HomeMy WebLinkAbout14-15747 /
CITY OF ZE HYRHILLS
?,:.v 5335-8T STREET
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ANNUAL ASSE BLY PERMIT
PERMIT�NFORMATION '```'��,���_`;�f r��;���� ;�LOCATION�INF�OFiMATION ._:��� �. '�,�
Permit Number: 15747 Address: 6251 FORT KING RD
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: 03-26-21-0010-09500-0000
Improv. Cost: �:'>'�:.. �° `� '�'�01NNER�INFORMATION
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Date Issued: 10/30/2014 Name: ALLIANCE CHURCH OF ZEPHRYHILLS
Total Fees: 50.00 Address: 6251 FORT KING RD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/30/2014 Phone: (813)782-8865
Work Desc: PLACES ASSEMBLY-ALLIANCE C URCH OF Z-HILL-EXP 10/15
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���`��CONTRACTOR S�:;�;�,;°��_ �:4�-.,_ _�_, - a APPLICAWTION.F.EES f ;:�r A�_.�,� ���,��%°1'.
OW ER FIRE PERMIT FEES 50.00
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FIRE SITE INSPECTION-Final �
OCCU PA CY LOAD: �2�
Occupancy by more than the numbe of persons above shall be considered
dangerous and unlawful. Occup nt load determined by Florida Fire
Prevention Code, N PA101, Section 7.3.1.2
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PERMIT OFFICE
PERMIT EXPIRES IN ONE (1 YEAR FROM DATE OF ISSUANCE
THIS PERMIT NEEDS TO BE POSTED IN ISIBLE LOCATION IN MAIN ASSEMBLY AREA
ZEPHYRHILLS FIRE RESCUE DEPT 6907 Dairy Rd, Zephyrhills, FL 33542
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Permit Appl cation
ate Received Phone Contact for Permit
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�wner's Name '� L.LIfJNCrE /Qc,.� ^�f7� G Owner's Phone Number � � �
�wner's Address '� (p� ��T �//JG
ee Simple Titleholder Name Titleholder Phone Number � � �
ee Simple Titleholder Address
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�b Address Lot# �
ub Division Parcel#
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent �g � �
� Comm Exhaust Kitchen Hood/Duct � 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 LPMatural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
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Sprinkler � ❑ ❑ � � � Recreational Bum
Fire Alarm � ❑ ❑ ❑ � � Sparlclers
Hood Cleaning � ❑ ❑ ❑ � � SprinklerSystem Installations
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) % �f� ��
� Fire Alarm Installation � Torch Roofing/Tar Kettle �/
� Fire Pumps � Waste Tire Storage ANNUAL
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� Fire Works
� FlammableApplication-ANNUAL Valuation of Project
� Fuel Tanks
Q Other:
:ontractor Company
ignature � �( ' Registered Y/N Fee Current Y/N
Address License#
LECTRICIAN Company
.ignature Registered Y/N Fee Current Y/N
Address License#
�LUMBER Company
' �ignature Registered Y/N Fee Current � Y/N
Address License#
�ECHANICAL Company
�ignature Registered Y/N Fee Current Y/N
Address License#
)THER Company
�ignature Registered Y/N Fee Current Y/N
Address License#
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)irections:
Fill out application completely.
Owner&Gontractor sign back of application,notarized(Or,copy of signed ontract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work o r$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(httpJ/appraiser.pascogov.com)
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