Loading...
HomeMy WebLinkAbout09-9012 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780 -0020 9012 ANNUAL FIRE PROTECTION MAINTENANCE ° _ { .t:l4i „d" r - - �.... .:. ,d::- ' Permit Number: 9012 Address 7643 GALL BLVD Permit Type: FIRE PROTECTION MAINTENANCE 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: ; ; a . Date Issued: 4/13/2009 Name: CHILI'S BAR & GRILL Total Fees: 25.00 Address: 7643 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/13/2009 Phone: Work Desc: FPM -HOOD CLEAN ANNUAL - CHILI'S - SCH 4/12/09 I • o 4 --kyvt .► 0 , • 6 � 4 x:41 SUNSHINE PRESSURE CLEANING FIRE PERMIT FEES 25.00 ( ,A07 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." �r P 'T 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 DE , /`Ih /2UI '/ /'THU IJ4:'l'2 ?Y. GH1'HY1 HILL bU1L1J1Nh i AL IV). iii - 10U-uuL1 1 r, uuu • 813 7415)-0020 ` City ofZephyrhilts Fire 1 2 l Pax- 813 -78O -0021 . •Per Applicaticn . na f contact for Permit Date Receives; eag Pil er o —hi �r— l �. • Owner's Phone Number • Z i 1 1 ,..4.6 - owners Nam( '7 1 - C ' i ` �._ • I . • Owner's Addrr, ; I 4(1 • r ' Urt __.__:. • i Fee Simple Ti' eholder Name r • Titlehakes Phone Number .I • • 1 1 I I t Fee Simple Ti"`eholder Address "7 ---- 7 --- .7 ---7----- • . mi g � ' Lot # Job Address i -� Sub Division .Parcel # _` _ .. . • • easenc=seseweisisonermassimemoseientismatiasima E ' Bio-Hazard Waste Storage - ANNUAL • El Fumigation Tent Comm Exhaust Kitchen Hood/Duct Hazairicgle Material (Tier II or RQ FacIllt ANNUAL • 0 Hood Installation I . -� Controlled Burn . E _.J , 'Emergency Generators 30 kw • = ' LP/Nab:raI Gas- Installation . [_ -] Emergency Generator 30 kw # I LP/Nab-al Gas- ANNUAL Sale • I • [..-] Fire Protection Maintenance - ANNUAL • F Flame of Assembly- ANNUAL . Sprinkler = I' ( Recreational Burn . 1 • Fire Alarm ' Ir Sparkle's • Hood Clean/SUppression Fe J SPrinkler System Installations 1. Fire Alarm installation ." • n Standpipe (Sprinkler Sys) . - -] Fire Pumps • • . • , . • = Torch F:aofing , ] Fire Works • .. j Waste'rire Storage ANNUAL I -_ i C _ _,J Flammable Application- ANNUAL _ i ' Valuati of Project • __� � II —. Fuel Tanks --- J Other: C,om Ct !9e � ,,^ _ early i n " Contractor 1 i I • ,,� Signature fa .. , 0/iFl Ftegiatea ed Y / N Fee Current I Y / N Addres r r '' '" - R IM1 / i Licenses # ! - . ELEC.I RICIP'V Company . Signature • Ftegirt' red Y / N ( Fee Currant j Y/ N `) Addresr •• . , � license: # I J • PLUMBER Company • . , :' `' Signature ' - • • • 'Registered . Y / N I • Fee Current. L. Y / N 1 • Addres,•, tJCansr ') 1 • MECHANICh Company 'Signature__ • Registered • Y / N j Fee Current ( Y / N Addres __ . Uce1 -l5 ( 1 OTHER --� company Signature Registered Y / N I Fee Current I Y / N nieseafasimeas Address i Licerw +; rf - CCEflrrm .,. --,... -e r_.:^cers....- r- - -r- �SMA16"1 it i i r a un�ai i Directions: , Mil out application completely.. of si contsr3ct with owner) Owner & Contrador sign back of application, .notarized (Or, copy If over $2500, a. Notice of commencement is required (Mechanical work over $ 5000) • • Supply two (z) sets of drawings .with applicable documentation ' J1ow 10-14 days for review after submittal date. Mar 31 2009 04:44 PM Dunnwell 9196611900 1/5 Dunn h f . City of Zephyrhills Building Department 5335 sin Street Zephyrhills, FL 33542 Jackie, I have included all the necessary paperwork required to update the information you have for our company. If you have any questions, please contact me at 1- 866 -774 -1100 xt _ 107 or alternatively at brian.lee _ a@dunnwell.com. Thanks for all of your help. Regards, Customer Service DunnWell, LLC Permit Information for Service Dated: 4/12/2009 11:OOpm Location Cleaned: Chili's PO Box 1908 • Garner, NC 27529 • PH 1- 866 -774 -1100 • FX 919- 661 -5745 • www dunnweC.com 4 .Na ions Provider(; t . Mar 31 04:44 PM Dunnwell 9196611900 2/5 DEC7'06/2007/TEU 04:22 PM ZEPHYRHILLS BUILDING FAX No. 813 P. 003 • - . .. . • - - City of2ephyrhills Fire . • 1 Feg-a13-780-0021 013-70P-0020 . - - • . , Perri* APPlicaliOn . • i / Phone.Contact for Fern* Mil ME . . Date Received . • .... _ 1 - Owners Name . e,.AN ; A" ■ .•• • ' . - : „I Owner's Phone Number 1 q13 1 l•'7R%11 oSiS . . 1 • , .. Owdere Addteee I - 77 & 4 / . OPri I jai. , . , - .. . . • • ... ..._,Li. Titleholder Phone Nlmiber • I . • 1 ' ' • i I .. . 1 1 paa Simple Titleholder, Name • - 1 : , • ... - ! • Fee SimpleTWebolder Address • 1 - • , , , .., . . . - - , - - , • _ : . . . • Job Address • - . 7 69 GA tt 1LV D i.ot# , , i . i . • • - submtsion - 17 7-7 7 -77.- . .1 .: Parcel # -..L .. . • No innic.1) t rfeturci'vumessimiejtosiLl I lU esu g assesn AA fearamse • . NIsimmitinallelataltlainemiallogillisomil • D Bio Waste Storage - ANNUAL - • Fumigation ent • I . Comm Exhaust Kitchen Nliod/liuct - ' • .. - E:D liamtutlous Mateddl Ciler II or RQ rat,/ ANNUAL - • . [ . Controllod Bum • . = Hood Installation , ' ■ . . ' El . Emergency Genemtor< ao kw • ED ' LP/Natural Gas-Inslan . ntion • I I . . . D Emergency Generator' 30 lei" ; • .. 1:::: LP/Natural Gas.ANNUAL Sale • .1 , • E:i Fire Protection - ANNUAL • .. , • • LI Places of AssernblyANNUAL • 1 • . • . • • Sprinkler 0 ' . El Recreational Bum . , • . i • 1 • • • . • • Fire A , lapi t ED Sparklers - - . • ; . - , , . • • • '" Hood tlianiSimpression ED ........- E:1 Sprinkler System Instailadons -• • • , .0 Fire Alarm Installation • ' .-; ' • , . =1 StendpIpee (SarInkler Sys) . i . . . .. I • 1 • ED Fire Pumps • ' . • . . -• •• • - • , , • El Torch Roaring • . - . . . : 0 Fire Works •• .. .. . . , - • ED Waste Ylre Storage ANNIVU, , r . 0. . ), 1 4 ,,,,x.e...., • 1 . , . I •• ...../ . . • • E Flemmable Application- ANNUAL • . . . . ' • • , • .17 Fuel Tanks . . . . . . • - ValUatlep of Prof t • - • - . El Other: - i 10 1111P 1— . • • .__..., _ . - - • _ . . • . _ .. • . ._ . • . Contractor • • Company its (.....y; ,,,,. I : ■-• ' . sIgnaiim s - -. - - . . ... . Roateroa . gum Fee curr4nt Num • • • • . -1, Address . 5o2 - • - I 6 e.... .,„ ( L . % License* ' ' • • ' ; • •• • 1 " • . . . . Pl - - • , , •. Company • . I • -. „ . Signature - . l • • • . Registered Y / N 1 Pee Currant l • Y / N 1 . • . 1 • •Address I •_. ' • • . .•• • , . • • ' 'Joann,* • . . PLUMBER -- • , . . , Company • . _ :' .. • SlonatUre • • • 'Registered . Y/N 1 • Fee Cu : t [ . Y/N 1 • - ._ - : . -•, Address-) ' • - . . ca ' - - ., . - • . - . Unse # L . . , • MECHANICAL . . . ; ' . Company - • • • " • ' 1 • .• ----- 'SIgnatUre • ' • • • Reglateral. Iffirgill - Fee Currint I Y / N 1 . Address 1 . " • License# 1 , . . , ' OTHER - . ' Company , , • . .• , . . Signature . ' • • Registered [ Y/ N j Fee Currdnt I Y 1 N I . - address " ' ' • • License rA . PIII out application completely.. ... • • • . • , ' . . • ; Owner & contractor sign back•of applicationenotorized (Or, copy °feigned contact with owner) If over OK .Notice of Commencement Is required (bAechanIcal work over 415000) , . . • . ' Supply two (2) sets of drawings AM applicable degumentallon • • • Allow 10.14 days for review after submits] date. - • • ! • . ' • - . , . . - • - Mar 31.2009 04:44 PM Dunnwell 9196611900 3/5 Cllent#:1009988 21DUNNWLLC ACOAD. CERTIFICATE OF LIABILITY INSURANCE DATE ( N Y' DIYYY PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BB &T Insurance - Wilmington ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 115 Third Street, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilmington, NC 28401 910 7724700 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER k Travelers Indemnity Company of CT 25682 DunnWell LLC Restaurant Svcs Inc; DB INSURER It Travelers Property Casualty Co of Am 25674 Marketing Inc; Carolina Comml Cleaners INSURER C Travelers Casualty & Surety Company 19038 PO Box 1908 INSURER o: Garner, NC 27529 INSURERS COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TR iN6gt TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATEIMM/ODYYI DATFReMNDNYI UNITS A GENERAL LIABILITY 6306113A941TCTO9 02/20109 02(20/10 EACH OCCURRENCE 61.000.000 x COMMERCIAL GENERAL LIABILITY WAYS nmi 5100,000 _ 1 CLAIMS MADE © OccuR MED EXP (My one ware) 55.000 _ PERSONAL & ADV INJURY 51,000,000 _ GENERAL AGGREGATE s2,000,000 GEMLAGGREG AT -- EUMRAPP VESPER: PRODUCTS - COMP/OPAGO 52, 000,000 — I POLICY l 17 I LOC B AUTOMOBILE ABRJTY 8106113A953TIL09 02120/09 02/20/10 COMBINED SINGLE LIMIT $1,000,000 X ANY ALL OWNED AUTOS BODILY INJURY �_ SCHEDULED AUTOS (PurPw%en) S X HIRED AUTOS — BODILY INJURY 5 X NON.OWNEDAUTOS (Peracddon* X Drive Other Car PROPERTY DAMAGE S X Lessor of Veh #CA20011001 Addl Ins Loss Payee (Peractld0M) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT S _ R ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY: AGG $ B EXCES9NMBRELLA PSMCUP6113A965TI 02/20/09 02/20/10 EACH OCCURRENCE 51 0,000,000 o OCCUR El CLAIMS MADE AGGREGATE 510.000.000 S DEDUCTIELB 5 X RETENTION S 10000 5 C WORXERS COMPENSATION AND PACRUB3470C16709 02/20/09 02/20/10 X ITORYi Nr I a EMPLOYERS` LLABIUTY ANYPROPRIETORIPARTNER,EXECUTIVE EL EACH ACCIDENT 51,000,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE • EA EMPLOYEE 51 ,000,000 If e, deeorAe under SPECIAL PROVISIONS below E.L. DISEASE- POLICY 51,000,000 OTHER DESCRIPTOR OF OPERATIONS J LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Certificate Holder Is additional Insured for work done on their behalf by insured. Form # CGD0370405 Is attached to General Liability policy which provldes Blanket Additional Insured coverage Nth() insured has agreed to such In a written contract or agreement. Form #CGD18B1103 Waiver of Subrogation also applies. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIE EXPIRATION City of Zephyrhllls- Building GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AR DAYS WRITTEN Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 130 so SHALL 5335 8th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Zephyrhllls, FL. 33542 REPRESENTATIVES. AUTHORED REPRESENTATIVE ACORD 25 (2001108)1 of 3 #M3201957 PGG 0 ACORD CORPORATION 1986