Dbpr Hr 7022 Form PDF Details

Form DBPR HR 7022 is a document used to request an exemption from the Florida Prevailing Wage Law. This law requires workers on public construction projects be paid the prevailing wage, which is usually higher than the minimum wage. In some cases, it may be more advantageous for a business to use a lower-paid worker instead of paying the prevailing wage. Form DBPR HR 7022 can be used to request an exemption from the law for a specific project. The form must be completed and submitted to the Department of Business and Professional Regulation at least 10 days before work on the project begins. Exemptions are granted on a case-by-case basis, so it is important to provide as much information as possible in order to increase the chances of

QuestionAnswer
Form NameDbpr Hr 7022 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names61C-4, E-mail, 1940, 2011

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DBPR HR-7022 –Division of Hotels and Restaurants Commissary Notification

STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Division of Hotels and Restaurants

1940 North Monroe Street, Tallahassee, Florida 32399-1011

Phone: 850.487.1395 – E-mail: dhr.planreview@dbpr.state.fl.us

Internet: www.MyFloridaLicense.com/dbpr/hr/

For Office Use Only

Log

Number

File

Number

NOTE – This form must be submitted as part of an application packet.

Section 1– Mobile Food Dispensing Vehicle Information

 

 

Owner Name

 

 

 

 

 

 

 

 

Phone Number (include area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Name (DBA)

 

 

 

 

 

 

License Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 2 – Primary Commissary Information

 

 

 

 

 

 

 

 

 

 

 

Primary Commissary Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Commissary Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

Zip Code (+4 optional)

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Primary Phone Number (include area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Primary Commissary License Number (if available)

 

Primary E-Mail Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Licensed By

 

DBPR

 

Department of Agriculture & Consumer Services

 

Department of Health

 

None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water Supply

 

 

Municipal/Utility

 

Supplier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of Primary Commissary

On-site Well

 

 

Permit Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Municipal/Utility

 

Supplier Name

 

 

 

 

 

 

Wastewater Disposal

 

 

 

 

 

 

 

 

 

 

 

 

Septic Tank System

 

Permit Number

 

 

 

 

 

 

of Primary Commissary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Package Plant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I intend to conduct the following activities at my primary commissary:

 

 

 

 

 

 

Dish or equipment washing

Yes

 

No

Storing food (including ice or drinks)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

Dumping wastewater

 

Yes

 

No

Storing dry goods

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

Receiving potable water

 

Yes

 

No

Cooking and/or reheating food

Yes

No

 

 

 

 

 

 

 

 

 

 

 

Washing the outside of the vehicle

Yes

 

No

Other (Describe below)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 – Signature

I certify that I am empowered to execute this application as required by Section 559.79, Florida Statutes. I understand that my signature on this written declaration has the same legal effect as an oath or affirmation. Under penalties of perjury, I declare that I have read the foregoing application and the facts stated in it are true. I understand that falsification of any material information on this application may result in criminal penalty or administrative action, including a fine, suspension or revocation of the license. I understand that failure to complete the application or submit required documentation will delay processing or approval of plans and licensure.

Print Name

Signature

Date

 

 

 

Please list additional commissaries used on the next page. Use as many pages as needed. Check here commissaries are used.

if additional

2012 November 1

61C-4.0161, FAC

Page 1 of 2

DBPR HR-7022 –Division of Hotels and Restaurants Commissary Notification

Section 4 --- Additional Commissaries

Commissary Name

Commissary Address

 

City

 

 

 

 

 

 

 

Zip Code (+4 optional)

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone Number (include area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Commissary License Number (if available)

 

E-Mail Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Licensed By

 

DBPR

 

 

Department of Agriculture & Consumer Services

Department of Health

 

None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water Supply

 

 

 

Municipal/Utility

 

 

Supplier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of Commissary

 

 

 

On-site Well

 

 

 

Permit Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Municipal/Utility

 

 

Supplier Name

 

 

 

 

 

Wastewater Disposal

 

 

 

 

 

 

 

 

 

 

 

 

Septic Tank System

 

 

Permit Number

 

 

 

 

 

of Commissary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Package Plant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I intend to conduct the following activities at this commissary location:

 

 

 

 

 

Dish or equipment washing

Yes

 

 

No

 

Storing food (including ice or drinks)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dumping wastewater

 

Yes

 

 

No

 

Storing dry goods

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

Receiving potable water

 

Yes

 

 

No

 

Cooking and/or reheating food

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

Washing the outside of the vehicle

Yes

 

 

No

 

Other (Describe below)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Commissary Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Commissary Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

Zip Code (+4 optional)

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone Number (include area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Commissary License Number (if available)

 

E-Mail Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Licensed By

 

DBPR

 

Department of Agriculture & Consumer Services

Department of Health

 

None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water Supply

 

 

 

Municipal/Utility

 

 

Supplier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of Commissary

 

 

 

On-site Well

 

 

 

Permit Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Municipal/Utility

 

 

Supplier Name

 

 

 

 

 

Wastewater Disposal

 

 

 

 

 

 

 

 

 

 

 

 

Septic Tank System

 

 

Permit Number

 

 

 

 

 

of Commissary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Package Plant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I intend to conduct the following activities at this commissary location:

 

 

 

 

 

Dish or equipment washing

Yes

 

 

No

 

Storing food (including ice or drinks)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

Dumping wastewater

 

Yes

 

 

No

 

Storing dry goods

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

Receiving potable water

 

Yes

 

 

No

 

Cooking and/or reheating food

Yes

No

 

 

 

 

 

 

 

 

 

 

 

Washing the outside of the vehicle

Yes

 

 

No

 

Other (Describe below)

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2012 November 1

61C-4.0161, FAC

Page 2 of 2

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2. Soon after finishing the last section, head on to the next step and fill in the essential details in all these blank fields - Dish or equipment washing, Dumping wastewater, Receiving potable water, Washing the outside of the vehicle, Yes, Yes, Yes, Yes, No Storing food including ice or, No Storing dry goods, No Cooking andor reheating food, No Other Describe below, Yes, Yes, and Yes.

Filling in segment 2 in DBPR

3. Completing Section Additional Commissaries, Zip Code optional, County, EMail Address, Licensed By, DBPR, Department of Agriculture, Department of Health, None, Water Supply of Commissary, Wastewater Disposal of Commissary, MunicipalUtility, Supplier Name, Onsite Well, and Permit Number is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

DBPR completion process clarified (step 3)

4. The subsequent section will require your involvement in the following places: Receiving potable water, Washing the outside of the vehicle, Yes, Yes, No Cooking andor reheating food, No Other Describe below, Yes, Yes, Commissary Name Commissary Address, Zip Code optional, County, EMail Address, Licensed By, DBPR, and Department of Agriculture. Be sure that you type in all required information to move forward.

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November, Receiving potable water, and Page of inside DBPR

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