HomeMy WebLinkAbout11-12077 CITY OF ZEPHYRHILLS �"��
5335 - 8TH STREET
(si3) �so-oozo 12077
ANNUAL ASSEMBLY PERMIT
Permit Number: 12077 Address: 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:
Improv. Cost:
Date Issued: 6/30/2011 Name: FAITH BAPTIST CHURCH
Total Fees: 50.00 Address: 38634 HWY 54 EAST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/30/2011 Phone:
Work Desc: FPM- PLACES OF ASSEMBLY - FAITH BAPTIST CHURCH EXP 6/2012
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OCCUPANCY LOAD:
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
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
eiaaao-oo2o City of Zephyrhilis Fire Fax-813-780-0021
Permit Application
Date Received � Phone Contad for Pertnit �� �
Owner's Name � 1 r� l'� ) � �S / � /�U� }l � ��(' Owners Phone Number [SLLS�L_J / a �. � � �
Owner's AdZ7ress ' � c1 �O � !"� lN . `�' �-= � Z L- I'" 1 � Y R�� !�- L- � 0�' L. �� �J �' 2..�
Fee Simple TiUeholder Name Tdleholder Phone Number �� �
Fee Simple Titleholder Add�ess
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Job Address � � (s� � 2-i-. � `� ��,. �.:.� � �� : . �:,. .: ,.;r _�... �.... ._...,. . . . .,. � . . _;...._ ,. . -
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s z�.=n��2N���s L..�,� a- �ot# 0
SubDivision Parcel# ��-.z���
� Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier II or RQ Facility) ANNUAL
� Comm Exhaust IGtchen Hood/Duct � Hood Installation
a Controlled Burn � LP/Natural Gas-Installation
a Emergency Generator < 30 kw a LP/Natural Gas-ANNUAL Sale
� Emergency Generator > 30 kw �Places of Assembly-ANNUAL
� Fire Protection Maintenance - ANNUAL � Recreational Bum
� mi � er
Sprinkler � ❑ ❑ ❑ � SparkleB
Fire Alartn � ❑ O ❑� � Sprinkler System Installations
Hood Cleaning � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
Hood Suppression � ❑ ❑ ❑� � Torch Roofing/Tar Kettle
� Fire Alarm Installation � Waste Tire Storage ANNUAL
a Fire Pumps
� Fire Works
� Flammable Applicatio�- ANNUAL r Valuation of Project
� Fuel Ta�ks
Q Other:
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Contractor �./ ��, /�� Company
Signature `-� �- " � 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 Currern Y/ N
Address License #
MECHANICAL Company
Signature Registered Y/ N Fee Current Y/ N
Address �icense #
OTHER Company
Signature Registered Y/ N Fee Current Y/ N
Address License #
_ _ , _ .. _. - � ._.
Directions:
FiII out application completely.
Owner & Contractor sign back of application, noharized (Or, copy of signed contrad with owner)
If over $2500, a Notice of Commencement is required (Mechanipl work over $5000)
Supply rivo (2) sets of drawings wffh applicable documentaUon
Allow 10.14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraise�.pascogov.com)