HomeMy WebLinkAbout09-9170 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780 -0020 9170
ANNUAL ASSEMBLY PERMIT
4- ' 144 a_ , - _
Address:
Permit Number: 9170 ess: 38634 HWY 54 EAST
Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: FIRE - PLACES OF ASSEMBLY Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Im rov. Cost:
Date Issued: 5/28/2009 Name: FAITH BAPTIST CHURCH
Total Fees: 50.00 Address: 38634 HWY 54 EAST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/28/2009 Phone:
Work Desc: PLACES OF ASSEMBLY - FAITH BAPTIST y CHURCH INC
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OWNER FIRE PERMIT FEES 50.00
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FIRE SITE INSPECTION -Final -"
OCCUPANCY LOAD:
Occupancy by more than the number of persons above shall be considered
dangerous and unlawful. Occupant Toad determined by Florida Fire
Prevention Code, NFPA101, Section 7.3.1.2
FIRE MARSHAL OFFICE: 813- 780 -0041
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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 R 110 Fax- 813- 780 -0021
Permit Application
Date Received — I 1 Phone Contact for Permit I 1 I 1 1 I
Owner's Name I j 4 1 rj .67,/ P Tls ) / 0 N ii ) ,_,� / 1 I Owner's Phone Number I Ri 3 I I 7a 11 1 CSe I
Owner's Address I S c'1 �y Lo 3 q N (it) y. .5 L' AS "T 2 L f-1l y R Jf f L L .s / t -' 4. 3� J SL I
Fee Simple Titleholder Name I I Titleholder Phone Number I 1 I 1 1 I
Fee Simple Titleholder Address I I
Job Address 1 3 e 6 3 1 -1- /f 1 Y s L-ris r. 2 rr p it y R N 1 L L s, p . 2 j-Li-)--I Lot # I
Sub Division
1 Parcel# I G,Z -,,aL 2 1-QDov. -v /y.v6 40 I
E Bio -Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Comm Exhaust Kitchen Hood/Duct n Hood Installation
Controlled Burn n LP /Natural Gas - Installation
0 Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale
0 Emergency Generator > 30 kw [ Places of Assembly- ANNUAL
D Fire Protection Maintenance - ANNUAL n Recreational Bum
r" m i IEEI m a
Sprinkler Li "'� 1 ❑ ❑ ❑ n Sparklers
Fire Alarm 0 ❑ ❑ ❑ I ( n Sprinkler System Installations
Hood Cleaning El ❑ ❑ ❑ I ( n Standpipes (Sprinkler Sys)
Hood Suppression El ❑ ❑ ❑ I ( n Torch Roofing/Tar Kettle
El Fire Alarm Installation n Waste Tire Storage ANNUAL
Fire Pumps
Fire Works
Flammable Application- ANNUAL 1
Fuel Tanks
Q Other: I I
Contractor pc,_ �' Company
Signature L �_"____ Registered Y / N I Fee Current I Y / N
Address I I License # I I
ELECTRICIAN I
Company I
Signature Registered Y/ N I Fee Current I Y 1 N I
Address I I License # I I
PLUMBER I Company
Signature I Registered Y/ N J Fee Current I Y/ N I
Address ( I License # I
MECHANICAL!
I Company I
Signature Registered Y/ N I Fee Current I Y/ N I
Address ( I License #
OTHER ! Company I
Signature I Registered ! Y/ N I Fee Current I Y/ N I
Address I I License # I 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 party Tax Notice (http: / /appraiser.pascogov.com)