HomeMy WebLinkAbout14-15726'-- t
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CITY OF ZE HYRHILLS
5335-8T STREET
� _ ` (si3)� o-oozo 157 6
ANNUAL ASSE BLY PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15726 Address: 5039 1 ST ST
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: 10-26*21-0010-12800-009
Improv. Cost: OWNER INFORMATION
Date Issued: 10/15/2014 Name: J & G RESTAURANT PROPERTIES LLC
Total Fees: 50.00 Address: 20015 TAMIAMI AVE
Amount Paid: 50.00 TAMPA FL 33647-3368
Date Paid: 10/15/2014 Phone: (813)713-0094
Work Desc: PLACES OF ASSEMBLY- THE GRE T CATCH EXP 10/2015 99 INSIDE 57 OUTSIDE
CONTRACTOR S APPLICATION FEES
OWNER FIRE PERMIT EES 50.00
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Ins ection Re uired
F RE S TE NSPE TI N-Final
OCCU PA CY LOAD: ��
Occupancy by more than the numbe of persons above shall be considered
dangerous and unlawful. Occup nt load determined by Florida Fire
Prevention Code, NF A101, Section 7.3.1.2
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PERMIT OFFICE
PERMIT EXPIRES IN ONE (1) EAR FROM DATE OF ISSUANCE
THIS PERMIT NEEDS TO BE POSTED IN V SIBLE LOCATION IN MAIN ASSEMBLY AREA
ZEPHYRHILLS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FL 33542
$��-7$o-ao2fl Gity of Ze hyrhilis Fire Fax-813-780-0021
Permit pplication
Dafe t2eceived v ��� ����-{ Phane Contact for Permlt�C�_��� ��
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Owner's Name � �� J 04mer's Phone hlumbec � � t t� �_t�
Owner's Address C � � / J�
Fee Simple Titleholder Name Titleholder Phone Number �� � ��
Fee 8imple Titleholder Address
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Jab Address � � � �LY�A �x��__�
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Sub Division Parcel#
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� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tenk
� Comm Fachaust Kitchen HoodlDuc# � Hazardous Material{Tier II ar RQ Faciiity}APINUAI
� Controlled Bum � Hood Installation �
oEmergency Genera#or<30 kw � lPlNatura}Gas-2nsfallation ('�
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Emergency Generator>30 kw LP/Na#ural Gas-ANNUAL Sale /��
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Fire Protec#ion Maintenance-ANNUA! Places of Assembly-ANIYUAL
t y emi �n er
Sprinkier � ❑ ❑ O � Recreationai Bum
Fire Alarm � ❑ ❑ ❑ � Sparklers - ��Z�
Haod C{eaning � � O ❑ � Sprinkler System tnstallations �
Hood Suppressian � ❑ ❑ ❑ � Standpipes(Sprinkler Sys) '���1
Q Fire Alarm Installatian � Torch Roofingtt'ar Kettle
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� Fire Pumps � Waste Tire Starage ANNUAL
� Fire Works
� FlammableApplication-ANNUAL �_��� Valuatian of Project
� Fuel Tanks ,
Q Other:
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Contractor �! ''' �-- Company
Signature ...�""""'— Regisiered Y/N Fee Current Y!N
Address License#
ELECTRtGIA11 Company
Signature Registered Y/N Fee Curcent Y/N
Address License#
PLUMBER Company
Signatute Registered Y/IV Fee Current Y 1 N
Address License#
MECHANICA! Company
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Ragistered Y t N Fee Current Y 1 N
Address License#
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Directions:
Fill out epplication completely
Qwner&Contractar sign back af apglication,rsotarized{Or,copy of si ned contract wittr owner}
if over$2500,a Notice of Commencement is required(Mechanical w rk over$500q)
Supply two(2)sets of drawings with applicable dooumentatian
A1Iow 14-19 days for review aRer submittal date. Parc I#-obtained from Propesty Tax Notiee{http:tlappraiser.pascogov.com}
de that t is e '
NOTICE OF DEED RESTRICTIONS: The undersigned un rstands h p rmit may be subject to"deed"restrictions"
, which may be mare restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions. °' . �
UNLICENSED CONTFtACTORS AND CONTRACTOR RESPONSIBILITIES: If fhe 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 requfred 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 Inspect(on 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 s(gn as the
contractor, that may be an indication that he fs not properiy licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buiidings, as specified in Pasco County Ordinance num6er 89-07 and
90-07,as amended. The unders(gned also understands,that such fees, as may be due,will be identified at the time of
permitting. It is further understood that Transportatian Impact Fees and Resource Recovery Fees must be paid prior to
receiving a°certificate of occupancy°or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florlda 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 dacument and promfse 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
wiil be done in compifance 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 certffy that no work or installation has
commenced prior to issuance of a permit and that ail 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 otNer government agencies may apply to the intended work, and that it is
my responsibility to identify what actions 1 must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmentaf Protection-Cypress Bayheads, VUetland Areas and Environmentally Sensitive
Lands,WaterlWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Aitering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health 8 Rehabilitative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protectlon Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:•
- Use of fill is not allowed in Flood Zone"V°unless expressly permitted.
- If the flll material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
°compensating volume"will be submitted at time of permifling which is prepared by a professional engineer
licensed by the State of Fiorida.
- If ihe fill material is to be used in Flood Zone°A" in connection with a permitted building using stem wall
construction,I certify that fill wlll be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the canditions of the building permit issued under the attached permit application,for lots less than one(1)
acre which are elevated by flll,an engineered drainage plan is required.
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 construcUon. 1 understand that a separate permit may be required for electrical work,
piumbing, signs,wells, pools, alr condiGoning, 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 af a permit prevent the Buildirig Official from thereafter
requiring a correction of errors in plans,constructian or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced wfthin six months of permit issuance,or'rf 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 Officiai for a period not to exceed ninety(90)days and will demonstrate
just�able cause for the extension. If work ceases for ninety(90)consecutive days,th�Job is considered abandoned.
PAYING TWICE FORE MPRO EMEN'TS TO YOUR PROP RTY.TIF YOU INT NDETO OBTAIN FINANC NG CION ULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMEPJCEMENT.
FLORIDA JURAT(F:S.117.03)
OWNER OR AGENT CONTRACTOR
Subsalbed and swom to(or aRirmed)before me fhis Subscrlbed end swom to(or aHirmed)befare me thls
by by
Who isfare personally known to me or haslhave produced Who Islare personally Imown to me or hasas IdenBficati na
as identlfipdon.
Notary Publlc Notary Pubiic
Commisslon No. Commission No.
Name oi Notary lyped,printad or stemped � Name of Notary typed,printad or stamped