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Home My WebLink About11-11491 . CITY OF ZEPHYRHILLS � ' S335 - 8TH STREET �si3� �so-oo20 11491 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 11491 Address: 5130 GALL BLVD Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL. Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-07000-0012 Improv. Cost: Date Issued: 2/08/2011 Name: LUPTON Total Fees: 25.00 Address: 5130 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 2/08/2011 Phone: Work Desc: FPM- HOOD CLEAN QUARTERLY LUPTONS I I 5. 0 � �� C ,(�� A inal 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 ^ s�s=7so-oo2o City of.Zephyrhilis Fire � �� Permit Appiication Fax-8�3780-0021 Date Received :�+ ,,,,,,,,,_. ;„,,,,� ,,�,,,�,,,, Phone Cont�at far Permit � Owner's Name F _� Ownar's Pncne Nwmber �j Owner's Address Fee Simple Titleholder Name TRleholder ph�ne Number �� Fee SimpleTitleholder Address :�' Job Addre5s �� 3 Q Qu„ �� Lot # Sub Division Parcei # LT!' � Bio-Hazard Waste Storage - ANNUAL � Fumigatfcn Tent � Comm Exhaust Kitchen Hood/Duct � HazarrJaus Metenal (Tier !1 or RQ fanility) ANNUAL � Controlled Bum � Hood fnstafi�tion � Emergerscy Gerteratar < 30 kw � LP/FJatural Gas-Instailation � Emergency Generator > 3a kw � LP/Naturai Gas-ANh1UAL Safe � Fire Pmtectian Maintenance-ANNUAL � Places ofAssembly-ANNUAL Q � em� Rn er � Sprinkler ❑ ❑ ❑ Recraetianal Bum Fire Alartn � p p ❑� � Sparkiers �2 � l� I �� Hood CleaNng � ❑ ❑ C] � Sprinkfer System Ittstallations � Hood Su r^ �'1 �pression � �' ❑ ❑ St2nd i es S ' � �__I � p p ( pnnkler Sys) Fire Alartn instailafion � Tor�h Roafingrl'ar Kettle � Fire Aumps � Wasta Tire Storage ANNllAL a Fire Warics � Flammat+ie Application- Ah1NUAL """ � Valuation of Project Fuei Tanacs Q Oth2r. �!r,;x� Contractor Comparry ' 5ignature � Registered Y/ hl Fee Currertt Y/ N Address � License # ELECTRICIAN s.c� Campany '—" Signature Ragistered Y/ N Fae Gurrsnt Y/ IW Address License # PLUMBER Company Signature Registered Y/ N Fea Gurrent Y/ N Addrass Li�ense # ��—��—"—"""'�'� lvfECHANfCAL Company Signature Registered Y/ h! Fee Current Y/ N Address �scense � OTHER i Company — Signature Registerad Y/ N Fee Gu:Tent Y I� Address � ,�,,,,,�,,,,.�,W o�,.��+�u..�+�,v��,�w..+, License # Directions: FIl ou, appiicatio� completely � Owner & Contractor sign back af application, notarized (Or, copy of signed contract wiYh owner) If over $2500, a Notice of Commertcement Is raGuired (Mechanical work �ver $5000) Suppiy twc (2) sats of drawings ��,�ith applicable documentatlon Allow 1 D-14 days for review a�ter submittal date. Parcei #- obtained frflm Properry Tax Nottce (http;//appra�ser.pascogov.com) ��'y�l ��-�— � � �� I' CY�- �, � c� � �- S� � �c�,c � "�%�-� e . {��' � `I 5 �, � �' �� r--h,` l�s �L � 3 S�Z .,� -�- . �- � l �u/�,� . � i; �, , `/�'`,�,,� �,o� , 0^102!'_01 1 10 48 Paye 111 �►��' CERTIFICATE OF LIABILITY INSURANCE 0 08/1� THIS CER7IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGAl1VELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTiFICATE OF INSURANCE DOES NOT CONS7ITUTE A CONTRACT BETWEEN THE ISSUING INSURER�S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certlficate hdder is an ADDI710NAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the tertns and condldons of the policy, certain policies may require an endorsement. A statement on this certlflcate does not confer rights to the certificate holder in lieu of such endorsement s. PRODUCER CONTACT NAME. Varcas Insurance Agency, LLC PHONE AfC No 2901 B West Hillsborough Ave -MAi� Tampa, FL 33614 P UCER Phone (813) 319-1940 Fax (813) 319-1944 INSURER S AFFORDING COVERAGE Nwc � INSURED INSURER A Bankers Insurance Group Hood Master Services LLC INSURERB. 1614 Marumbi Ct INSURERC W estley Chapel, FL 33544- iNSUReR o. INSURER E (813) 957-8197 INSURER F . COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY OLI Y XP �7R TYPE OF INSURANCE N POLICY NUMBER MMIDDIYYYY MMIDDlYYYY LIMITS GENERAL LIA&LITY EACH OCCURRENCE $ 'I,OOO,OOO � COMMERQAL GENERAL �IABILITY PREMISES Ea occurrence $ �� c�niMS-Maoe � occuR 090410003184700 Meoe>w�a.nyonePerson� $ 5,000 fi ❑ N '��'�/20'�� 12/31l2011 pERSONAL& ADVINJURY $ �.��0.�� GENERAL AGGREGATE $ 2.000 OOO GEN'L AG!=REGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 'I OOO OOO � POLIry ❑ JECT ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) � AfJ'f AI_iT0 BODILY INJURY (Per person) $ � ALL OWNED AUTnS BODILY INJURY (Peracaden[ $ ❑ Sr_HEGULEG qUTpg ❑ PROPERTY DAMAGE � HIRED AUT�=�S 1Pei acudent) ❑ VJON-OWPIEGAUTOS $ ❑ � � UMBRELLA LIAB � �CCUR EACH OCCURRENCE $ EXCESS LIAB rLAIMS-MAGE AGGREGATE $ � DEDUCTIBLE $ RETENTIGN $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y� T RY IMIT ER ANY PROPR�ETORIPARi1JER/EXECUTIVE E L EACH ACCIDENT $ OFFICERIMEMBEREXQUDED� N!A (Mandatory in NM E L DISEASE EA EMPLOYE $ If ves desaibe undai DES�`RIPTION OF ��PERATIONS below E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS l VEHICLES (Attach ACORD 101, Addkional Remarks Schedule, if more space is required) CER7IFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCElLED BEFORE THE IXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hood Master Services LLC ACCORDANCE WITH THE POLICY PROVISIONS. 1614 Marumbi Ct W estley Chapd, FI 33544 AUTHORIZED REPRESENTATIVE �:r r ,� - : �;°+tiF:%: 9�"�es�r.�� ,' i= %"'' O 7988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) QF The ACORD name and logo are registered marks of ACORD