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Home My WebLink About12-12837 CITY OF ZEPHYRHILLS .. 5335-81'H STREET �`"" " (sis)�so-oo20 12837 ANNUAL ASSEMBLY PERMIT Permit Number: 12837 Address: 38543 4TH AVE Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Ciass 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: 11-26-21-0010-16800-0170 Improv. Cost: Date Issued: 2/23/2012 Name: 1 ST CHURCH CHRIST, SCIENTIST Total Fees: 50.00 Address: 38543 4TH AVE Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 2/23/2012 Phone: (813)782-2264 Work Desc: PLACES OF ASSEMBLY- FIRST CHURCH OF CHRIST SCIENTIST � O� 2 ' 2-`�� - ma 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 a�3-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application ►ate Received � ' Phone Contact for Permit ,�.T�... ..., � -._.��F;= �,�,»,��.�:��:�-,��.� � ��. — / �-��.�.. .. .,.>x,�. ��,-.. hvner's Name ' (�;G, -�' �� -�„� Owners Phone Number hvner's Address y� ��. , �ee Simple Titleholder Name Titlehoider Phone Number �� 7�a �-3 �ee Simple Titleholder Address r�.. r . °-��. _. iob Address �� Lot# iub Division �5»*..,^s-� ..�� Parcel# � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent a Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL � Controlled Bum � Hood Installation � Emergency Generator<30 kw � LP/Natural Gas-Instaliation � Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL '�(� Places of Assembly-ANNUAL y�_�� ❑ y emi � er ❑ Sprinkler ❑ ❑ ❑ Recreational Bum Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � O ❑ ❑ � � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � Fire Alarm Installation � Torch RoofinglTar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL � Valuation of Project Fuel Tanks Q Other: „�.-<��<-�: � :ontractor Company >ignature ,�t� Registered Y/N Fee Current Y/N Address License# :LECTRICIAN �ignature Company Registered Y/N Fee Current Y/N Address License# 'WMBER ignature Company Registered Y/N Fee Current Y/N Address License# IECHANICAL ignature Company Registered Y/N Fee Current Y/N Address License# THER gnature Company Registered Y/N Fee Current Y/N Address . License# rections: ,,,�,^„�� 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: Tnt �e u at'�ions. The u de�rsigned a's umes respons bilbry for compl ance w�h any which may be more restrictive than Cou y 9 applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contra or 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'vif�lat�he under state law. If the owner or intended contractor are uncertain as to what licensing requirements may app y 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 haas the ownea sign as the portions of the "contractor Block" of this application for which they will be responsible. If you, 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, CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, a ofrthe aF o)rida Construct'on L en Law—Homeowner's certify that I, t he applicant, have been provided with a copy Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If t he app licant 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'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. Apptication 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 regutations, 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 t 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, a4ter, 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 DER'O AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO MENCEMENT ' CONSULT WITH Y�UR LEN FLORIDA JURAT(F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to(or affirmed)before me this Subscribed and swom to(or affirtned)before me this by bY Who is/are personally known to me or haslhave produced Who is/are 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