HomeMy WebLinkAbout11-12282 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
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(si3) �so-oo20 12282
ANNUAL ASSEMBLY PERMIT
Permit Number: 12282 Address: 7909 GALL BLVD
Permit Type: FIRE PLACE OF ASSEMBLY ZEPHYRHILLS, FL.
Class of Work: FIRE-PLACES OF ASSEMBLY Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost:
Date Issued: 8/23/2011 Name: RUBY TUESDAY RESTAURANT
Total Fees: 50.00 Address: 7909 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/23/2011 Phone:
Work Desc: PLACES OF ASSEMBLY- RUBY TUESDAY- EXPIRE 8/2012
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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
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sisaao-oozo City of Zephyrhills Fire v ` Fax-813-780-0021
Permit Application
Dat4 Recei�-e� Phone Contact for Permit r /�� � 0O
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Owner's Name �� s Owners Phone Number �� s �1 S w
Owners Address Q(� .� �.�,! G� �1 {, � r�µ / r�� t—{ �� 3�' g Q �
Fee Simple Titleholder Name Titleholder Phone Number C� ��
Fee Simple Titleholder Address
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Job Address �� oa G� t� �`J � �-� �'1 � h 11 � S �` 3 3 S'CZ Lot # �
Sub Diwsion Parcel # 3�1 �� ���0 �� lOd ��
� Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Tier II or RQ Facility) ANNUAL
� Controlled Bum � Hood Installation
� Emergency Generator < 30 kw � LP/Natural Gas-Installation
� Emergency Generator > 30 kw a LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
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Sprinkler � ❑ ❑ ❑ � � Recreational Bum
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
� Flammable Application- ANNUAL Valuation of Project
� Fuel Tanks
Q Other•
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 Current Y/ N
Address
License #
MECHANICA� Company
Signature Registered Y/ N Fee Current Y/ N
Address
License #
OTHER
Company
Signature Registered Y/ N Fee Current Y/ N
Address
License #
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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CITY OF ZEPHYRHILLS, Vendor ID / Location Reference Number
0002820026
Check Sort Code: TaxEs
Unit Number/Name Invoice Invoice Gross Discount Net
Number Dat� Amount Amount Amouni
7178 7178 11-12 ASSEMBLYOBLI7/2011 50.00 0.00 50.00
50.00
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