HomeMy WebLinkAbout08-7635
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
7635
ermit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
7635
FIRE PROTECTION MAINTENANC
FIRE-PROTECTION MAINTENAN E
COMMERCIAL
Address: 39248 8 AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 13-26-21-00800-0011
3/17/2008
25.00
25.00
3/17/2008 Phone:
FPM-CADDIE SHACK-ANNUAL HOOD CLEAN
Z I L
39248 8 AVE
ZEPHYRHILLS, FL. 33542
J
f1'~rll/
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 INSPEcnON
CALL FOR INSPEcnON - 8 HOUR NOnCE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
City of Zephyrhills:
Phone: (813)-780-0020
FAX: (813)-780-0021
Building Dept.
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: TO: Ms. Mickey FROM: Jackie :
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: FAX#:813-780-7869 FAX#:813-780-0021 :
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: DATE:3-10-08 # OF PAGES: 8 :
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: MESSAGE: :
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: Attached with this cover sheet I am sending over the information that was submitted to :
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: register R&L Cleaning and the application filled out by Mr. Phillips for the cleaning of the :
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: hood out at the Caddy Shack. I am sending over also the letter from the fire marshall that :
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: indicates that a permit has to be submitted prior to cleaning any hoods attached with a fee of :
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I $25.00 I
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: Thank you, :
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I Jackie I
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FROM : R&L CLEANING
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L C~,e ~"tA~
r 31o'9.*, ~ub~ t;.
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Fee Simple TIdehold<< Address r
613-7BOJ.1020
Date Received
~:6;''F w--
Owner's Name
Ownefs Address
FAX NO. : 813-737-2080
Mar. 07 2008 09:51AM P1
1~3Y
City of.ZephyrtJills Fire
Permit Applj~tic~
otr ._" "" ?tJ~_ConI2:t fo~ .:..e:1'i1it J,. . , ., .JJ.... . _. LL , _
I Owners Phone Nlr.Ibe: I 8\~ Il.,~ '< I [ffLS
::aX-81 S-780-00:! 1
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J ntleholder Phc:me Number I
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Fee Simple 11uenotder Name
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DFiTeP&Rnll$
. D. FIre Works
o Aammable App/tcab)- ANNUAL
o rue/Tanks
. 0 Other. I
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. Fill outappJlcatlon ~.' .
Owner 5: CDr11raettlr sign badt c:rf~an. ~ed .
!r over ~OO. Ii Notice of Comm :.'r:. (Or. ~.at slgned ClX1lRI;t 1Iith owner:>
SUpply two (2) sets of CIl3wins;5 ~';"~llIcaf wortc -'Wr $5OOD)
A1/!:lw 10-14 days 10: ruvlew mEr ~ datD.
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Job Address
Sub Division
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Bio-Hazard Waste Storage - ANNUAL
Camm ExhauSt KI1::hen Haod1Ouet
ConlroHe:I Bum
. Emergency GeneraIl:Ir < 30 ltw
Emergency Generater;> 30 kw
Fire Pratedion Mainl~ - ANNUAL --
FumigatIcn Tent
Ha%ardau5 Ma1!!Iial cr-lI or RQ Fac:iity) ANHUAL.
Hood InsIlIIIation
LPJNabnI ~...~
LPJNabnI Gas-ANIllUAL Sale
P/aceS of AssembIy-ANNUAL
Recreational Ban .
o
'Flre Ao'arm . 0
HcocI C1ean1SUppressiCln ~
Fire Alarm InsI3IatiwI
Sprln/der
SparJders
SprinIcJet System lnsUIDafions
S1mldpipes (Sprinkier Sys)
Torch Fwatng
Waste Tire Stor.lge ANNUAL
1 Valuatio.n of ?reject
~
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Fee Current
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Fee Cl.Il'nII'lt
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FROM : R&L CLEANING
FAX NO.
813-737-2080
Mar. 07 2008 09:52AM P2
. :::~~.~"~:~"
.. -........-.
N~T'CE OF DEED RES~'CT~ONS: "The ~ndersi~ned understands lhat this permit may be subject.to,ad~'~d" restrictions"
-Whl~ may be more ~tnctJYe tnan . County regJlations. The undersigned assumes responsibility'for comoJiance with . clOY
'appllcable deed restrrctions. . . .
UNLICENSED 'CONTRACT~RS AND CONTRACTOR 'RESPONSIBJl.ITIES: If the owner has hired:a "contractor . or
contractors. to und.ertake ~vcrx:, they may be requir€d to be Jlcensed in accorda:,ce with state and local regulations. If the
contractor ~ not /l~nseo as req~rred by Jaw, both the'owner and contractor may be cited'for a misdemeanor violation
~nder state law. If the ow~er o~ Intended contracto!' are uncertain as to What licensing requirements may apply for the
Intended work, they are advISee! to .contact me Pasco Cour.1;y Building lnspection Division--licensing Section.at 727-84.7-
8~. .FU~her~~, if the owner ha~ hired a ~ontrac!:or or contractors, he is ilctm:ed it> have the co:'\tractor(s) sign
portions of jthe COf,fractor Block" of th~ application for which they will !?e responsible. tf you. as the .owner sign as the
. co~tractor, ,that m~ be an indication that he is not properly liCensed and is not enfitJed to pennitting :pHvlJeg~ in PasC9
County. f .' ' . .
. CONSlR~ION'UEN LAW {Chapter 713.:Florfda statutes, as amended): Ifv;duation ofworlc.is.$2.500.00 or more. I
certify that: I; 1he .appflCant, have been provided with a copy of the "Florida Construction :LJen Law-Homeowner's '
Protection Guide" prepared by the- Florida Department of Agriculture and ~umer Affairs. If the app1icant is. someone
. other than the .~~,' I certify that J M\le abtam~ a copy of the above desaibed document ~ promise' jn good.faith to
deliver It to..the "owner" prior to commencemenl . ..'
l. CO~CTOR'SIOWNER2S AFFIDAVIT: .J certify ~ aU the'information in this 'app1i~tion is accurate and
; that at! work will be done'. in compl1ance with aIi aPplicabJe. I~ tegU~g construction.. zoning and land
j develoPment Application is ~eby made to oblain a permit to do WOT1t.and instaDation as 1.ndicSted. I certify
1hat no work or Installation';has commenced priOi- to issuance of a permit and ihat all work win he performecj to
: meet stand~rds of an laws regulating oonstruction, County end City codes. zoning regulations, and l,and
,development regulations in the jurisdiction~ I afso certify that I understand that the reguiations of other
. I. goye~ment agen~es may apply to the intended work" and that it is my responsi~illty to identity what acfions i
\ must take to be in compliance. . .' ,
If I am the AGeni FOR THE OWNER., I promise in good faith to inform the owner of the penniUing conditions set forth in
. this affidavit .prior to commencing constrUcfion. ) understand that a separate permit may be requ!r:ed for electrical Work,
. plumbing, ~;gns. wells, pools. air conditioning,' gas. or other InstaJlations. not specfficaRy inciuded. iJ:I' ~~e appl~cation. . A
permit issu~d shaoi be construed to be a license to prpceed with the work. and ~t as- authority to viol~, .cancel. alter.' or
set aside any proviSions of .the technicaf codes, nor shall issuance of a pennit prevent the Builcfmg Official irom thefeafter
requiring a PmTection of IN'rors in plans; constructien or Violations of any codes. Eve!')' permit issued, sh~ become invalid
urness the Work authorized by such permit is commenced within six months of permit issuance. .or if work a~r.ized by.
the permit ~ sus~!!d or abandoned for a pericx;j of sbt (6) nionths ~ the fim~ ~ ~ ~ commenced. ~ extenSion.
may be requested; in Writing; from the BuIlding Official for a period not to ~ nInety (90) days an~ win demons~e
justifiable ~use tot the extension. If work ceases for ninety (90~ consecutive days, the j~b is conside~ abandoned.
. WARNING!to OWNER: YOUR FAJ~~ TO RECORD.A NOnCE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 'IF YOU INICND 10 08.TAIN FlfiANcU.iG, CONSULT
. " OURLEHDER OR AN ATTORNEY BEFORE RECORDJ YO . F MMalCEM~NT.
!=LORlDA JURAT (F.S.;117.03)
I
OWNERORAGENT :' ~ .
. Subsaibed end swam to (or affirmed) before me this
- .,by
Who lsIare personally known to me or haslhave produced
I . as idenllfi:::atlan.
COHJ'RACTOR
SutJscirIbeD.and ~
'. ;by
INIiJ islare personaUy kncwn to me or haslhave produc:ed
, as idenfificaUan.
'"
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. No!mYPublic
N'0IaIy Public
,
Commission 1IJo.
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Cootn'1lssiOn ND.
. .
NanJe of Notanr (yped. PrInted orstmlped
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Name of Notary typed, prinIed or $!mnped
"
FROM R&L CLEANING
FAX NO.
813-737-2080
Mar. 04 2008 06:36PM P1
R&L Cleaning
P.O. Box 2231
Seffuer,Florida 33583
- Restaurant Equ;pm@n/
flthatJst Hoods,
DIl(1s. Filters
- Buildings
- Parking Lots
. Sidewillks
. Dip Tanks
-Ware Wash
Randy Phi/iips
Tel: (813) 49!i-4S3.fi
, OIIice: (813) 737-208tJ
FaJr: (8'3) 737-2080
March 4, 2008
Specialists in Hot & Cold Wafe' Pressure Cleaning
U~ · llISfInd - Bonded COtrII1IerdaI . Residentiill
To whom it may concem,
Enclosed are my documentations that you are requesting. Will summit a General Liability
certificate with you as a holder as soon as you send me $100 to cover my cost to do this. I
will be the only person authorized to pick-up pennits.
Sincerely,
Randy Phillips
R&L Cleaning
FROM R&L CLEANING
FAX NO. 813-737-2080
Mar. 04 2008 06:38PM P2
-.-. ....-...-.. .....-...--..:-.
TOM GALLAGHER STATE OF FLORIDA
CHIEFFlNANCfALOFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
*.. CERTIFICATE OF EXEMPTION FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
.
01-03-2006
This certifies that the individual listed below has elected to be exempt from
Florida Workers' Compensation Law.
- .,,~ .:~
-:it~~!"~~ ~I
~~~~~ ~: i~ ~.a. ~~.
* * EXPIRATION DA TE: '2l22l2Dci~ ~ ~.~. !. $' ~. .=-..,;: t'- .
-.=-: =-:-: ~ ~ S : ~ i :..~~.-: 4:10 Jr -
~;~~~ ~.. ~ :: :"=-!'.~ --
_ . RANDF . ~ = ~~.:~ .~~ _.
.......... -;"'" ;" .;':;. ~~~;:; ..lL~ -. - "
8tl16~ ~., ~ : ~~. 1_ .~ ~....
":iiiW ... .... -..: "'';='''. ~ ~ ,;;... ~
&:er - ~- .-..-
:.. ~&: ~- ~ING LLC
1> . 'BOX 2231
SEFFNER FL 33583
12/22/2005
EFFECTIVE DATE:
PERSON:
FEIN:
......,
BUSJ.~$~~
.,,;;, ~. A.'hnRESS:Jt
~ '~,"" ~ ~ ~~...z.. ,..-
'''''''''~I!' ..... oJ .",._
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PHILLIPS
SCOPE OF BUSINESS 1- PRESSURE WASHING
OR TRADE;
IMPORTANT: Pursuant to Chapter 440 . OS(14}r F.S., an officer of a corporation who elects
exemption from this Ghapter by fifing a certificate of election under this section may not recover
benefits or compensation under this chapter.
. QUESTIONS? (850) 413-1609
DWC-252 CERTIFICATE OF ~LECTlON TO BE EXEMPT REVISED 01-04
"
FROM R&L CLEANING
FAX NO.
813-737-21218121
.------..
2007,.2008 HILlSBOROUGH COUNTY BUSINESS TAX RECEIPT
MC;1LI'l1ElI 8E#JS IiMI\/
000
oce. CODe
280.029
BUSINESS "TYPE
PUBue SERVlCE-JANrrORIAL (3 OR lESS EMPLOYEES)
_..m1/;> 00 ~ 2--.' 00
~lB ~ ~~ . .
. . ... I -.. . '"5 EDISONRD
.2 . ,..' ~. '" . LClCA1ICN.... 33547
tWIE
MAILING
ADDRESS
R & l ClEANING LLC
9615 EDISON RD
UTHlA FL 33547
BUSINESS TAX RECEIPT
DOUG BELDEN. TAX COLlECTOR
813-635-5200
lltlS BECOM&$ A TAX RECe1PT WHEN VALIDATED..
11M H!R!8V p.uo A PRMI.EBE TAX '10 9lGAGI!
IN BUOIli8S. ~0FI5lllil0N. OR OCCUPAllON SPeCFIB:J IEAECN.
'"'
Mar. 1214 21211218 1216:38PM Pi
"'--...-
'- .----- ~ .
EXPIRES 9-30-2008 FOUO NO.
RENEWAL 164721.0000
SURCHARGE
22.00
PAID - 5175 - 85
08108I2007 - 22.00
"
FROM: R&L CLEANING
FAX NO.
813-737-21218121
Mar. 1214 21211218 1216:36PM P2
ACORn.
DA Tf (MMlDOtVVVV)
CERTIFICATE OF LIABILITY INSURANCE 2 2 2008
THIS CERTIFICATE IS ISSUeD AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHlS UPON THE CERTIFICATE
HOLDER. THIS CERnFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUClES BELOW.
PRODUCER
KILBRr.oE INSURANCE
400 N Parsons
Brandon, FL 33511
Et13) 684-7467
INSURED R &. 1. Cleaning,
LLC.
INSURERS AFFORDING COVERAGE
~A:. Co Insurance
INSURER B:
NiURER C:
MSUAE'R 0:
INSUJlER ~
NAIC#
COVERAGES
9615 Bdison Rd.
Lithia, PI. 33547
7 7-2080
THE POLICIES OF INSURANce USl'ED BB...OW HAVE BEBlISSUED TOnElNSUR8) NAMED ABOVE FOR niE POUCY PERIOD INDICATED. N01WI1liSTANDlNG
At('( REQUIREMENT. TERM OR CONomON OF ANY CONTRACT OR 0THEFt DOCUMENT WITH RESPECi TO WHICH THIS CERTlFlCA'Tl! MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HeReIIllIS SU8JECTTO ALL THE TEfWS. EXCt.USlONS AND CONomONS OF SUCH
POUCIES.AGGREGATE L.IMrrSSHOWN MAY HAVE BEEN ReOUCEDBYPAID C1..AIMS.
iNiR=: ~~NE POlJC'/'~11ON
I LTR 1YPE OF WSURANCE POlJCY NUMBER OA: DA: L/Mm;
~ERAI. L\A8IUlY EACH 0CCtlRR&NCE $ 1. 000 .OOC
.x OIALGEleAL LIABIlITY PREMISES IEa!lClUlllCe' $ 100 ooe
I-- Cl.AIMSMAOE [iJ OCCUR IIB>EICf' (AnyClflllINllBClnI S 5 .ooe
A GL3393S61 0J.{20/08 01/20/09 PEA8OHAl.&MNINJURV $ 1 000 OO(
'"-- GEHaw. AGGReGATE $ 2 000.00.(
QEN"t. AGGQGA1IO UMIT N'PUES PER
Xl POliCY -r=r~ -n LOC PRODUCTS. COMPIOP AGG S 2 000 OO(
~OU08IlEL.IABlUI'v l:OM8INED SINGLE I.JMIT
ANY AUTO l&;I--.q S
-
"-- AI..1. OWNED AUTOS
8ODILYINJ\JRV
SCNeDULEl) AUYOS cPer_> $
I--
"'- HIReD AUTOS
IlOOt. VlNJURY
NON-OWNEDAlITOS (P\.-,....",..., $
-
PROfIERTy IWIAGe $
(P'erf( nJ III
RGeUAB~ AUTO OM. Y .E;AAC:CIt1eIT $
ANYAUTO EAACC $
ontERTHAN
AUTDON/.Y; AGG $
~LIA8IUTY eAcH 0CClJIlAl;NCe S
OCCUR D~ AGGI'lEGAlE $
~= $
S
$
WORI<eM~TlOHANO $
EMf'l.OVERS" IJA8lllTY I~~~l I\,I~
~~~1rNll !.L &A.CH ACCIDDlr S
~~=..sbo!law E.L DISEASE - a EMPloVEI $
OllU;R E.L DISEASE. POlICY UNIT $
OESCAlP'noffOF ~TTOHS'l.OCATIOHs fVB4ic..es'EXCLusIciiSADDIED BY
~ISP&r::1AlPRovlsroNS
CERnFlCATE HOLDER CAN~nON
-
lDr Pr@DIlntltion ~8ea 0Dly*****..*
Original will be issuecl at ~e rel!Uest:
of the iDsured.
SHOUl.D IIHY OF"1lC AeOYE Dl!.o -. ---' I"OUlzs lie CAIlICiU.SJ 1liRJQl: lllF e;l/I'IllU.~
1>>.110 ntEREOF. 'ntI!. ISSuMG __ WILL ENDEI\VCR TO ~ ~~ _fTTC>o
NOTICIi. TO''1J:'Ii\QERT''lAC:'.A.TE HOI.DE!R ~.,.o THE l..E1=T. OUT' r~ ...C~ ClC> ::JIO ~'I"'\.
MI()SE NO/~ nil ,.... nv ~ MIV"'" ,~...... fNa~ rr,,;; .~ ,...,