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HomeMy WebLinkAbout3101 Orlando Dr 92-1155 Kmart_Little Cesars Permit applicationqs- PLANS ROTPrIlVG SFACILITY: ` ADDRESS: 45 4 7- L PAR So Z' L'o /vT•T N1:3g PLAN R-ppRovAL CO==R:1'" L.4 . i r %Icy N PHONE: # +,, cwr R: -. rww. i .: I--T vc Cam-4 1 1 PHONE: Facility is subject to the following provisos and/or ccments) TYPE OF W-.A= SUPPLY: MUNICIPAL: 2 Sri WELL: See attached (?b be approved by Water Coordinator) TYPE OF SEiig.CE DISPOSAL: MUNICIPAL: C 1, Approval is re Seating Capacityi6c— Nu of N Tl' S meter Q A..—" r of Lad_e's water Fees= cm fiY, 2res indicat-od on CE]i S: r - 4L k avatories w- 1 ? be a=te uc to s=-. is . n Vest_cule rl'.r ifreSt_rCClil Gpe*s C—egtly Leto FCCd Serf Ce Area. T c lighted a -its are required. (50 or rrnre sects) . t/'++ If-clos7-a de rice r Quirerd on res=,=L and all exit doors . Res =CCmS must mee` handicap rey iiarm--=, (Eldg. DE_Jt.) L` Consi`'i t±GP_ Cn premises. ` Soap and towel dispensers required for all hzr:dsink locati ors . Building permit required frcm local aut_ority. Waste plumbing required for ice maciire, soda disre-r ise-r, refrigeation units, steam tabt(;: Lj' coffee urns o Iar e- =rnt which discharge into floor drains. gaps are r -Lined) All waste plumbing, water lines must be eff floor.oFt figs lN' z 5 q-ND LCZv{rn,F-% 0 Floor drains, if utilized mzlst be ccorst ct=d to facilitate effe-'tilve drai nine . Floor drains are prohibited in wa-lk-in cooler or freeze-r unless properly gap_ .) - Dishwashing machines met be indirectly connected waste toplumbing except within 10' ft. of trapped floor drain. y^ Grease interceptor - (applies to CEDS system only.) Size:_ Food- wz.ste grinder is prohibited frm dischasq + o T}grea interceptor. HRSSEMINOLECOUNTYPUBLIt; H A?T DA 3004 SOUTHGATE DRIVE SANFOR. D,. FLORIDA 32773 , f A 30 ~ s L ` 'j- TAPPROVED REVIEWED BY:. DISAPPROVED I • Q' Z REVIEWED! ) y CO M M Ei 1T i (j o.. D PRr .da, AREA - - - Install Employee hand wash s2.nk in dishwaskng area t/ '_Bquipaent should meet safety and performance req i rements covered in applicable standards -of Arrerican National Standards Fnstitute (ANSI), the National Fire Protection Association (NFPA), Underwriters Laboratories (UL), or the American Society of Mechanical Engineers (A&ME) . OR S=SSION OF E aX2 IMDIC_zMN CLaMPLIANCE WIT:i APPLICABLE STANDARDS. t/ Water Heater (hot waterregui red to a11 sinks excluding restrocros ) Callon size BTU's KW e_ Emloyee handwash sink required in each food prep area. hree co=a tmnt sink with drainboards at each end. Dishhwasher tvae (high t=ature dishwasher requires hood with exhaust fan). l 1 All em-lipirP.nt must be sealed toaet-he1 and to wall or adequate cleaning s, ace Provided betty n, under or behind e pme_nt . lam% Floor ,* ; it must be on six inch ( 6 ") legs. Heavy table equiprent must have 4 inch (4") legs or be sealed to the table. Exhaust hood with automatic fire suppression syst in over all cooking surfaces. 1 t1 St meet _SPA 96 or fire c9-nar `L r_- t reau=_ =Ti_r1tS .) G t"T' F`R D - pT. T.vS P t Tt o N 1}> .D PtrPRov JaILtorlal s=nk must be installed as not to Conta,e food Contact Sur=aces.e r r ,- o 1 idevice' n -Re.. < < "nd i--.Stallatlon ourside o= =oOC p_ er) are . aCC_ Lion, ,,, mcps to allow for te dryi ngi s r ui _ with s re location re 1—ater tS . J L,— FF1oorS u ' t he =—L= h and and easi-1v cleanable. T vpe unct ire van the floor and w l must have a rounded sa_T11ta17V -lc_._c Veb This applies to all areas except -a;-g r:azzm. - walls and ce l i ngsmast be cons t _ c =d as to i_-_s e cle bi1i tv . A LL s P L,* , ., c Tv - food must be six inches (6") off the floor in d,-y storage and in to wal {- in cooler or freezer. Y k-gin cooler or freezer should have rust -proof shelving. Raw w is prc- ted. storage area should be provided for e,mloyeepersonal belongings. This area should be away from food and food preparation area. 2Al1 light fixtures in food preparation area rmst be shielded divate lighting must be provided for clean-up pu_r-_ ses. Solid waste disposal must be adequate. A paved duster pad is recom nd_ed. Storage area must be adequate. Salad Far/Buffett must have sneeze guard. Custcuer access counters must have food shields if food product is dimlaved. oFF'r- of nEs r, PROGRai*+r - - lNot; f-yiiO_, L L_ r_-_ __ -t when construction is completed and certificate of occupancy is issued. All equipTent must be operative upon final inspection. Proposed menu submitted. Install cold running water ice cream dipper.well if menu includes serving bulk ice cream. z:. Other: LICENSE REQUTRE= : _ FCCD S'VICE 1) State License (Division of Hotels and Restaurants. Will not be issued Without Health Departne_nt approval). 2) Cc=ational License. FOOD CUT —LETS 1) State License (Depa-nt of Prrric,Lture ) 2) Ccctmational License. FCCD PR=-SSORS 1) State L. ca"se (DeOa_Ttent Of pCriCLt1Le) . 2) Ccctmational License . TABLE V PLACES SERVING FOOD AND/OR DRINK MALES FEMALES , No. of Water Lava- No. of Water Lava - Males Closets. Urinals torics Females Closets torics 1-40 1 1 1 1-40 1 3 -. - 41-90 2 : 1 •1 ' 41-90 2 . 1. l 91-150 2< 2 _'2 1-150 3' • 2 151-225 © (2 2 151-225 4 2 226-300 3 3 3 226-300 5 3 301-400 4 3 3 301-400 6 3 Where the number exceeds four hundred (400) Where the number exceeds four hundred (400) there shall be provided one (1) water closet or here shall be provided one (1) water closet and one (1) urinal and one (1) lavatory for each one (1) lavatory for each one -hundred one -hundred Twenty-five (125) males. twenty-five (125) females. 1. See Footnote No. 10 for counter or bar Urinals: Sec Footnote No. 3. space. 2. Curb service to be based on a minimum 4. The number of water closets, urinals, i. of one person per 100 sq. ft. of parking area. and lavatories shall be based on the seating 3. Public food service establishments that rapacity of the establishment. If no seating offer only takeout service will be required to arrangement is shown, see Footnote No. 10. provide only one toilet for use by employees 5. Unless separate facilities art provided and guests under the following conditions: for employees, the number of employees shall a. The number of employees and patrons be included in the maximum number expected ' does not exceed nine expected to be present at at one time. If separate facilities arc provided one time. for employees, the number of facilities shall be b. The estabIishmcnt dots not allow in accordance with Table III Places of consumption of food on the Iicensed premises Employment. or provide equipment such as table, chairs, See Footnote Nos.12 &._13,)___ benches, counters, etc as a convenience for patrons to consume food on the licensed premises. a STATE OF FLORIDA SEMINOLE COUNTY i PUBLIC HEALTH UNIT_. DEPARTMENT OF HEALTH AND ENVIRONMENTAL HEALTH SE&IC 146 3004 Southgate Drive REHABILITATIVE SERVICES Sanford, Florida 32773-5407 JORGE DEJU, MID., M.P.H. 407-321-5479 DIRECTOR AND HEALTH OFFICER SUNCOM 355-2605 TO WHOM IT MAY CONCERN After obtaining Certificate of Occupancy from Building Department, contact the Office of Restaurant Programs for Food Service License approval. Then contact the Division of Hotels and Restaurants to obtain Department of Business Regulation (DBR) license. office of Restaurant Programs telephone (407) 321-5479 Inspectors Bill Wilson extension--2618 Efren Vazquez extension--2618 Division of Hotels and Restaurants telephone (407) 423-6985 423-6986 423-6987 Dept. of Business Regulation Div. of Hotels & Restaurants 400 W. Robinson St. Suite 509 North Tower Orlando, Florida 32801 Have Certificate of Occupancy before seeking opening inspection. Obtain Manager Certification. (For information r-aarding this requirement call office listed below.) HRS SE-KNOLE COUNTY PUBLIC HEALTH UNIT c OUTHGATE DRIVE FLC-RIDA 32773OR.D APPROVED DISAPPROVED REVIEWED? CuMMENTS: REVIEWED BY: ORLANDO Royal Oak Village Sboppin2 Co-nte: NW Comer of Holland Exp and Hwy 4=6 234 S. Semoran Blvd. Dates: Every Monday througb Friday Times: 9:00/ 11:00/ 1:00/3:00 407) 823-9816 LAWTON CHILES, GOVERNOR DR 22-024 1 Re Jj91h a L.AIVON CHILES, GOVERNOR r RETUR1i TO: STATE OF FLORIDA DEPARTMENT OF BUSINESS REGULATION DIVISION OF MOTELS AND RESTAURANTS SEE REVERSE SIDE FOR CORRECT MAILING ADDRESS APPLICATION R LICENSE DO NOT WRITE IN THIS SPACE CONTROL NUMBER COUNTY-1 FILE NUMBER This application must be filed with the Division of Hotels and Restaurants pursuant to Section 559.79 F.S. A copy of this law is on the reverse side' of this application. Based on this law you must supply the division with the following information and pay the required licensed fee prior to the commencement of operation. Chapter 509.241(1) F.S., states, in part. "It shall be a misdemeanor of the second degree, punishable as provided in §775.082 and §775.083, to operate without a license." Read carefully and provide the following information... NOTE: This application will be returned if it does not bear an authorized signature or is incomplete. I. NAME OF OWNER CORPORATION OR INDIVIDUAL): INDICATE NAME OF PRESIDENT, IF CORPORATION: 2. NAME OF BUSINESS 3. Establishment Location Address: COUNTY 4. BUSINESS PHONE: AREA 5. Federal Employers ID Number 6. Sales tax # 7. Alcoholic Beverage License: indicate type and number CITY HOME PHONE: AREA Social Security # — 8. INDICATE Designated mailing address if different from that included on line 3. MAILING NAME MAILING ADDRESS MAILING CITY STATE ZIP — Please check if exempt) ZIP 9. CHECK ONE (a) SOLE PROPRIETOR (b) PARTNERSHIP (c) CORPORATION (d) OTHER 10. CHECK ONE (a) NEW BUSINESS (b) CHANGE OF OWNER (c) RENEWAL PURPOSE 11. OPENING DATE or date of change of ownership 12. Indicate names, addresses and phone numbers of each person who owns ten, percent or more of the outstanding stocks or equity interest. Middle Last Name First Name Initial Home Address Do Not Use P.O. Box Phone Number City, State. Zip 13. (a) Has any person interested in the operation of this establishment whether owner, operator, agent, lessee, or manager been convicted within the last five years in this state or any.other state of the United States of soliciting for prostitution, pandering, letting premises for prostitution, keeping a disorderly place, illegally dealing in narcotics, gambling, or any other crime reflecting on professional character? Yes No b) Have you been convicted of any felony within the past 10 years? Yes No 14. Do you hold or have you held within the last 5 years a license from HRS for an adult congregate living facility at this address? This application must be signed under oath or affirmation by the applicant or owner"oFchief executive of the application, without the need for witnesses. If a corporation is in the hands of a "receiver or trustee, this application shall be executed on behalf of the corporation by the hands of a receiver or trustee. I certify that 1 am empowered to execute this application as required by Section 559.79 F.S. I further certify that I understand that my signature on this application should have the same legal effect as if made under oath. r wr ncc nTltATr TIIC 11rrMQFTI PRFMICF l V ! L. 1 LLAJL IwLLI \.V l\!\Ll• ALL •aa va a.a. PRINT NAME OF APPLICANT ay.. .. . . ...—.- TITLE DATE SIGNATURE OF APPLICANT MO DAY YR k- s. J ITEMS NECESSARY FOR ISSU ,i CE OF LICENSE PRIOR TO OPENING: x t I. Approved Inspection Form: a) Lodging - Approved Inspection Form required from the Division of Hotel and Restaurants. (New Accounts Only) b) Food Service Associated with Lodging - Approved Inspection Form required from Division of Hotels and Restauraws Inspector. c) Food Service not associated with Lodging - Approved Inspection Form required from Health and Rehabilitative Services Office of Restaurant Inspector. 2. Beverage License (if applicable) - Send Approved Inspection form with application to Division of Alcoholic Beverages and Tobacco. 3. Florida Sales Tax Number or proof of exemption. 4. Federal Employers ID Number (if applicable). 5. Appropriate License Fee (check made out to Division of Hotels and Restaurants - ask inspector for correct amount). 6. Complete with all preceding forms and information and send to the appropriate District office. DISTRICT I _ Athens Building 8405 N.W. 53 Street, C-240 Miami, Florida 33166-4544 PHONE (305) 470-5680 SUNCOM 429-5680 23 - Dade 54 - Monroe DISTRICT 11 Robert Hayes Gore Building 201 W. Broward Blvd. Suite 104 Ft. Lauderdale, FL 33301-1846 PHONE (305) 467-4448 . SUNCOM 453-4448 16 - Broward 18 - Charlotte 21 - Collier 32 - Glades 36 - Hendry 46 - Lee 53 - Martin 60 - Palm Beach DIVISION OF HOTELS AND RESTAURANTS DISTRICT III Park Trammel Building 1313 Tampa Street, Room 106 Tampa, Florida 33602-3329 PHONE (813) 272-2200 SUNCOM 571-2200 19 - Citrus 24 - Desoto 35 - Hardee 37 - Hernando DISTRICT IV 400 W. Robinson Street North Tower, Suite 509 Orlando, FL 32801 PHONE (407) 423-6985 SUNCOM 344-6985 15 - Brevard 38 - Highlands 41 - Indian River 45 - Lake 57 - Okeechobee 58 - Orange Must be completed at time of inspection. 39 - Hillsborough 51 - Manatee 61 - Pasco 62 - Pinellas 68 - Sarasota 59 - Osceola 63 - Polk 66 - St. Lucie 69 - Seminole 70 - Sumter 74 - Volusia OFFICE USE ONLY DISTRICT V 1127 Arington Road Jacksonville, FL 32211-5812 PHONE (904) 727.5540 SUNCOM 841-5540 11 - Alachua 12 - Baker 14 - Bradford 20 - Clay 22 - Columbia 25 - Dixie 26 - Duval 28 - Hagler 31 - Gilchrist 34 - Hamilton 44 - Lafayette 48 - Levy 52 - Marion 55 - Nassau 64 - Putnam 65 - St. Johns 71 - Suwannee 73 - Union DISTRICT V1 No. 5 Miracle Strip Loop Suite 4 and 5 Emerald Coast Professional Center Panama City Beach, Florida 32407-3850 PHONE (904) 235.31701 SUNCOM 771-2000 13-Bay I67 = Calhoun 27 - Escambia 29 - Franklin 30 - Gadsden 33 - Gulf 40 - Holmes 42 - Jackson 43 - Jefferson 47 • Leon 49 - Liberty 50 - Madison 56 - Okaloosa 67 - Santa Rosa 72 - Taylor 75 - W akulla 76 - Walton 77 - Washington Classification: Apt Hotel Motel zooming House i ransient r%pt Condo: Group Collective Individual Food Service: Seating Non Seating Food Service Identification: Associated with Lodging - Free Standing - Grocery Store - - Fast Food Temp: 4-18 days 6 mos I yr Classifications: CAT COM TPK VEN ORT ITL MEX HIS GRK SEA AMR CAF THE - OTH Number of Units (lodging) or seats (food service) - -- MFDV/Theme Park Food Cart Information Commissary name Commissary telephone # Commissary Control Number ------ ---.- Commissary address _ _.... MFDV Vehicle Identification Number Vehicle License tag number --- -- License fee amount Inspector Name - PRINT) SECTION 559.79 FLORIDA STATUTES Section 1. Each application for a license issued by the IUcpartment of Business Regulation shall include a statement showing the name and address of each person who owns tcn percent or more of the outstanding stock or equity interest in the licensed activity and the name and address of each officer, director, chief executive or other persori who, in accordance with the rules of the issuing agency, is determined to be able directly or indirectly to control the operation of the business of the licensed entity: and cacti application for renewal of such a license shall set out any changes in the required names and addresses which have occurred since the license was issued or last renewed. Section 2. Each application for a license or renewal of a license issued by the Department of Business Regulation shall be signed under oath or affirmation by the applicant or owner or chief executive of the application, without the need for witnesses unless otherwise required by law. SECTION 559.791 FLORIDA STATUTES Any license issued by the Department of Business Regulation which is issued or renewed in response to an application upon which the person signing under oath or affirmation has falsely sworn to a material statement, including but not limited to, the names and addresses of the owners or managers of the licensee or applicant, shall be subject to denial of the application or suspension or revocation of the license and the person falsely swearing shall be subject to any other penalties provided by law.