9enerator that is installed
:omment: REFAIR EMERGENCY LIGHT ON SOUTH WALL IN SANCTUARY yBULBrator shall be permitted to be used for the stair shaft and
Ref Numbf�r NFPA � - ---- �2��.6.2_
(2006) Florida Fire Prevention (2007) 1 12,1 pe�mits and App o a sD OUT � U
he AHJ shall b� authorized to establish and issue ` -� 1
� life or propert�� pursuant to Section 1 �2, Permits, certificates, and a rovals ertainin to conditions, o erations, r
omment: OBTF,IN AN ASSEMBLY PERMIT FOR THE SANCTUARY PERMpT M p 9
ERMIT
p o materials hazardous
AY BE 06 7AINED AT THE CITY BUILDING DEPT. FEE IS WAIVED FOR
Ref Numbei NFPA101 (2006) Florida Fire Prevention (2pp7� q 6 1.2
�y requirement: that are essential for the safety of buiiding occupants and that are not specificall
the authority havingjurisdiction. Authority Having Jurisdiction. ________
�mment: INSTA! L LIGHTVI/EIGHT TRUSS SIGNS AT MAIN DOOR OF CHURCH H y p�ovided for by this Code shalt be determined
� MAIN DOOR C)F THRIFT STORE. PAPERWORK PROVIDED
ALL (EAST SIDE), ON GAR,qGE BETWEEN GARqGE DOORS, AND
re - - ------ --
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Pre-existing Ou�standing Violation
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