HomeMy WebLinkAbout16-17720i �
�� _ :.,. -: : �� CITY OF ZEPHYRHILLS
, 5335-8TH STREET
', (813)780-0020 177 0
� ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit�Number: 17720 Address: 7909 GALL BLVD
Per¢nit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book:
Proposed Use: COMMERCIAL � Lot(s): Block: Section:
Squ�are Feet: Subdivision: CITY OF ZEPHYRHILLS
E�t. Value: Parcel Number: 34-25-21-0010-00100-0000
Impr'ov. Cost: OWNER INFORMATION
Date Issued: 9/08/2016 Name: RUBY TUESDAY RESTAURANT
Total Fees: 50.00 Address: 7909 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/08/2016 Phone:
Work Desc: PLACES OF ASSEMBLY- RUBY TUESDAY EXP 8/2017 248 SEATS
C�JNTRACTOR S APPLICATION FEES
WNER FIRE PERMIT FEES 50.00
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,= Ins ections Re uired '
F RE SIT INS ECTION-Final
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OCCUPANCY LOAD: �
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Oc ��upancy 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 �
PERMIT OFFIC
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
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� s�s-ieo;,0020 -;_� City of Zephyrhilis Fire � �JD ( �� Fax-813-780-0021
� Permit Application
Date Received Z� �� Phone Contact for Permit�� 3 � _ ��(�
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Owner's Name � �-�.`e�JC�.Ct ,�--(�C Owner's Phone Number �� ��� S1Db
Owner's Address� � _J� (�t7. `�k�C�'1 !�w'� ` '� `�r V l���C � 31�a�
I Fee Simple Titleholder Name Titleholder Phone Number � � �
' Fee Simple Titleholder Address
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Job Address , � ��� G�i ,� �1 J W 'e h f � 1 ��S ��+ ��Sy2 Lot# �
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Sub Division Parcel#
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� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent �
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL /��
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� � Controlled Burn � Hood Installation � �
� Emergency Generator<30 kw � LP/Natural Gas-Installation
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
__ ____ � Fire Protection Maintenance-ANNUAL _ _ _ �Places of Assembly-ANNUAL_ _ _ _
� tr y emi �n t er < '
, Sprinkler � ❑ ❑ ❑ B � Recreational Burn
I� Fire Alarm ❑ ❑ ❑ S arklers �/
, � � � P
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
II Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) I
� Fire Alarm Installation � Torch Roofing/Tar Kettle ,
� Fire Pumps � Waste Tire Storage ANNUAL
� Flammable Application-ANNUAL V81U8t1011 Of PfOJ2Ct I
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� Fuel Tanks
!, Other:
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Contractor � � Company
Signature G Registered Y/N Fee Current Y/N
Address ��� (� ��C h �t �Lfw! �1«'C -T�-�1 1�►License#
ELECTRICIAN . Company
Signature Registered Y/N Fee Current Y/N
Address �� ' License#
PLUMBER { Company
Signature I Registered Y/N Fee Current Y/N
Address �j - License#
MECHANICAL I Company
Signature Registered Y/N Fee Current Y/N
Address �j License#
OTHER I Company
Signature Registered Y/N Fee Current Y/N ,
Address �� License# �
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Directions: � ,
Fill out application completely. I
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) i
If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
Supply two(2)sets of drawings with applicable documentation
iIlow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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