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Home My WebLink About08-7717 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 ANNUAL FIRE PROTECTION MAINTENANCE 7717 Permit Number: 7717 Permit Type: FIRE PROTECTION MAINTENANC Class of Work: FIRE-PROTECTION MAINTENAN E Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: Date Issued: 4/08/2008 Total Fees: 25.00 Amount Paid: 25.00 Date Paid: 4/08/2008 Phone: Work Desc: FPM-SUPPRESSION ANNUAL-MCDONALDS Address: 6042 ALL BLVD ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: Name: MCDONALDS USA, LLC Address: 6042 GALL BLVD ZEPHYRHILLS, FL. 33542 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 City of Zephyrhills =F1.m:) Pennlt Application ~~teReceived -~:~~ % I ,- -~~fu,.Penn/t "I 353 IJ/79'bll~sL"'-lgl =::i~~;~~~J~~;';;~~ n. (gT/ Fee Simple TItleh0Ider Name _ _ _ l1lIeholder Phone Nwnb./I II _II Fee Simple TItleh0Ider Adc:kua I I I Lot. -I I 813-780.0020 Job Address Sub Division D D D D D D Blo-Hazard Waste Storage - ANNUAL Comm Exhaust KItchen HoodIDuct Controlled Bum Emergency Gener8tDr < 30 kw Emergency Gener8lDr> 30 kw Rre ProhletIon MaIntenance - ANNUAL -Ol!!!l] ~ ~ ~ c c CL-J Occcc::J Occcc::J ~ c c_~c::J Sprinkler Fn A1ann Hood CleanIng Hood Suppl8SSIon ~ = I ,{jL~ I :?1~~1f~4~~~ Address I PlUMBER I Signature Addressl MECHANICALI Signature Address I OTHER I Signatln Addrus I Oirections: Are A1ann Ins1aIIalIon Fire Pumps Are Worlcs FJammabIe AppIIc:atJon- ANNUAL Fuel Tanks __ I'" -. Parcel . i I I .' I I ~ i o o o o o o D Rec:ntatIonaI Burn D Sp8rkIers D SprlnIder Sysl8m JnstaIIdons D S1IIndplpes (Sprinkler Sys) 0- Torch RoofIngITar KeIIIe o Waste TIre Storage ANNUAL Fumigation Tent Hazardous Material (TIer II or RQ Facility) ANNUAL Hood InstaBatlon LP/NaU'a1 Gas-lnstaIJatIon LPINatLnI Ga~NUAL Sale PIlIces of AssembIy-ANNUAL I Valuation of Project =~~~~~~ ___ LIcense' ~9'7.5L?5~//9K'8 ~y I RegIstered Y I N I Fee Curntnt l Y I N I I Y/N I I license # Company Registered Y/N Fee Current license # Company Registered LIcense # Y/N I FeeCurntnt I Y/N I I Y/N'I FeeCurntnt i Y/N I - ~ Company Registered LIcense # Fill out application completely. Owner & Connctor sign beck of appkatIor.. not8rized (Or. copy of lIIgr:Ied contraet with owner) If over $2500. a Notice of ComrneI arnent Is required (MechanIC:aJ work over $5000) Supply two (2) sets of dnlWlngs with applicable docurTlelltdol. ' Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax NotIce (http://appralser.pascogov.com) 'NOTICE OF:DEED RESTRICTlo~derslgned understands that this -permit may .be~.slJb~~eSd(.!f'estrlctlons. which -may be more 'restrictive 'thanlOoiit1lfn'"egulatlons. "The ,undersigned assumes responslblllty~lDPmpllar.1Ce\wIth any .applicable deed restrictions. .' .. _ 'UNLlCENSED'C~CTORS~"ND 'CONTRACTOR :RESPONSIBIUTIES: . -If -the owner tta15_.I.b..Qd.a .contractor 'Or- - contractors 10 undertake work, they may be required 1o.be licensed In accordance with state and .\ocal're.gulatlons. If the contractor Is not lIcenSed as required by law, both the owner and contractor may be cited 'for .a 'mlsdemeanor violation under state law. ,If the owner or Intended 'cootract.or are uncertain ,as to what licensing 'requirements may :apply for the Intended work, they are advised to contact1hePasco County Building Inspection Dlvlslon-Llcenslng Sectlon.at 727-847- 8009. Furthermore, If the owner has hlred;a contractor or contractors, he Is advised to have 'the .contractor{s) sign portions of the "contractor Block" of 1hls application 'for which 1hey will be responsible. If you, as 1he owner' sign as the contractor, that may be an Indication 1hathe Is not properly licensed and Is not entitled -to permitting ,privileges In Pasco County. CONSTRUCTION LIEN LAW (Chapter713, 'Florlda Statut.,." .amended): If valuation of work is $2;500.00 or more, I certify that I, 1he applicant. have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by.the Rorida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify 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. CONTRACTOR'S/OWNER'S ,AFFIDAVIT: I certify that all the information in this application Is accurate and that all work will be done In compliance with all applicable laws regulating construction, zoning and land development. Application Is hereby made to obtain a permit to do work and Installation as Indicated. 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, County and City codes, .zonlng regulations, and land development regulations In the jurisdiction. I also certify that I understand that the regulations of other . government agencies may apply to the Intended work, and that It Is my responsibility to identify what actions I must take to be In compliance. If I am the AGENT FOR THE OWNER, I promise In good faith to Inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other Installations not specifically Included In the application. A permit Issued shall be construed to be a license to proceed with the work and not as authOrity to violate, cancel, alter, or set aside any provisions of the technical codes, nor shallls~uance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become Invalid unless the work authorized by such permit Is commenced Within six months of permit Issuance, or If work authorized by the permit Is suspended or abandoned for a period of six (6) months after the time the work Is commenced. An extension may be requested, In writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. .., work ceases for ninety (90) consecutive days, the job is considered 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. =~~~117>03) ~~_ s~ and~ to (or amnned) before me this subsa1bed and ~ ( 1m) ~ VYho la/are personally known to me or halIIhave produced wtlo 181... oersonallv knoWn 19 me or va produced as identification. ' as Identification. Notary Public ~4~N~_~ CommIsSion No. CommIsSIon No. NBlTle of Notary typed, printed or stamped NBITI8 of Notary typed, printed or stamped ~PU~o FRANCIS G, SPERLAZZA )u;,t.. MY COMMISSION # DD347356 '~'!"'.4 EXPIRES: November 26. 2008 ~~:.fo.rARY Fl. NOIII'\' Dl...... AIIoc, Co. .R~, To: Hernando Fire & Safety From: Tom Browning 4111200811:01:31 AM (Page 4 of 8) ACORD,. CERTIFICATE OF LIABILITY INSURANCE I DAlIi~'W.., 4/1/2008 PItODUCEIt PIlone: 1352 119t'\-~~32 THIS CERTIFICATE IS ISSUED AS A MAneR OF INFORMATION I3n~nil\llnsllnIl1l:c A;!\'llcy Inc. -l3rooks\illc !'lIX: (352)796-8811 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERnFICA TE DOES NOT AlIENO. EXTEND OR I' 0 Bo.x lllll ALTER THE COVERAGE AFFORDED BY THE POUCES BELOW. 13rooksville. Horida 3~60S INSURERS AFFORDING COVERAGE NAIC. - II8JRER A: Bri<Ib>etickl En'{lIoycn; Jnswancc Co. 10701 Hernando Fire & Sal;;ty Equipment Company INSURER B: 1109 I'ullce De LC,\1l HI \'J . , 13ruoksvillc. I'L 3~h() I INBURERC: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOO tlDlCATED. NOTWITHSTANDING A~ REQUIREMENT, TERM OR CONDITION OF AN'( CONTR,t,CT OR OTHER DOCUMENT WITH RESPECT TO WHIOi nls CERTIACATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES tESCRl8ED.HERBWS SUBJECI.T.O.ALLnE reBUS, exa.USlONS.uD.COllIDlTlONS.QESlOl. .. POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEENREOUCED BY PAID CLAIMS. LTR- I'CLICY_ E ~ ~ lYP ~LUABIUTY ElIOt OCCURRENCE S ---1 ~MERC IAL GENERAL UABlLITY PR S CLA.MS MADE 0 OCCUR MEDEXP(Anr-pormn) S -' PER801W. & /IIIJV IUlRY S . OENERALAOGREGATE S ---' -- ~N'LAGGnE9UMlTnPER: PROOUC11I-COIFIO' AGO S POL,C" r:r8; lOC ~UABUrY COIBNED lIINQU! LMT S ~y AU10 lEa ........0 - . - ALL OWNED AUTOS IIOOIL Y INJURY S SCHFntK-EDAUTOS (....--) - - HIRE!) AUTOS BODILY INJURY (Per ecdlIeriI) S - NON.()WNED AUTOS - - -' PROPERTY MIMGE S - - (Per -*IerlI) - ~ UABlUTY AUTO ONLY -EIIACODBfT S rlANV""TO . oneRTHAN FAACC S AUTO ONLY: AGO I ~8SIUMIIRELLA LIA8LITY EACH 0CCUfI'lENCI! S' OCCUR 0 ClAIMSMAIlE AGGREGATE S S ==1 DEDUCTBLE S RE1EN r'ON S S A WORKERS COMI'I:NSA lION AND O!OG-:I7315 '+.1/2008 ~/Ji1009 ~I 10m- EIIII'LOYERS' UAIlIU rY J(X),ooo N4YPROPRIETORPARTNERlEXECUTIVE E.L, EACH ACCIDENT $ OFFiCERlMEMBER ExCLUDED? E,L, DllIEASE -Ell BFlOYEE S J(X),Ooo tfyel, deSCrib8lll':.i::1 E,L, DISEASE - PClUC'f L1Mrr 500,000 SPECIAL PROV ,S () N~ below S 0T1ER I ! I DESCR....ION ~ OPI:RA liONS/lOCATIONS/VEHICLES/ EllCUI8ION8 AIlOED BY ENDORSEMENT /SPEClALPROWlION8 hre Equipment ...,,:, , ,IIIJ IIE.tallation CERTFICATE HOLDER IllllJcr', Nature.>1 1:,'"",[ : Certilicatc tioldcr COVERAGES 533:-- 'Ih ~l L~I'II\1l1d:,:I'L 33540 CANCELLAnON StlClULDNn Of'TIlE AIIOYE DE~ POIJCld _ CNICELUID ~ TIlE 1llP1tA11llN DAlIi TllEIIEOf'. THE ..uwa __ WLL ENIIEAVOll TO -. ..lL DAYI WNTTEN ~ TO THE CEKTlPlCAft IIOLIlEIl __ TO TIlE I.S'T. aUT'~ TO DO 80 IIW.L ~ NO OBLIGA T1ClII OR IJI\8aJI'Y Of' ANY _ UPClII T" --. ITS AGENTS OR REPllEIENTATIYE8. AUTIIOItIEED~ Cil~ ,,: Ll'phyrhills o ACORD CORPORATION 1988 ACORD 25 (2001/08)