HomeMy WebLinkAbout09-9516 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9516
ANNUAL ASSEMBLY PERMIT
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Permit Number: 9516 Address: 6 151 12TH 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:
Improv. Cost: tifiLaj
Date Issued: Name: CHURCH OF THE NAZARENE
Total Fees: 50.00 Address: 6151 12TH ST
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: Phone:
Work Desc: FPM- PLACES OF ASSEMBLY- FIRST CHURCH OF NAZARENE
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E 50.00
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OCCUPANCY LOAD: 7
Occupancy by more than the number of persons above shall be considered
dangerous and unlawful. Occupant load determined by Florida Fire
Prevention Code, N FPA101, Section 7.3.1.2
FIRE MARSHAL OFFICE: 813- 780 -0041
I IC R
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 City of Zephyrhills Fire Fax- 813-780 -0021
Permit Application
Date Received 1 Phone Contact for Permit I I I
Owner's Name / /AS / Clek ° ocA �,+f ef}/Q Owner's Phone Number
Owner's Address !` / s'/ /.40 ps/
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address I
Job Address 6/S/ /Atk 6 / Lot #
Sub Division Parcel #
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I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier it or RQ Facility) ANNUAL
n Controlled Bum n Hood Installation
n Emergency Generator < 30 kw n LP /Natural Gas - Installation
n Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale
nl Fire Protection Maintenance - ANNUAL l5t Places of Assembly- ANNUAL
!Carly' iSemII FAFTI 1 tither
Sprinkler n ❑ ❑ ❑ I I Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I n Sparklers
Hood Cleaning I ❑ ❑ ❑ I 1 n Sprinkler System Installations
Hood Suppression n ❑ ❑ 0 I I 1 Standpipes (Sprinkler Sys)
F - 7 Fire Alarm Installation n Torch Roofing/Tar Kettle
n Fire Pumps n Waste Tire Storage ANNUAL
n Fire Works
I I Flammable Application- ANNUAL ( I Valuation of Project
I I Fuel Tanks
[ Other: 1
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Contractor / Company I
Signature / 4 iC14.,xi • p Registered Y / N 1 Fee Current I Y / N I
Address I 1 License # I
ELECTRICIAN Company I
Signature Registered Y/ N I Fee Current I Y/ N 1
Address I 1 License # I
PLUMBER Company
Signature Registered Y/ N 1 Fee Current 1 Y/ N I
Address I 1 License # (
MECHANICAL Company I
Signature Registered Y/ N I Fee Current Y / N I
Address I I License # I
OTHER Company I
Signature Registered Y/ N 1 Fee Current 1 Y / N j
Address ] License # I
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized (Or, copy 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)
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