HomeMy WebLinkAbout14-15250 ` � CITY OF ZEPHYRHILLS �
5335-8TH STREET
(sis)�so-oo20 1525
ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15250 Address: 38112 15TH AVE
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: 11-26-21-0010-01200-0250
Improv. Cost: OWNER�INFORMATION "
Date Issued: 5/06/2014 Name: NYE, McALVANAH & HENSON
Total Fees: 50.00 Address: 38112 15TH AVE
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/06/2014 Phone:
Work Desc: PLACES OF ASSEMBLY- BRIGHT BEGINNINGS TOO INC EXP 5/2015
CONTRACTOR S APPLICATION FEES
FIRE PERMIT FEES 50.00
�.
^ (� 1
�� ,��
��
�
Ins ections Re uired ,
FIRE SITE INSPECTION-Final
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
�^�^ �" f � r
�l�-:���� �' �f��'fC��'��-}��,!
1
PERMIT OFFICER �
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
s�3aeo-oo2o City of Zephyrhills Fire Fax-813-780-0021
� � z Permit Application
Date Received ��� Phone Contact for Permit A�N� �
.
��._..._._----- - --- ,Y..-- .._��___.�.�
_.__V_.____y._.__._.___�__.._.,,____..._.�__.�._..._..._�-._.. ---- ----------._.�__..__..��.�,� _,_ .
Owner's Name i � ( Owner's Phone Number �T ���
Owner's Address `�g � �'�/�� L- '�- �'�ji � �
Fee Simple Titleholder Name ' Titleholder Phone Number � � �
Fee Simple Titleholder Address
6._'.�_..._.e._�.K�_ - -- - - - _ - - - - ._.�
Job Address Lot# ��
Sub Division Parcel#
��.v__._ __._.�._._ A, r-.�.�.._.�.,_ --_�,_.._ �,w...��.�..-_�...�.�._.....,� _._._. - - ..,..�.v._.�__,..�...m_._._.__._�.._�...�..W�.�._..,..a.,
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
� Controlled Burn � Hood Installation
� Emergency Generator<30 kw � LP/Natural Gas-Installation
� Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
t y emi �n t er �
Sprinkler � ❑ ❑ ❑ � � Recreational Bum
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
Hood Suppression � ❑ O � � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofing(far Kettle
� Fire Pumps � Waste Tire Storage ANfdUAL
� Fire Works
� Flammable Application-ANNUAL Valuation of Project
� Fuel Tanks
Q Other:
�;:.��_._.._._.__....�� - �...� --- _�...4._..n._.___ — _ �..�.....���._r _.�_.w_,�����,�,�.°�-,.F.w._.._�.._.___ ,.�..._ _..,�e_._�.:_.�._
Contractor � Company
Signature Registered Y/N Fee Current Y/N
Address �� � z License# �
ELECTRICIAN Company
Signature Registered Y/N Fee Current Y/N
Address Cicense#
PLUMBER Company
Signature ' Registered Y/N Fee Current Y/N
Address License#
MECHANICAL Company
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
�...__. _._ - -
�_..�_�___ _�,�._. ._'__ .� ......_...r._ ,=,____.,.. - ` - -�- - -� --___._,___ ..,._._a__�-- __.___ _.__ _...---_�
_ — _ _. __ -...___ _._..___, ._---__�._,....z_ ___.,��._.:__.._�• .. . -
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)
�