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Home My WebLink About14-15858 I - CITY OF ZEPHYRHILLS �,, ± 5335-8TH STREET =' ti� - ('si3)�so-oo20 15,858 , ANNUAL ASSEMBLY PERMIT ff`� PERMIT INFORMATION � LOCATION INFORMATION Permit Number: 15858 ; Address: 37411 EILAND BLVD 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: 03-26-21-0010-05300-0000 Improv. Cost: ! OWNER INFORMATION Date Issued: 12/16/2014 ; Name: SABRA HEALTH CARE HOLDINGS III Total Fees: 50.00 ' Address: 37411 EILAND BLVD � Amount Paid: 50.00 ; ZEPHYRHILLS FL 33542 Date Paid: 12/16/2014 i Phone: (813)783-8100 Work Desc: PLACES OF ASSEMBLY-ACTIVITIES ROOM - EXP DECEMBER 2015 CONTRACTOR S APPLICATION FEES FIRE PERMIT FEE � 50.00 I i i I � � � � � �� i i �� 2, _ � � � - Ins ections Re uired FIRE SITE INSPECTION-Final i � i i i i I i I I OCCU PAN CY LOAD: �a � � � . � � 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 ' ' � . , ,. �� - ��-a. � ; PERMIT QFFICE � 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 813-780-0020 Clty�of Zephyrhills Fire Fax-813-780-0021 Permit Application � DatE Received��Y�_J ^� �`� T_�� __ i ,� �_� Phone Contact for Permit`�_�,� �ets Name ,� h��S Owner's Phone Number � `7��j �/Q�j ers Address '7 j f (�j, d � � I �� i�. � I � � � Fee Simple Titleholder Name ; Titleholder Phone Number Fee Simple Titleholder Address ' �'.u___�_.�__d - - �-�ti�----�---��--�°°--�--- - - - ---�.�_� f_ Job Address i a Y Lot# � i Sub Division � Parcel# �--�.~_...�,..�._._.�. a.._.,,..- ..._,..-_,,.�.,,....�,�..�-...�....�.........�..,,a.�.....-'�°:.�---=-:t��_....._._.._,..�,_.,�.�..-��___._-..._.__.._-�.� .�_._._...,.�w�.�._---___A....._...,,..,.e. � .,..i.,.. ....,�.T.P-�---._. � �Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent I � 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 � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL n Places of Assembly-ANNUAL� �7/U17/� v�uY� �.r"� try emi �n t er Sprinkler � ❑ ❑ ❑ � Recreational Burn Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � ❑ ❑ ❑ ;� � Sprinkler System Installations �/�� / Hood Suppression � ❑ ❑ ❑ �� Standpipes(Sprinkler Sys) l � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps i � Waste Tire Storage ANNUAL � Fire Works ! � Flammable Application-ANNUAL ; Valuation of Project � Fuel Tanks � Q Other: � _..._.._.RQ__s� _.__-v..._____.�_._..,-�.�.._..,=�_w.__._..m__.�- - _._._n....i._,��.._..�.._..�.,._�.�,�..�_.,._,�_m..N._.,._.._.__.._. _n._,._._...�.--_--,».°y:� Contractor � � Company i ig ature , 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 Curcent Y/N Address � License# MECHANICAL Company Signature � Registered Y/N Fee Current Y/N Address j License# OTHER � Company Signature Registered Y/N Fee Current Y/N Address � License# c�,.:__.�...�.,...._.._. ' - - -- - ...,_..__�.:..__..:_ ...�__._-,__..__�..d:__......:_ . -._..�_4..._._�__,_e. ,�..,._-�--_-__.._,_�.._.___-___d._._. ._W_____., Directions: ..�-._____.,-_.__. �.�__.___ _�___._.__� __. ....__.,>_..,,_..._�.._.�.._�_..._._._,_.�.._., Fill out application completely. � Owner 8 Contractor sign back of application,notarized(Or,cdpy 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) I , NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions" I which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any y �-• , _ applicable deed restricfions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor ar contractors to undertake work,they may be required to be licensed fn accordance with state and focal 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 appiy for the intended work,they are advised to contact the Pasco County Building Inspectlon Division—licensing Section at 727-847- 8009. Furthemtore, ff the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the°contractor 81ock° 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 entiGed 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 buildings, as spec�ed in Pasco County Ordinance number 89-07 and ' 90-07, as amended. The undersigned also understands,that such fees, as may be due,will be fdentified at the time of permitUng. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to • recefving a'certificate of occupancy°or final power release. If the project does not involve a certiBcate of occupancy or � final power release,the fees must be pafd prior to permit issuance. Furthermore,if Pasco County Water/Sewer Impact , � fees are due,they must be paid prior to permit fssuance in accordance with applicable Pasco County ordinances. , 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 °Flarida 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 abtained a copy of the above described dacument 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 wark will'be done in compliance with all applicable laws regulat(ng construction,zoning and land development. Application is ' hereby made to abtain a permft 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 wlll 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 otfier government agencies may apply to the intended work,and that it is my responstbility to identify what actions I must take to be In compliance. Such agencies include but are not limited to: i - Department of Environmental Protection-Cypress Bayheads, VVeUand Areas and Environmentaily Sensitive Lands,WaterNVastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering � Watercourses. - Army Corps of EngineersSeawalls,Docks,Navigable Waterways. - Department of Health 8 Rehabilitative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment, � Septic Tanks. � - US Environmental Protec0on Agency-Asbestos abatement. , - Federal Aviation Authority-Runways. � 1 understand that the following restrictions apply to ihe use of flll:• - Use of fill is not allowed in Flood Zone"V°unless expressly permitted. - If the ftll material is to be used in Flood Zone "A", ft is understood that a drainage plan addressing a °compensating volume"will be submitted at time of pertnitting which is prepared by a professional engineer licensed by the State of Fiorida. - If the fill material is to be used in Flood Zone°A° in connection with a permifled building using stem wall . construction,I certify that fill wlll be used only to fill the area within the stem wall. - , - If flll material is to be used in any area, I certify that use of such fill 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 condltions of the building permit Issued under the attached pertnit application,for lots less than one(1) , acre which are elevated by flll,an engineered drainage plan is required. If I am lhe AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting canditions set forth in this affidavit prior to commencing construction. I understand that a separate peRnit may be required for electrical work, plumbing, signs,wells, pools, air 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 shali fssuance 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 shail become invalid unless lhe work authorized by such permit is commenced within six months of permlt fssuance,or ff work authorized by the permit is suspended or abandoned for a periad 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 justffiable cause for the extension. If work ceases for ninety(90)consecutive days,th�Job is considered abandoned. PAYING TWICE FORE MPROVEM N'TS TO Y UR PROP RTl(.71F YOU NT NDETO OBTA N FI�ANCSNG CIO SULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT � � FI.ORIDA JURAT(F:S.117.03) OYYNER OR AGENT CONTRACTOR - I Subsalbed and swom to(or atflrtned)before me thls Subsaibed end swom to(or affirtned)before me this by by � Who Islare personalty knovm to me or haslhave produced Who is/are personaliy known to me or hasas identlfica�ona asidentlficatlon. Notary Pubtic Notary Public Commisslon No. Commisslon No. Name of Notary typed,printed ar stamped � Name of Nobry typed,printed or sfamped � ,