HomeMy WebLinkAbout00-9860
BUILDING PERMIT
'JJ ~ , ~
BUILDING
1 'l .. '7~
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
'-7 su
~ ,~
PLUMBING
Permit
09860
J () /2fo /00
Date
MEC~NICAL
Sewer Conn
Water Conn:
Pmperty Own." ~/A f\ 'j Vult UclA fl'l
Job Address: I 5' l{ 6Q, II - tr I wI.
Parcell.D, # ",?)'':J f' '2" ODIO.. O..{"(O 00 - 0000'
Zoning: Energy Code: Radon Gas:
Descriotion of Work T /I~; 0... re #1 C V(( ./- ," C>.... i
Water Meter:
T,I.F.'s:
I ~. 7.!.
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
5- / 9- t:!J (
DATE
Complete Plans. Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
City license Registration #
State Certified license#
_ Sign
Company
Address
Telephone#
Inspector
DATE
S'/C
Valuation or
Contract Price
J~
t
IS2
ce
ELECTRICAL
I ..,,,
'3~2-sh 7- 7992-
C 7/"-I-;;L6 5 ~
~!~ yf 5 P/~ttlb
PLUMBING I '::,'"-L( 6
(G..,.,dy DeJ.
BUilDING J 1 r
~:r~""
C{4~ S
MECHANICAL
Ftr,
Pre SlB 1'-2J~ :se..
lintel
FRM, 12..-Z~...~tJ@
Insul. Cl
Wl
Tp, Servo ~
Rough In J ~-L&-- (;) )
Meter Can
Const. Pole
Pool
Pre.Meter
Final
SLB ~
Tub Set J 2..-~..C){?t:::!!../
Water
Sewer //~ /5'-00 51<.
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($ 25,001 shall be made for each trip for each trade:
a, Wrong Address
b, Condemned work resulting from faulty construction.
c, Repairs or corrections not made when inspection called.
d, Work not ready for inspection when called.
e, Permit not posted on job site,
f, Plans not at job site.
g, Work not accessible,
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same,
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED
PLANS REVIEW FEE
OWNER'S NAME
Gang Yu Huang
PHONE
813-989-2677
JOB ADDRESS
7?S4~~11 Rlvrl. Zpphyrhill~. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
1S-?S-?1-OOlO-OS600-0000
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
GdAL'l'ERATION
o REPAIR
o INSTALL
DSIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
~ COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
Off OF UNI'rS
o SWIMMING POOL
o MOBILE HOME
o OTHER
I2D RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
Interior Renovation
BUILDING SIZE
15 X 70
SQUARE FOO'rAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENER~Y FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED E'OR ALL NEW CONSTRUCTION,
PERMITS REQUESTED
~ BUILDING
IKJ ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o W,R.E,C,
S PLUMBING
H MECHANI CAL
$
VALUATION OF MECIIl\NCIAL INSTALLATION
o GAS
lID ROOFING
o SPECIAL'l'Y
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
,0 OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
:;i!illlli!lil!:1!:1J!IIIIIIIIl1;'i:!ii!iiIml:I:!!i!l:liil!!1!!:~;in:!!I!I!i!:i!n'!:I,:!;i:!:;!,' ,:I'P9ij~~g~qI{,{SE;:9;~"~"~
SIGNATURE
BUILDER
******************************************************************
COMPANY Sandy Developmenu Company, IHc,
STATE CERT OR REGIST # CRC010921
CITY PROCESSING 1# 235 ~~
V
ELECTRICIAN
SIGNATURE
I- / COMPANY First Class Electric
('( P'/ STATE CERT OR REGIST 1# I.) 0 I <:;-/7
,L'I;t,!(...I \..- ,l,:../-_) '-,:-- CITY PROCESSING 1# / //,;../ ....r-
*** * * * ** * ***~'" ~'~ * * * * '" * * * * * * * * * * * * * * ** * * * ** * * * *** ** **** *~* *** ** *
PLUMBER
**********~**************
COMPANY RIl~ty's P;llmhin~
STATE CERT OR REGIST 1# c..\='e~ 5 c., ~ ~
CI~Y CESSING 1# ~ Y Co ~
~j ,- ~ ~n 11-,
********** * ** '******** ---;;;****~ j)
COMPANY SQ'lth9P" COlll:fQ~t
STATE CERT OR REGIST 1#
CITY PROCESSING 1#
SIGNATURE
MECHANICAL
SIGNATURE
*****************************************************************
OTHER
SIGNATURE
COMPANY
STATE CERT OR REGIST 1#
CITY PROCESSING 1#
*****************************************************************
/
COIWJ 'l'.LUI~~ or' l'l;;HM.L'l' ^VI"llJ^Vl'l'
A, N01'ICE OF DEED RES'l'RIC'j'IONS
The undersigned understands that this permit may b,e subject to "deed restrictions" wh.ich
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contJ:actors to undertake work, they may be required
to be licensed in accordance with state and loc<ll J:egulations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state law, If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-661l.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contJ:actor that may be an indication that he is not properly lic,ensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C, TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D, CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E, CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoJ:mation in this application is accurate and that all work will
be done in compl~ance with all applicable laws regulating construction, zoning, and land
development,
Application is hereby made to obtain a penllit to do work and installation as inqicated" I
certify that no work or installation has commenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is IllY responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Dayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses,
*Army Corps of Engineers-Seawalls, Docks, Navigable WateJ:ways
*Department of Health & Rehabilitative SeJ:vices, Environmental Health Unit-Well,s,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used ill Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance"
A permit issued shall be construed to be a license to pJ:oceed with the work and not as
authority to violate, cancel, alter, or set aside any pJ:ovisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code, Every permdt
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee chaJ:ge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be c01\sidered abandoned,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR TT RNEY BEFORE RECORDING YOUR NOTICE OF COMMENC T JOBS UNDER
$2 500 IN VALUE DO N '1' N '1'0 RECORD AND POST A "NOTICE OF COMMENCEME
w.
CONTRACTOR
STATE OF FLORIDADQ C'
COUNTY OF l :5 0
The foregoing inp,trument was aC,knowledged
Befor~ me this '-(rJ,I\ ~ay Of.r-()CJ"Dber-, 1!!Po..Jl:oO
by ,Je'f or'Y\e ~ n..r (;
n( (name of person acknowledged)
~who is personally known to me, or
STATE OF FLORIDA A 6
COUNTY OF U CO
The foregoing intlrument was()ackn~Wledged .~
Before me this ~ of eJcfnbPr, ~~
by -'era (Y'lf' W ' {(e,rr
\on (name of person acknowledged)
~ho is personally known to me, or
o who has produced
(type of identification)
~id not take an oath
Owho has produced
( type
Odid no
of identification)
take an oath.
ture of person taking acknowledgement
~ 0 B~OWN
Name type M.CStMfoflllMwldFd
My comm, expo ~. 26. 21m
Comm. No. CC870680
"ELISA D, BROWN
Name l:.ypecfto~'.cS*otsfQeekIIed
My comm, exp, Sept. 26. 2003
Comrn. No, CC870680
..&.-
SANDY DEVELOPMENT
7254 GALL BLVD.
SQ. FEET PRICE
MAIN OR LIVING AREA 1,572 $ 16,00
OTHER AREA UNDER ROOF $ 15.00
OTHER
VALUATION $ 25,152,00
FEE SHEET $ 150,00
ADDRESS $ -
DRIVEWAY $ -
BUILDING: $ 225,00
CREDIT: $ -
BUILDING LESS CREDIT: $ 225,00
ELECTRICAL: $ 38,72 Hood system
PLUMBING: $ 57,50 alterations to be
MECHANICAL: $ - permitted
RADON: $ 15,72 separately
TOTAL $ 336.94
SEWER: $ -
WATER: $ -
IRRIGATION: $ -
TOTAL: $ -
I
I
I
I
WATER METER:I $
IRRIGATION METER $
SUB-TOTAL $
336.941
TIF'S'r
99% $
1% $
TOTAL: $
336.94 I
ChlN~ Wok.
DEPARTMENT OF BUSINESS & PROFESSIONAL REGULATION
Jeb Bush, Governor
Cynthia A. Henderson, Secretary
P2> -d ( - d-3~
OPENING/LICENSING INSPECTION INSTRUCTIONS
After completing construction, and you have received your certificate of occupancy from the
local municipality, contact the Division of Hotels and Restaurants to schedule an
opening/licensing inspection, Please allow 3-5 working days response time for your request.
Prior to scheduling the opening/licensing inspection, you must provide to this office written
approval for water and wastewater (sewage) disposal systems from municipality/DOH/DEP and
the completed plumbing requirement letter from the local building authority if required in the
comments section of the plan review specification work sheet.
At the time of inspection, you are responsible to provide the following on site:
1. Approved and stamped food service floor plans.
2. Specification work sheet.
3. Certificate of Occupancy from the local building and fire departments.
4, Completed application for license, Incomplete applications will be rejected,
5, License fee,
At the time of the inspection all equipment; coolers, freezers, hot water heaters, etc. must be
functional. Hot and cold water must be plumbed to all required sinks and all plumbing must be
functional. If applicable, the automatic fire suppression system must be currently tagged and the
gas turned on. After completion of a satisfactory inspection and payment of fees, a receipt for
license will be issued on site,
If applicable, requests for alcoholic beverage licenses may also be signed at this time,
NOTE: Any changes made to submitted and approved plans made during
construction must immediately be brought to our attention.
Do not call and schedule an opening inspection unless you are truly ready as outlined above. A
failed inspection will further delay the licensing process,
Division of Hotels and Restaurants
PARK TRAMMEL BUILDING, 1313 TAMPA STREET, SUITE 106. TAMPA, FLORJDA 33602-3329
Telephone (813) 271-2200 Fax (813) 272-2200 ' Toll Free 1-800.880-7753
INSTRUCTIONS
FOR COMPLETING
The Division of Hotels and Restaurants
..
APPLICA TION FOR LICENSE
Welcome to the Division of Hotels and Restaurants! Our goal is to provide fast and courteous service for you in the licensing
application process, Please read the following information before completing your application, You are assigned to a district
based upon the county in which your business is located, Refer to page two of the application for your district office location
and telephone number, If you have any questions about the licensing process, please contact your district office,
ITEMS NECESSARY FOR ISSUANCE OF LICENSE PRIOR TO OPENING
1, Beverage License (if applicable) - Contact the Division of Hotels and Restaurants for an inspection, Send approved inspection form with
application to the Division of Alcoholic Beverages and Tobacco,
2, Florida Sales Tax Number or proof of exemption - Contact the Department of Revenue, Sales Tax Division, at 1-800-352-3671, For
additional information: http://sun6.dms.state.fI.usldor/businesses
3, Federal Employers' Identification Number (FEIN), Contact the U, S, Intemal Revenue Service for an FEIN application (SS-4) at
1-800-829-3676 or download from the Intemet at: http://www.irs.ustreas.govlprodlforms....Pubslforms.hfml
For additional information:
htfp:Jlwww.irs.ustreas.govlprodlforms....Pubslpubslp583toC.hfm or
http://www.irS.ustreas.govlprodlbusjnfolindex.hfml
4, Social Security Number or Individual Taxpayer Identification Number (!TIN) - The Internal Revenue Service assigns an (TIN to
individuals who are not eligible for a social security number due to their status as an alien. The ITIN is formatted in the same configuration as
a social security number, The only difference is that an ITIN begins with a nine and the number will appear in the format: 900-00-0000, This
number is available to alien operators upon their application on IRS form W-7, Application for IRS Individual Taxpayer Identification Number,
To obtain the form, the applicant should contact the IRS at the number above or download the form from the Intemet at:
http://www.irs.ustreas.govlprodlforms....Pubslforms.hfml. The IRS will process the application for an (TIN within five to six weeks, The
ITIN should appear on the Application for License in the space provided for the social security number,
5, Plan Review - For public food service establishments ONLY: please contact the division's plan reviewer at the appropriate district office prior
to new construction or remodeling which affects sanitation and/or safety requirements, Plans must be approved by the division prior to
construction,
6. Completed Application for License - The application form must be completed in its entirety, including signature, before the licensing
process may continue, Forward the completed form with payment of application and license fees to the appropriate district office, Any
omissions will result in your application being returned and delay issuance of your license, Please allow at least 30 days prior to your intended
opening date for processing of your license application,
7, Appropriate Fees - Contact your local district office for the correct amount of your license fee, In addition to the license fee, each application
for a new establishment or change of ownership must be accompanied by an application processing fee of $50, For your convenience, you
may combine the license fee and additional fees in a single check or money order made payable to the Division of Hotels and Restaurants,
8, Opening Inspection - Once all of the above requirements have been met satisfactorily, the division will schedule an opening inspection,
For additional information, see the following publications:
. Guide to Public Food Service Establishment Licensing (OSPR Form HR 5030-027)
, Guide to Public Lodging Establishment Licensing (OSPR Form HR 5030-028)
, Guide to Public Food Service Establishment Plan Review (OSPR Form HR 5030-016)
. Guide to Mobile Food Oispensing Vehicles (OSPR Form HR 5030-032)
, Guide to Mobile Food Oispensing Vehicles - Hot Oog Carts (OSPR Form HR 5030-033)
. Guide to Theme Parle Food Carts (OSPR Form HR 5030-031)
. Guide to Temporary Food Service Events (OSPR Form HR 5030-034)
These and other useful publications are available from:
Hospitality Education Program
Division of Hotels and Restaurants
Department of Business and Professional Regulation
1940 North Monroe Street
Tallahassee, Florida 32399-1014
Telephone: 850 - 644-1463
Toll Free: 800-704-1076
Fax: 850 - 644-8681
Fax on Demand: 850 - 644-9338
http://www,hospitalityeducation,org
DBPR Form HR 5121-020
_ A T,Ddirimt Of~TYice TD TM HospitDlity Indlulry
J31 ?
Hospitality Education Program
Revised 2000 February 10
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
Division of Hotels and Restaurants
www,hospitalityeducation,org
APPLICA TION FOR LICEN$E
Required for licensure es e public food service or lodging esteblishment plKSuant /0 s, 509,241 FS _.. 61C-1_002 FAC
TYPE OF APPLICATION
c=J New Establishment
(PLEASE PRINT OR TYPE)
I Opening ITII
Date ~
MOnh Day Year
c=I Change of Ownership
.S~~~~~D - D -I
Check if exempt
I Owner
Name
(Corporation or Individual: For applications from individuals, please place name in the following order: LAST NAME, FIRST NAME, MIDDLE INITIAL)
President Name I
LAST NAME
Telephone: Business
(Z) Seating - # of seats
(Z) mmmt~~~~~sarkFoodCart':
(G) Vending
---~--~-------~-_._^--~-_.
(G) No Seats
------~_.__.__.-
(G) Catering
(0) Mobile Food Dispensing Vehicle"
(P) Temporary
(1) Non-Transient Apar1ment
(2) Hotel
................................................. ..................-.............................-.....
(3) Motel
(5) Transient Rooming House
(6) Individual Condominium
(6) Individual Resort Dwelling
(7) Transient Apartment
(8) Group Condominium
(8) Group Resort Dwelling
(9) Collective Condominium
----
(9) Collective Resort Dwelling
. Provide Vehicle Identification Number as
applicable in the space below, Use separate
sheet if necessary for group licensing of theme
park food carts,
(10) Ncn- Tla1Sient Roormg House
(11) Bed and Breakfast
',NUMBER OF UNITS'
I-D-O
Sole Proprietor
Partnership
Corporation
Other
FIRST NAME
. -
.
MIDDLE INITIAL
Under the Federal Privacy Act, disclosure of social security
numbers is voluntary unless specifically required by federal statute,
In this instance, disclosure of social security numbers is mandatory
pursuant to Title 42 United States Code, sections 653 and 654; and
sections 409,2577,409.2598, and 559.79, Florida Statutes, Social
security numbers are used to allow efficient screening of applicants
and licensees by a Title IV-D child support agency to assure
compliance with child support obligations. Social security numbers
must also be recorded on all occupational license applications and
are used for licensee identification purposes pursuant to the
Personal Responsibility and Work Opportunity Reconciliation Act of
1996 (Welfare Reform Act), 104 Pub,L.193, Sec, 317.
lications from individuals, ease ace name in the foliO win order: FIRST NAME, MIDDLE INITIAL, LAST NAME
FOR ESTABLISHMENTS OWNED OR OPERATED BY PARTNERSHIPS, CORPORATIONS OR COOPERATIVES, please attach a separate sheet or sheets listing the name, address,
and social security number of each person who owns 10% or more of the outstanding stocks or equity interest in the licensed activity and the name, address, and social security numbers of
each officer, director, chief executive, or other person who, in accordance wnh the rules of the issuing agency, is determined to be able directly or indirectly to control the Operation of the
business of the licensed entity,
Has any person interested in the operation of this establishment, whether owner, operator, agent, lessee or manager, been adjudicated guilty, or forfened
a bond when charged wnh solicning for prostnution, letting premises for prostnution, keeping a diSOrderly place, illegally dealing in narcotics, gambling, or
any other crime reflecting on professional character wnhin the last fIVe (5) years in this state, or any other jurisdiction of the Unned States?
DYes
DNO
D No
Has any person interested in the operation of this establishment, whether owner, operator, agent, lessee or manager, had a license for an Adu~
Congregate Living Facilny at this establishment denied, suspended or revoked pursuant to s, 400,414, F,S" wnhin the last fIVe(S) years?
DYes
THIS APPLICATION MUST BE SIGNED UNDER OATH OR AFFIRMATION BY THE APPLICANT OR OWNER OR CHIEF EXECUTIVE OF THE ESTABLISHMENT, WITHOUT THE NEED FOR
WITNESSES, IF A CORPORATION IS IN THE HANDS OF A RECEIVER OR TRUSTEE, THIS APPLICATION SHALL BE EXECUTEO ON BEHALF OF THE CORPORATION BY THE HANOS OF A
RECEIVER OR TRUSTEE,
I certify that I am empowered to execute this application as required by Section 559,79, F.S. J understand that my signature on this application has the same legal effect
as if made under oath, To the best of my knowledge, all information contained on this application is true and correct. I understand that falsification of any information on
this application ma result in administrative action, includin fines u to $1,000, suspension or revocation of the license,
Applicant Name and Title (please print or type)
DBPR Form HR 5021-020 Revised 2000 February 10
Applicant SIgnature Date
NOTE: PLEASE KEEP ALL INFORMATION CURRENT REGARDING THE LICENSED PREMISES.
District 1
Athens Building
Suite C-240
8405 NW 53rd Street
Miami, FL 33166-1544
Counties 23 - Dade
District 2
Suite 600
1700 NW 64 Street
Ft. Lauderdale, FL 33309-1801
Toll Free 800 - 780-5680
Phone 305 - 470-5680
Fax 305 - 470-6746
54 - Monroe
Toll Free 800 - 532-3287
Phone 954 - 958-5520
Fax 954 - 958.5522
Fax 2 954 - 958-5563
Counties 16 - Broward 53 - Martin 60 - Palm Beach
District 3
Park Trammel Building
Suite 106
1313 Tampa Street
Tampa, FL 33602-3338
Counties 19 - Citrus
37 - Hernando
39 - Hillsborough
District 4
Suite 290
941 West Morse Boulevard
Winter Park, FL 32789-3700
Counties 15 - Brevard
41 - Indian River
45 - Lake
58 - Orange
District 5
Suite 350
7960 Arlington Expressway
Jacksonville, FL 32211-7467
Counties 11 - Alachua
12 - Baker
14 - Bradford
20 - Clay
22 - Columbia
25 - Dixie
26 - Duval
28 - Flagler
31 - Gilchrist
District 6
7946 Front Beach Road
Panama City Beach, FL
32407-4817
Counties 13 - Bay
17 - Calhoun
27 - Escambia
29 - Franklin
30 - Gadsden
33 - Gulf
40 - Holmes
42 - Jackson
43 - Jefferson
District 7
Suite 107
4100 Center Pointe Drive
Ft. Myers, FL 33916-9460
Counties 18 - Charlotte
21 - Collier
24 - DeSoto
32 - Glades
35 - Hardee
36 - Hendry
Toll Free 800 - 880-7753
Phone 813 - 272-2200
Fax 813-272-3344
61 - Pasco 63 - Polk
62 - Pinellas 70 - Sumter
Toll Free 800 - 375-6975
Phone 407 - 623-1240
Fax 407 - 623-1026
59 - Osceola
66 - Saint Lucie
69 - Seminole
74 - Volusia
Toll Free 800 - 226-5561
Phone 904 - 727-5540
Fax 904 -727-5558
34 - Hamilton
44 - Lafayette
48 - Levy
52 - Marion
55 - Nassau
64 - Putnam
65 - Saint Johns
71 - Suwannee
73 - Union
Toll Free 800 - 370-5170
Phone 850 - 233-5170
Fax 850 - 233-5174
47 - Leon
49 - Liberty
50 - Madison
56 - Okaloosa
67 - Santa Rosa
72 - Taylor
75 - Wakulla
76 - Walton
77 - Washington
Toll Free 800 - 226-7359
Phone 941 - 278-7355
Fax 941 - 278-7359
38 - Highlands
46 - Lee
51 - Manatee
57 - Okeechobee
68 - Sarasota
SECTION 509,241. FLORIDA STATUTES
LIcenses required; exceptions
(1) LICENSES; ANNUAL RENEWAlS,- Each publiC lodging establishment and pUblic
food service establishment shall obtain a license from the division, Such license may not be
transferred from one place or individual to another, It shall be a misdemeanor of the second
degre'e, punishable as provided in s, 775,082 or s, 775,083, for such an establishment to
operate without a license, Local law enforcement shall provide immediate assistance in
pursuing an ill'dgally operating establishment, The division may refuse a license, or a renewal
thereof, to any establishment that is not constructed and maintained in accordance with law
and with the rules of the division, The division may refuse to issue a license. or a renewal
thereof, to any establishment an operator of which. within the preceding 5 years, has been
adjudicated guilty of. or has forfeited a bond when charged with, any crime reflecting on
professional character, including soliciting for prostitution. pandering, letting premises for
prostitution, keeping a disorderly place, or illegally dealing in controlled substances as defined
in chapter 893, whether in this state or in any other jurisdiction within the United States, or
has had a license denied, revoked, or suspended pursuant to s, 400.414, Licenses shall be
renewed annually, and the division shall adopt a rule establishing a staggered schedule for
license renewals, If any license expires while administrative charges are pending against the
license, the proceedings against the license shall continue to conclusion as if the license were
still in effect,
(2) APPLICATION FOR L1CENSE,- Each person who plans to open a public lodging
establishment or a public food service establishment shall apply for and receive a license from
the division prior to the commencement of operation, A condominium association, as defined
in s, 718,103, which does not own any units classified as resort condominiums under s,
509,242(1 )(c) shall not be required to apply for or receive a public lodging establishment
license,
(3) DISPLAY OF L1CENSE,- Any license issued by the division shall be conspicuously
displayed in the office or lobby of the licensed establishment, Public food service
establishments which offer catering services shall display their license number on all
advertising for catering services,
SECTION 509,261, FLORIDA STATUTES
Revocation or suspension of licenses;
fines; procedure
(1 ) Any public lodging establishment or public food service establishment that has
operated or is operating in violation of this chapter or the rules of the division, operating
without a license, or operating with a suspended or revoked license may be subject by the
division to:
(a) Fines not to exceed $1,000 per offense;
(b) Mandatory attendance, at personal expense, at an educational program sponsored
by the Hospitality Education Program; and
(c) The suspension, revocation, or refusal of a license issued pursuant to this chapter,
(2) For the purposes of this section. the division may regard as a separate offense
each day or portion of a day on which an establishment is operated in violation of a . critical
law or rule,' as that term is defined by rule,
SECTION 559,79. FLORIDA STATUTES
Applications for license or renewal
(1) Each application for a license issued by the Department of Business and
Professional Regulation shall include a statement showing the name, address, and social
security number of each person who owns ten percent or more of the outstanding stock or
equity interest in the licensed activity and the name, address, and social security number of
each officer, director, chief executive, or other person who. in accordance with the rules of
the issuing agency, is determined to be able directly or indirectly to control the operation of
the business of the licensed entity, and each application for renewal of such a license shall
set out any changes in the required names and addresses which have occurred since the
license was issued or last renewed.
(2) Each application for a license or renewal of a license issued by the Department of
Business and Professional Regulation shall be signed under oath or af!irmation by the
applicant, or owner or chief executive of the applicant without the need for witnesses unless
otherwise required by law,
SECTION 559.791, FLORIDA STATUTES
False swearing on application; penalties
Any license issued by the Department of Business and Professional Regulation which is
issued or renewed in response to an application upon which the person signing under oath or
affirmation has falsely sworn to a material statement, including, but not limited to, the names
and addresses of the owners or managers of the licensee or applicant, shall be subject to
denial of the application or suspension or revocation of the license, and the person falsely
swearing shall be subject to any other penalties provided by law,
NOTICE TO DISABLED VETERANS
Section 205,171, Florida Statutes, exempts disabled veterans and their
surviving unremarried spouses from the payment of the first $50,00 of any
state business or occupational license fee,
DBPR Form HR 5021-020
Revised 2000 February 10
Establishment is to meet all standards of Chapter 509. Part t Florida Statutes. and Chapter 61 C-4. Florida Administrative Code
SPECIFICATION WORKSHEET
.. Establishment Name: (l h\ ,,) CJo.,~ LA.. )&
'_ll1LllfJljJl~1;ljlWJ}JlljjfSl~lJAlllrR'Gq$ll?'l€JlEJJlIJtjltgiJ1JllllllltrflfJj$fjltIlEfla.;~;li~!
F OR" WALL CEILING
o ew construction
Conversion
o Remodeled
o Closed at least one year
License Number:
(if applicable)
~.dS4\ ~
Food Storage
Wash Area
Restrooms
Worksheet Code Key
E Comments:
S Satisfactory
U Unsatisfactory
NA Not Applicable
E Existing
C Caution: Information inadequate
or potential operational violation,
will be checked during inspection.
'..-Y7iEllffli'i#I!%B~t#<ti
Jl~~;_LLJ. ~~~U';r-.'
Portable extinguishers provided as required by NFPA 10
IE S Hood automatic fire suppression system meets NFPA 96;
no mesh filters allowable
1m .s Exit doors open outward
1m .s Public access to exit does not go through kitchen. storage
- rooms. or restrooms \ p v..b \ \ t..,
11/ Number of exits, a: \ 't-YVl pLO.je
IE Square footage of establishment: ,
IE ~ All gas appliances shall have a nationally recognized test.
ing laboratory seal such as AGA or UL
. S itizing facilities provided
three compartment sink 0 dishmachine
IIlI ~ Wash sinks with drainboards
. ~tJer shown: D 4 03 D 2 compartments
III f'J One/two compartment food prep sinks
Nu. er shown:
-
.:11 _ Hand sin~ in food prep area(s)
Number shown:
E ~ Hand sink in remote mechanical dishmachine area
1m Comments:
II!]
* local fire department is the final authority having jurisdiction,
II) Dishmachine type:
IE Comments:
II] ~Approved local exhaust ventilation installed at or over all
cooking units such as ranges. griddles. deep-fat frying units.
and other units of equipment which release appreciable
quantities of steam. odors. grease. or smoke.
D ~ Restrooms ventilated or provided with windows to the out.
side
DBPR Form HR 5021-011 (Formerly BPR 21-011)
Renumbered 1999 May 25
1m ~Ice machine installed in protected area and properly
drained
IE ~ Displayed food protected
D N~RUnning water dipper well for bulk ice cream service
D Equipment to maintain proper food temperatures
~ Refrigeration _Hot/holding units
III S; Laundry facilities properly located
IIi] ~ Designated areals) ,for employees' personal articles
II] ~Designated storage area for maintenance and cleaning
equipment
Mop wash facility with hotp.qd cold running wa
to sanitary sewer locatioA::>
IE] ~Faucets with hose fitting and hose bibs to have back flow
protection device
1m '~BacksiPhOnage/backflow protection if no air gap/break
1m ~ Refrigeration waste piping shall discharge indirectly into
floor drain or other approved receptor
C" Adequate number of public restrooms provided
5- Hot/cold water to all lavatories utilized by employees
5-Doors to be self-closing
~ Restrooms accessible by customers without going through
food preparation, food storage, or ware washing areas
IIil Comments:
I
",,1m
III
IE
IE
II]
~ Waste container, grease receptacle, co\"p~c~ on non'ab-
sorbent surfaces.DlA )'V\4/S i:'tY'
_Compactor area drained to'sanilary sewer
IE
D
Comments:
Light fixtures required to be shielded, coated, or covered where food is
stored, prepared, displayed, or where food is open or exposed.
DBPR Form HR 5021-011 (Formerly BPR 21.011)
B
m
o On-site Well, c;J Other
Supplier Name:
Written approval for use issued by:
B
D
OJ
B
Public well permit number:
o Package Plant 0 Septic Tank System
Written approval for use issued by:
System name:
Septic Tank System permit number:
Tank size: gallons Drainfield:
Grease Trap:] ~O gallons Location:
square feet
1m Seating capacity as indicated by plan: \ 0 fY'\D')(
D 0 Plans approved as is date: / /
~ans approved with noted provisos date: .li1d.1/ 0()
o Plans denied date:_/_/_
Resubmit corrected plans as indicated
Provisos/comments:
Applicant name:
Please print
Applicant signature:
date: ---.!---.!_
Renumbered 1999 May 25
APPLICATION FOR;s:; ,
PLAN REVmWf~d.\ .
, O~~~V~~S
Address '874-7 Ter.fte.. Te.rt~,e. il""l City Tu-- ~ 7e;r~:.::L
State & Zip Code -'- '3 }/,,~ 1 . Telephone (~l..Jl!L >-(
. ~~. (0") f...:.-~
1 Responsible Agent: Name :-) ~ ." LA') . WI" l<A-- Title
or It"", thin oWNrl
Address (~?ltY3 ~30 I City
,.... .fL ZlpC,', 3 :';0'1- . T,I,p'''' rS51J5il:2:-
.
..
Please Print or Type
I Establishment Name
Cotpout. ,nd ,uUIt name
wbtf1lppIOprilt.
c
1 Establishment location 1 '2
Addt.u 'Ad City
2.6
10wner Name
AJ G;- ~.(
I Menu Information: Types of food involved and method of servicg. Attach a copy of proposed menu
flf necessary),
I Waste Water Disposal. Prior to the opening inspection, the applicant must provide written
approval for waste water disposal from the appropriate agency (HRS County Public Health
Unit, Department of Environmental Protection, municipality or sewer district), Written ap.
proval may be a copy of a utility bill, a receipt or permit, or a letter from the appropriate
agency,
Will your establishment be served by:
A. Septic tank system? 0 Yes
a Package sewer plant? 0 Yes
C. Municipal[utility seWer? taYes
ONo
DNo
DNo
If you answered YES to item B or C, complete the following:
"-.,
Name of municipal/utility agency CITY Or 26 PH"if( H II..L..s
Size of grease trap 150 gal. location ~e~
i Water Supply. Prior to the opening inspection, the applicant must provide written approval
for a potable water supply from the appropriate agency IHRS County Public Health Unit,
Department of Environmental Protection, municipality or sewer district). Written approval
may be a copy of a utility bill, a receipt or permit, or a letter from the appropriate agency,
Will your establishment be served by:
A. On,sitewaterwell? DYes
B. Municipallutifitywater? ~Yes
DNo
oNo
If you answered YES to item B, complete th~ following:
Name of municipal/utility agency
err...,.
OF :Z6PHY~IL.L'$
I . . I . I I
D Basic Faci/it Information
o New Construction
o Conversion of existing
structure to food service
o Closed at least one year
Ji:I Remodeling of existing food service
Name of existing public food service establishment
d~/'u...
CAFe MAP,e.IO
iii If existing structure, provide description (examples: steel warehouse,
old wood frame bu~ding in historic district, etc.):
tSHof'PlI4-G CeN'Te~
2-
Note: Constru:tion fJl1ish schedules of noor, walls and ceiling rT'.Jst be provided on floor
plans,
IJlI Solid Waste Disposal.
Disposal Type (dumpster, grease container, garbage can, etc.)
01 j foo1.f'c:;-r~
Waste water from cleaning containers disposed on site?
DYes 0 No
m Will establishment have an Alcoholic Beverage license?
o Yes ~No
If YES, the estabfishrrent must meet all the sanitary requirements of the state before tfe departrr.ent
staff may S9n the apprcation for beverage rCerlSe. AD required eqliprrent and fixtt.l'es ITLISt be instaKed
and operatirYJ properly before approval can be given pursuant to s,561.17(2), Florida Statutes,
m Projected Seating Capacity: Number of Seats
~
[()
(Y)AX
mConstruction: Anticipated Start ~Ikl 00 Completion 1.2...1.212) 00
Manl!'! D.y Yut MMlh O'y rur
Plans are reviewed on a first-come, first,served basis. Florida law allows 3D days for processing,
Atter plans are approved and ccnstruction is complete, please contact your tfrvUicr. 6strict offiCI! fer
an inspection, It you do not elmently hold a BPR license for this establishment, s~bmittal of an
ApprlCation for Ucense and the appropriate icense fee is requird at the tme of the c~e:ing inspect:cn.
'i13-7i;.-/l'1,
ke:~
......~
~'~
SIGNATURE OF APPLICANT
ie/Db Iou
MONTH DAY YEAR
R Form HR 5021,010 IFormerly BPR 21,010)
, I ,
. . . I
R!'I!lid 19~9 JI;:Y 29
v ,,,,{llE:~r&.\ D~:~TMENT OF BUSINESS AND PROFESSIONAL REGULATION
... ~,-- ~ ~ DIVISIOn of Hotels and Restaurants
~.< 'APPLICATION FOR
PLAN REVIEW
'Estahlishment location 1 '2
Addrru and City
ze
'Owner Name
C^-'lC:C
Address ~ }4-7Te;rfce. re.ftr;~(.e. It vJ 't
City
~;.< t-f... (efr.:....':;;....
State F.L Zip Code ~>t.{ 1 . Telephone (3/;. tJjl:,)./
~~.G)~,-
Responsible Agent: Name ..... ~~1I\.Q." lA,) .1l"~/",R.lY Title
at OU...,lhln oWNrl
'dd"" (:.1 ?,()"\ ~L~ I
State .fL Zip Code '3 l~~.:2~
City
Telephone r '35:1 ).562-
Menu Inlonnation: Types oUood involved and rrethod of servic~, Attach a copy of proposed rrenu
Crt ro:essaryl,
d~I' u..
Name of existing public food service establishment
CAFf MADJC:,IO
BPR license number 01 existing public food service establishment
o If existing structure, provide description lexamples: steel warehouse,
old wood frarre bu~ding in historic district, etc.):
cSHoPPt~G CE.N.:re.R
2-
Note: Constnx:lion finish ~hedules of floor, walis and ceiling rrusl be provided on flocr
plans,
M Solid Waste Disposal,
Disposal Type (dumpster, grease container, garbage can, etc.)
Waste Water Disposal. Prior to the opening inspection, the applicant must provide written
approval lor waste water disposal from the appropriate agency fHRS County Public Health
'Jnit, Department of Environmental Protection, municipality or sewer districtl, Written ap..
Jroval may be a copy of a utility bill, a receipt or permit, or a letter from the appropriate
1gency,
.viii your establishment be served by:
'I. Septic tank system7 0 Yes
1 Packagesewerplant7 DYes
~ r'l'unicipal[utility seVier? IIlYes
'Dlj M.Pc;-r~
Waste water from cleaning containers disposed on site?
[] Yes
o No
""~-
m Will establishment have an Alcoholic Beverage license?
DYes ~No
PAY TO THE /....., V ( J _
ORDE. R, ,OF ...L/ I J.-=> ill air- II/) r,;: / . '.;7'
. , \ .,. I " - c. S Ntff) ;(b<:~~'
=.....'evQ.(\-ey,r:,V.J.<<:I!:F_,/V,.., . ' URCHASERS3 NI'G.V '"OT'..
j- ~ YV~c __ " TER'f>i3'1:AEV~Sf/S':6E c .,
IS$I}I!d by Int+,;qrJl~rl i1J"mt!llf i"' ~, _ AUT .J n71. E , "
'.... --=.ss::--:->:-,",'~: '., ~y..~~=s, III" 'P1'..,.. ':"'''' r:IJ'~Uh",M ~'~"" ,1""-'''"1 [lIIWIII".-..",. l~n,," J"I'C:"'~C"::,~~, REPRESEr. r" TIV[
I: .0 2 .00 ~ 00': ~ 0 0 b . -g-S -9 O~2~S'Q'~,~;'.":'"-~-'"-._-- '"-. ., _ ,;,_~~,.~~_=~__
DNa
DNo
DNo
~
~,
I' (i~~~N?' I(~[[y
I,
r
r you iJnsIVcred YES to item B or C, compIete the lollowinr
'lame of municipal/utility agency
ell'{ op
;ileof grease trap \lSO gal. location
Vater Supply, Prior to the opening inspection, lhe applica
or a pOlable water supply from the appropriate agency {
J~partment of Environmental Protection, municipality or s I!
nay be a copy of a utility bill, a receipt or permit, or a lelt
'/ill your establishment be served by:
l On,sitcwaterwell? DYes
l, Municipal/utilitywater7 ~Yes
PAY EXACTLY
DNa
DNa
, you Jnswered YES 10 item 0, complete lh~ following:
'ame of municipal/utility agency
c rf"'i
OF :Z5PHY~HfLL~
~'~
SIGNATURE OF APPLICANT
I I
Form HR 5Q21,010 (Formerly BPR 21,010)
. I :.
. r.l.....'..."""r...'''''ll~~ll~~nt
J1IJ1@I0JJEYf @~~~.
06-196903250
::i!'
82,40/10,1
-"
...." -'
~6~
ie/ob 100
,r-.,lDNfH DAY YEAR
R,',"!i11999 Nt::9
Received Feb-06-01 13:36 from
02/06/01 13:42 FAX 9733753768
9733753768 ~ SANDY DEVELOPMENT CO
R-S REST,EQUIP.
-pr M rr .;p:::- qg/,() flU1lANT EQUIPMENt -t:l
di.S1 ~., ~ QeQ
.. ~ '.";,... ~" ~.
Nfl WtJ/<' 9: ". ·
FloAirp
page 1
raJ01
~
-~~~~ l;/
) rise above the ordinary
UP-BLAST BELT DRIVE &: DIRECT DRIVE EXHAUST FANS
1'4 bolated. COlllpletely Enclosed OrIve Compartment to protect form motor alrbome con lam!nants ,
ok Durable ll00-H14 Aluminum Fan Wheels to Insure a spark-proof and rust'res1stant performance,
fj; Efficient Centrtfugal Wheels puJI more atr under high ..tatlc pressure WIthout overloading the motor,
'Il PoslUve, Forced-A1r Molor CoollnJl: System to prokmg fan lire and save on costly servicing and replacement.
-k Spun A!umlnum Housing to pro"'de rust. free , ~allier resistant durability,
1'4 cUp-blast Direct Drive: .J
High Vertical Discharge Pattern prevents reclrculatjon of contam!nants on adjacent rooftop equipment,
[~~~~ -,
-k ^ Wide Variety of motor H,P, Rattngs to proVide a large range of air movement capactt1...... ----1
Variable Pitch Motor PuIlc ,All unit u to and Indu t 1 HP arc a roved (or UL Llst1n 11762,
SPECIFICATION SUOQBST 1 SPUD 1 PHM& 2 8PBm 1 PHASE I 'PaD It PHA8B III1PEBD 3 PBA8B
RPM MAU-VP lllS/201/230V 115/2SOV 208/230/46OV 208/230/46OV
ADl'PAN PREFIX PREFIJ[ PUF1X PUFIX
70 1690 S.lO U6hp 11-115 M!
250 1725 S-10 1I6hp 11-115
580 ,1620 S-10 1I6hp 11-115
1160 1590 S.IO 1/4hp 11-116 21_115,
1600 1720 S-10 113111' 11-115 21-1115 13-208 '
2080 1710 S-IO 112hp 11-115 21-1115 13.208",." ,,-'
2825 1700 S-123Nh 11.115 21.115 13-208
1400 1280 g.10 lI3hp 11-115 :n.115
1700 1420 S-IO 1/3hp 11.115 21-1 uS
2100 1625 S-10 lI2hp 11.1115 21-115
2400 1775 S-I03l4h 11.115 lll.l115
2046 742 8.12l12hp 11-115 21-115
2361 805 S-12 112hp 11-115 21-115
2876 913 S-12 3/4hp 11-115 21.115
3462 1044 S.121.0h 11-115 21-115
3953 1157 S-12 1.Sh 11-115 21.11&
2598 673 8-12 112h" 11-115 21-115
3367 766 fS.12 l.Ohp 11.115 21-1US
4143 875 8-15 LOhl> 11-115 21-1115
4762 968 8.151.0hp 11-115 :I1-U5
5593 1100 S-lS l.Shp 11.115
6 7 8-15 2.0h 11-115
3621 576 S.151.0h" 11-1115
4716 659 S-IS Uhp 11.115
5537 730 S.IS l.Shp 11-115
66S6 831 5-112.0 11-115
7492 912 S.182,Oh 11-115
6419 1S07 S.182.0hp 11.115
7801 I 577 S-183,Ohp 11.115
8884 635 S-185.0hp 11-115
10573 727 S-185,Ohp
12808 864 S-18S,Ohp
DU-DlRECf DRIVE BDU-BELT DRIVE
. 230/240V ONLY
MODEL
DU.8
DU.9
DU-18
Du-atS
DU.S3
DU-50
DU-75
8OU-214
BOU-314
8OU-414
8DU-514
BDU-I80
BDU-181
BDtT-182
8DU-I83
8OU-I84
BUD-201
BDU-ll02
BDU-203
BDU.2M
8DU-~lS
8DU-242
BDU-US
BOU .244
BDU.:US
BDU-a46
8OU-304
BDU-305
BDtT-308
Bl;)U .307
BDU-S08
HP
1/8
1/8
1/8
1/4
1/3
1/2
3/4
1/4
1/3
1/2
3/4
1/4
1/3
1/2
3/4
1
1/3
1/2
3/4
I
1~
2
1/2
3/4
1
l~
2
1
1\-2
2
3
5
275
440
815 '
1350 I
1760 I
2340
30501
1720 I
1960 '
2310 ,
2575 !
2465
2739
3196
3733
4190
3292
3884
4527
5067
5826
6458
4568 i
5445 i
6157 I
71411
7930 '
7305
8494
9453
11016
13153
21.118
21-1UJ
2l.11lS
21-1115
DIRECT VRIVE SERIES DIMENSION
MOnJtL
DU8 . DUD
DUll
[ DU25 .1lU75
BT
13W'
151h"
23"
I -~~-f-
T.' ,.
W i B C F RO ~i I 'l' HT
19*'" Ph" 16~" ~"12W' I I I
24"/1'f.l" 18~" 11"''' 14~" .L' d. _
I '-. .
:wI I,," 21" 20\;" 17" ~"'~ ~
13-208
13-208
13.208
13-208
13-208
13-208
13-208
13-208
13-208
13.208
13-208
13-208
13-208
13-208
18-208
13-208
13-208
18-208
13-208
13.208
13-208
13.208
13-308
,:r: ~\~
111J
~ -
@0
23-208
23-208
23.308
28.~8
23-208
28-208
23-208
23-20.
23-208
23-208
23-208
23-208
23-208
23-aoa
23-208
23-2Ge
23-208
:a3-aoa
a3-208
MODEL HT
BDU214. BUD5141 22W'
IDUI80 . BDVl84 31W' 28" 26"
8DI1201 -1IJ)V2061 31 W' 2" 28" 26"
BDtrJ42. 8OU248 37Vl' l!!./" 33" 31"
BDU304 - BDI1S08! 39" SPA" 2" 40' 331""
.. ~~~~:~;J~~~~~~~~:~OR AN~: ~;Q~5~~~a:~~~;:~~~~_~~ ~~t=;Jr
L "'"''''''u~- - to. 0''''"0 1R" "'.,,~"" ,"'"".".. 'A>C ",.,,,.,,,, e ~""'re' ""
~[;J)fi
Received Feb-06-01 13:36 from
02/06/01 13:42 FAX 9733753768
9733753768 ~ SANDY DEVELOPMENT CO
R-S REST.EQUIP,
~uaANl EQUIPMENT ""~
..~ ",t.S1 1a. 4: ~.:L JA G COIi~.
FloAi rp ) rise above the ordinary
BELT DRIVE FILTERED MAKE-UP AIR FANS
,:. C':nbll1('1 I,; ~on"lr\Jrl(,ci of 18 gnug<' gnlvnnl:l,ed Sleel for uddt'd durablllty and slr(:ngth
;.,; GasH\' s..ry\n~d, t<>p c'n'er allows for easy serv'l('mg of blowE'r, moror. bell aruJ fillers
;.,; Mo.-It:] S iO "nn S 12 wall or roof mount olher mooeb roof rnounL Clnll'
;.,; Low promr u Emo:-rgrn,y disconnect switch
page 2
14l 02
..- -:"':~,'~. _.~ .~'~;'~l;-~~.
. ,...~.., .," ../~
. <"".,-c,~_=;:i,;,.~ ~
't&~"'~ ' '" ~
PHYSICAL DIMENSION
MODEL NO, A (SQ,) B D E (OUTLET)
5,10 2S!i~ 2-1 30li~ 1]3/8.'\13,(S
5-12 33' 24 35' 13]/2-,,155/8
5,]5 J6 2S 38 l:i7/lr:<lR3i8
I
,518 ,W :JO 42' 1_8 7/S'x21 i/~l
MflIiEi.: HP'RPA( FPM : ' ,---qM AGAUIIST STATIC PRIlSSURE !
NO, " 0 ,1;;0 ,250 ,375, ,50 ,,750 ,8T5,.,1-,OO I
400 1113 13~S
.1.10 122,1 14~5 !.ClS ,
O 4BO 1.3J5 ::' ~S . lln I
,1. 61500 1390 1640 i2S0 180 i
520, 1445 1700 1350 3';0 j'
..... ' 540, 1502 H60 1440 920
, 4,580:'1613"'IS00 1600 1240 -
I " (SOO 166~ 1980 16130 1340 16'J
U1 < 3 (S40 1780 2100' 1820 1530 500 ' I
~, : 680 1M2 2230 ~91~00-E1~~g i;;g 5*g I
-- ;720' 2003' 23S5' <- <- a
t, 2, 760 2114 2500 2360 2020 1 T40' 1240 140 I
'41300 2225 2630 2410 2180 1920 'I' 1630 420, J
3J ! 320 :!28l 27'00 25QO 2260 2020 I 1760 700;
I MOUlLi lIP IRPM' FPlI CFM AGAINST Sf.ATJ(: PIlES8UllE I
' NO I I 0 '12~, ,25,0 ',376 I ,50 : .750 1,875 1.00
1 514110 1 n 2100 '40 I
:..>' 440 1454 2310 1900
f'\ 1 ' '45lJ 1520 2420 2040
"'I :1;31480 1587 2525 2160
500 1653 2630 2280
_ ",,>,540 1785 2340 2520
'0 -".]56 4"-4-
I . '4i 600 1983 3155 2860
:..)i : 620 2049 3;: ~ \
UJ -'-:660-21111-:3470 32:lS
1 I ~SO 2~4S ~~;5 3350
_: 7,Q0. 2~H_2.€!89 4~
: no 2380 3785 3550
1',; 740 2445 3890 3675
, lIlAXOOJIf
UP I I
! Il.l'M: CrM rPM
:,4() 1760 1502
000' 1980 1663
580 2230 1892
1,'. 760 2500 2114
,) 4 82Q 270Q 22>.11
1/6 4C'O 2100 1322
1 4 440 2310 1454
113 500 I 2630 lS53
12 560 2945 1851
3. 4 620 3260 2049
1 '7(10 3C80 23:,..-1
11.'2 740 3890 2446'
1, 340 2940 1335,
1/3 380 3300 14g2 I
1/2 460 4000 1806 I
3/4 500 4325 1964 i
1 56Q 4850 2::'99:
. 1 1/2; 540 5550
'2 700 6C5~
112 ; 330 4525
3.--4 190 515-0 1851
t 420 5775; 199,3
1 1/2 480 6600 2278
2 I 540 7425' 2562
] I SOQ 8250 2847
5 I no J 9900 3417
ll5V
MODEL PREFIX
11-115-1/&H
11-U5-1/4H,
11'115-1/3H
11,U&-1/2M I
U'11H/4H
U-U5-1/~ ,
U.Us.l/4H
11,U5-1/31<1 i
11'115-1/2H '
U-UlI-3/4J! i
11-115-1111' ,
2.HU2.,1H J
11-111;01/ 4H
11,11.1/31<1 I
U-U.1/21<1 :
11,1.15-3/4H
U,U&1HP ,
11-115-1,5H
11,U5-
11.1.1..1/21<1
11-1.15-3/411
U-1.15-UlP
11-U5-1,$H
1.1-1.15-2HP I
1.1-U5-3HP
U,U5-SHP
U,a08-1/111<1
11-208-3/4H
11,20&-1/2H
11-206-3/4H
11,208-1NP
U-2~8-l.IH
11-205-1/2H
1.1..208-3/4H
U.208-1HP
1.1.-208-1.5H
1.1.,20ll-2HP
11-20&-1/2H
1.1..20&-3/4H
11'205-1HP
11.208-1,5H
U.20..2HP
1,---',
-"
@"
. -~;~ .
- -"'~~.\~\ .." .
SPEEii'3 PIWE
208 230 460 v
MODEL PRmi
!
, 13'205-1/4H
13-20ll-1/3H
I 1.3'20"1/2H
I p.ZO&-3/4M
I 11-208-1/41<1
I 13-206-1/314
i 13-208-1/2H
13-20&-3/414
13-20S-1HP
13-20&-l,SH
13,20IU/4H
I 2.:),20&1/3H' -
13.20&-1/211 ..
13.20..3/4H :
! 13.201l-1HP
1.1.3-20IU,1H ,
, 11-208-21<1'
I 13-205-1/2H
! :U-208-3/411
I 13-20&1KP
U-20~l,5H
11-208-2HP
13-208-3HI'
13-20B-IHP
.
,~i _
.~:
. .
-:--- - : SPECIfICATION: :
MODELl .. i ,.
NO i HP!RPM) FPM; 0 1,125 ,250 ,375 ,so ,7~ ,S75 1,00
I'" ,1/4, 340 , 33!\ ~~40' 2240
U I 'l/,313~O 1492 3300! 2NO_~Sl.
1- 2i 420 t649 3625; 3125 2375
" 460 1806 4000, 35;:~, 2925
..... }f41 500 1964 4325' 3900 3400
I _1 ':>,~O 2199 4850: 4550 4050
Ul '1,/.1600 23:>6 5200 4900 4450 300: I ~
'640 2513 '55!;O; 52 4 4 "
, 2 700 2749 6050' 5850_:i4SO. 5075 4750 3700 2750 45Q
MODIlLI I' -- I CFM AIlAINST ST~TtcP~ESSUU I
NO i iP RP10IL FPM !' 0 : ,125 ,250 r ,375 ,50 .150 1875 ; l,'OO.J
: ',-' ~5,3.7 ~ : _j
'3'4 3M, 1708 4950,4200 2850'12850 I~
rn I ' : 51: <>0' 7 - . 0 775 '
IoU, 1 '42Q 1993' 577 5 <l 4QO 17 -c
;;460' 2183 6325 5850 5150; 5150 4000,1200 -;
.....' '1480 2278 6600 .6150_5500i 5500 4~101 70' ,
, ! SOC 2373, 6iOO 6450 5825 I 5825 5000 I' 3 00,
I '~i 540 2562, 7425 7050 6450' 6450.58 ,
UJl3 .5$0,2752,8000 7600 7100,7100 650016000 2000
, I~OO: 28~7 8250 1900 7400' 7400 ~900 6350: 0 4
. ! 640 3037: 8800 8400 80oo! 8000 7500 I 6800 5600 1400
- : 680 3227.9300 9000 8600 i 8600 8200 7100 6600, 2600]
" ; 10Q 3322 19600 9300 8900' 8900 8500 '8100 7000 4500
: 720 3417 _ 9900 91';00 $200 9200 8800 I 8400 7500 saoo
11.23C-1/2tl
1.1.,U0.3/4H
U-230.1/2H
11.23o.:J/4H
U.23o.:LHP
U'23C-1,5H ;
j
1.1..230.1/2H i
; 11-230.3/4" I
'U.23o..1.H' I
: 11.230.1,&" I
U.230.2HP
l 1.1-2>>1/2H !
U.2.3C-3/4W \
! 1.1.2JO.:LJfP :
U,23C-l,IH I
11-23C-2HP :
r
i
~
I SP D "
208 V 230 V
M~P.HJI~~IX >I' MOQEL PIl~X:
D
~-i I
I- I
I' !
: B I
j. '1
11
r:.+
- I-=--~=I
--.-......'--'~---
---'"--..............~
---..------
-------
- -''-_-..---..
1======
--'-""'""---
--------..
- -'--'-,,_.--,
, '-:0=====1'
I-....;~:=:===
" [=::~:="::~:':'=':==:J
~
f-
A
~
..
.. ~..!!9 ~E~~~~~~:..':~,~"~~~~OR AN~. ~;;~':~~8~~'~Jo?';~~~~~~ II
,~ FIQ~lr('2 8/97 f,"'CTORY: 40 Cornp!own ROOd ~<~:lp!ewooc ',u, 07040 fEL 973,3753388500,628-3388 FA-x: 973,.} 75-,3768