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Home My WebLink About14-15882 i �� CI OF ZEPHYRHILLS ' 5335-8TH STREET ;,. � � �sis)�so-oo2a 15882;F�`�. ANNUA ASSEMBLY PERMIT � PERMIT INFORMATION � ! LOCATION INFORMATION Permit Number: 15882 Address: 5220 10TH ST " Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet; Subdivision: CITY OF ZEPHYRHILLS Est. Value: � - Parcel Number: 11-26-21-0010-18100-0110 ' Improv. Cost: ' # OWNER INFORMATION " Date Issued: 12/29/2014 Name: CROSSROADS PENTECOSTAL CHURCH Total Fees: 50.00 Address: 5220 10TH ST Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 ' Date Paid: 12/29/2014 Phone: 813-714-3822 Work Desc: PLACES OF ASSEMBLY- C URCH;- 159 exp 12/15 , CONTRACTOR S � APPLICATION FEES � FIRE PERMIT FE S 50.00 � v /� � �� .' l � ' . Ins ections Re uired FIRE SITE INSPECTION-Final i � OCCU ANCY LOAD: Occupancy by more than the n mber of persons above shall be considered dangerous and unlawful. O cupant load determined by Florida Fire Prevention Cod , NFPA101, Section 7.3.1.2 i I � �� PERMIT OFFICE PERMIT EXPIRES IN O E (1) YEAR FROM DATE OF ISSUANCE THIS PERMIT NEEDS TO BE POSTE IN VISIBLE LOCATION IN MAIN ASSEMBLY AREA ZEPHYRHILLS FIRE RESCUE EPT - 6907 Dairy Rd, Zephyrhills, FL 33542 � I i I � I I CI OF ZEPHYRHILLS � . 5335-8TH STREET ,� � � (sis)zso-oo20 1588 � ANNU ASSEMBLY PERMIT � PERMIT INFORMATION ( LOCATION INFORMATION � Permit Number: 15883 ' Address: 5220 10TH ST Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL. Class of Work: FIRE-PLACES OF ASSEMBL Township: Range: Book: Proposed Use: NOT APPLICABLE � Lot(s): Block: Section: Square Feet: � Subdivision: CITY OF ZEPHYRHILLS Est. Value: � Parcel Number: 11-26-21-0010-18100-0110 Improv. Cost: �I- - . OWNER INFORMATION Date Issued: 12/29/20�4 I Name: CROSSROADS PENTECOSTAL CHURCH Total Fees: 50. �� , � Address: 5220 10TH ST Amount Paid: 50 � 'L ZEPHYRHILLS, FL. 33542 Date Paid: 12/29/2014 �c�`�' Phone: 813-714-3822 Work Desc: PLACES OF ASSEMBLY- H LL 48 W/BP#15882 exp 12/15 CONTRACTOR S - 1 APPLICATION FEES FIRE PERMIT E S ' 50.00 i � I � �.. � �/ 1 �' Ins ection's Re uired FIRE SITE INSPECTION-Final i i � OCCU ANCY LOAD: � � Occupancy by more than the n mber of persons above shall be considered dangerous and unlawful. ccupant load determined by Florida Fire Prevention Co e, NFPA101, Section 7.3.1.2 , � �� k� PERMIT OFFICE PERMIT EXPIRES IN O E (1); YEAR FROM DATE OF ISSUANCE ' THIS PERMIT NEEDS TO BE POSTE IN VISIBLE LOCATION IN MAIN ASSEMBLY AREA ZEPHYRHILLS FIRE RESCUE DEPT - 6907 Dairy Rd, Zephyrhills, FL 33542 i ! \ � 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Perm it�Application Date Received � I Phone Contact for Permit `�_�� -e�.,�,T--�---��.�..-,._-.__.......-..- _.__.� T._�._.__. - -.�....., -_�__..._�._..e.�.,-_,.U.-�_,.�_.....,�_-��....----__ -� - - - - - Owner's Name OS'�j�A�S � -� ,�G�. I Owner s Phone Number � � � Owner's Address Jr�� ,� � �� ,/� J'�7//S �� Fee Simple Titleholder Name Titleholder Phone Number .� � � , Fee Simple Titleholder Address � 1 �-:��..,�,,.-_..,>_.� `°"-.��-~"�--- - ""`=°--�"�-°4`�-- Job Address � Lot# �� Sub Division Parcel# ��..._-..+..:~�- _..-.o....�.w...�....._..�n.,.._.,,.._,.�...,...,..- ---°�:-�.'_°µ.�+..�0.`-�---°- ,�...�..<_..a..,�._...�:.��-..-.,�, K..w�__._.,�°-�+.�..�.�......_""'-.-'°-.`°,:� � 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 � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL I � Places of Assembly-ANNUAL tr y emi n t er ��'p,2 Sprinkler � ❑ ❑ ❑ � � Recreational Bum (, v 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 I � FlammableApplication-ANNUAL Valuation of Project � Fuel Tanks I Q Other: � - �...�,..,r___.�___._�...�...,.... r_....� .�._.�..__r� —_..:._.s��-�P-�,:m�.�..._-- -�..,...� - - ..�...�._.....:.�w_.__�..�.�.....�....�...�...�,.....�.�.,m.�-.-�,.--� � Contractor ' Company Signature ,Q�/. Registered Y/N Fee Current Y/N Address � License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address � License# PLUMBER � Company Signature I Registered Y/N Fee Curcent Y/N Address � License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address � License# OTHER i Company Signature i Registered Y/N Fee Current Y/N Address � License# - -_._..___�_:...__-.-__.....�_.__n�__��,-_....�_.._,��v_._.._._�_ s_..�._�_ ..a�_.�_�__.:�,.....___.,�_..____.,..�_.�...�._�....-.._....��.�..�_ �,�..�_�._._.,_�.._._�_...�. ,I �.:�T..�..._.� .. . . .:____..,._.�.�..._._w...- Directions: I Fill out application completely Owner&Contractor sign back of application,notarized( r,copy of signed contract with owner) If over$2500,a Notice of Commencement is required( echanical work over$5000) Supply two(2)sets of drawings with applicable docume ation I Allow 10-14 days for review after submittal date. Pa Icel#-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" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any � applicable deed restrictlons. _ � UNLICENSED 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- 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 awner sign as the contractor,that may be an indication that he is not properly 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 canstruction of new buildings,change of use in existing buildings, or expansion of exisfing buildings,as specified in Pasco County Ordinance number 89-07 and 90-07,as amended. The underslgned also understands,that such fees,as may be due,will be identified at the time of • permitting. It is fu�ther understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to rece(ving a'certfficate of occupancy"or Tinal power release. If the project does not involve a certificate of occupancy or finai 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 Pasca County ordinances. CONSTRUCTION LIEN LAW(Chapter 713,Florlda Statu�es,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 document and promise in good faith to deliver it to the`owne�'prior to commencement. CONTRACTOR'SfOWNER'S AFFIDAVIT: I certffy that all the information In this application is accurate and that all work will be done in compliance with all applicable laws regulat(ng 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 commen�ed 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, zonfng regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of otfier govemment agencies may apply to the intended work, and that it is my responslbility to identify what actions I must take to be in compliance. Such agencies include but are not limlted to: - Department of Environmenta( Protection-Cypress Bayheads, Wetland Areas and Environmentaily Sensitive Lands,Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. - Department of Health 8 Rehabilitative Serv(ceslEnvironmental Health Unit-Welis, Wastewater Treatment, Septic Tanks. - US Envi�onmental Protectlon Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of flll:� - 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", (t Is understood that a drainage plan addressing a °compensating volume"will be submltted at time of pertnifling which is prepared by a professional engineer licensed by the State of Florida. , - If the fill material is to be used in Flood Zone °A° in connection with a permitted building using stem wail construction,I certify that fill will 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 flll will not adversely affect adjacent properties. If use of flil is found to adversely affect adjacent properties,the owner may be cited for violating the conditions of the building pertnit issued under the attached permit application,for lots less than one(1) acre which are elevated by ftll,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 construction. I understand that a separate permit may be required for electrical work, plumbing, signs,wells, pools, alr conditioning, gas, or other installations not specfficaliy 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 of a permlt prevent the Buildirig Official from thereafter requiring a correction of errors in plans,construction or violations of any codes. Every peRnit issued shaii become invalid unless the work authorized by such permit is commenced within 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 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 ORE MPRO EM N'TS TO YOUR PROPERT1f.TIF YOU INT�NDETO OBTAIN FI�N NC NG CIO SULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'TSCE OF COMMENCEMENT FLORIDA JURAT(F:S.117.03) OYVNER OR AGENT CONTRACTUR Su6salbed and swom to(or afllrmed)before me this Subsaibed end swom to(or aflirtned)before me this , by bY Who Is/are personally known to me or haslFiave produced Who Is/are personaliy known to me or has s Identifioab n. asidentlficatlon. i Nofary Public i Notary Public Commisslon No. Commisslan No. Name of Nofary typed,printed or stamped �Name oi Nofary ryped�Printed or stamped II � . ��- "' j- — " � � 'I' -- �! , ,!, i 4 - i' � � 5220 /Ot/�S't W � 5�, � � �„� � � �.Q�oY �8.�6 � _t 1�1 �� a¢�a��lG, `{L 3353 9 � �� `---- I � ��J �� u � � �8/3J-3 95-5 96 0 �`4-- u � To Wl�►oin It May Concex: I am writing tliis letter in regards to ou annual AssemUly Fee, I am asking thar su�ce we are 501c that we could be exem t from paying tlais fee. Any help you cou�d give us would be muc� appre�iated. I��, v,� U�� l�U �/�-2 � Thank'You � �j��IL�`-- _ � � �� l �� .. ._ � �,�5 � 1� Pastor Sreve McAdams Pl�one: (813) 395-596a (813)- 714-3822 �� Crossraads Pentecostal Cburch � Pastor Steve McAdams � I �"J //�.Si.. �'n�� f.; l�)r��;� ,..' Sunday AM 10:30nnn � E: /I _., { :�Y . �' Wednesday 7:OOPt,n t i + ' 352-521-3965 � �� t ' 8i3-714-3822 ��Ii;: .. , � .. i' r�.�'�� %`l 71ie ChurCh where everyone is wetcome � I � I � i � i ��. �• � Jacqueline Bo es From: Bill Burgess Sent: Thursday, December 4, 20141:39 PM To: Jacqueline Boges Cc: Steve Spina Subject: FW: Assembley Permi Church From: Daniel Spillman Sent: Thursday, December 04, 2014 10:26 AM To: Bili Burgess Cc: Joe Poblick Subject: RE: Assembley Permit Church I missed you yesterday when I came by. I'm not c azy about doing favors but if it has been done before I guess it is ok with me as well. Thanks ds From: Bill Burgess Sent:Thursday, December 04, 2014 9:36 AM To: Daniel Spillman Cc: ]oe Poblick Subject: Assembley Permit Church Chief, Steve wanted me to get with you in regards to a equest for waiver of an Assembly Permit fee. It is my understanding that some of the other Chiefs have done this in t e past. If this is something you want and can do (by ordinance) I would have no problem.As the permitting official/depa ment, I do not believe this is something�I can or should do myself...Let me know,Thanks, Bill William A. Burgess City of Zephyrhills Building Official � � i I 1 ' i �