HomeMy WebLinkAbout14-15311 . CI OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 1 1
COMM EXH UST HOOD/DUCT PERMIT
� PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15311/15325 Address: 7331 GALL BLVD
Permit Type: FIRE COMM EXH HOOD/D CT ZEPHYRHILLS, FL.
i Class of Work: FIRE-HOOD SUPPRESSIO SYS Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 34-25-21-0000-00300-0020
Improv. Cost: 20,076.00 OWNER INFORMATION '
I� Date Issued: 6/10/2014 Name: MERCHANTS STATION c/o PHILLIPS
Total Fees: 130.00 Address: 7331 GALL BLVD
Amount Paid: 130.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/10/2014 Phone:
Work Desc: INSTALLATION HOOD SYS EM- BREAKFAST STATION
CONTRACTOR S APPLICATION FEES
HOOD DEPOT INTERNATIO AL INC FIRE PERMIT F ES 50.00 FIRE PLAN REVIEW FEES 50.00
FIRE INSPECTI N FEES 30.00
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Ins ections Re uired
FIRE LIGHT TEST-Final
s
Chapter 633, Florida Statutes,authorizes th City to charge and collect user fees to pay for the costs of fire
prevention and protection related activities ch as inspections, plan review, administrative fees,and other
costs rel ted to the aforementioned.
Complete Plans, Specifications and Fee Must Acco pany Application. Commencement of work without written approval of
the Fire Department's Fire Marshal or required p rmits or opening up for commercial activity without an approved final
inspection shall be charged double permit fee pe day of operation or a minimum of$100.00, whichever is greater. All
work shall be performed i accordance with City Codes and Ordinances.
"WARNING TO OWNER: Y UR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY ESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR ROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH OUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOU NOTICE OF COMMENCEMENT."
- ��' 1 �. � � ��;i
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CONTRA OR SIGNATURE PERMIT OFFICER
PERMIT EXPIRES IN 6 M NTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPE TION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS F RE RESCUE DEPT- 813-780-0041
1-
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e�saeo-oozo City o Zephyrhills Permit Appli on nFax-813-780-0021 ��D Q.
Building Department/}����j�,� �/J����T / Q
/// L�il t� l�'/ /
Date Received �
Pho e ContactforPermitting
Owners Name e rCi i7�� J� � �� Owner Phone Number
Owners Address ��Q� �(f/� /�it � "• �� Owner Phane Number
Fee Simple Titleholder Name Owner Phone Number
t
Fee Simpie Titleholder Address
JOBADDRESS �J� � I( IVC� LOT# �
SUBDIVISION PARCEL ID �jJ ^� �-��Qd��Q�j DU�0� � ���v0/-0i� ��a
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW coNSTR B ADD/ALT 0 SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK 1��T��� �O�JC � S t�/LL.
BUILDING SI2E SQ FOOT GE� HEIGHT �
�BUILDING $ ALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ MP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
ECHANICAL $/1 �n/ VALUATION OF MECHANICAL INSTALLATION
l/f �!E�
� QGAS 0 ROOFING SPECIALTY 0 OTHER
� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
�
�a 1 BUILDER COMPANY
� SIGNATURE REGISTERED Y/ N FEECURRE� Y!N
q�
\ Address License#
\
ELECTRICIAN COM PANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL«- COMPANY D(x- d
SIGNATURE��'---�'" REGISTERE� Y/ N FEE CURRE� Y/N
Address � Q�. � � �v./Q� � License# (,���1�l���.�
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after sub ittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanilary Facilities&1 dumpster,Site Wo Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets of Building Plan plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after sub ittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster Site Wo Permit for all new projecls.All commercial requirements must meet compiiance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all EW construction.
Directions:
Fill out application completely
Owner 8 Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is require . (A/C upgrades over$7500)
" Agent(for the contractor)or Power of Attomey(for the o ner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Applica ion Only)
Reroofs if shingles Sewers Service Upgrades A/ Fences(PlotlSurvey/Footage)
Driveways-Not over Counter if on public roadways..nee s ROW
ti
Fd0710E OF DEED RESTRICT OIdS: The undersigned understands that lhis permit may be subject to"deed"restrictions"
which may be more restrictive han County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UfdLICEMSED COfdTR,9CT0 S �4i�D COPdTRi4C'TOFt RESPOR151�ILIYIES: If the owner has hired a contractor or
contractors to undertake work, hey may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as r quired by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner r intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advise to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the ow er has hired a conlractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Blo k"of this application for which lhey will be responsible. If you, as the owner sign as the
contractor, that may be an indi ation that he is not properly licensed and is not entitled to pe�mitting privileges in Pasco
County.
TRAMSPOR7ATION IAflP/ACYI TILtYIES IflflPAC7 AfUD RESOURCE FtECOVEitY FEES: The undersigned understands
that Transportation Impact Fee and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or ex ansion of existing buildings, as spec�ed in Pasco County Ordinance number 89-07 and
90-07, as amended. The und rsigned also understands, that such fees, as may be due,will be identified at the time of
permitting. it is further unders ood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a°certificate of occu ancy"or flnal power release. If the project does not involve a certificate of occupancy or
final power release, the fees ust be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be pai prior to permit issuance in accordance with applicable Pasco County ordinances.
COMSTRUCTIOfV LIEId LA1�1( hapQer 713, Florida Statutes,as amended): If valuation of work is$2,500.00 or more, I
certify lhat I, the applicant, h ve 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 ommencement.
COYdTRACTOR'SIOlAlWER'S FFIDANIT. I certify that all the information in this application is accurate and that all work
will be done in compliance wit all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a per it 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 th regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify wh t actions I must take to be in compliance. Such agencies include but are not limited to•
- Department of En ironmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WaterMlas ewater Treatment.
- Southwest Florid Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
' - Army Corps of En neers-Seawalls,Docks,Navigable Waterways.
- Department of He Ith � Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental rotection Agency-Asbestos abatement.
- Federal Aviation A thority-Runways.
I understand lhat the tollowing estrictions apply to the use of fill:�
- Use of fill is not all wed in Flood Zone"V"unless expressly permitted.
- If the Till material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a I
"compensating vol me"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the Sta e of Florida.
- If the fill material i to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certi that fill will be used only to fill the area within the stem wall.
- If fill material is t be used in any area, I certify that use of such fill will not adversely affect adjacent ,
prope�ties. If use f fill is found to adversely affect adjacent properties, the owner may be cited for violating ,
' the conditions of t e building permit issued under the attached permit application, for lots less than one(1) ,
acre which are ele ated by fill,an engineered drainage plan is required.
If I am the�1GEPdT FOR TF9E dHWER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commenci g construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, ir conditioning, gas, or other instailations not specifically included in the application. A
permit issued shall be constru d to be a license to proceed with the work and not as authority to violate,cancel,alter, or
set aside any provisions of the echnical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors n plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by uch permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or aba doned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,f om the Building Official for a period not to exceed ninety(90)days and will demonstrale
justifiable cause for the extensi n. If work ceases for ninety(90)consecutive days,the Job is considered abandoned.
WdRAlIP1G TO OWIf�ER: YO R FAILl9RE TO RECORD A MOTICE OF COBAMEMCENVEMT AflAY RESUL7 Ild YOUR
PAYIRIC TWIICE FOR IVWPRO EfIfIE�IYS TO YOUR PRO�ERN. IF YOU IVdTEND TO OBTAIM FIPlAtdCIMG,CORISULT
WlITH VOUR LEPlDER OR AM TYORPlEY BEFORE f2ECORDIPIG YOUR ICE OF CO ER10EnAER1T.
FLORIDA JURAT(F.S.117.03j .
OWNER OR AGEfdT CONTRACTOR n
Subscribed and sworn to(or affirmed) e(ore me this Subscribed and o r affirmed)b ore is
by by ii 4 Gb
Who is/are personally known to me or aslhave produced Who Is/are personally known to me or haslhave produced
as Id nlfficaUon. as Identlficadon.
Notary Public Notary Public
��,�",,,,- JACQUELI BCGES
Commission No. Co m sio �•
_; ;FE� mmiss on "n40520
Name of Nolary typed,printed or slam ed Name of N tar� � intg�g��r�g ����seranceB0a385-7013
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•710 S Powerline Road #H • Deerfield Beach • FL • 33442 • (954) 570-9860 • Fax:
(954) 570-9865
Breakfast Station #6
7331 Gall Blvd
Zephyrhills, FL 33541
IN-3288
� �
I To Whom It May Concern,
c
Below please find the cost f r the above job:
The cost for the Hood install tion including Material and Labor - $20076.00
The cost for installing the Fi e Suppression including Material & Labor - $ 1500.00
Total Cost of job $21576.00
If you have any questions pl ase feel free to contact Lori at 800-322-8730.
Thanks,
� �
����"�
Michael Lubowicki 7ack Kanter
Owner Owner
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with:;stainless,;ste�l'.'baffl.e=;f�lte�s_;:inc ;n�descent>lights,-:fiall:length�make=up a�i�plen�.; �
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; l Aiisul'3�1�U�:3gallori:Fire�Stipressiou witli f.efii.#aooltup �
Ansu1�R1,Q2:3`gallon fire:;sappressi'o,. �system�w�tli:.fel'ti:.kinoktip: Incltides enlii�e�uistallatiion...and
pei�riiifs Exclusions IT.mon lalioi an ;gas�valves oVer z". :Coriti�ental U��.Qtily: �
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Constnietecl'�of 20�;a.polishe�l stainl� :s steEl.. Cut to.size,.vuith.=moldipgs�1ud`trcrii�uicl"ud'e.d;.
Qu�nity-= tatal-square feet o1':u�e�i to:be.covercei:
E�li�tust�.CF1V[`-0, 1VI�tJ:�1: CRiV1-_0
Cont....
16TD��5't'1 ee��.;f31��d:,Ht�ilsortf L^T 3�h67
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' AYI��EX1�aust:and:iSupply�DueCi�uorlt;:lia ed_on 1�.6'�:single:stbry,ro:o'f
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FLORlDp'S,tIEARQUAitTEFPS FOR COlYIMER�11t1 K! .�-H�ti`
- '-- - VENTILATIOH'SYSTE�S"�•� . .. .,
AUTHORI TION FORM
Qualifiers Affidavit
� KNOW ALL MEN that I Michael ubowicki do hereby constitute
�
� and appoint Phil Reyes Roger Beckham (,r�Ge, �ev'►�r�
� Russell Koss Greg Brodmerkel �c.�� (3�-�}. a�'vn�a
�
� my true and lawful attorney-in-fact fo unlimited permit use from the City of Zephyrhills.
1�
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Sign ture of Qualifier
1/'�
State of Florida, County of ' �- �
Sworn to a ' d before me th s� day of��, 20 ( �f , by ��'�k�l ����-�c�,�
Who is rsonally know o me or has produced as identification.
�����dai'D AS y�►����,�r�r
Si ature, Notary Public — State of Flo ida �\�.��Ro,,,,,, >`,
�'���90N EXP/F�. s.
r ev:��5���9�Zp�s' �'��`.f,..
�,ui� � I�`��'"� y �U� � :O.
Printed, Typed, or Stamped Name of otary (�e��� o'�� m�°�
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�EP�F��'R�[LL. �F[RE t3EF��E��'!��[�T
6907 Dairy Ro d,Zephyrhills, FL 33542
� FIRE S�R ICE USER�FEES
Occupancy No.: (}a � .
I Plan No.: . Contractor:
Business Name: Billing Address:
Business Addcess:
� Business Phone No.: Billing Phone No.:
, Business Fax No.: Billing Fax Na.: �
Contact: � Contact:
� PLAN REVIEW FEES • INSPEGTION°F ES PERMIT FEE FALSE ALARM FEE
�Site Plan 1�UC Mnual ' C Sprinkler S50 1st Alarm WC
Multi-Fami(y/Commercial .06 sf 1st Re-inspection C Standpipes S50 2nd Alarm N/C
(Minimum Charc,�e$25.00 2nd Re-inspection � 00 Fire Pump S50 �3nd Alartn N/C
��Plan Revisions DBL 3rd Re-inspection .a 50 Hoods S50 4th Afarm �100
dth Re-Inspect3on � 00 f.ire Alarm �50 � 5th Alann ��5p
SPRINKL£R SYSTEMS (Business dosed untii � LP Gas S50 6th Alartn $2pU
a0-25 Heads �50 violaUons coReded) Natural�Gas $50 NoN co�wwce $150
26 plus Heads a100 SPRINKLER SYSTEM Fue!Tanks- Permna $50
STANDPIPE SYSTEM Hydro Urtdergrounds 45 Spa�iclers 5100
�Per Rise� $50 Hydrostatic Test 65 Persynem Fire Wo�1cs 5500
FIRE PUMP Aa:eptance Test 5 Aer sys�em Camp Fire �25�
� Pe�Pump $100 . Hydrant Flow 75 Controlled Bum 5100
FIRE ALARM SYSTEM HoodlDuct �50 ,
�0-25 Oevices �50 FIRE•ALARM S1�STE Place of Assembly $50 �m,ua�
26 plus Devices �100 System�Acceptance 50 Flre Protedio� �25
SUPPRESSION SYSTEMS 8 Recail Acceptance 50 Ftammable Appiicatton �50 �nnua� '
.
Wet S50 OTHER INaste Tire Storage �50 �nnuat
Dry �50 Flre WalUSmoke Watl 15 perwall Generator<I(W �100
CO2 �50 LP Gas 25 per�k Generator>30 KW 150
Other �$50 NaturAt Gas 25 per system Bio-liazarcl Waste $100 Mnua1
KITCHEN DCHA�JST Fumlgation Tenting $50
�HoodlDuc:ts �50 Tent 105c10'or greater 15 per tent Torch PoUApplied a50
OTHER Fire Pump . Hai.Matecials 5100 nnnuat
�LP kutallatlon perlank $50 F(re Suppression 30
Fuel Tank IashallaUon a50 System Acceptance , �
{Per Tank) �50 E�aust HoodlDud 30
�NawralGas Installation �50 �Re-inspection BL
(Per System) (other than annuat)
�Spray Booth �50 a Inspection scheduled BL e
and cancelled less than
24 hours
Construction Insp. C
�. Emergency Vehicle A� 50 FALSH ALARM
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