HomeMy WebLinkAbout08-7368
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
7368
Permit Number: 7368
Permit Type: FIRE PROTECTION MAINTENANC
Class of Work: FIRE-HOOD SUPPRESSION SYS
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees: 25.00
Amount Paid: 25.00
Date Paid: 1/08/2008
Work Desc: LUPTON -
Address: 5130 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 1I-'U.:1-2../- 00 10 -01
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Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fire
prevention and protection related activities such as inspections, plan review, administrative fees, and other
costs related to the aforementioned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of
the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final
inspection shall be charged double permit fee per day of operation or a minimum of $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
....
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
813-780-0020
Date'Received
Owner's Name
Owner's Address
City of Zephyrhills Fire
Permit Application
* 13~~
Fax-813-780-0021
Phone Contact for Penn it
I Owner's Phone Number I 2' I '3 II 71 01 IS-I/ I
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I Titleholder Phone Number I T I J - II 71 $-1 J / S7 / I
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Fee Simple Titleholder Name
Fee Simple Titleholder Address
Job Address
Sub Division
Ze"l.y,.l.;t!.s IF! :r "1 rI^- I Lot#
... ...
Parcel # 111-2'''.lI-~D/~ "07d?tJt1'-~/;t.
(Uti I AINt:U I-KUM t-'KUt-'t:K I Y I AX NU 11l;t:)
D
D
D
D
D
D
D
D
D
D
D
D
D Fumigation Tent
D Hazardous Material (Tier II or RQ Facility) ANNUAL
D Hood Installation
D LP/Natural Gas-Installation
D LP/Natural Gas-ANNUAL Sale
D Places of Assembly-ANNUAL
D Recreational Bum
D Sparklers
D Sprinkler System Installations
D Standpipes (Sprinkler Sys)
D Torch Roofing
D Waste Tire Storage ANNUAL
Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen HoodlDuct
Controlled Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
Sprinkler
Fire Alann
Hood Clean/Suppression
Fire Alann Installation
D
~
Fuel Tanks
&~ I Valuation of Project
Company
Registered
License #
Fire Pumps
Fire Works
Flammable Application- ANNUAL
Other:
Contractor
Signature
Address I
ELECTRICIANI
Signature .
Address I
PLUMBER
Signature
Address I
MECHANICALI
Signature
Address I
OTHER
Signature
I
Company
Registered
License #
Company
Registered
License #
Company
Registered
License #
Address
Company
Registered
License #
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ls'1J~~2D4:JC)/~.Y' I
Y I N I Fee Current Y I N I
I
Y I N I Fee Current
Y/N
, Y I N I Fee Current
Y/N
Y I N I Fee Current
Y/N
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.
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to. "deed" restrictio.ns"
which may be mare restrictive than Co.unty regulatio.ns. The undersigned assumes respo.nsibility far co.mpliance with any
applicable deed restrictio.ns.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the o.wner has hired a co.ntracto.r o.r
co.ntracto.rs to. undertake wo.rk, they may be required to. be licensed in acco.rdance with state and lo.cal regulatio.ns, If the
co.ntracto.r is no.t licensed as required by law, bath the o.wner and co.ntracto.r may be cited far a misdemeano.r vio.latio.n
under state law. If the o.wner o.r intended co.ntracto.r are uncertain as to. what licensing requirements may apply far the
intended wo.rk, they are advised to. co.ntact the Pasco. Co.unty Building Inspectio.n Divisio.n-Licensing Sectio.n at 727-847-
8009. Furthermo.re, if the o.wner has hired a co.ntracto.r o.r co.ntracto.rs, he is advised to. have the co.ntracto.r(s) sign
po.rtio.ns o.f ,the "co.ntractor Black" o.f this applicatio.n far which they will be respo.nsible. If yo.u, as the o.wner sign as the
co.ntracto.r, that may be an indicatio.n that he is no.t properly licensed and is no.t entitled to. permitting privileges in Pasco.
Co.unty. .
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuatio.n o.f wo.rk is $2,500,00 o.r mare, I
certify that I, the applicant, have been pro.vided with a co.py o.f the "Flo.rida Co.nstructio.n Lien Law-Ho.meo.wner's
Protectio.n Guide" prepared by the Flo.rida Department o.f Agriculture and Co.nsumer Affairs. If the applicant is so.meo.ne
ather than the "o.wner", I certify that I have o.btained a co.py o.f the abo.ve described do.cument and promise in go.o.d faith to.
deliver it to. the "o.wner" prior to. co.mmencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the info.rmatio.n in this applicatio.n is accurate and
that all wo.rk will be do.ne in co.mpliance with all applicable laws regulating co.nstructio.n, zo.ning and land
develo.pment. Applicatio.n is hereby made to. o.btain a permit to. do. wo.rk and installatio.n as indicated. I certify
that no. wo.rk o.r installatio.nhas co.mmenced prio.r to. issuance o.f a permit and that all wo.rk will be perfo.rmed to.
meet standards o.f all laws regulating co.nstructio.n, Co.unty and City co.des, zo.ning regulatio.ns, and land
develo.pment regulatio.ns in the jurisdictio.n. I also. certify that I understand that the regulatio.ns o.f ather
i go.vernmentagencies may apply to. the intended wo.rk, and that it is my respo.nsibility to. identify what actio.ns I
must take to. be in co.mpliance.
If I am the AGENT FORTHE OWNER, I pro.mise in go.o.d faith to. info.rm the o.wner o.f the permitting co.nditio.ns set fo.rth in
this affidavit prio.r to. co.mmencing co.nstructio.n. I understand that a separate permit may be required far electrical wo.rk,
plumbing, signs, wells, po.o.ls, air co.nditio.ning, gas, o.r ather installatio.ns no.t specifically included in the applicatio.n. A
permit issued shall be co.nstrued to. be a license to. proceed with the wo.rk and no.t as autho.rity to. vio.l ate, cancel, alter, o.r
set aside any pro.visio.ns o.f the technical co.des, no.r shall issuance o.f a permit prevent the Building Official fro.m thereafter
requiring a 'co.rrectio.n o.f errors in plans, co.nstructio.n o.r vio.latio.ns o.f any co.des. Every permit issued shall became invalid
unless the Yvo.rk authorized by such permit is co.mmenced within six mo.nths o.f permit issuance, o.r if wo.rk autho.rized by
the permit is suspended o.r' abando.ned far a perio.d o.f six (6) mo.nths after the time the wo.rk is co.mmenced. An extensio.n
may be requested, in writing, from the Building Official far a perio.d no.t to. exceed ninety (90) days and will demo.nstrate
justifiable cause far the extensio.n. If wo.rk ceases far ninety (90) co.nsecutive days, the jab is co.nsidered abando.ned.
WARNING1TO 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENC ENT.
FLORIDA JURAT (F.S. 117.03)
I
CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as identification.
OWNER OR AGENT
Subscribed and sworn to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as identification.
Notary Public
Notary Public
Commission No,
I
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
I
Dee 26 07 03:29p
Lupton's Catering
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SERVICE CONTRACT
Fire Systems Inc.
".O.So)( "'74'
ST. PET!RSBURG, FL. 3374J-tJ741
727-U7- IZIS
FIRE SYSTEMS AND EXHAUST HOOC ClEANING SfRVlCE
DATE: DECEMBER 26.2007
TO LUPTONS'S
5130 GALL BLVD.
LC~MYRHILlS, FL 33542
813-715'1511
S~U:S9nSON I .JnR P/"VMl;HT TI:ItAIS t1UIi p,t,TI:
KEVIN T LUPTON'S 30 DAYS
QTY DtSCRIPTlOH UNrr PRICE LINE TOTAL
SUMANNUAL LlEAl'fIHCi ANO SERVICE MAI}.JTENAN'CE OF EXHAUST ,
"000 AND FIRE SYS1UULONG WITH CERTIFICATION AND DECALS I 145.00
PER NFPA FTRE COCE STANDARDS
fir. EQuipmenr service included
: Exhaust HtIIntt s)I5'tem and Fire System clt:lI"ln! :;en-ice fne !udeO
I Semi.anflUal se"'ic~ contract for work listed and performed in
I accordClnce witl'i descril'tfon. Sign below to aCc:P.l'lt thi~
a!lreemftlt. Contract term for 1 year from date of this .!lreement.
( Rechargeli and emel'!ency service additional charges} SALES TAX 52.15
. . I
AuthDn'Zed by TOTAL j S 797,15 '
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FIR6 p~V6NnON SP6CIALfST
THANK YOU FOR YOUR BUSINESS!
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Pasco County Parcel: 11-26-21-0010-07000-0012001
Page 1 of 1
Search Again Show Map Generalized Buildina Schematic Estimate Taxes Frequently Asked Questions
Other Agency Data: Tax Collector School Board Suoervisor of Elections
I Data Current as Of: I Weekly Archive - Saturday, December 15, 2007
Parcel ID 11-26-21-0010-07000-0012 (Card: 001 of 001)
Classification 21 - Restaurants
Mailing Address Assessment (totals)
LUPTON REAL ESTATE GROUP INC Ag Land $0
PO BOX 16768 Land $116,475
TEMPLE TERRACE, FL 336876768 Building $263,808
Physical Address Extra Features $6,658
5130 GALL BLVD
ZEPHYRHILLS, FL 33542-4930 Total Assessment $386,941
Legal Description (First 4 Lines) Save Our Homes $0
PORTION OF VACATED SCLRR R/W Taxable Value $386,941
IN SEC 11 DESC AS:COM AT NWLY
COR OF BLOCK 184 OF CITY OF
ZEPHYRHILLS PB 1 PG 54 TH S65
ppq: Land Detail (Card: 001 of 001)
Use I Description II Zoning II Units I Type Price Condition Value
2100 I RESTAURANTII 00C2 II 7,000,00 I SE $6.24 1.25 $54,600
2 II 2100 RESTAURANTII 00C2 II 33,000.00 I SE $1.50 1.25 $61,875
Additional Land Information
Acres II 0,92 II Tax Area II ~ II FEMA Code II X Ilcommerical codell M3012DS
Building Information - Use 21 - Restaurants (Full Service) (Card: 001 of 001)
Year Built 1979 Stories 1.0
Exterior Wall 1 Common Brick Exterior Wall 2 None
Roof Structure Irregular Roof Cover Built-Up Tar and Gravel
Interior Wall 1 Wood Panel or Custom Interior Wall 2 None
Flooring 1 Cork or Vinyl Tile Flooring 2 Ca rpet
Fuel Electric Heat Forced Air - Ducted
AIC Central Baths 2.0
Line Description Sq. Feet Repl. Cost New
1 s.,"A 1,672 $146,420
2 BAS 3,154 $324,988
3 FEP I 100 I $8,243
Extra Features (Card: 001 of 001)
Line Description Year Units Value
1 PAV ASP 1980 15,040 $3,046
2 I SPRNKFP I 1980 4,446 $3,612
I Sales History I
Previous Owner ROR LLC
Year Month Book/Page I Type I Amount
2007 04 7553 / 0633 WD $0
2007 04 7467 / 1369 I WD $525,000
2003 04 5326 / 0668 .oc $0
Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Questions
Other Agency Data: Tax Collector School Board Suoervisor of Elections
t..............lln~~...,1C>...... n"",{'f'\O'f'\'\T r:mn/~e~rcn/naTce1.asDx?sec=11&twn=26&mg=21&sbb=001 0&... 12/18/2007
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01/08/2008 14:33 7273431422
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FIRE SYSTEMS
PAGE 01
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'--
12-14-200'
ALEX SINK STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORI(ERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRV EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. ,~
re,~~, ~~ \,0 ~
EFFECTIVE DATE: 12/14/200' EXPIRATION DATE: 12/13/2009 e~ ~ if, Db
PERSON: HOCH KEVIN J o''J~ S \ ~ \.... ~
FEIN: 200640754 , ~ ~ 11 crt
BUSINESS NAME AND ADDRESS: 'v
FIRE SYSTEMS INC \
2824 56TH ST N
SAINT PETERSBURC FL 33710
SCOPES OF BUSINESS OR TRADE:
1- FIRE EXTINGUISHER SERVICE
IMPDRTANT: Persa'nl" CRlp/.' uo . 051141. F.S.. .n Dllieer D' . corponUu who .'ects exelllpli.. "'''' Ihls ch.ple, by liIing . cc"iliutn .r ,llcUon und.r lhi!
secll.. III.Y .ot r.caver b...'ils If c'''''''.'.llo. e.der lIIi. "eple,. P".......I 10 Ch.oler 44D.OSlTzl. f.S., C.nlff..,.. .1 .1."".. t. h. .....', .,ply ...11' ..'11I1. Ihe
leepe .1 tile busl...> or If,'e IISfe' In 1"- noUn or el.ell.. II Ite n...,.. PiorsPlol 10 Chlpl.r 440.0&H31, f.S., Nollces af .I.ello. II b. IItlllpl ... e"tlflcll81 af
tle.li.. 10 b. .Jre.pl sh.1I be subjecI t. ,eVentl.. If, .t ny II.. alter the 'iling 0' Ihe nallce Dr /h. iSh..ce ., 'h. conlflclre, llIe penon ..... In llIe .'Un Dr
c.rliliul. " looger "'eels die r.""lr...IltS of ",I~ S""on for Iste.nc. 0' . certi'iest.. n. 'epltllllenl ..11 ,.vele n c"rtl/lcl'e .1 '.Y Um. for 'Iilore D' IRe P.,50.
named In Ibe .ertl/lcl'o 10 lleel Ih. r.o.i,.",e..s el 'his netl...
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
QUESTIONS? f8S01 413-1609
-.-.--------..______.............____._..4..........0y.0.........._...........__~_..~~~_:'________._u,...__
....~---.......".. 0"'-
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPAATMENT OF FINANCIAl. SERVICES e
DMSION OF WORKERS' COMPENSATION
CONSTRUCTIDN INDUSTRY
CERnFlCATE OF ELECTION TO BE EXEMPT FROM FLORIDA , " ,
WORKERS' COMPENSATION LAW
trrCCTIVE 12/1./200., tXl"lltATION DATI!; 12/13/200.
PERSON: KEVIN ~ HOCH
FEIN: 200640754
BUSINESS NAME AND AODRESS:
F IIIE SYSTeMS INC
2824 56TH S1 N
SAINT pn~RSBl1FlC, n 33710
SCOPE OF BUSINESS OR TRADE:
1- FIRE Ell:T1NGUISHER SERVICE
~
F IMPORTANT
PursUlllt to ChaPter 440.051141. F.5.. an officer of 8 l:orlloration who
o elects exemption from this chapter by filing II l:ertifil:llte of ellction
l under this sedion may not rel:over bene"its or compensation under this
o chapter.
H Pursuarrt to ChIPter 440.05(12), F.S.. Certificates of election to be
E exempt.. applV only within the scope of the business or trade listed on
the notice of election to bl exempt. ~
R .
E Pursuant to Chapter 440.051131, F.S., Notices of election to be ex empti'
and certificates of elel:tion to be eJlempt shall be subject to revocation
if. at any tilll!! ah!!r th!! filino of th!! Itoti!::!! 0' thl! is!lullftu nf th"
certificate. the plrSon nllned on the notice or certHicate no longer meets
the rellulremellts of this section for issUlll1ce of 0 certificate. The
deplrtment shall revoke II certificate at any time for failure of the
person named on tile cenificate to meet tile requiremellts of tnls
section.
QUESTIONS? (85DI 413-1609
CUT HERE
.. Carry bottom portion On the job, keep upper portion for your records.
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06