HomeMy WebLinkAbout14-15276 �`' ' CITY OF ZEPHYRHILLS ��
, 5335-8TH STREET
(si3)�so-oo20 15 6
ANNUAL ASSEMBLY PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15276 Address: 39602 AMETHYST WAY LOT 5
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: EMERALD POINTE RV RESORT
Est. Value: Parcel Number: 24-26-21-0020-00000-0050
Improv. Cost: OWNER INFORMATION
Date Issued: 5/14/2014 Name: EMERALD POINT RV
Total Fees: 50.00 Address: 39602 AMETHYST WAY LOT 5
' Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/14/2014 Phone: (920)840-7890
Work Desc: PLACES OF ASSEMBLY CLUBHOUSE EMERALD POINTE �-�C' zo/5
�, CONTRACTOR S APPLICATION FEES
OW ER FIRE PERMIT FEES 50.00
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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
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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
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�. s�3aao-oo2o City of Zephyrhills Fire Fax-813-780-0021
�1� Permit Application
Date Received Phone Contact for Permit A�`� �
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�wner's Name ��' aG.!J GPdjod��OG �!/ �=����/ Owner's Phone Number � � �
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J�wner's Address � ��'F�'� ��'��T� S'i��A� ���iT�/C��/L4.�� �L���J�' ��5�'
i Ou0Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
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Job Address �Lot# �
Sub Division Parcel#
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� 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 LP1N �LGas=ABIN Al.�al.e_ 1,
� Fire Protection Maintenance-ANMUAL Places of Assembly-ANNUAL �'(,t,�f/`
t y emi �n t er ' ______,_
Sprinkler � ❑ ❑ ❑ B � Recreational Burn /.e.,i'
Fire Alarm � ❑ ❑ ❑ � � Sparklers �¢,�' n/.`W
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� Hood Cleaning � ❑ ❑ O � � Sprinkler System Installations �
, Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) �( `
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� Fire Alarm Installation � Torch Roofing/Tar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Fire Works
� Flammable Application-ANNUAL V21U8tI0n Of PfOj@Ct
� Fuel Tanks
Q Other: -
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r tor y � Company
ignature /3'L��t'� � ��1���� 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#
MECHANICAL Company �
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
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Directions:
Fill out application completely.
Owner 8 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)