HomeMy WebLinkAbout10-11311 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 11311
LP /NATURAL GAS PERMIT
Permit Number: 11311 Address: • - rJj,O W.7
Permit Type: LP /NATURAL GAS EPHYRHILLS, FL.
Class of Work: FIRE -LP /NATURAL GAS Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est. Value: Parcel Number: 34- 25 -21- 0090 - 00000 -0000
Improv. Cost: 1,820.00
Date Issued: 12/14/2010 Name: GRAND HORIZONS
Total Fees: 125.00 Address: 7645 GREEN SLOPE DR
Amount Paid: 125.00 ZEPHYRHILLS, FL. 33541
Date Paid: 12/14/2010 Phone:
Work Desc: INSTALL LP GAS LINE IN KITCHEN SET LP GAS TANKS
5 . 5.
FIRE PLAN REVIEW FEES 50.00
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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."
COQ RACTOR SIGNATURE rd I • 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
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813-780-0020 City of Zephyrhills Fire I ' 1 0 ( ( Fax- 813-7$0 -0021
Permit Application
Date Received l a- /h 1 Phone Con - r__ •3
—
Owner's Name jl In i , # A - 1 6 Owner's Phone Number I 1 1 1 1 I
/Owner's Address 7, N r: _4": l ../! • i - 3 II s '_ i - • ?. A '
Fee • le eholder Name Titleholder Phone Number I I I
Fee ' ple Titleho r Address I
Job Address -74 �� C� S 2 h/ `� �� Lot #
Sub Division I Parcel # I I
n Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent
El Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
n Controlled Bum = Hood Installation
Emergency Generator < 30 kw I ( LP /Natural Gas- Installatior 6/? ,9r7 / (1° DI6 7/ 5)
r . Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale
Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
ry (Semi (j Other /� , //
Sprinkler 0 ❑ ❑ ❑ n Recreational Bum _ /� /�!/ /(cam
Fire Alarm 0 ❑ ❑ ❑ I I n Sparklers 1/'
Hood Cleaning 0 ❑ ❑ ❑ I 1 n Sprinkler ys em Installations 4
Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys)
n Fire Alarm Installation n Torch Roofing/Tar Kettle
Fire Pumps n Waste Tire Storage ANNUAL
Fire Works
Flammable Application- ANNUAL 1 I Valuation of Project
n Fuel Tanks
Q Other: I
Contractor Company
Signature Registered Y/ N � Fee Current I Y/ N
Address I I License #
ELECTRICIAN Company
Signature I Registered Y/ N I Fee Current 1 Y/ N
Address I I License #
PLUMBER Company
Signature Registered Y/ N 1 Fee Current I Y/ N J
Address I License #
MECHANICAL Company
Signature Registered Y/ N I Fee Current I Y/ N
Address I I License # I
OTHER ' ��� �'
/ � . C ompany ►ii:i.t' ' LJ : l
Signature / • / 41 I Registered Y / N Fee Current Y / N
Addres aLzenfin p A S�� License # I D7 3 s-
I
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 subject to "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", 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, 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF C MMENCEMENT
FLORIDA JURAT (17.03) A
OWNER O GE / ' L# /Aw� / . ��1. ; ONT • • + / A'
Subscribed swo f (or affirmed':: • r- e this Subscribed and s 7 %. or affirm - • • re • is
f ?_ - //7 by ✓/ �ii�! / �. 7 � j AO b �. �.,_.jI I �
Who is /are perso ■ - II nown to me or h- ave pro • uced Who is are pe :. na k • wn to 671 o ha ave produced
as identification. , as identification.
% %� - 1 _ . . :y �- blic ��r1 _ ,� . { 1 �� iy��' • •tary Public
C Commissio • • ••. I
omm
Cission OD 734406 = ;r n Commissio 00 734406
T.���[•,.r .raid
Na `3"': ,. i ,�.��: Name of No y rf,.t. ° . .. 800 -3854019
• . i Bonded ' Thu Tiny Fain lmuenoe • u� .. ,19
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, H. 33542
Fire Marshal Bus (813) 780 -0041
Kerry Barnett Fax (813) 780 -0044
E -mail: kbarnett ), ire.zephyrhills.11.us
Plan Review #: 10 -151
Project: LP Tank Installation
Number of Pages: Packet
December 13, 2010
I have received and reviewed the plans for the installation of an LP tank located at 37601
Corey Lewis and will allow the project to move forward. Please note that this review does
not eliminate any further requirements as the project continues moving forward. By paying
for permit, contractor acknowledges to comply with the items listed below. Should anyone
have any questions, please do not hesitate to contact the Fire Marshal's office.
1. Shall be compliant to NFPA 58.
2. Tank shall be a minimum 10 feet from building and line of adjoining property.
3. Install bollards in front of tank due to its location by parking lot.
4. Ensure tank is properly placarded (704 diamond) and also that no smoking signs are
posted by tank.
5. Cylinder shall not be set on soil. Shall be on a solid foundation such as masonry.
6. Seal hole where pipe enters building.
Inspections Required:
1. Pressure Test
2. Final (once appliances • •lied up)
-.. iii -
i
KERRY BARNETT, '4 -*i • R HAL
** *Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance with applicable fire safety codes. This review is not intended to be a final approval of the
submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance
with all applicable NFPA codes and local ordinances. In the event that further examination or site
inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole
expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure
to be in compliance with all applicable NFPA codes and local ordinances.
ZEP'IYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrhills, FL 33542
Foe Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044
FIRE SERVICE USER FEES
Occupancy No.: 1 �/
Plan No.: ID ` . ) Contractor: 1XchRS r''��
Business Name: • (c, '- tdt t c:
>ez 4 -7 14 / 4 /1 S Billing Address: '/Ge#
Business Address: 76.0 1 �l ea...'S hyv higS
Business Phone No.: Billing Phone No.:
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
R Site Plan N/C , Annual N/C —
Sprinkler $50 i 1st Alarm N/C
Multi - Family /Commercial .06 sf 1st Re- inspection N/C _Standpipes $50 ^ 2nd Alarm N/C
—
(Minimum Charge $25.00
— —
2nd Re- inspection $100 Fire Pump $50 — 3rd Alarm N/C
1:1 Plan Revisions DBL _ 3rd Re- inspection $250 _ Hoods $50 r-- 4th Alarm $100
4th Re- Inspection $500 Fire Alarm $50 _ 5th Alarm $150
SPRINKLER SYSTEMS (Business closed until i i,LP Gas $50 6th Alarm $200
,_
0 - 25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150
26 plus Heads $100 SPRINKLER SYSTEMS
— Fuel Tanks - per tank $50
STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100
0 Per Riser $50 _ Hydrostatic Test $65 per system Fire Works $500
FIRE PUMP _ Acceptance Test $45 per system — Camp Fire $25
El Per Pump $100 _ Hydrant Flow $75 ~ Controlled Burn $100
^ FIRE ALARM SYSTEM _ Hood /Duct $50
0 - 25 Devices $50 _ FIRE ALARM SYSTEM — Place of Assembly $50 Annual
26 plus Devices $100 — System Acceptance $50 —
Fire Protection $25
SUPPRESSION SYSTEMS _ Recall Acceptance $50 — Flammable Application $50 Annual
Wet $50 OTHER _ Tire Storage $5 Annual
Dry $50 Fire Wall /Smoke Wall 15 per wan Generator < KW $100
_ CO2 $50 P Gas �' • tank Generator >30 KW 150
— Other $50 Natural Gas per system Bio-Hazard Waste $100 Annual
KITCHEN EXHAUST — _ ^ Fumigation Tenting $50
0 Hood /Ducts $50 _ Tent 10'x10' or greater $15 per tent —
Torch Pot/Applied $50
OTHER _ Fire Pump $45 Haz. Materials $100 Annual
LP Installation per tank _Fire Suppression $30
Fuel Tank Installation _ System Acceptance
(Per Tank) $50 Exhaust Hood /Duct $30
El Natural Gas Installation $50 Re- inspection DBL
_
(Per System) (other than annual)
LI Spray Booth $50 0 Inspection scheduled DBL
and cancelled less than
_ 24 hours
_ Construction Insp. N/C
..��q-; V� — Emergency Vehicle Acs $50 FALSE ALARM
PLANS TOTAL! c INSPECTION TOTAL! o25 PERMIT TOTAL — TOTAL L_
GRAND TOTAL ' (' - 1
Comments:
Date: i, -1 t?>l
InspActor: r 1/ & Y 1.L 4 " - /
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ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD /YYYY)
10/1212010
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Janlelson McLean Corporation ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box621149 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
825 Executive Drive
Oiledo FL 32762 Phone: 407-366 -3482 INSURERS AFFORDING COVERAGE NAIC #
INSURED Bahrs Propane Gas &AR' Con Il oning, Inc. INSURER A: AIXSpecialty Insurance Ccr7pany
4441 Allen Road INSURER B: Nova Casualty COnparly
INSURER C: Zenith Insurance Can arty 00984
Zephyrhllls FL 33541 INSURER D:
_ INSURER E:
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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
I TR NSRG TYPE OF INSIIRANCE POLICY NUMBER DATF IMM/11I1/YY1 OATS IMM/I1lVYYI LIMITS
GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY L.GZ-CL- 002000 OW01/2010 09/01/2011 DAMAGE
SFSOFa $ 330,000
c
CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GENII AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2 000 , 000
/ I POLICY PRO —
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
B X ANY AUTO LCP-CL -0010005 -0 09'01/2010 09/01 /2011 (Ea accident) $ 1,0(10,000
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS
BODILY INJURY
X NON -OWNED AUTOS (Per accident)
X CC VP CEO $ 1,000 —
X LL $ 2,000 PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ _
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND X -A V I IM s- O FR
C EMPLOYERS' LIABILITY 2$36554610 05/1112010 05111/2011
ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 500,000
OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500,000
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City Of Zephyhlls DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
FAX # 813 - 780.0021 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE _ <BKG
ACORD 25 (2001/08) ACORD CORPORATION 1988
uec :u ui.ura 813 681 1955
12/02/2010 15:44 8137831374
BAHRS PROPAt� S A /[, rNt� P 1
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PROPOSAL
l!OA (5'
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Are6 7988 81 3 -782 -501-3
4441 Allen Road — Zepbyrbilis, FL 33541
Pb_ 813 - 782.5013 Fax: 813 -783 -1374
E -mail: bahrs.ac@tamlpabay.tr.com
Proposal Submitted To: Rick Woolfolk Date: 12/02/10
E-mail: PhonelFax 813 -681- 1955 -0/ 813- 299 - 1548 -C
Name: Bulls -Eye Construction, Inc. Job Name: Grand Horizon Clubhouse
Street: 12814 CR. 39 S Street: 7645 Green Slope Dr
City: Lithia City: Zephyrhiils
State & Zip: Fl 33547 _ State & Zip:
We hereby submit specifications and estimates for GAS SET LP FOR KITCHEN
,REVISED PROPOSAL
Labor & Material for 4 drops on inside pipiwg,1 outside stub out on north side
for future grill (5 drops total) to include appliance connectors, shut offs
tied to suppression system (provided by contractor) 1200.00
Additional piping to tank of approx 80 ft., outside piping from tank to kitchen,
hook up tankless water heater outside 250.00
Set 250 gallon above ground, company owned tank (contractor to dig hole
if tank is to be buried) 200 gallons gas @ 1.85 gal 370.00
No annual rental fee
Price does not include taxes
Price does not include any permits
Ali material is guaranteed to be as specified. All wont to be completed in a workman like manner according to
standard practices. Any altercation or deviation from above specifications involving extra costs, will be executed
only upon written orders, and wiU become an extra a over aad above the char
upon strikes, accidents or delays $ � All agreements contingent
void thereafter at the option of c undersigned control. The proposal subject to acceptance within days and is
Authorized Signature 6k4143 ,444 - 1
Acceptance of Proposal
•
The above prices, specifications and conditions are hereby accepted. You are authorized to tie
Payments will be made as outlined above. �work as sspec Payments
ACCEPTED: Signature �r�
Date: Signature
•
Bobbie Swetland
From: Kerry Barnett
Sent: Wednesday, June 22, 2011 6:21 AM
To: Bobbie Swetland
Subject: RE: Gas permit & suppression permit for 37601 Corey Lewis Ave - Clubhouse for Grand
Horizons
Bobbie, //; 6(/q(
With reference to the gas permit a plan was received from your office for review on 12/9/10 and completed and turned
back to your office on 12/13/10. The plan I have is a copy so I know an original was submitted back. If your office does
not show a permit check with Bahr's Propane and see if they have anything on file for it. If they state that they do not
have record of one then I guess it would be up to your office since you all handle permitting. The project for the gas
installation has already been completed, inspected and signed off on. In my opinion it would be wrong to now go and
charge for that permit.
As for the hood suppression I do not have anything on file for that therefore I would assume nothing has been received.
I do not believe any work has been completed yet on that system. I will call Bullseye Construction and let them know.
Kerry
From: Bobbie Swetland
Sent: Tuesday, June 21, 2011 7:51 AM
To: Kerry Barnett
Subject: Gas permit & suppression permit for 37601 Corey Lewis Ave - Clubhouse for Grand Horizons
Good morning Kerry,
You gave me a final ok on gas lines for above referenced project on
6/17/2011, however I could not locate any permit for same. I double
checked with Jackie yesterday & she couldn't find anything either plus she
said no permit shown for suppression either. Let me know what direction
you want to take.
Thank you.
Bobbie
Bobbie Sharon Swetland
City of Zephyrhills - Building Dept
813 - 780 -0020 ext. 3512
813 - 780 -0021 Fax
bswetland Ca�ci.zephvrhills.fl.us
1