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Home My WebLink About11-12468 C�TY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 12468 ANNUAL ASSEMBLY PERMIT Permit Number: 12468 Address: 6251 FORT KING RD Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBLY Townshi Proposed Use: NOT APPLICABLE p� Range: Book: Square Feet: Lot(s): Block: Section: Est. Value: Subdivision: CITY OF ZEPHYRHILLS Improv. Cost: Parcel Number: 03-26-21-0010-09500-0000 Date Issued: 10/21/2011 Name: ALLIANCE CHURCH OF ZEPHRYHILLS Total Fees: 50.00 Address: 6251 FORT KING RD Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 10/21/2011 Work Desc: FPM- PLACES OF ASSEMBLY - ALLIANCE CHURCH OF Z-H LL EXP 10/2012 � C�fi� � �,Z��l� , - 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 PERMIT EXPIRES IN ONE (1) YEAR FROM DATE OF ISSUANCE IC R 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 ,/��,,p �� /l�`�r� �ity or �epnyrnms rire � ! Permit AppliCation rax-a�s-iuu-wz� Date Received � � '�'^°R Phone Contact for Permit 6 , � w,... �� Owner'sName }�/¢L.1—/�}il9CC �,�/(J/�C�-r � z— ' `° � Y F ��`� Owner's Phone Number g� 3 � {,J[ � S�p� Owner's Address 6aS/ Fn �� 2�� __ o 6 � �E�°f{ �ff /t1-S �L - 33�`"�� Fee Simple Titleholder Name �� Fee Simple Titleholder Address C Titleholder Phone Number � ° - ;-s�:�a�z- ��.. � x � _ JobAddress � � �� ;"�;;n'w - Y.�;. ;�;;,_°�- Sub Division Lot # 4, �� s • �.yr,:� ; . .,�°�� . Parcel # ��i��>... � �- ,� ��--�-x. . � Bio-Hazard Waste Storage - ANNUAL ' 3 �� :YK � rv � �� .�� x.�.;r�.��-��,�.. � Fumigation Tent Comm Exhaust Kitchen Hood/Duct � a hlazardous Material (Tier II or RQ Facility) ANNUAL Controlled Burn � Emergency Generator < 30 kw Hood Installation � Emergency Generator > 30 kw � �P�Natural Gas-Installation a Fire Protection Maintenance - ANNUAL ' �P�Natural Gas-ANNUAL Sale Places of Assembly-ANNUAL ❑ � Y emi � er Sprinkler � � � ❑ Recreational Burn Fire Alarm � � � � ❑ ❑ Sparklers Hood Cleaning � � � � ❑ ❑ Sprinkler System Installations Hood Suppression � � � � ❑ � Standpipes (Sprinkler Sys) Fire Alarm Installation � � Toroh Roofing/Tar Kettle Fire Pumps a � Fire Works Waste Tire Storage ANNUAL • � Flammable Application- ANNUAL � Fuel Tanks Valuation of Project Q Other: .. p'$.:�'� _ '.''.fiL.w�'n£I�.} t?�'; ...: a:e' ' '�.. -:��.. r.8 R�i r ;�' : Contractor � ` �s`_. � - -.��„.�,.m �,.� � �*w��.� a�� =::��^� �r: , �u;:� „ �,w 5ignature Com an �� dL2 P Y Address Registered Y/ N Fee Current Y/ N :LECTRiCIAN License # iignature Company Address Registered Y/ N Fee Current Y/ N 'LUMBER License # ignature Company Address Registered Y/ N Fee Current Y/ N ECHANICAL License # gnature Company Address Registered Y/ N Fee Current Y/ N fHER License # �nature i Company Address Registered Y/ N Fee Current Y/ N ections: License # Fill out application completely Owner & Contractor sign back of application, notarized (Or, copy of signed contrect with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicabie documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice htt //a ( P� ppraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS The undersi9nns. The undersign d a responsi�ilty for compl a t w'th any which may be more restrictive than County regulatio applicable deed restrictions. UNLICENSED CONTRACTORS AND bONe�ed o EcenOsedSiBac'coEdance th s ate a d local egulation If contractors to undertake work, they may q I for the contractor is not licensed as required bY ��nbactohare uncerta n as what I censeng r qu� emen may app yio ation under state law. If the owner or intended intended work, they are advised to contact th�ea con ac or org ontracto sP he��s advised to I have he contractor(s) sign 8009. Furthermore, if the owner has hire portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as t e contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. 500.00 or more, I CONSTRUCTION LIEN LAW (Chapt 1 3 ovided wsh a t copy of he a F o Construct on L en $ aw—Homeowner's certify that I, the applicant, have b p Protection Guide" prepared by the Florida Department of A�gf the descr bed document nd prompse n fa th to other than the "owner", I certify that I have obtained a copy deliver it to the "owner' prior to commencement. _ CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify tha 'cableeaws r egu ating on� zon ng and land that all work will be done in compliance with all app ' development. Application is hereby �dceea °o`ao ssuance of a perm and I that all will performed that no work or installation has com P meet standards of all laws re e ul u�isdic on tr ictaiso certify u stand that he ons other development regulations in th � government agencies may apply to the intended work, and that it is my responsibility to identify what actions must take to be in compliance. If I am the AGENT FOR THE OWNER, I p ti�mise �u that a�s parat permit may be req u ed for c I work, this affidavit prior to commencing construc lication. A plumbing, signs, wells, pools, air o eda°� gse to p oceed the work and not a or ty to violateecancel, alter, or permit issued shall be construed t set aside any provisions of the technical o struct on oaviolation of any cod sp t iss ed shall become inval d requiring a correction of errors in plans, c unless the work authorized by such pefo �a�se od of six (6) m after the tme the commenced An exte sion the permit is suspended or abandoned p may be requested, in writing, from th`eo k oe ety (90) days, theeob is de ed ba� donedstra e justifiable cause for the extension. If n� WARNING TO OWNER: YOUR FAILURE YOUR PROPERTY TIF YOU NTEND TO OBTAIN F NANC NG, CONSULT PAYING TWICE FOR IMPROVEMENTS TO WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) CONTRACTOR OWNER OR AGENT 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 haslhave 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 tYped, Printed or stamped ,,,�,,,�.,�,�.�-.., ,..