HomeMy WebLinkAbout12-13614 �
CITY OF ZEPHYRHILLS
5335-8TH SIREET
(813)�8o-oozo 13614
ANNUAL FIRE PROTECTION MAINTENANCE
Permit Number: 13614 Address: 5658 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE-PROTECTION MAINTENAN E Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-05700-0252
Improv. Cost:
Date Issued: 11/15/2012 Name: ERIC HOOPER INC/WENDYS
Total Fees: 25.00 Address: 5658 GALL BLVD
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542
Date Paid: 11/15/2012 Phone: (813)782-5442
Work Desc: FPM- QUARTERLY HOOD CLEANING FOR WENDY'S
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Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the costs of fre
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$100.00, whichever is greater. Ail
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO IN Y R NOTICE
OF COMMENCEMENT." '
PERMIT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
e�3-78a-o02o ���� City of Zephyrhiils Firt Fax-813-780-002�
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SuPplY 1wo(2)sets of drawir�gs with appiicable documerrtatio�
r'.I�ow 7 D-i4 tlays ior rewew aYter suL'iruT.a�::a.e. °�"°r'�-^`���ed�sm pm:>,nrh�T$x.hlotice lhttv��/app2+se�.pascc�aovi ceml
CERTIFICATE OF INSURANCE
GENERAL AGENT (SSUE DATE(MM/OD/YYYY)
Ta co Underwriters, Inc.
PO Box 1�7069 ound Drive This certificate is issued as a matter of information only and confers
Ctearwater, FL 33762 no rights upon the certificate holder This certificate does noi
AGENCY NO.00931 — 00 amend,extend or alter the coverage afforded by the policies below.
INSURED
SOUTHERN FiRE SYSTEMS, INC. COMPANY AFFOROING COVERAGE
NAUTILUS INSUfiANCE COMPANY
Po aox zs�a� 7233 EAST BUTHERUS DRIVE
COCOA FL 32923
BREVARD SCOITSOALE, AZ 85260
PRODUCER
GETRATESONLINE.COM, INC
2025 MURRELL RD
STE 130
ROCKLEDGE, FL 32955
COVERAGES
This is to certify that the policies of insurance listed beiaw have been issued to the insured named above for the policy period indicated, not
withstanding 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 al!the terms, exciusions and conditions of such policies.
Limits shown may have been reduced by paid claims.
POLICY POUCY
TYPE OF INSURANCE POLICY NUMBER EFF.DATE EXP.DATE LIMfTS
MM OD MM DD
GENERAL LlABIIITY NN221011 03 1 y 2�12 03 i 1 2�13 GENERAL AGGREGATE $1,��O,�Q
Commercial GL � � � �
� OCCUff6nce , / PFODUCTS-COMPL/OPSAGGREGATE $ �JOO,OOO
❑ Claima Made V pERSONAL&ADVERTISfNG(NJURY
Generat Agg Limit Applies Per (My one person or organization� $ rJ0�,�0
� Po��� EACH OCCURRENCE $ rJOO,QOO
❑ P[oject
❑ LOCation DAMAGE TO PREMISES RENTED TO YOU
❑ Other (�Y one premises) $ 1�j,�0
MEDtCAL EXPENSE (Mynne persQn) $ S,QQQ
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE
❑ Excess Uability
Umbrella Uabiliry $ $
❑ Occurrence
❑ Claims Made SURPLUS LINES INSURERS' POLICY RATES
� ������$ AND FORMS ARE NOT APPRC?VED BY ANY
❑ Retention $ FLt?RfDA REOULATORY AQENCY.
DESCRIPTlON OF OPERATIONSJLOC�ATIONS/RESTRICTtONS/SPECWL ITEMS
ANSUL CLEANING SYSTEM&CLEANING OUTSIDE SURFACES
THIS tNSURANCE IS ISSUED PURSUANT TO THE FLORIDA SUHPLUS UNES lAW. PERSONS INSURED BY
SURPLUS UNES CARRIERS DO NOT HAVE THE PROTECTION OF THE FLORlDA GUARANTY ACT TO THE
EXTENT OF ANY RI(3HT QF RECOVERY FOR THE OBUGATION OF AN UNLICENSED}N3URER.
CERTIFICATE HOLDER CANCELLATION
Should any of the above described pc�licies be cancdfed
before the expiration date thereof, the issuing company will
endeavor to mai! � days written notice ta the cert'�"icate
holder named to the left, but faRure to maN such notice shati
impose no obtigatlon or lfabitity of any kind upon the
com�ny, its agents or representatives.
���C �,�P�SENTATNE
SURPI.US LINES AGEfJT,t_IC�A2066'95 A"`'"`7`"�'
13577 FEATHERSOUND DR.,PO BOX 17069
�LE,HF�IWASER,FL 33782
S948(Q9/03)