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Home My WebLink About14-15737 !/. CITY OF ZE HYRHILLS 5335-8T STREET !' , y (si3)� o-oozo ��737 ANNUAL ASSE BLY PERMIT � .��^��.�PERIVIIT:INFORMATION- � ' ��LOCATION`INFORMATION�r�`=��a��:"��` ' Permit Number: 15737 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: =�� : � ..�'�':��;�:=01NNER�INF,�ORMA�TION � � ' � �P��,;,,;.r�. t � .: � � � Date Issued: 10/21/2014 Name:� ST. ELIZABETHS EPISCOPAL CHURCH Total Fees: 50.00 Address: 5855 16TH ST Amount Paid: 50.00 ZEPHYRHILLS Date Paid: 10/21/2014 Phone: Work Desc: PLACES OF ASSEMBLY-ST ELIZAB TH'S EPISCOPAL CHURCH EXP 10/2015 <.z,.. ,..�s _� - - _=��_q. s'-:`�_ ��CONTRACTOR S ' `�: �.`�. '' � APPLICATION>FEE$:°� K; ��:.:��. FIRE PERMIT FEES 50.00 _ <� � ( /� I ��»�"�aa x t'� -�`� , , x�, X;:. ' . . '�.� ' - e�.i`e; ' ��E`'4�"",��t �3C^trt -- �s+ '- K��`�� ` �x,� ,': �,a> "��. :� �Ins ection �Re uired_;<: , u�-� ��_, �.-r�- �.. FIRE SITE INSPECT ON-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 .�� -� ��,�:a, 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 s��-�80-002o City of Zep yrhills Fire Fax-813-780-0021 Permit plication Date Received Phone Contact for Permit`4� � � �-----.�,..,.V._...._.._....�..�.�.._.�...�.__<__.. _�_�.,��...e...�...,.n=��`_..___u,._ �_��.e.---ro-,�.�___...,.�st..W..a..w___�. __...a � Owner's Name � �'7'� ��1Z��Dt.� � �ScO � D G� Owner's Phone Number ��?j ��a �oZ.O a Owners Address 58 S� I lS/�� S ' Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titleholder Address .�,��.�..__._._,�.,��.�.. - - ��=�... - ��..s_�,�- '--='� Job Address s „Lot# + � Sub Division Parcel# s�.,.��,..�...._..�..::�r_.�_.�x,..,,:...ti,_..�.�..�,,,� _ .�..._�.M:�..____..,.....�� .4-. ._..�..��.�._.,.._._�_,.�,.._.�.e.,.�rm._..,.___.a�.�._�__�..,_..,��..__�_—� � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL � Controlled Bum � Hood Installation � Emergency Generator<30 kw � LP/Natural Gas-Installation � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL �' Places of Assembly-ANNUAL try emi �n er � � 2� Sprinkler � ❑ ❑ ❑ � Recreational Bum � > Fire Alarm ❑ ❑ ❑ Sparklers �� Hood Cleaning � ❑ ❑ ❑ � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � Standpipes(Sprinkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL Valuation of Project � Fuel Tanks Q Other: ..:�_._._�.�.�._._�.:ti...�._.,..._.. ._....� __�_-.:_>_...a_e.._._n.z...._�..�.___..�__�.��_ ___....., -�-..,.�.��..�.�.._ -- -.�.P..��_.._,.__ �..��._:.�--.,r_.,��._«..-� Contractor � Company Signature � 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# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License#- OTHER Company Signature Registered Y/N Fee Current Y/N Address License# .�--�- ._r.._�__..P=-...�_.,_.....__4--°___--�...__�.._a�.,�_,�.,.._.d..___�__.-__--� _ �___,._.___,._...�y,..v_�:.___._._...,.�__._._e.._..«„�.._...-.r__..��,�__.�.�--�--.-_a Directions: Fill out application completely. Owner 8�Contractor sign back of application,notarized(Or,copy of sig ed contract with owner) If over$2500,a Notice of Commencement is required(Mechanical wo k over$5000) Supply two(2)sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parc I#-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. UNUCENSED 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- I 8009. Furthermore, (f the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the"contractor 61ock° of this application for which they will be responsible. If you, as the owner slgn as the contractor, that may be an indication that he is not properly licensed and is not entiUed to permitting privileges in Pasco County. TRANSPORTATION IAAPACTIUTILITIES IMPACT AND RESOURCE RECOVEPtY 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 buildings, as specified in Pasco County Ordinance number 89-07 and 90-07,as amended. The undersfgned also understands,that such fees,as may be due,will be(dentified at the time of permitting. It is further understood that Transportation 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 WatedSewer Impact fees are due,they must be pafd 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 Conshuction Lien Law—Homeowner's Protection Guide°prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant ls 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`owne�'prior to commencement. CONTRACTOR'SlOWNER'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 davelopment. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or fnstallation 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 ottier 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. Such agencies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, VVetland Areas and Environmentally Sensitive Lands,WaterlWastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. - Department of Heaith 8 Rehabilitative ServiceslEnvironmental Health Unit-Welis, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill:• - Use of fili 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 permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fili material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction,I certffy that fill wfll 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 fiil will not adversely affect adjacent properties. If use of flll is found to adversely affect adjacent properties,the owner may be cited for violating the conditions of the building permit issued under the attached permit application,for lots less than one(1) acre which are elevated by fill,an engineered drainage plan is required. if I am the AGENT FOR THE OlNNER,I promise in good faith to inform the owner of the permifling conditions set forth in this affidavit prior to commencing construction. 1 understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specitically 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,oancel,alter, or set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Buildirig 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(ssuance,or ff work authorized by the permit(s suspended ar abandoned far 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,th�job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMBflENCEMENT MAY RESULT IM YOUR PAYING TWICE FOR IMPROVENiENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCIMG,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F:S.117.03) OYYNER OR AGENT CONTRACTOR Subsalbed and swom to(or affirmed)before me this Subscrfbed and swom to(or afflrmed)before me this bY 6y . Wha Is/are personally knawn to me ar haslhave produced Who Is/are personally known to me or has/have produced as identlficatlon. as Iden86cation. Notary Publlc Notary Public Commisslnn No. Commissfon No. Name of Notary typed,printed or stamped Name of Nohary typed,printed or shamped