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Home My WebLink About13-14027 ° CITY OF ZEPHYRHILLS 5335-8TH STREET (si3)�so-oozo 14027 ANNUAL FIRE PROTECTION MAINTENANCE Permit Number: 14027 Address: 7821 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: Improv. Cost: � Date Issued: 3/26/2013 f z Name: CHINESE TAKE OUT RESTAURANT Total Fees: 25.00 Address: 7821 GALL BLVD Amount Paid: 25.00 ZEPHYRHILLS, FL. 33542 Date Paid: 3/26/2013 Phone: Work Desc: FPM SEMI ANNUAL HOOD SUPPRESSION FOR HONG KONG CHINESE RESTAURANT �� .��- � "� � � 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 pertormed 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 sisaso-oazo City ofZephyrhills'�ir�e�• Fax-81;r780.0021 Permit Application Date Received � � Phone Corrtact for Pertnit � � � �.. � Owner's Name L e � Owner's Phone Number .� r'�� L_ILL�!1 L.L.L_LJ Owner's Address y� �j�J- (� Fee SimpleTitleholder Name ?iUeholder.Phone Number r_� � � Fee Simple Titleholder Address �a Job Address / �� G // v Lot� C 5ub Division Parnel# � Bio-Hazard Waste Stordge-•ANNUAL Q Fumigation Tent � Comm F�chaust Kitchen HoodlDuct � Hazardous Material(Tter fl or RQ Facility)ANNUAL � Controlled Bum � Hood Installation � Emergency Gene2tor<30 kw � LP/Naturel Gas-Installation � � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Saie ` � Fire Protection Mairrtenance-ANNUAL � Ptaces of Assembly-ANNU ry ' emi �' er /J/�� vf�i 5prinkler � ❑ ❑ ❑ � Recreationai 8um Fire qlarm � ❑ n ❑ � � 5parklers Hood Cieaning � ❑ ❑ ❑ � � Sprinkier 5ystem Ynstallati s Fiood 5uppression � ❑ � ❑ �� 5tandpipes(Sprinkler Sys) ' � Fire Alarm Installation � Torch RoafinglTar KetUe Fire Pumps � Waste Tire 5torage ANNUAL Fire Works Ftammable Applioation-ANNUAL Valuation of Project Fuel Tanks � Other: - Contractor Company 5ignature ' Registered Y/N Fee Curtent Y/N Address License# ELECTRICIAN Company Signature Registered Y/N Fes Gurrent Y/N Address License# PLl1MBER Company Signature Registered Y/N Fee Curtent Y/N Address . License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Addr=ss License# OTHER CompanY �/Ifej�+ ,rt�'r Signature Registerad Y N Fae Current Y/ N Address v License# �j . .... Directions: - Fill out appiication completely. Owner&Cont2ctor sign hack af application,notar¢ed(Or,capy of signed corrtract with owner) , tf over$2500,a Notice of Commencement is required.(Meehanical work over$SDDD) Supply 1wo(2)sets of drawings with applicable documerttation Allow'I D-74 days�for review after submittal date. Parcel#-abtained irom Property Tax Notice(httpJlapp2iser.pascogov.com) �NOTIC� OF:D:EDR�STr?ICTIONS: "The.undersigned understands that this permit may.be•sub�ect:to�ude�d°�;�e�t�i��onSn which may be more restrictive than Counry regulaiions. 'The.undersigned assumes responsibility:for:�ompliarsce��v'tth any applicable deed rsstricfions. �UNLICENSED �CONTR;4CTDRS AND-COI�IT'RA�T�R R�SP.DI�SEBIL[TEES: If-the owner has-hired-:a�c�ntractor �or � contractors to undertake work, they may be requirsd�o be licsnssd in accordancs with state and local•regulations. tf the contractor is not iicensed as required by law, both the owner.and contractor may be ci�ed-For a�misdemeanor viofation under state law. (f-the owner or intended coniractor are uncertain.as�to what Iicensing•requirements may:apply for the intendsd work,-they are advised�t� contact the•Pasco County Bui►ding tnspection Division—Licsnsing�S�etion.at727-847- 8009. Furthsrmore, ii tha owner has hired:a contractor or contractors, he is advised �to have�the corrtractor(s) sign portions of the "contractor Bloc}�' of this appIication-ior which-they will be responsible. If you, as•the owner�sign as the contractor, that may be.an indicaiion that hs is not properfy Iicenssd and is not en�itled-to�permitting.privileges in Pasco County. CCINSTRUCTION.LEcN.LAW(Chapter7'I3, Fforida Statutes,.as:amended): If va(uation of work is�2;�D0.00 or more, I csrtify that 1, -the applicant, have been provided with a copy of-the �Fiorida Construction Lien Law—Homeowner's Protection Guide' prepared bythe rlorida Departrnent of Agricuttttre and Consumer AfFairs, lf the appficant is•someons other than the"owner", I certify that 1 have obtained a.copy of the above described document and promise in good faith to defiver it to the"owner�prior to commencement. - CONTRACTOR'S/OWNFR'S•AFFIDAVIT: I certriy that all the information in this apptication is accurate and that ali work will be done in comptiance with all applicabte taws regufating construction,..zoning and land development. Application is heraby made to obtain a permit to do work and instaltation as indicatsd. I certify that no work or instaltation has commenced prior to issuance of a permit and-that ali work will be pertormed to meet standards of all laws reguta�ing construction, Couniy and City cocles, Zoning regula�ions, and land developmsnt rsgulatior�s in the jurisdiction. 1 also certify that 1 understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibiliiy to ider�tify what actions I must take�to be in compliance. t�I am the AG�NT�FDRTHE OWNFR, I promise in good iaith to ir�form the owner of the permitting conditions set forth in this afridavit prior to commencing construction. t understand that a separate permit may be required for elsctrical work, plumbing, signs, welis, pools, air conditioning, gas, or other instatfations not specifiically inciuded in the application. A psrmit issusd shall�be construed to be a Iicense to proceed with the work and not as authority tA vio}ate, cancel, alter, or set aside any provisions of the technica! codes, nor shali issuance of a permit prevent the Buifciing Offcial from thereafter requiring a correc�ion of errors in pfans, construc�ion or viola�ions of any codes. Every permit issusd shall become invaiid unless the work author¢ed by such permit is commenced within six manths ofi permit issuance, or if work authorized by the permrt is suspended or abandoned for a period af six(6) months after the time ths work is commenced. An extension may be requssted, in writing, �irom the Suilding Ofricial,for a psriod not to exceed ninety (90) days and wiil demonstrate jusfifiiabla cause for the extension. If work ceases for ninety(9D)consecutive cfays,the job is considered abandoned. WARNINGTO DWNER: YOUR FAIL'URE TO REC�RD A'NOTICE'OF'COMM�NCEMENT Mi4Y-RESULT IN'YOUR PAYING'iWlCE FOR IMPROI/FMENTSTO YOUR PROPEi2TY. IF YOU INTFNDTO OBTAIN-�INANCIPIG, CONSULT WITH YOUR LENDER DR AN ATTORN�Y BEF�RE RECCIRDING YOUR NUTICE OF COMMENCE�IIEi�tT FLORiDA JUt4AT(F.S.117.03) OWAlHit�R AGEM' COHTRACTDR 5ubscribed and swom to(or affitmed)beiore me this Subscdbed and swom to(or affirmed)before me this by by Who is/are personalfy known to me.or haslhave produc�d Who islare persortalty Imown to me or has/have prnduced as identification. as idenflfication. Notary Pub[ic Notary Pubiic Commission No. Commission No. IVame of Notary typed;pr9nted er sfamped Name of Notary iyped,printed or stamped JeffAtwater Casia Sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas DIVISION DIRECTOR Keith McCarthy ��,�^��- SAFETY PROGRAM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East Ga�nes Street -Tallahassee,Flonda 32399-0342 Te1.850-413-3644 Fa.�.850-410-2467 Commercial FIRE EQUIPMENT Co. - _- _�V---��^ - � . �_��_-__.��_ �_�� P.O.BOX 2442 BRANDON FL 335092442 �d1��11.d�I�t6�d�1��61d�dJ��l��ld FIRE EXTINGUISHER PERNIIT THTS CFRTFiES THAT: BRIiCE V�_RNADOE EMPLOYER: Commercial FIRE EQUIPMENT Co. 10236 Fisher Ave Ste F Tampa FL 33619 LICENSE #: 385042-0002-1988 -Fire Equipment Class D License Has Complied with Florida statutes and has qualified for the type and class sho�m herein to service, recharge, repair, install, or inspect all types of pre-engineered Fire Extinguishers. Excludes service, repair, installation, or inspction of any type of Halon Pre-Engineered System. Issue Date: Ol/O1/2012 Type: 09 Class: 04 County: Hillsborough LicenselPermit Number: 394637-0002-1988 Expiration Date: 12/31/2013 � - �� Chief Financial Officer , �� '4CORp� CERTIFICATE �� OF LIABILITY INSURANCE °"""' THIS CERTIFiCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL ER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATNE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER phone: (407)332-0033 Fax: (407)332-0030 CONTACT �nsurance Solutions of America,Inc. INSURANCE SOLUTIONS OF AMERICA,INC. """"E PHONE -�� DBA:ISU-INSURANCE SOLUTIONS OF AMERICA cac,rio,en� (407)332-0033 r�,��, (40�332-0030 910 BELLE AVENUE,SUITE 1140 E-�nAa __ ___— _ ADORESS WINTER SPRINGS FL 32708 �ooucea 16�� _________ CUSTOMER ID. INSUREO INSURER(S) AFFORDING COVERAGE B.WAYNE ENTERPRISES�WC. INSURERA Arch Insurance Co. — ��*- DBA COMMERCAIL FIRE EQUIPMENT COMPANY INSURER 8 Harteysville Mutual Insurence Co. P.O.BOX 2442 INSURER C Bridgefield Employers Ins.Company 10701 BRANDON FL 33509 iNSUaea o INSURER E COVERAGES �NSURER F CERTIFICATE NUMBER: 19185 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE �ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM'ED ABOVEMBOR'THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 7ERM 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, INSR� AppL SUBR. _LiR TYPE OF INSURANCE INSR wvD POLICY NUMBER POUCV EFF ppugy�p A GENERAL LIABILITY lN!�D-D/1'YYYI__ (MWDDryyyy) LIMITS MFGL07210001 09/08112 09/08113 EACH OCCURRENCE a 1,000,000 X �COMMERCIAL GENERAL LIABIUTY DAMAGE TO RENTED-- �-- j CLAIMS-MADE X OCCUR P��"!��Sl��!9�!�el—__ _+a JrO�OOO Meo.exa�nny«re�so�� ;�_ 5,000 PERSON,q�&ADV IWURY a 'I,(�OO,OOO GEN'L AGGREGATE LIMIT APPLIES PER� GENERqL AGGREGATE �� I,OOO,OOO L--- X POLICY P�� OC PRODUCTS-COMP/OP AGG $ Z�OOO�OOO JECT - . _ B AU70M081LE LIABILI7Y $ — BAOOO00012414P O9/O8/12 09/O8/13 COMBINED SINGIE LIMIT � —"--- X ANY AUTO (Ea acddenq � � �,QQQ,��Q ALL OWNED AUTOS BOOILY INJURY(Per pgrson) � S SCHEDULED AU70S BODILY INJURY(Per acddent) $ HIRED AUTOS PROPERTY OAMqGE � --- (Peraccident) a NON-OWNEDAUTOS _ __ _ �_ _ a - - UMBREILA LIAB OCCUR _ _ __ __ - i S__ �_ Excess �we CLAIMSMADE EACH OCCURRENCE '� - - --�-t--- AGGREGATE DEDUCTIBLE .- _ _ _ ____i$ _ RETEN710N S _---- -- ---'-�— ---� A WORKERS COMPENSATION - ( � S AND EMPLOYERS' LU181lITY HSO-ZH47� O9IOH/��I O9IOH/�.3 �( � W�STATU- � !-QTM ANY PROPRI£TOR/PARiNER1EXECUTIVE r�N __.TORY UMITS__ � GR.�; OFF�cERM�uBER EXCLUDEmr N 1 A E.l.EACH ACCIDEN7 _ i a �,OOO�OOO (Mandalvry in NH� _-__ rc yes.aesc�ee wwe� E.L.DISEASE-EA EMPLOYEE �E 1,000,000 DESCRIP710N OP OPERATIONS bebw r E.L.DiSEASE-POLICYLIMIT �I$ ��QQO,OOO -t---- i DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks 5chequle,if more space is required) i -�- -�-- -�-- CERTIFICATE HOLDER CANCELLATION City of Zephyrhilis SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 5335 Eighth Street THE EXPIRATION DA7E THEREOF, NOTICE WILL BE DELNERED IN Zephyrhilis,FL 33542 ACCORDANCE WITH THE POLICY PROVISIONS. Fax-813-780-0021 AUTHORIZED REPRESENTATIVE —� — ---- Attention: ACORD 25(2009/09) The ACORD name and logo are registered ma�rks of ACORDCORD CORPORATION. Ali rights reserved.