HomeMy WebLinkAbout18-19384 CITY OF ZEPHYRHILLS
. ..- :,, 5335-8TH STREET
s y � ' - (813)780-0020 19384
FIRE STANDPIPES PERMIT
' PERMIT INFORMATION LOCATION�INFORMATION I
I Permit Number: 19384 Address: 7350 DAIRY RD
Permit Type: FIRE HOOD SUPPRESSION SYS ZEPHYRHILLS, FL.
Class of Work: FIRE-HOOD SUPPRESSION SYS Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35-25-21-0010-06900-0020
Improv. Cost: 500.00 OWNER INFORMATION
Date Issued: 3/01/2018 Name: ADVENTIST HEALTH SYSTEM
Total Fees: 160.00 Address: 7050 GALL BLVD
Amount Paid: 160.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/01/2018 Phone: (407)975-3000
Work Desc: REPAIR/REPLACE SUPPRESSION SYSTEM
CONTRACTOR S APPLICATION FEES
A LINE FIRE&SAFETY N FIRE SUPPRESSION 50.00 FIRE PLAN REVIEW FEES 50.00
FIRE INSPECTION FEES 30.00 CONTRACTOR CERTIFICATE 30.00
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Ins ctions Re uired '
FIRE BALLOON TEST-Final
� 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
COMMENCEMENT 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
� CORDING YOUR NOTICE OF COMME MENT "
I �
CONTRACTOR SIGNATURE PERMIT OFFIC
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
. . , y . ; ,���I:N E
^ ,�� - - - - Office: 352-728-1440
, �. . _.._
� Fax: 352-728-8332
Fi rE �r SafEt=y.;� �Nc:_
www.alinefire.com
2U01 °South;St: � Leesburg; Fiorida:.34748,
PERMIT AUTHORIZATION LETTER
� 1,� i
I hereby authorize ���e,c � r�r.�b�c`�cj
to pick up permits and sign any documents relnted to:
� All Permits
❑ Address/Parcel #
❑ Permit #:
�a-'1� ��- � ��je5�'— -
Print Name: Signature:
License#: FED11-000016
The foregoing authorization letter was acknowledge before me this 2�J day of
� , 20�by�b�Xf l�/ �D 1vPX5C�G
❑ Who is personally known to me
❑ Who has produced identification
Notary Public Signature: �.1��.�i��i���.�i��'��
My Commission Expires: M�� 2�, 1-1/�
..���:.,.,.
�•4�► MELfSSAA�.MERCER
��,,....,.
�;�;.'� M1'COAAMISSION t�GG 107558
'z's '�� EXP�RES:May 23�202�
�ei �;;•'
'�•������� O:W�64 T1MU NOFdry'tIW{C UfldE11M1�li
"Sales,Service and Installation"
FIRE EXTINGUISHERS/FIREALARMS/EMERGENCYEXIT LIGHTS&FLOOD LAMPS/
CABINETS/PRE-ENGINERED FIRE SYSTEMS/VEHICLE SYSTEMS/CLEAN AGENT SYSTEMS/
813-780-0020 , , _ , City of Zephyrhills Fire / Fax-813-780-0021
' ' ' Permit Application J l�p— S�jZ�
Date Received J 1� i Phone Contact for Permit 35� -� / `7
___._____...._._.._.....�_._..__.�_._.......___.__...._...__._..._..._._._.___..�.
_ ..._ . ____...._._�.__ ..._���..._ _.�_. _.... ____._,._.._ _.._.._..._.._._._._,._.__a,.,_ ._.,�.__
Owner's Name � , _ �� �lf � � ^ ��L.• Owner's Phone Number � � �
Owner's Address �. , i' �E� _ {�'\�i,, L' � �j �' `� (� � f
Fee Simple Titleholder Name Titleholder Phone Number �� � �
I Fee Simple Titleholder Address � � II
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, JobAddressT{ N�_�._�. �� �,a i ��.• ��� �Lot# Y�
Sub Division Parcel#
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� Bio-Haz Storage-ANNUAL � Fumigation Tent
omm Exhaust Kitchen Hood/Duc � Hazardous Material(Tier II or RQ Facility)ANNUAL
ontrolled Burn � Hood Installation
� Emergency Generator<30 kw � LPlNatural Gas-Installatior
� Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
� Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
Qtr Semi An Other
Sprinkler � ❑ ❑ ❑ � � Recreational Burn
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
� Standpipes(Sprinkler Sys) � V I ���
� Fire Alarm Installation � Torch RoofinglTar Kettle
� Fire Pumps � Waste Tire Storage ANNUAL
� Flammable Application-ANNUAL Valuation of Project
� Fuel Tanks
Q Other:
��:.,..�....�.�..�,..� ....�_ _„_. . __._..,_.._ ._._��._ ____�_._ .�. ._.___._.�..� ..._..�_.. .____�._..._ _._. - __ �..�_._:_.�
i Contractor Company � ���
.r -
Signature 1 �� - Registered Y/N Fee Current Y/N
I Address License#
ELECTRICIAN Company
Signature Registered Y/N Fee Current Y/N
Address License#
PLUMBER Company
Signature " Registered Y/f� Fee Current Y/N
Address License#
MECHANICAL Company
Signature Registered Y/N Fee Current Y/N
Address License#
OTHER Company
Signature Registered Y/N Fee Current Y/N
Address License#
.. _..._._. . _ ._.�_ .___..__..__ __.---.__._�_. __...._._ .._ _.._._.._._.,,_.. _._�.�_�.____ ..:�__ _ ,
Directions: __ _ _. __.. ._._.._ .___. _...__ .._. . ...__.
Fill out application completely
Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner)
If over$2500,a Notice of Commencement is required(Mechanical work over$5000;
Supply two(2)sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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' NOTPCE OF DEED R�STRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
whiCh may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have 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 commencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
that all work will be done in compliance with all applicable laws regulating construction, zoning and land
development. Application is hereby made to obtain a permit 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 the regulations of other
government agencies may apply to the intended work, and that it is my responsibility to identify what actions I
must take to be in compliance.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING TO OW . RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEN TO OBTAIN FI ANCING, CONSULT
W TH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR E OF COMM EMENT.
FLORIDA JURAT(F.S. 117.03)
OWNER OR AGENT CONTRACTOR `— - C���'
Subscribed and sworn to(or a�rmed)before me this Subs�c,�ribe-d,�d swor�t,o��,o,�r a,ffi,�rm�d��b ore e this
bY -�,Z�bY I�v{J����Q��OX
Who is/are personally known to me or has/have produced Who is/are personall known to me or haslhave produced
as identification. Nt as identification.
Notary Public r� ►�• W Notary Public
Commission No. Commissian No. R�,t �D���
M�•l tssa M. Mer�et-
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
�1•���1 �1G.N�7��.�Kf�VGR
.s Y� A�IY COMMISSWti�GG 1O755E
x EXPIRES:M�y 23,2021 I
''ti:P,;.4` BaMed TT�ru Nahary Pubie thi6en�liMs I
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I 7350 Dairy Rd. °�� � -�
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7epr.yrhills, Fl. �354U I1 S ALL�D �}�_ �; �`� r � �� '�
I Ph: 813-760-2875 0 0 0 �� _ "�
� Contact: Lance Wooles -� 4 'x � �'
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i 4 Bumer Range I � �'� � � �
30 e 36 in.� �Q
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F'.re Contractor:
ti-;_,ine Fire and Safety, Inc.
� 2001 South St.
j Leesburg, Fl. 34748
� (352) 728-�440 Notes: This is a residential(4)burner electric stove used in NON-conunercial cooking operations
Protected by Ansul UL 300 chemical
Fla, St. ::ic#:7500490002.�006 * Class K extinguisher and placard will be installed within 30 ft, of hazard per NFPA 10
i — * .� Denotes electronic temp. sensors set at 190 def. F
I Qa�ali�er. * System will be tied into central fire alann.
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�_ Robert W _Rc;<.����_
f - :r'=�a��rr hy: Robcr�t .W. Bower.S'ox ` r—BRAND,OF.S.YSTEM IS :Pre-engineered Accueex.XRRS
a Pipe: ��ainless braided bose.
� ' e Electrical done'by others.
� lo Above done in aceordance to Manufaczarers Specifications,and allloeal codes
' ' i ar.d standards.
� ' I• Appi6ances are electric operated.
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� Fp�� F��ady Hood
ENGINEERED RESTAURANT SYSTEMS
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`;Please read ancl';save;the�e:instructions-for futiire.refer.ence:;Re�d carefully. befor.e-attemptirig to assemble„i�nstall,`,
,�;oper.ate.or�rriamtain,the product.described Pratect,}�o,urself anel.;others by oki`ser�ting ail.safety information .Failure -
�;tp:corriply'vuith-,instructioi�s;could''result:iri:perso�al:injury anclloc`property:dariiage!"',�`.,n.:=: °" � r�-•. - "=° - � _-
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To reduce the risk of fire, electric shock, or injury To reduce the risk of range top grease fire:
to persons, of�serve the following: • Never leave surface units unattended at high
o Use this unit only in the manner intended by the settings. Boilovers cause srnoking and greasy
tnanufacturer. spillovers that may ignite. Heat oils slowly on low or
� Before servicing or cleaning unit, switch power off medium settings.
at service panel and lock the service disconnecting @ Always turn hood �N when cooking at high heat or
means to prevent power from being switched on when cooking flaming foods. '
accidentally. When the service disconnecting means • Clean ventilation fans freq�.�en�ly. Grease should not
cannot be locked, securely fasten a prominen± be allowed to accumulate on fan or filter.
warning device, such as a tag,to the service panel. e Use proper pan size. Always use cookware
m Installation work and electrical wiring must bE appropriate for the size of:he surface elc-r�i��r�t.
done by �qualifi�d person(s) in accordance�viti� �tll
applicable codes and standards, including fire rated 7'o reduce the risk of injury to persons in the event
construction codes and standards. of a range top grease fire, observ�t�ne fc�fiowong:*
• Sufficient air is needed for proper combustio� ° SMOTHER FLAMES with a close-fitting lid, cookie
and exhausting of gases through the fiue sheet, or metal tray,then turn off the burner. BE
(chimney) of fuel burning equipment fio prevent CAREFUL TO PREVENT BURNS. If the flames do
backdrafting. Follow the heating equipment not go out immediately, EVACUATE ANQ CALL THE
manufacturer's guideline and safety standards such FIRE DEPARTMENT. ` "
as those published by the National Fire Protection • NEVER PICK UP A FLAMING PAN. You may be
Association (NFPA), and the American Society burned.
of Heating, Refrigeration and Air Conditioning • DO NOT USE WATER, including wet dishcloths or
Engineers (ASHRAE), and the local code autl�orities. towels-violent steam explosion will result.
• When cutting or drilling into wall or ceiling, do not "Based on "Kitchen Fire Safety Tips" published by
damage electrical wiring and otl��r hidden utilities. I�FFA.
• To reduce the risk of fire or electric shock, do
not use this range hood with an additional speed
control device.
• Ducted fans must always be vented to the
outdoors.
• To reduce the risk of fire, use only metal ductwork.
• Use with approved wiring only.
� '> Tfll;; �ii lil I71LIS� Uc C,J,i"OUC1C�Cia.
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d� ' ,. . - Fir�.Ready�Hoocl�
' ��7t�1"�'�I�t1 � ���ii/ 1`� �/��`�C� ^ �nuirontt�e�tat f1�or�itoring i Rre-S�{�pr�ssio�t
• Fs�e�ctior�s
The XRR�funct�ons as a siandard �rentilation range �he cc�ntro!{er-operating system is designec##a er�hance
hood with the added capability to suppress stovF;top t}ztia#unc�ionality of tlie unit and the safety of the cooking
fiires. er�vironr�tent.
Designed for use over a standard 30 and 36 inch '��e system relies on input from a set cf thermostats to
residential range, ifi uses a mechanical, commercial style cantro!the fan and shutoff power to the stove v✓hen the
autamatic fire suppression system. temperature reaches preset paints.
Refer to the illustration beiow to familiarize yourself with As the temperature rises,the controUer monitors the
the following functions. environment with tl�e three (3)thermostats.The board is
� r�cantro�ler prc�vic�es an internal aiarm plus programmed to respand to twa ternperature threshoids.
co��i�ections for up to two external �aRarrns that n�ay ga Tne fir�st af �150"F and ti��e seconci,at 1�0°F.
to a lacai alarm panel andior r�emote Iocation, i.e.#he p,t the first temperature threshald ofi 150°F, the
local fire department. ventilatian fan will turn on, regarc��Pss c�f the fror�t
6 The unit is powered from standard �i 15 VAG!6Q Hz/ � p�n��switch setting.
single phase. A main Power�witch is located at the At the secand temperature th;�ashoid of 1�O�F:
upp�r left of the front surf�ce. (Remote ADA switches
provided}. fi. The power disconnect ta the stove (vahde ar
p F'or normal daily use, th�� unit provides a fan speeu contactor} is de-energized, shutting off power to the
control knab and a light switch for the light. s#ove.
• A Reset Buttan (white) is�rovided to energize ihe �� T��"�Q��3" �iarm output is tripped, inc�ivating a
cuntroller and the rnain power disconnect cor.tactor trouf�fe condition with the unit.This output is from
{electric raE�ge}or valve{gas stove). Upon iniiiai power contncts GO and YO an the contrc;ller.
up,the control system is nat enabled anc!this reset 3. The on-board audible alarm sounds{high pitched
buttan needs to be pressed. In doing so the Status tone}. .
LED below the reset switcl� will turn from red to green. � - -"�"
See page 21 for controlier schematic.
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fiusal Svitch Pre3sure Gau{�4 �^ �/� (Red l'apol
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Installatian IElevation
A. Hood (30 or 36 inches)
B. Appliance (for reference purposes)
C. Range Disconnect - electric, gas or dual (optional)
D �as R�nci� ElPment �isconnect(not sho�nrn)
t. 'i"he CIocK(3ox. Rang� Element Time-Out System (o�tionai) '
F. Handicappe�Accessible Control Bnx(optional)
G. Manual Pull Station (optional)
fl�ounting Bracicet for a 30-inc� unit
� �o�,�,,,. � !.--:,,.-�;
-�--,-� A � iVlounting Brack�#
6 8 1 �
F.._... ��_..� o0
I A. Center nolches
"I/'yln� I ' �, � � � ��— ' B. Cri�ical fr�ounting pcints must be
a '
� _ o oF oF oF oF IIU-�/ltiin
� I I secured to studs or clrywail hangers.
� � i �;�;,�.
�, I� � �� oF ,=F �_�F �F � i G. Rear access to junctian box
' ` _.. _�-, � connectian
i i I � , � D. Primary access point for
� _ � _ _ = connections to juiiction box
o co co co cD co
n h � � � E. Secondary acces� point for
N � � � T connections to �ocfd (options/
0
'� accessories)
F. Additionai mount,ng points. Secure �'
Nlounting �racicet for P��I�A 6nst�lla$tor� minimum of three(3) screws per row.
I�. ._.."'...'______""2P�ti!91n. '___'.�._. ._'___�I I�—�5-7i8in.__.y'
�__.
��•�------- A —�--- —:
I'ia � �°� � Cal-�i^,�!Fi�n? CahinM�mnt
_� `�� n •' � �..
,-:,�����.--� � �— . . , I ' r-----_, _—— ---�
% � , , , i C::binet 13ottom
�= ' o � cF oF oF oF �!(}5;75m.
�� + � 7-inch Round Duct
I � � � i - V1f>Ir Accessk-:olo I
�
i
, I � � � a 7-ia^.c�
� �.•-�• .rT., ,^., �, o F o F r_,F o F
.'�,
I � •"
i A ,
_' �
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I I '
� Eleclric::l ��!�'c�
.' . .� . . . Access Yr.le � I
c c c c c c -- �
O ` N N N T
N a (D �o CL
�,. �
�"� ' � , ' `. � ' ,; ... .. �._. � �.. ,Fiso'Resciy Hood��
• , ,
" �a���e In�#al��t�o�s
13oof l;ap
ryyonicrs) �
10 in.Ductwork-. �`
Inline Duct Fan-. ��in.to 10 in.Transition
(ProvidedJ "a/
- - Wall Mount Fan Box
with,4ccess Cover tor
�Servica and Mount�n,y
: � (provided)_
Soffit-. Soffit-+ -Fan
Plenum Ready �
Supply Cable to Fan 7 in.Ductwork- -.° �
Cabinet--> lprovidedl
Cabinet-. Plenum Ready
Supply Cable to Fan
(provided}
Range Hood _ Ranc�e Hood
�,ovided) � —110 VAC Supply Cable �p,a�;d��� �� a---1 10 VAC Supply Cable
. (prov�ded) . .. (Pruvide�P
- ----Power Disconnect Cable - .- -- Pcwer Disconnect Cable
Airflow ��1OVidz�� Air(low tArovided)
, . - - � '::s;' - ;.` _ ',' - ..,.. , • . -
`Exterraal�;Ean .Iniine Fan'=``y. �',, ,
_:...,.._. .,. -_.._._T...__... ..:..:..-_._.._.�....�•�.,-..,.. .,,-- - .. - �xternal:Eaa.�.V11a11:M�aunt.Fan:' - -
�..
Soffif-� Soffit--.
Cabinet--. Cabinet-.
�3'/z x 12-in.Ductwark
-Wall Cap
Range Hood , ,l (byofhen,•J Range Haod
(providud) � - =-:�� (provided) �
--110 VAC Supply Cable . \ ;10 VAC Supply Cable
` �� (provided) ' ':- � t (crovided)
'� � � s I 1 Power Disconnect Cable
Airtlow --Po�ver Disconi�ect C2ble Airflow r v�ded
(provided) (P° � 1
~` ' �Integral'Fan�Rear Discharge, -. ; - - -�Integrai Fan�;Eronfi Recircqlaticr- . ., '" - �
G _.�.. �_..._. ,�.w:.:.�,,. : ..,.x.,.�.....�... a .. �".. .. - _ _ _, ;; ... _, .._.. ...._. ..�_. ��... ._.:�.<_. ,. .� �. . . ..
�� - . �. �
"Fire.Ready,Naad . : . ' , . , _ . ' ' - . , _ - dm.
' �����•�d��� ����a°������
On the controller, there are two rows of LED indicato�s ___—
next to the X (inputs) and two rows of LED's on the Y Status display-L ❑RUN ❑?FcG.CIE�R.
area(outputs). � X o❑ ❑ ❑ o s
,L�D�. - : Inpu�t �-,-T'-.: �.' ' � <�LEC7� Input/output-I
� a❑ oo ❑�
5cenario ' � , I � o❑ ❑ ❑ ❑3 ;
LabelY ,.FunGtion,, •.: -. -.. - ,: . . '�,. Stafe'� display Y o�`�,,.�c�.�a�'�
Hose Hose in piace� On �_. 4❑ ❑5 �,� �,o�� �
XO Sw'tc �'w. i
i h Hose disconnected Off ;e�,., i
Reset When switch is depressed On "��. i
X� Switch Switch not pressed Off �-� �
��,�w
Pressure Pressure okay On ----'`J�'"
X2 Switch Pressure failure Off The controller's operating system is designed to
X3 Service Servicing unit On enhance the functionality of the unit and the safety of
Switch Normal operation Off the cooking environment.
Both low temp thermostats
X4 Tempe ature below 150°F �n Q►�aPt'Y1 �Oil11G'Cf10ilS
Switch Either thermostat at or above �ff Alarm Duiputs: i he ofiher funct;on of the controller
150°F is to report afarms from the system either for a system
Alarms are configured for fault or as a result of a system discharge. Refer to
Remote normally closed(jumper On Fire Alarm System Connectior.s on page 14 in this
X5 and installed) installation manual for informaiion on how to connecf
!.ncal /11�rms Alarn���re configi.ired T�r t��fr ti�e alarrr� u.�tputs.
normally o�en (no jurnper)
High temperature thermostat Output Y1 and common C1 are configured to close with
X6 Temperature below 190°F ��' the discharge of the extinguisher tank. This condition is
Switch High temperatui•e thermostat I determined by the controller with the to+N �ressure input
at or above 190°F �ff fro��n the switch and a high temperature condition frorn
^ CE[�:; . .,`Output- . . '. . -. . „ i. , :. .'"L'ED.;
the 190°F rated thermostat. Both cond�tions must be
_Scenar.io � = �resent in order for this output tu irigg�r.
Cabel_ Function_ . :,�� ._ ,.:.. :,., ��, :, . `.;Sta�e..
Low gas switch activates OR � (vote that tl��microswitch outputs are dry contac�type,
output for hose switch activates OR high On' rated for low voltage, and can be.normally open (NO)or
YO Local Alarm temperature switch activates normal!y closed (NC), witli a common.Therefore do not
Normal operation Off' produce any current or voltage output.
Output for Loss of pressure AND high �
Y1 Remote temperature(fire su�pression On` o
Alarm discharge) Pressing the reset button will not turn off alarm. Unit
Normal Operation Off� needs to be recharged to reset Giarm.
Y2 Normal Alarm condition On _
Condition Nor�nal condition Off
When controller turns the fan Service�vvitch: The b�ack s��v�tch next to the controller
Y3 Fan on
On and internal audible alarm is trsa service switch. It can
When controller is not running be switched on or off. When it :s switched to on,the
the fan �ff remote alarm and local r,..'�',h,,+"^"'°'`'�4'�`A�;,b � �;3%��
alarm are deactivated. Its "�� '� '`�? �
When power is being set �.;K�r : :�'�� '"�� ' "
to as�4lectric disconnect Qn' P P � � �� „��
� �� ur ose is to allovv service ;.;y:��, ,,x,„.�� j:�`�,Y,'"���;�,�.a�
� � ME:�,x�.4.i. .1....:-�1;:,:� ��,. {.�.
Y� f'aNt'r (r�on�nal upc;ration) i to,'�e cotiducted and °:..�-z�'�;�,�;�`$��<i^..,;F:!;'w..:'�iet:.�k�;:���
Disconnect - �.;,�:a������r�f:�,,#e;rr�x�"�:;,?g:'`' y; �
When power is lost to gas/ Off compor,ents tesied witho�t ����..h�;,,;y�r�,� ;�� ;.,�;_.. i
�,' :�'
electric disconnect setting off the alarm. Once � ���;::�'M, �Y�' �" ��
�� � `� i �rr,�.,�,'.<
�:�:.�°r.:. ,,,�s�. i '�r
Horn is on On testin or service is done, `-���°������ � �
Y5 Horn _� g �r����;;;�y �r�� xs:,,��;}r, �,���
Horn is oFf Off turn the service switch to �ssi�f•-,_ ..���- 3�';•�� ' � a
�� , �f,: ..�,�-
off for normal operation. `
`The LED's state depends on whether the alarm contacts are NOTE: LED will flash orange Service Switch
set up for normally open or normally closed.These contacts and green. in the OFF position
are set up for normally open from the factory(LED's illumin�te
during alarm).To configure the fire contacts for normally
closed state(LED's illuminate on no alarm),a jumper must '" -'
be placed between two terminals. Please see page 14 for
additional information. •
�� . . _. ..` , ` ... : _ � , . : `.Firo Fieady•Hood_:�
� ' ' � • O�
• • �M f1;�QiitOfl .
�»�� ti�—
' .,r�^�,
- '.:Yar�w„=`--`-'..+�c
I City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
r
Contractor/Homeowner: �n-e. �
Date Received: �- 7 7— l[� �
Site: �jU /�
Permit Type: ������'Z
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ �
This comment sheet shall be kept with the permit and/or plans.
- �--- �-������ i
Gerie Brown—Fire Safety Officer Date Contractor and/or Homeowner
(Required when comments are present)
' , .�.
ZEPHYRHILLS FIRE DEPARTMENl'
38410 6th Ave Zephyrhills, FL 33542
FIRE SERVICE USER FEES increase 1/1/2018
Occupancy No.: � /'
Plan No.: Contractor: ���`��%�����'"�
Business Name: ra,z�., '�-�Ir � ��//� C�i.�c' Billing Address: �f�S�.�( �{'�-►'�/Icx
Business Address: "7 3 �v ���c�. 2�' 1l�f��c./�^�*e� �.c.� `3�-7�1 3'cf'��a
Business Phone No.: Billing Phone No.: I
Business Fax No.: Billing Fax No.: I
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE '
Annual- '
Education,healthcare,De
tention&Correctional Public
j Assembly,Business, schools,
. Storage,Mercantile and Churches
iSite Plan N/C Indusfial. no charge Sprinkler $50
?Multi-Family/Commercial .03 sf up to 800 sq ft $ 24.00 Standpipes $50
;(Minimum Charge$24.00 801-1,500 sq ft $ 34.52 Fire Pump $50 �
�;Plan Revisions DBL 1,501 -2,500 sq ft $ 60.02 � Hoods $5d
� 2,501-3,500 sq ft $ 90.02 Fire Alarm $50
SPRINKLER SYSTEMS 3,501-5,000 sq ft $ 127.52 LP Gas $50
{0-25 Heads $50 5,501-7,500 sq ft' $ 187.52 Natural Gas $50
!26 plus Heads $100 7,501-10,000 sq ft $ 262.52 Fuel Tanks- pertank $50
STANDPIPE SYSTEM 10,001-15,000 sq ft $ 375.02 Sparklers $100
�;Per Riser $50 15,001-20,000 sq ft $ 525.02 Fire Works $500
FIRE PUMP 20,001-30,000 sq ft $ 750.02 Camp Fire(recreation $25
��Per Pump $100 30,001-40,000 sq ft $ 1,050.02 C9 ed Bum(1 a
FIRE ALARM SYSTEM 40,001-60,000 sq ft $ 1,500.02 Hood/Dact $50
4 0-25 Devices $50 60,001-80,000 sq ft $ 2,100.02 ssem y $50 Mnual
80,001-($2,100.02)per
i 26 plus Devices $100 ea add 1,OOOsq ft $ 0.06 Fire Protection $25
S.UPPRESSION SYSTEMS (Business closed until Flammable Application $50 Mnual
W vio 'ons corrected) Waste Tire Storage $50 Annual
Dry SPRINKLER SYSTEMS Generator<KW $100
$50 Hydro Undergrounds $45 Generator>30 KW $100
� Other $50 HydrostaticTest $65 persystem Bio-Hazard Waste $100 nnn�ai
�CHEN EXHAUST Acceptance Test $45 persystem Fumigation Tenting $50
ucts $50 Hydrant Flow $75 Torch PobApplied $50
OTHER Haz.Materials $50 Annual
�LP Installatlon per tank $50 FIRE ALARM SYSTEM ,
Fuel Tank Installation $50 System Acceptance $50
(Per Tank) $50 Recall Acceptance $50
�Natural Gas Installation $50 OTHER
(Per System) Fire WalUSmoke Wall $15 perwan
�Spray Booth $50 LP Gas $25 per�ank
Natural Gas $25 persystem
Tent 10'x10'or greater $15 pertent
-- 5
0
System Acceptance
Exhaust Hood/Duct $30
Re-inspection DBL
(other than annual)
Inspection scheduled DBL
� and cancelled less than
' 24 hours
____- B Construction Insp. N/C
Emergency Vehicle Acce $50
� PLANS TOTAL /OcY INSPECTION TOTAL� PERMIT TOTAL /o�
GRAND TOTAL o °`�
Comments:
Date: �-�1• j�i' Inspector: - _
see back
mn .
FALSE ALARM FEE
1stAlarm N/C
2nd Alarm N/C
3rd Alarm N/C
4th Alarm $100
5th Alarm $150
6th Alarm $200
NON COMPLIANCE $150
Cont.Annual Inspection Fees
3-11 Units price per unit $ 5.36
12-25 Units price per unit $ 4.82
26-50 Units price per unit $ 4.29
51-100 Units price per unit $ 3.75
100 or more Units price per unit $ 2.68
Fire Safety re-inspection types
First Re-inspectioi N/C
Second re-inspect $75 �
Third re-inspectior $ 125.00
Inspection scheduled but cancelled 24 hrs $ 50.00
TOTAL �
nm
.y;. .
� �� y - � A=�I N E i : 2_�28-1440
�� Off ce 35
Fi�rE �r SafEty� �NC. F�: 352-728-8332
2001 ,South St; • Leesburg, .Fiorida 34748 �Walinefire.com
PERMIT AUTHORIZATION LETTER
I hereby authorize Aaron Silvis
to pick up permits and sign any documents related to:
� All Permits
❑ Address/Parcel #
❑ Permit#:
Robert W. Bowersox - � ,�
Print Name: Signature:
License#: FED11-000016
The foregoing Quthorization letter was acknowledge before me this a$ dny of
, 20�by �D��' �✓. �F�V�/P.9'�(�kl
{� Who is personally known to me
❑ Who has produced identification
Notary Public Signature: ,��,�'�,��,��a��l'�
My Commission Expires: ��/�,Ll '2�J� � �
M�rry��
r�;l:!,�y MEUSSA�I.MERCER
� MIY COMMISSfON+�GG 10T558
�� r�= EXPIRES:Me�r 23,2021
. p�y�}►���.y�����y����,.y
�MM���DV�NRI 1111Y rwivJ fWIRr NRJVIt11iEIL
"Sales,Service and Installation"
FIRE EXTINGUISHERS/FIREALARMS/EMERGENCY EXIT LIGHTS&FLOOD LAMPS/
CABINETS/PRE-ENGINERED FIRE SYSTEMS/VEHICLE SYSTEMS/CLEAN AGENT SYSTEMS/
, . • .S�fF�- :-�w ' � , .r,� . . "f,:�-..r.�. .. - „ ....c. � - . --.,-... _r-��>:•�� -.. . , , , ,� - .� . _f ^ , .� - '
.,. � _ _Sn r\. ,!t. � , i - � 1 • ..!- r � _
1- r
. � License# �� � �� SYSTEM INSPECTION FORM
(352)72&1440 Tel. Class A#FEDi i-000016 Dat County/ i^'A.H.J){` U�300, wet Dry
(352)728-8332 Fax Class D#75004900022006 -���4� I k za�A t l�,I 15 ves'I� No❑ u
A �I IVE Annual Semi-Mnual� Rech. Installation Renovation Manufacturer
� n�er.�
FirE � Saf�ty, �NC. Location of Syst ms Cylinders M/oydel Number
SALES AND SERVICE �� ���e �`�v� ` � ���
Gylinder Size Maste Cylinder Size Slave Cylinder Size Slave
2001 SOUTH STREET,LEESBURG,FLORIDA 34748
Serial Number Serial Number '.�Serial Number ��
Name �e��`�P"�r��_� ��e<< 1 � 2.7 7C�S � �
� -. Fuse Links 360° FUSE Links ^� '�- °F Thermostat -�F1~
Address � J�� ��'�' � �'
I D Number: Date: � � Number: ,plumb�
City ���`�r��1►S � r- �J�� /
Hood#1 Size: Hood#2 Size:
Telephone( ) Duct#�size: � Duct#1 Size: _--�'`�/
OwneY or Manager ouct#2 s�ze:�f/ ouct a2 'z�
O
Store Number Last 6 Year Date Last Hydro Test Date Last Recharge Dat
Related Invoice � �
Manufacturer's Manual Reference
1. Check haiard against original layout,note any changes � Page Number: Drawing Number:
2. Pressure gauge indicator in operable range for stored , /
pressure cylinders � Cartridge: Inspected❑ Replaced❑ s ��A
/' Weight: Pressure: Last Test: ����1 �
3. There are no visible signs that system has been fired or �
been tampered with Y Fuel Shut Off �
4. Check ail piping an conduit Must be immobilized with � Electric: Shunt-Trip❑ Gas:Mech❑ eiectric,�f size:�`��S� ��"� `�
proper hangel5 and bwdckets Electrical s unt-rrip Location:
5. All hood penetrations are welded or have grease tight `, � P � S`�vP Fe-�s� SG�`C(',�
fittings ' �V Fire Alarm Panel Location:
6. Check positioning of all noules � y�� ��^� �� � �����P
7. All noules are of proper iype y
8. Replace all protective covers on nozzles or nozzle seals � 27. ReseUcock control head �
9. Clean Nozzles � 28. Fan warning sign on hood ,YesC�-N�'C'�'
10. Check cable nut travel tolerances � 29. Cartridge(s)installed Yes-�NaC�
11. Test system operation from terminal link for proper operation 30. If all cooking surFaces not protected give customer �
12. Test system operation with manual and remote manual for / full information
proper operation �� 31. Proper separation between fryers 8�flame Ye�-No�'
' 13. Test operation of gas valves � � 32 Inspection safety pinsAock bars are removed Yes�� No❑
14. Test operation of micro switch(s) 33. Inspection and senrice tag on system cylinder
15. Clean excess grease from conduit at comer pulleys . /' and remote pull station Yes� No❑
and components y � 34. Personnel has been instructed on operation of ,
16. Replace fusible links(every 6 months) `/ system(s)and portable(s) Yes� No❑
17. Fitters are of proper type Yes�No❑ 35. Are hand portable extinguisher(s)property
. 18. Filters are clear of grease Yes'[�j No❑ serviced Yes�l No❑
' 19. Hood and duct are clean of grease � Yes p No_❑ 3g, portable extinguisher iyrpe 40 BC❑ K type�[�✓
20. All filters are replaced in hood Yes�I No❑ 37. Portable extinguisher(s)have proper rating Yes d No❑
21. Exhaust fan(s)are in operating condition Yes�No❑ 38. Is fire alarm connected to the fire suppression �,
22. Replace and seal all safery pins in manual and _ / system? Yes� Mo❑
remote releases � 39. Is fire alarm reset Yesr No❑
23. Replace system covers 40. Pictures taken Yes� No�
24. Fuel shut-off is in on position YesC�-Plo�� 41. Drawings attached Yes b No❑
25. Customer lit pilot lights Yes{�-N�0'°' 42. Maintenance performed per MFG Manual Yes,�7 No❑
26. Clean system cylinder �r 43. Maintenance performed per presently,adopted NFPAs , Yes� No�l
COMMENTS: 44. Indicate standards used:NFPA 17 ,an 4� NFPA 17A � NFPA 96 �
�; �e��u�'�yiP�.� T"t�c�(�v� `�-e.�� w�C� �e p�•�r��I�s �1�e 1 �u��e ��r�°, s���cs.-.. �1�...s���
( e �, ` 1 r f
�'�c.,. �C.S�_ �la rr� �n�� S�N<<P • �.�d5��-IG��� Q n�� �lcC��� rv� t� �n/'v���•
c�+�t �P �v���,nP��� P�r, C� �v. �� �(_ �� ��f P (� ��
HOOD
�,�� �v�� : `7 3�a
�e n���� �-�.�-� �u�c�
� ��� S�S��-
�
�
., �
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� Q �I�vf�e,� ��n�,t,
Appliances and Sizes(Left to Right)
An A-Line Fre and Safety,Inc.authorized technician has completed your life safety inspection per local code,NFPA guidelines and manuFactures requiremenis.Safe operation of your equipment is the responsibilii�l of the facility
owner or tt�eir agent You are responsible for ensuring that any correotions and repairs to your I'rfe safety systems are completed.A-Line Fre and Safeiy,Inc.will provide a formal quotation to complete the required repair to_bring
your life safety systems back into compliance.A-Line Fire and Safety,Inc.does not assume any liability for the condition of your I'rfe safety systems and is acting as an advisor on the warking condition,performance potential and
code compliaq e of your I'rfe safeiy systems.According to Florida State Shatue 633.071,a copy of the inspection report noting any deficiencies shall be forwarded tn the local authority within 3A days`ofU)e date o service.�lJriless yo
fU
specificall�la or�eA-Line Fr and Saf ,Inc.to pertorm the necessary repairs,any deficiencies,impairments or required repairs discovered as a resutt of our inspections are not�tti,e responsibildy�of.A-�n�F�and Sa�,Inc�
Tec S an i n t A� i ss Si na re �Customer Si�ure
9 9 , �/ � �
(/l a 0 � �. ��;/"..r� .dr'd�'/, �'� �
i / �
Permit No. Da e Time In Ti e Odt Signature Printed
sw����� ��� �3 1� � � ��,,.�� �� .��t�ir
The above named technician wrho holds a State of Florida permit certifies that they personally inspected ttie system and found the conditions
to be as indicated on this report.A-Line Fire&Safeiy,Inc.