HomeMy WebLinkAbout11-12086 ' CITY OF ZEPHYRHILLS
' S335 - 8TH STREET
�sis>>so-oo20 12086
LP/NATURAL GAS PERMIT
Permit Number: 12086 Address: 5963 GALL BLVD
Permit Type: LP/NATURAL GAS ZEPHYRHILLS, FL.
Class of Work: FIRE-LP/NATURAL GAS Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 10-26-21-0020-00000-0021
Improv. Cost: 1,250.00
Date Issued: 7/05/2011 Name: ABC PIZZA OF ZEPHYRHILLS INC
Total Fees: 125.00 Address: 5963 GALL BLVD
Amount Paid: 125.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/05/2011 Phone:
Work Desc: GAS LINE FOR APPLIANCES (SUNRISE EATERY)
' ' • 5.
FIRE PLAN REVIEW FEES 50.00
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Chapter 633, Florida Statutes, authorizes the City M 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 pertormed 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 A7TORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEM T."
✓ �
CONTRACTOR GNATURE 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
. � a��-�ao-oozo City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Dale Received Phone Con18c1 tor Permit � C� C�
Owner's Name Owners Phone Number ���
o�rg nnare� d ,P
fee Simple TiUeholder Name Tidehdder Phone Number ���
Fee Simple Tilleholder Address
Job Address /� � I� �;1 � Lo� � �
Sub Division Parcel �
� Bio-Hazard Waste Storape - ANNUAL � Fumigation Te�t
a Comm Exheust Krtchen HoodJDuct � Hazardous Material (Tier 11 or RQ Facility) ANNUAL
� Concrolled Bum � Hood Inatallatlon
� Emergency Generator < 30 kw LPlNatural Gas-Installation
Emergency Generator > 30 kw LPlNatural Gas-ANNUAL Sale
� Fire Protection Maintenance - ANNUAL Q Placea of Assemby-ANNUAL � I 2 V�1�
� �� � � �
Sprinkler � ❑ O ❑ � � ReCteadonal Bum
Fire Alarm � O ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ d� � Sprinkler System Insta{lations
Hood Suppression � O O ❑� � Sfandpipes (Sprinkler Sys)
� Fire Alarm Installation � Torch RoofingJTa� Kettle
a Fire Pumps O Waste Tire Storage ANNlIAL
� Fire Wo�lcs
Flammable ApplicaGon- ANNUAL �j� �(,Q Valuation of Project
� Fuel Tanks
Q Other: , ' � ,�ir cr.e� .9TRS✓x T,�4(��
Contractot Compeny
Signature Registered Y I N �ee Cunent Y/ N
Addresa License �
ELECTRICIAN Compeny
Signature Repistered Y/ N Fee Curcern Y! N
Address L�cense #
PLUMBER Comparry j G.
Signature Reqistered Y/ N Fae CurreM Y! N
Address License f
MECHANICAL �pmpe�y ��
Signature Reyistered Y I N Fee Cuneat Y/ N
Address V��ye g
OTHER Comparry
SipnaWre Registeried Y/ N Fee CurreM Y! N
Addreas License #
Directions:
Fill out application complelely.
Owne� & Contractor sign back o( application, notanzed (Or, copy of signed conMact with owner)
Ii over E2500, a Notice o( Commencement ia required (Mechanical work over 55000)
Suppry two (2) sets of drawings with applicade documenlation
Allow 10-14 days for reviaw atter submittal date. Parcet #- abtai�ed from Properry Tax Notice (http:!lappraiser.pascopov.00m}
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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 RESPONSIBlLIT1ES. If the owner has hired a contractor or
contractors to undertake wo�k, they may be required to be licensed in accordance with state and local regulations. lf the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
unde� 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
CON8TRUCTION LIEN LAW (Chapter 713, Flo�ida Statutes, as amended). If valuation of work is $2,500.00 or more, 1
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 applicaGon 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 instaliation as indicated. I cer6fy
that no woric or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of ali 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
govemment agencies may apply to the intended work, and that it is my responsibility to identify what actions 1
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 afF'idavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air condi6oning, gas, or othe� instaltations not specifically included in the appiication. 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 af 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 wo�lc ceases for ninety (90) consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE T� RECORD A NOTICE OF COM ENCEMENT MAY R SULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT D TO BTAIN FlNAN ING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N ICE CO NCE T.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONl'RACTO
Subscribed and swom to (or affirtned) before me this Subscribed and s o (or aifi ) befo me this
by by '
UVho is/are personally known to me or haslhave produced 1Nho is/are nna �y knnwn L_mP or haslhave produced
as identification. as identification.
Notary PubliC �C�WDl� � (JVi�J �_Notary Public
Commission No. Commission No. � !7 '13�7�'7 �
� S l.�is. ( S�,
Name of Notary typed, priMed or slamped Name of Notary typed, printed or stamped
EDNM110 �. V�
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Zephyrhills Fire Rescue
6907 l)airy Road. Gephyrhill�, I� L>35�?
I�irc Marshal L3us (813) 7�it?-0041
Kerr�� 13ai I�ax (81 ;) 780-U04�
E-mail: kbarnettl�i;.tire.Lephyrhills.fl.us
PlanReview #: ] 1-093 � �. .. __..._ ._�_�_..___..__.___._._..___. ,...._ __..._..._..._.._.._.____,..
Project: Gas line instal(ation/addition
Number of Pages: 1
July 1, 20] 1
1 have received and reviewed the plan for extending the gas line to the additional cooking
equipment located at 5963 Gall Blvd and will allow it to move forward. Paying for permit
contractor acknowledges complying with the items listed below. Should anyone have any
questions, please do not hesitate to contact the Fire Marshal's office.
1. Ensure installation is installed in accordance to all applicable NFPA codes.
2. Ensure gas valve is located below ceiling.
3. additional requirements may be required at time of pressure test to ensure entire
system is compliant.
Inspection Required:
1. Pressure Test
2. Final
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KERRY BA ETT, FIRE MARSHAL
***Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance wrth applicable fire safety codes. This review is not intended to be a final approval ofthe
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.
z����n1;���0��� FiR� ���►���
6907 �airy Road, �ephyrhills, FL 33542
�=ere Chief Ke�rh Wifiiarns I�us (8'i3)180-bU41 Fax (813)7�0�0()��
FIRE SERVICE USER FEES
Occupancy No.:
Plan No.: �' ,��'� � la-5 , y c4 S ` -
�' � � _. Contractor _ �
Business Name .�� � t�,�� �' Billing Address: ��� S=" �J"" �
Bus�ness Addres U � �, ��,--�/ .r- � t
Busmess Phone No � Billing Phone No.: � "�
Business Fax No Billing Fax No.. —
Contact Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
8 Site Plan N/C Annual N/C Sprinkler a50 1 st Alarm
N!C
Mu�t� O6 sf 1st Re-i�spection N/C Standpipes $50 2nd Alarm
(Mmimum Charge $25 00 2nd Re-irts NiC
P���� 3100 Fire Pump $50 3rd Alarm NIC
� Plan Revisions DBL 3rd Re-mspection �250 Hoods $SO 4th Alarm
5100
4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150
SPRINKLER SYSTEMS (Busmess closed until P Gas �� 6th Alarm g200
8 0- 25 Heads $50 vwlations corrected) Natural Gas '$50 NON COMPLIANCE
26 plus Neads $100 SPI2INKLER SYSTEMS Fuel Tanks- $1 SO
�� ��k aso
STANDPIPE SYSTEM Hydro Undergrounds a45 Sparklers g�pp
� Per R�ser $50 Hydrostatic Test a65 pe�system Fire Worlcs $500
FIRE PUMP Acceptance Test $45 �� sy5�em Camp Fire $25
� Per Pump $100 Hydrant Flow S75 Controlled Burn y�pp
FIRE ALARM SYSYEM Hood/Duct $50
0- 25 Devices $SO FIRE ALARM SYSTEM Place of Assembl
y $� Annual
26 plus Dewces $100 System Acceptance a50 Fire Protection $�
SUPPRESSION SYSTEMS Recall ACCeptance $50 Flammable Application $50 Annual
Wet $50 OTHER Wasfe Tire Stora e
9 $� Annual
�rY $50 Fire WaI1lSmoke Wall $15 „perwan Generator < �(yy g�op
CO2 $50 Y P Gas �per tank Generator >30 KV1I 15p
Other $50 Natural Gas `� Per system Bio-Haza�d Waste
�100 Annual
KITCHEN EXMAUST Fumigation Tenting $Sp
� Hood/Ducfs $50 Tent 10'x10' or greater $15 Pe. te�t To►ch Pot/Appl�ed $50
OTHER Fire Pump $45 Haz Materials
^ $�� Annual
P Inslallabon pr,r lank � Fire Suppression $30
Fuel Tank Instal�alion $50' System Acceptance
(Per Tank) $50 8 Exhaust Hood/Duct $30
� Natural Gas Ins�allation $SO Re DBL
(Per System) (otherthanannual)
� Spray Booth $SO � Inspection scheduled DBL
and cancelled less than 8
24 hours
Construction Insp. N!C
Emergency Vehicle Ac� $50 � FALSE ALARM
PLANS TOTAL (?��_I INSPECTION TOTAL � PERMIT TOTAL L S��
T TOTAL I I
GRAN� TOTAL —
Comments '� �
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»Y ZEPHYRHII,LS �EN 10EVIEW�
Date: ��SHAL' OFFICE
"eviewer:
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Gasmasters, lnc.
2615 E. 7"' Avenue, Tampa, FL 33605
Office (8 i3) 24 i-0258 � Fax (813) 248-4571 � Lic. # CFCO37165
Srate LP Lic. # MG 13116
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; � DEFARTMCONSTRUCT�QN�IN'17�RY���CEIi9�N��HOARIILATION
' $EQ# L10083001792
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j 08 30 2010 100086673 C�CU37�:.6`5. .:, � �'`��`�=-;• �-'
i The PLUMB.ZNG -CONTRACTOR =;f'� ' ' ' y-+;;t=`�� �-_ _ . `.
Named below I5 CER�IFIED ' '`" `"• � �' •°�
ry
� Under the provisions of Chap�er�-•, 8:` :'F�. .' -"°"".� � .
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� Expiration date: AUG 31, 2012 ':'�,����� .��t- �• - •
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� GASMASTERS TNC • �'- ' �."'�,� , , ,
2615 E 7TH AVENUE ` . , �•�'��°'"'
TAMPA FL 33605 "' �4.'� `'} '- -� '
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CHARLIE CRIST CHARL �'UT$M
GOVERNOR
� � - v � �-. � S�ECR�TARY '
, QISPLA�F;AS REQUIRE �1f LAW
281;►-2011 HILLSBOROUGH COUNTY BUSINESS TAX R�CEIPT EXPIRES 9-30-2011 Faio«o.
FACR �� �
0 0 0 10 RENEWAL 30451.0000
H. TE TA7(
OCC. CODE BUSINESS TYPE suRCw�ce
090.020 CONTRACTOR - PLUMBING 46.00 18•00
y
BuSwESS 2615 E 77H AVE
LOCATION TAMPA 33605
Nntu�e WINTER FRANK LAWRENCE QBA GASMASTERS INC
MAILING 2615 E 7TH AVENUE
AooRess TAMPA FL 33605-0000
B U S I N ES S TAX R E C E I PT DOUG BELDEN, TAX COILECTOR PAID - 4253 N - 85
s1s-�as-szoa o7»�20�o se.00
HAS NEREBY PAIDA PRIV0.EGE TA7( TO ENGAGE THIS BECOMES A 7AX RECEIPT VYHEN VAl.IDATE�.
IN BUSINE88, PROFE88lON. OR OCCUPA710N SPECIFIED HEftEON
- .._....� ... �..-..,..,...
I _"""_"_"'___ ""'"'_____'""""""'_""""""_
� 32GN YOUR CARD I
(This card is non-transferable and is revocable for cause�
i I
j7'he contractor listed hereon will be held responsible �
�for all permits issued under this card. If this card i�j
jloat or stolen, notify the Hillsborough Co Contracror ;
��icensing Team immediately at (8]3) 635-7308/7309. �
�Yaur card ioust be renewed prioz to the expJration date �
j shown on the fronL I
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i
i � Siqnatu1 not valid unless signed ' �
j
I CERTIFICATE OF COkII�87RNCY �
I HILLSBOROUGH COUNTY, FLpgIDA �
Type CEkTIFIED PI,UMBING CONTRACI'OR �
NO PERMIT UNTIL STATE REGISTSRED, IF APPL7CASLE �
� ;:rCO37.IG�� i2/:31/2012 �
• CPrtificate No Expiration Date �
• i lssued To I
� WINTER FRANK L
�
� DBA:GA3MA$TER3 INC I
� Workers'Comp: 09/O1/2011 �
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A� °� CERTIFICATE OF LIABILITY INSURANCE B/31/2010 1
' THIS CERTIFICATE tS ISSUED A3 A MATTER OF INFORMATiON ONLY AND CONFERS NO RIGHT8 UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATf DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXYEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOE$ NOT CONSTI7UTE A CONTRACT BETVYEEN THE IS3UING fNSURER(8), AUTHORIZED
REPRE8ENTATIVE OR PRODUCER, AND THE CERTiFICATE HOLDER.
APORTANT: If tha certiflcate holder is an ADDITIONA� INSUREQ ths po8cy(ies! must be endoreed. If 3U6ROGATION IS WAIVED, subject to
che tertns and Conditlo�s of the policy, certain policles may require an e�dorsement. A statement on thia ceKiflcate does not coMer �ights to the
certiflcate holde► in lieu of such endorseme s.
vROOUCea NAME:
• --- - - - - --- -- .._..- ---
Work Comp Spacialist � . (800) 508 _9126 __ _ ` F � (877y4 __
' tuc. No�:
PO Box 9435 no�E : . --------..T_._.— ----- —.--.
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Panama City Bea FL 3241 _ iNSUr�a�a�n�oaaHOCOV�w►oe ! _ . _%uucr
INSURED INSURERA:$r1f�g6flAl.d Emp�O Ii1813r8I1CA �1�7�1__
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INSURER 8:
fi88IDa8C9�8� IriC. INBURERC: --- - - -- - ° -•- -----�-----------
----- --- -- - - --- - - - --' - � ----- °- �--
2 615 E. 7 th Ave . i ��� p �
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IN3URER E : ---------- --.
Tampa FL 33605 INSURERF:
COVERAGES CERTIFICATE NtJIIABER:�1083103253 REVI810N NUMBER:
THIS IS TO CERTIFY THAT THE POl{CIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TH£ POLICY PERIOD
INDICATED. N0TIMTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 1MTH RESPECT TO WH1CH 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 HA VE BEEN REDUCED BY PAIO CLAIMS.
L�M TYPE OF INSURANCE � POLICY NUMBER � MMID EF MMWDIYYYY I --. .-- ---- UNITS -- --
GEN£RAL UA6IUTY , � ' EACH OCCURRENCE ; S
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GEML AGGREGATE UMIT APPLIES PER: I I ' PROOUCTS - COMPlOP AGG � S
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DESCPoPi10N OF OPERATIONS ! tOCA110N31 VEHICLES (AetaM ACORD 101, Addltlena� R�mrlcs �ehWuM, M mon spac� 1s rputntl)
CERTIFICATE HOLOER CANCELLATION
(813) 788-3293 SHOUlO ANY OF THE ABOVE DESCRIBED pOLfCIEB BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, N071GE WILL 8E DELIVERED IN
C1� of Zepkyrhills ACCORDANCEINITH TlfE POLlCY PROVISIONB.
5335 er.t� st
Zophyrhills, FL 33540 AUTHORIZEDREPRESENTATIVE
ICovin Campbell/JANIB � �
ACORO 25 (2009/09) � f868-2008 ACORD CORPORATION. All Nghta reseroed.
IN3o25 �zaoeoe> The ACORD name and logo are registered ma�lcs of ACORD
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