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Home My WebLink About08-8464 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8464 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 8464 Address: 5658 GALL BLVD Permit Type: FIRE PROTECTION MAINTENANC E ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-05700-0252 ah mprov Cost : Date Issued: 10/27/2008 Name: ERIC HOOPER INC/WENDYS Total Fees: 25.00 Address: 5658 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 10/27/2008 Phone: (813)782-5442 Work Desc: FPM-HOOD CLEAN-3-4 MONTHS- WENDY ' t4w FIRE PERMIT FEES 25.00 uuiii : 12✓� ss r ._ FIRE ACCEPTANCE Final 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 NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041 I�/ 1q Fax-813-780-0021 813780-oo2o City of Zephyrhills Fire f1'r� permit Application Phone Contact for Permit 32 y� 1=LSJ rte Received Owners Phone Number Nees Name i n i r Net's Address Titleholder Phone Number se Simple Titleholder Name _____________ ri ae Simple Titleholder Address Z �, C1r 113_ L 5 Lot �b Address Parcel# ub Division QQ Fumigation Tent Bio-Hazard Waste Storage-ANNUAL a Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL Controlled Bum Hood Installation L Emergency Generator<30 kw P/Natural Gas-Installation LP/Natural Gas-ANNUAL Sale Emergency Generator>30 kw Places of Assembly-ANNUAL Fire Protection Maintenance-ANNUAL y emr ®7 Sprinkler 0 O O Recreational Bum ❑ D D ❑ L Sparklers Fire Alarm Hood Cleaning ■ ❑ D D Sprinkler System Installations Hood Suppression ❑ ❑ D LII_ I Q Standpipes(Sprinkler Sys) Fire Alarm Installation Torch Roofing/Tar Kettle 3.4 TM�� Waste Tire Storage ANNUAL Fire Pumps Fire Works r' Valuation of Project Flammable Application-ANNUAL Fuel Tanks Other: Company t Contractor Registered Y/N Fee Current Y/N Signature Address 0 Q License# ELECTRICIAN Company Registered Y/N Fee Current (_Y/N Signature --"" I Address r License# PLUMBER T Company Registered Y/N Fee Current Y/N Signature License# Address MECHANICAL Company Registered YIN Fee Current i N Signature LI License# Address OTHER F Company Signature Registered Y/N Fee Current Y/N License# Address Directions: Fill out application completely. contract with owner) Owner&Contractor sign back of application,notarized(Or,copy f signed 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. Parcel#-obtained from Property Tax Notice(httpJlappralser.pascogov.com) N01'ICE OF.DEE�Ô REStRICTIONS: The undersigned understands that this permit may be subject:to-"deed",restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for:compliarce,with any applicable deed'restrictions.• �' contractor= or UNLICENSED CONTRACTORS AND'CONTRACTOR RESP ITI ONSIBILES: If the owner .q as rid contractors-to undertake work, they may be required to be licensed in accordance with state añd1IrjlaU0ns. If the contractor is not licensed:at required by law, both the owner and contractor may be cited-for a misdemeanor vifl violation under state law. if the owner or intended contractor are uncertain as to what licensing,requirements may applyo intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section.at 727-847- 8009. Furthermore, if the owner as hired.a contractor or contractors, he is advised to have the contractor(s) sign "+ this applicafi#n-foor which they wiltbe responsible. If you, as the owner signas the portions of the "contractor Blocs, n v#e es in Pasco contractor, that may be an indication that he is not propa69 fit ai�s�ett d is not entiped` p rml tl g pq 9 County. CONSTRUCTION LIEN. cant,(Chaptern 3,provided roFloridae tth o copy o amended) 'Florida Construction Lien Law—Homeowner's 500.00 or more, I certify that t, -the applicant, have p is Protection Guide" prepared by the Florida Department of Agriculture above described document and prorr►isecaint9ood faith t° other than the"owner", I certify that I have obtained a copy of the deliver it to the"owner" prior to commencement. CONTRACTOR'SIOWNER'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 I and land do work and-4n& iatio indicated. I rt developmenf: Appttc�tFon is Hereby made to obtain a permt� ify that no work or installation has commenced prior to issuance of a permit and,that all work will be p road to d meet standards of all laws regulating construction, County and City codes,.zoning regulation , 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. promise in good faith to inform the owner of the permitting conditions set forth in If I am the AGENT FOR THE OWNER, I this affidavit prior to commencing construction. i understand t iat a separate permitspecifically be requireduded in the appiincation work, plumbing, signs, wells, pools, air conditioning, gas, or att�er, � permit issued shall be construed to be a license to proceed ivfth the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building l Officialed from nhe invalid er requiring a correction of errors in p n ermit is uction or violations of any commenced within six months of permit is. Every sssumit ance, or if work authorized by unless the work authorized by such pthe the perlrli$is suspendQ41 or abandoned Building fod of six r a months not to exceed the (90) days and will demonstrate may be requester!; iri v extension, ,t. 90 cons trye days,the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety( ) n6im ENT.I&Y- ULT IN YOUR WARNING TO OWNER: YOUR FAILURE TO aAlNp I E,� TF CANN ► SNG, CONSULT PAYING TWICE FOR IMPROVEMENTS TO Y FUR PROPERT ING YO R NP-O E OF COMMENC NT. WITIi YOUR L.ENi R�R AN FLORIDA JURAT(F.S.111-W) OWNER OR AGENT CONT'RAcroR Subscribed and swum to(or affirmed)before me this Subscribed and awom to(or affihmed)before me this Who isfare personally m me or vutw as idendftcation. as tdentfication. Notary Public Notary Public Commission No. commission No. Name of Notary typed,prin ted or stamped Name of Notary typed,printed or stamped I�i7r-VAgi'1 rnil IRITV All1QIhiGCC TAY i3r-f°`'1=IDT ACCOUNT NO. 2008 2009 TAX RECEIPT SO HOULD BEDISP DISPLAYED ON P EMIS SING RESTRICTIONS 200430283 THE PEfSOd S),QR ENTITY EELS BUSINESS PERIOD: OCTOBER 1,2008 - SEPTEMBER 30, 2009 EXPIRES: SEPTEMBER 30,2009 SOUTHERN HOOD PROTECTION ISSUED PURSUANT AND SUBJECT TO FLORIDA STATUTES AND BREVARD COUNTY CODE ISSUANCE P 0 BOX 237345 DOES NOT CERTIFY COMPLIANCE WITH ZONING OR OTHER LAWS. COCOA FL 32923-7345 EUSINESS FAX REC6PF IS SUBJECT-i)EEVOGAi ON EUn ZONING VIULAUIONS,ANDi ORi AILURE TO MAINTAIN REGULATORY PRE-REQUISITES AS REQUIRED FOR BUSINESS CLASSIFICATION(S).OR SUBSEQUENT ACTIVITIES. NOTIFY TAX COLL FCTOR I,)PON CLOSING OF BUSINESS. A PERMIT IS REQUIRED TO ADVERTISE(including with signage)"GOING OUT OF BUSINES5". POE' NORTHCUTT, CFC, CP"M",,Tax Cc!lectcr, Brevard County LOCATION: P 0 Box 2500,Titusville, Florida 32781-2500 4060 QUAIL PATH RD (321)264-6910 UNINCORP. DISTR. 2(NOT M.I.)FL 32926 UPON A CHANGE OF OWNERSHIP OR LOCATION, BUSINESS TAX RECEIPT SHOULD BE TRANSFERRED WITHIN 30 DA`fS. OWNED BY: JOHN HUSSEY BUSINESS CLASSIFICATIONS,DISCLAIMERS,AND RELATED FEES EXEMPTIONS: NON EXEMPT PENALTY: $.00 470485 PRESSURE CLEANING 820005 2008-2009 RECEIPT AMT $37.00 RCT. NUM TILL DATE AMT PAID PAID-1256333.0001-0001 TV2 09/22/2008 37.00 BRANCH OFFICES: Merritt Island Office. 1450 N.Ccurter..ay Pkwç Merritt Island, FL 32953 (321) 455-11,13 Melbourne u Office, 1515 Sarno Road, Melbourne, FL 32935 (321)1f 255-4453 C Palm Bay Office. 450 C� Dr. SC lmBay, FL 2-2909 `221) 952-6325 By �, Cogan :. v�. Pa. v�.,, MAIN OFFICE: ^00 South St.. 6th Floor,Tltusvi?!e, FL 22780 (321) 261-6912- (321) 33 2199, ext. 46010 5 UKUr'?Ut NAUTILUS INSURANCE COMPANY .COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS POLICY NUMBER: NC825358 Extension of Declarations is attached. Effective Date: 10/11/2008 12:01 A.M. Standard Time LIMITS OF INSURANCE ❑ If box is checked, refer to form S132 for Limits of Insurance. General Aggregate Limit(Other Than Products/Completed Operations) $ 2,000,000 Products/Completed Operations Aggregate Limit $ 1,000,000 Personal and Advertising Injury Limit $ 1,000,000 Any One Person Or Organization Each Occurrence Limit $ 1,000,000 Damage To Premises Rented To You Limit $ 50,000 Any One Premises Medical Expense Limit $ 5,000 Any One Person RETROACTIVE DATE(CG 00 02 ONLY) This insurance does not apply to"bodily injury', "property damage"or"personal and advertising injury"which occurs before the Retroactive Date, if any,shown here: NONE (Enter Date or"NONE"if no Retroactive Date applies) BUSINESS DESCRIPTION AND LOCATION OF PREMISES BUSINESS DESCRIPTION: FIRE SUPPRESSION SYSTEMS-INSTALLATION&REPAIR LOCATION OF ALL PREMISES YOU OWN, RENT,OR OCCUPY: ❑ Location address is same as mailing address. 1. COCOA FL 32923 - 2. Additional locations(if any)will be shown on form S1 70. LOCATION OF JOB SITE (if Designated Projects are to be Scheduled): PREMIUM RATE ADVANCE CODE# - CLASSIFICATION * BASIS PR/CO All Other PREMIUM 94381 - Fire Suppression Systems-installation, p 16,700 25.329 423 servicing or repair-including products 75.970 1,269 and/or completed operations 91523 - Cleaning-Outside Surfaces of Buildings ( p IF ANY INCLUDED and Other Exterior Surfaces-including products and/or completed operations 259.979 - I * PREMIUM BASIS SYMBOLS + = Products/Completed Operations are subject to the General Aggregate Limit a = Area (per 1,000 sq.ft.of area) o = Total Operating Expenses s = Gross Sales (per$1,000 of Gross Sales) c = Total Cost (per$1,000 of Total Cost) (per$1,000 Total Operating Expenditures) t = See Classification m= Admissions (per 1,000 Admissions) p = Payroll (per$1,000 of Payroll) u = Units (per unit) __ PREMIUM FOR THIS COVERAGE PART $ 1,692 FORMS AND ENDORSEMENTS (other than applicable Forms and Endorsements shown elsewhere in the policy) Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue: Refer to S902 Schedule of Forms and Endorsements THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. S150 (10/04) Includes copyrighted material of Insurance Services Office,Inc.with its permission. Copyright ISO Properties,Inc.,2000