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Home My WebLink About09-9696 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9696 FIRE STANDPIPES PERMIT ten. a Permit Number: 9696 Address: 7643 GALL BLVD Permit Type: FIRE HOOD SUPPRESSION SYS ZEPHYRHILLS, FL. Class of Work: FIRE - PROTECTION MAINTENANCE Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35- 25 -21- 0110 - 00000 -0040 Improv. Cost : ,f nrq `° > :. _ : w. . , .. �.. Date Issued: 10/29/2009 Name: C HILI'S BAR & GRILL Total Fees: 25.00 Address: 7643 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 10/29/2009 Phone: Work Desc: FPM-HO SUPPRESSION SEMI- CHILI'S BAR-SCHEDULE 10/30/09 w-"w � d -; $ '�' ` 3 $P b 'a°E >ivia €fist � �'' .... `'.Y A .t A '} ; d5 g" � 3 P iS 5 f � 'fi f FIREMAST R FIR - ERMIT FEES _ 25.00 C #1 I ( i ° Eb ,f C (4 0) dam" (0 (31/09 FIR U •N T -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 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." I _ tcF1 CONTRACTOR SIGNATURE 1 # IC R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041 ' 913- 780 -(J20 City of Zephyrhills Fire > Fax -813- 780-0021 Permit Application _ Date Received JV ' i 9-` - .2c' 7 1 Phone Contact for Permit FEW Lt 75 �C :..- ' - ,. asa...z.ru:. +,:a -x::,wa% ^.._. , -; „a,. . ,>r.,:<• _,..., ,.::w..W.- .p .. .:....•;�eas'w' . ,�,�s .... >� br .:??u e t . _ . _ _ - _....,., a :r0- � .w..a •; Owner's Name Owner's Phone Number I _ Owner's Address Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address I I Job Address cii, A , j I2r 4 (%r, 11 7 , 'i3 f` , 5 -- ` 13 t 70A r_ 3 35 I Lot # Sub Division Parcel # ,. "�: +�kx ?";:t�.�; ?cc.:4.� a4.:?.roaauc. u'fi'. .,,- .,... _,rs.++�?v i; . , .... �:°�'rt.. � ,. ....:s.?* z+,c c,*F,. ""'�'S .� _;..�e :#Sv�z'zx�: sz:�^ t�Nr;.�.s:#H 0-e . , n. .r.:'Wr,a.� ,r°,a, >.m`t �€<- �ac;�a'sU.�.� ✓ <.., , _ -::. ,... v�`i'. n Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent I I Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL FT Controlled Bum n Hood Installation El Emergency Generator < 30 kw n LP /Natural Gas - Installation I 1 Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale FT Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL ILttny) (semi Other Sprinkler n ❑ ❑ ❑ n Recreational Bum Fire Alarm El ❑ ❑ ❑ I n Sparklers Hood Cleaning ❑ ❑ ❑ I 1 n Sprinkler System Installations Hood Suppression I idi ❑ ? . ❑ I l I I Standpipes (Sprinkler Sys) I Fire Alarm Installation ![ n Torch Roofing/Tar Kettle (n Fire Pumps n Waste Tire Storage ANNUAL Fire Works n Flammable Application- ANNUAL 1 1 Valuation of Project n Fuel Tanks Q Other: I .eta =:25, 'Sl lZ ..e „k= ..x s.- .s..4z�s”' u, n �. .':i4F 0-i?' a -y?S8C:S drr v.A.',,.3%`tc x F.ab »:;'se:., ,, +u«r- rzM. w'_X "L'h3 "ki:..Y' :k' 5.., n_f �:..X, _.u.. dJi <:4:.a „a _ ..s ss<<. vd eix: =.Xr .pYn'a^sY .,� . „dw:r. ,'0. ✓..,a0-.�§t?' Contractor �1 Company M - p h3 - P' r j kY)-� fj tr' I Signature Registered Y/ N I Fee Current I Y/ N Address 1 -/70! oG i-c. F4r r- i5 Lire-" - re.. - 41 1 License # 71, C ,.-00(, I ELECTRICIAN Company I Signature Registered Y/ N I Fee Current I Y / N I Address I I License # I PLUMBER Company Signature Registered Y/ N I Fee Current I Y/ N Address I I License # I MECHANICAL Company I Signature Registered Y/ N . I Fee Current I Y/ N I Address ( I License # I OTHER Company I Signature Registered Y/ N I Fee Current I Y/ N I Address License # R. 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. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subjectto "deed "restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired :a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. 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 Pasco County Building Inspection Division — Licensing Section at 727 -847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law— Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner ", 1 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, zoning 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 shall issuance 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. If 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 TT RNEY BEFORE RECORDING YOUR NOTICE OF • MENCEMENT. FLORIDA JURAT (F.S. 117.0 / OWNER OR AGENT CONTRACTOR ' -.411116116_ Subscribed and swom to (or a' ed) before m - his Subscribed and swom to (. affirmed) before me this by by Who is/are personally known to me or has/have produced Who is /are personally known to me or has /have produced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped • 10/30/2009 08:08 2399852122 PAGE 02 .... .. ; c@RTIFICATE NUMBER . IR'I1FICATE.OF: INSURIANCE 628791 ' PRODUCER 'n11e CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN0 CONFERS 140 RIGHTS VPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POUCY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BV THE POUCIES DESCRIBED HEREIN. Marsh, Inc. COMPANIES AFFORDING COVERAGE 1166 Avenue of the Americas New York, NY 10036 COMPANY A: Al South Insurance Co. Telephone (212) 345-5000 COMPANY 13: Commerce & Industry Ins Co COMPANY C: Fireman's Fund Insurance Company INSURED COMPANY D: Illinois National Insurance Co. COMPANY E: Insurance Company of the State of PA Master Protection. LLC COMPANY F: Nat'l Union Fire Ins Co of Pittsburgh, PA dba FireMaster COMPANY G: New Hampshire Ins. Co, 13050 Metro Parkway, Unit 1 Fort Myers, FL 33966 United States - COVERAGES THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE tNSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIRMENTS, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES USTED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND 6XCLUSIONB OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDuCEO BY PAID CLAIMS, _ ..- CO TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POUCY LIMITS LTR DATE (MMIDOIYY) EXPIRATION G GENERAL LIABIU Y GL 09043 - 63 (Primary GL) 10/1/2009 10/1/2010 GENERAL AGGREGATE 54.000,000.00 X COMMERCIAL GENERAL, PRODUCTS - COMP/OP AGO $4,000,000.00 CLAIMS MADE L' J ocCU PERSONAL A AOV INJURY $2,,p00...0_00.00 OWNER'S & CONTRACTOR'S EACH OCCURRENCE $2,000,000.00 FIRE DAMAGE (My PAP No) $1.000,000.00 MED EXP (Any ono person) $10.000.00 F AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _AUTOMOBILE 091 (M A) 10!1/2009 10/1/2010 57,500,000.00 F X ANY AUTO CA 091 -93 -97 (VA) 10/1/2009 10/1/2010 F X HIRED AUTOS CA 091 -93-96 (AOS) 10/1/2009 10/1/2010 . X NON-OWNED AUTOS ii we sT A WORKERS coMPENe XJ atuT7RV oTae ATION AND WC 060 - 113.8747 (CT,GA,PA,SC) 10/1/2009 10/1/2010 ccv A B EMPLOYERS' LIABILITY WC 080-18-8741 (FL) 10/1/2009 10/1/2010 ' . EL EACH ACCIDENT $2,000,000.00 D THE PROPRIETOR! WC 060.18.8744 (MI) 10/1/2009 10/1/2010 EL DISEASE-POLICY LIMIT $2,000,000,00 E PARTNERS/ExECUTWE WC 060-16 -8745 (AR,MA,VA) 10/1/2009 10/1/2010 F OFFICERS ARE: WC 060.16.8742 (OR) 10/1/2009 10/1/2010 ELDISEASE.EACH $2,000,000.00 F WC 060.16 -8740 (CA) 10/1/2009 10/12010 O wC 060 -16-8748 (AOS) 1011/2009 10/1/2010 — 10/1/2009 10/1/2010 G WC 080 -1�6 -8743 (TX) G WC 060168746 (ND,NY,OH,WA,WI,WY) 10/12009 ' 10/1t2010 , EXCESS LIABILITY GENERAL AGGREGATE $11,000,000.00 G X 0114ER THAN UMBRELLA FORM GL 090 - 73 - 84 (Excess GL) 10/1/2009 10/1/2010 PRODUCTS . COMP/OP AGO 511, 000,000.00 EACH OCCURRENCE $5,500,000.00 71 UMBRELLA FORM _ pROPERTY OTHER C Bukdar'a Risk/netelIenon/ConlreCt WORM OC 9112960 5/1/2009 5/1/2010 Liar) $1,000,000,00 par /Obs4e d Rental Equipment/Contractor's Equipment OC 9112660 5/1/2009 5/1/2010 USD 31.000,000.00 per/absile C BIenKMt Tranos OC 9112960 5/1/2009 5/1/2010 USD 51,000,000.00 par common*, ' DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES/SPECIAL ITEMS pre /Act: city of 2aphyrhilln CERTIFICATE HOLDER , CANCELLATfON • City of Zephyrhills SHOULD ANY OF TNa nOUCIEB OEBI.CO HEREIN BE CANCELLED BEF T H E EXPIRATION D rA ATE THEREOr. THE INSURER AFFOROINO COVERAGE WILL ENDEAVOR TO MAIL Zia OATS WRITTEN NOTIOE TO WIG CERTIFICATE NOLOCrt 5335 Eighth Street BUT COVE RAGGE, BMW NONCE OR LABILITY Zephyrhills, FL 33540-4312 REPRF_9 NTATIVEB, OR THE i$SUIROFTN B CERTIFICATE. United States ( -.}--, ---. MARSH USA INC, BY: FranNln HoNock, Global Matins Davld KonO, CowAly ProgrAM Two Prepram vduo" AS OF :1/30/2009 L.Or qu,Aeiena renar"tag chin e,rtirioat.n eentnct: Mary vgge (Rmail: marm9e0rirnmaater mpc,CO' Clone: 230_ee0 1693( 10/30/2009 09:47 2399852122 PAGE 02 y�y L ... CER IFICATE OF. INSURANCE i 628718 CATENUMBER PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER OTHER THAN THOSE PROVIDED IN THE POUCY. THIS CERTIFICATE DOES NOT AMEND, ENTER!) OR ALTER THE COVERAGE AFFORDED EY THE POLICIES DESCRIBED HEREIN. Marsh, Inc. COMPANIES AFFORDING COVERAGE 1166 Avenue of the Americas - New York, NY 10036 COMPANY A: Al South Insurance Co. Telephone (212) 345 -5000 COMPANY B: Commerce & Industry Ins Co COMPANY C: Fireman's Fund Insurance Company INSURED COMPANY D; Illinois National Insurance Co. Master Protection, LLC COMPANY E: Insurance Company of the State of PA COMPANY F; Nat'l Union Fire Ins Co of Pittsburgh, PA dba FireMaeter COMPANY G: New Hampshire Ins. Co. 13050 Metro Parkway, Unit 1 Fort Myers, FL 33966 United Slates COVERAGES. . . THIS is TO CERTIFY THAT THE POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED, NOTMTHSTANDING ANY REOUIRMENTS, TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES LISTED HEREIN IS SLIDJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CLAIMS. CO TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY uMITS LTR DATE (MMIDDIYY) EXPIRATION G GENERAL LIABILITY GL 090 - 73 - 63 (Primary GL) 10/1/2009 10/1/2010 GENERAL AGGREGATE $4,000,000.00 x COMMERCIAL GENERAL PRODUCTS - COMP/OP AGG $4,000 QQO.OQ CLAIMS MADE IT OCcu PERSONAL & ADV INJURY ,- $2000.090.00 OWNER'S & CONTRACTOR'S EACH OCCURRENCE $2,000,000.00 FIRE DAMAGE (My cone Ore) $1,000,000.00 MED EXP (Any one parson) $10,000.00 AUTOMOBILE LIABILITY C OMBINED SINGLE LIMB F CA 091 -93 -98 (MA) 10/1 /2009 10!1!2010 37,500,000.00 F X ANY AUTO CA 091 -93.97 (VA) 10/1/2009 1011/2010 F X HIRED AUTOS CA 091.93 -96 (AOS) 10/1/2009 10!1/2010 X NON - OWNED AUTOS A WORKERS COMPENSATION AND WC 060 - 116 - 0747 (CT.GA,PA,SC) 10/1/2009 10/1/2010 X 1 wc A1urcA'r R *Ie made EMPLOYERS' LIABILITY 6 WC 060 - 1 (FL) 10/1/2009 10/1/2010 EL EACH ACCIDENT � $2,000,000.00 D THE PROPRIETOR/ WC 06046 4744 (MI) 10/1/2009 10/1/2010 G PARTNERS/EXECUTIVE WC 060.1164745 (AR,MA,VA) 10/1/2008 10/1/2010 El. DISEASE - POUCY LIMIT $2,000,000,00 F OFFICERS ARE: WC 060 -18 -8742 (OR) 10/1/2009 10/1/2010 EL DISEASE.EACH $2,000 F WC 080 - 1 (CA) 10/1/2009 10/1/2010 G WC 080 -116 -0748 (AOS) 10/1/2009 10/1/2010 G WC 060 -1e -8743 (TX) 10/1/2009 10/1/2010 G WC 080188746 (ND,NY,OH,WA,WI,WY) 10/1/2009 10/1/2010 -- EXCESSUAEIUTY GENERAL AGGREGATE $11,000,000.00 G 5] OTHER THAN UMBRELLA FORM GL 090 - 73 - 64 (Excess GL) 10/1/2009 10/1/2010 PRODUCTS COMP /OP AGG 31 1,000 000.00 EACH OCCURRENCE 35.500,000.00 7 UMBRELLA FORM — PROPERTY OTHER C builder, RI1WIn laIIa1IonIContraci Works OC 9112060 5/1/2009 5/1/2010 USD 41,000,000.00 par Jobalta t: Rental EOuIpmenUConlreclora Equipment OC 9112900 5/1/2009 5/1/2010 USD 31,000,000.00 perJobelle C Blanket Transit OC 911280 5/1 /2009 5 /1/2010 USD 31,000,000,00 per cam/spoon DESCRIPTION OF 0PERATI INS /LOCATIONSNEHICLESISPECIAL ITEMS Protect: City of Zephyrhillo CERTIFICATE .HOLDER CANCELLATION BMOUID ANY OF THE POUCIEB DESCRIBED MEREIN BE CANCELLED BEFORE THE EXPIRATION were THFRFOr, THr. City of zephyrhils INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS V.WTTEN NOTICE TO THE CERTIFICATE MOLDER 5335 Eighth Street NAMED HEREIN, DUI rAILURC TO MM. SUCH NOTICE SMALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE IS OF TMI3 CERTIFICATE. Zephyrhills, FL 33540 -4312 _ United States 1 ,- >.. -..) - 1 r A«.PG ,A, 94054- MARSH USA INC, BY Franklin HeOock, Glooal Marina d K 1 -. . aeuallY ProOrem Transh Progrwn VALID .AS- oF: 9130/2008: : P 7:motl rAaArdino thiA cArtitiCAtA COACACD: Mary Vopt (Email: marv0Otalfiromaoter- mpc.tor, Phone: 23P -4?E- 1 10/30/2009 09:47 2399852122 PAGE 03 SU00O241 • r Lee County Tax Collector '1� 2480 Thompson Street -. Fort Myers, Florida 33901 www.leetc.com Tel: (239) 533 -6000 - Local Business Tax Account: 9802794 Dear Business Owner. Your 2009 -2010 Lee County Local Business Tax Receipt is attached below. Please detach the receipt and display it in a place that is visible to the public and available for inspection. The Lee County Local Business Tax Receipt is in addition to any other license or certificate that may be required by law and does not signify compliance with zoning, health or other regulatory requirements. The Lee County Local Business Tax Receipt is non - regulatory and is not an endorsement of work quality. Your 2009 -2010 Local Business Tax Receipt is valid from October 1, 2009 through September 30, 2010. Annual account notices are mailed in August to the address of record at that time. Please follow the instructions on the back of this letter to transfer your Local Business Tax Account due to a change of business name, ownership, physical address or you are closing your business. I hope you have a successful year. z 7.1... 4 - I . 4 . Lee County Tax Collector Detach and display bottom portion and keep upper portion for your records 'LEE COUNT :LOCA L. 'Ream ` - - . -- g - BUSII LESS TAX - �' ACCOUNT NUMBER: 9802794 ACCOUNT ,EXPIRES T ` 0 2010 May engage in.the.b of: . - BUSINESS SERVICE Location 13050 METRO PKWY UNIT 1 FT MYERS FL 339613 THIS LOCAL BUSINESS TAX RECEIPT IS NOttREG'ULATORY FIREMASTER MASTER PROTECTION CORPORATION THIS IS NOT A RILL.. -OD NOT PAY 13050 METRO PKWY UNIT 1 FT MYERS FL 33866 PAID 017193.1031 09//03/200911:53 AM DP500 350.00