HomeMy WebLinkAbout18-19775 I '
� CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19775/
FIRE SPRINKLER SYSTEM PERMIT
PERMIT INFORMATION LOCATION=INFORMATION
Permit Number: 19775 Address: 4330 20TH ST
Permit Type: FIRE SPRINKLER SYSTEM ZEPHYRHILLS, FL.
Class of Work: FIRE-SPRINKLER SYS Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 13-26-21-0070-03900-0020
Improv. Cost: 15,000.00 OWNER INFORMATION
Date Issued: 6/08/2018 Name: NESTLE WATERS NA INC
Total Fees: 65.00 Address: 4330 20TH ST
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/08/2018 Phone: (813)783-1959
Work Desc: RELOCATING BACKFLOW FOR SPRINKLER SYSTEM
CONTRACTORS APPLICATION FEES
WAYNE AUTOMATIC FIRE SPRINKLER FIRE INSPECTION FEES 65.00
41� � 9 V 6 2-
qk)
Ins ections Required
FIRE-PRESSURE TEST
FIRE ACCEPTANCE 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 performed 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
RECORDING YOUR NOTICE OF COMMEN ENT."
CONT OR SIGNATURE PERMIT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
813-780-0020 City of Zephyrhills Fire Fax-813-780-
Permit Application
Date Received 5/30/18 Phone Contact for Permit 813 630 0303
Owner's Name NESTLE WATERS NORTH AMERICA INC Owner's Phone Number
Owner's Address PO BOX 120029 STAMFORD CT 06912-0029
Fee Simple Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
Job Address F 4330 20th St. Zephyrhills, FL. 33542 Lot#
Sub Division Parcel#
N I±U_F ROW.PRO EER-7777 rAX NO ICE)-----
F-1 Bio-Hazard Waste Storage-ANNUAL Fumigation Tent
Fj Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier 11 or RO Facility)ANNUAL
F-1 Controlled Burn Hood Installation
F-1 Emergency Generator<30 kw LP/Natural Gas-Installatior
F-1 Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale
Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL
FQN-1y] rS_em7, An l'Uffi—er—1
Sprinkler F-1 0 0 0 F-1 Recreational Burn
Fire Alarm F-1 0 0 0 Sparklers
Hood Cleaning F-1 0 0 1-] Sprinkler System Installations
Hood Suppression El 11 13 0 Standpipes(Sprinkler Sys)
Fire Alarm Installation Torch Roofingf-rar Kettle
Fire Pumps Waste Tire Storage ANNUAL
Flammable Application-ANNUAL $ 15,000 Valuation of Project
Fuel Tanks
Other: c, f-to A A t-
Contractor Company Wayne Automatic Fire Sprinklers Incl
Signature Registered = Fee Current I Y
Address 3226 Cherry Palm Dr. Tampa, FL License# FPC17-000106
ELECTRICIANI Company
Signature Registered Y/N Fee Current L�/N
Address License# I
PLUMBER Company
Signature Registered Y/N Fee Current Y N J
Address License#
MECHANICALI Company
Signature Registered Y/N Fee Current Y N J
Address License# F_
OTHER Company I I
Signature Registered I Y/N Fee Current L_L/N J
Address License# F_
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)
,
NOTICE OF DEED The undersigned understands that this permit may be subject to"deed"restrictions"
which may ba 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 o contractor or
contractors to undertake wmrk, they may be required to be licensed in accordance with state and |nua| regulations. If the
uuntnodmr is not licensed as required by |am. both the owner and contractor may be cited fora misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended vvork, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at727-D47-
8OU9. Furthennone, if the owner has hired o 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 bean indication that heio not properly licensed and is not entitled to permitting privileges in Pasco
County.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes,ueomnwndmd): !f valuation of work io$2.5OO.00or more, |
certify that |, the app\inont, 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. |f the applicant |osomeone
other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver ithn the^ownar"prior tucommencement.
- CONTRACTOR'S/OWNER'S AFFIDAVIT: | certify that all the information in this application is accurate and
that all work will be done in compliance with nU applicable |ewo regulating uonatruotion, zoning and land
development. Application is hereby made to obtain o permit to do work and installation as indicated. / 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 |avvo regulating construcLion. County and City nodeo, zoning regulations, and land
development regulations in the jurisdiction. | also certify that | understand that the regulations of other
government agencies may apply bo the intended work, and that it iamy responsibility hoidentify what actions |
must take toboincompliance.
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. | understand that a separate permit may be required for electrical vvork,
p|umbing, yigno, vvaUo, poo|o, air conditinning, gao, 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 insuonoe, 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 naquasted, in writing, from the Building DMioiai fora period not to exceed ninety (QU) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
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 RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JuFmT(F.o.117»3) /
OWNER OR AGENT CONTRACTORSubscribed and sworn to(or affirmed)before me this Subscribed and sworn to(orri Mmed)befoFe Fme this
'
—by
Who is/are personally known~^~~ has/have produced `~~ s~~personally me~ '="~~
produced
as identification. -------- —� as identification.
L2Notary Public Notary Public
Commission No.
~~°
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
7EA
DELZ�, DEAN
019
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
Date Received: cSO —45
Site: 6 7—
Permit Type: cs r4e- . i�e&)
Approved w/no comments:MI Approved w/the below comments: R Denied w/the below comments: E-1
This comment sheet shall be kept with the permit and/or plans.
Gene Brown-Fire Safety Officer Date Contractor and/or Homeowner
(Required when comments are present)
ZEPHYRHILLS FIRE DEPARTMENT
38410 6th Ave Zephyrhills, FL 33542
FIRE SERVICE USER FEES increase 1/1/2018
Occupancy No.:
Plan No.: Contractor: 6L ,/le �iG!
Business Name: Billing Address:
Business Address:
Business Phone No.: Billing Phone No.:
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE
Annual-
Education,healthcare,De
tention&Correctional Public
Assembly,Business, schools, I,
Storage,Mercantile and Churches
Site Plan N/C Industrial. 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 " $50
2,501-3,500 sq ft $ 90.02 Fire Alarm $50
SPRINKLER SYSTEMS 3,501-5,000 sq ft $ 127.52 LP Gas $50 j
0-25 Heads $50 5,501-7,500 sq ft $ 187.52 Natural Gas $50
I;
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 Controlled Burn(15da: $100
FIRE ALARM SYSTEM 40,001-60,000 sq ft $ 1,500.02 Hood/Duct $50
0-25 Devices $50 60,001-80,000 sq ft $ 2,100.02 Place of Assembly $50 Annual
80,001-($2,100.02)per
26 plus Devices $100 ea add 1,000sq ft $ 0.06 Fire Protection $25
SUPPRESSION SYSTEMS (Business closed until Flammable Application $50 Annual
Wet $50 violations corrected) Waste Tire Storage $50 Annual
Dry $50 SPRINKLER SYSTEMS Generator<KW $100
CO2 $50 Hydro Undergrounds $45 Generator>30 KW $100
Other $50 Hydrostatic Test $65 per system Bio-Hazard Waste $100 Annual
KITCHEN EXHAUST Acceptance Test $45 persystem Fumigation Tenting $50
Hood/Ducts $50 Hydrant Flow $75 Torch Pot/Applied $50
OTHER Haz.Materials $50 Annual
aLP Installation 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 Wall/Smoke Wall $15 perwall
Spray Booth $50 LP Gas $25 per tank
Natural Gas $25 per system
I
Tent 10'x10'or greater $15 per tent
i
Fire Pump $45
Fire Suppression $30
System Acceptance
Exhaust Hood/Duct $30
Re-inspection DBL
i
(other than annual)
Inspection scheduled DBL
and cancelled less than
_ 24 hours
--HConstruction Insp. N/C
-Emergency Vehicle Acce $50
I
PLANS TOTAL INSPECTION TOTAL g� PERMIT TOTAL
GRAND TOTAL o0
Comments:
I
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Date: Inspector:
see back
mh
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e' S 3226 CHERRY PALM DRIVE
TAMPA,FL 33619
\"N/WAYNE qj 81 3-630-0303•FAX:813-630-0312
11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc.
FORT MYERS,FLORIDA 33905
904-268-3030-FAX.904-268-0724 222 CAPITOL CT. 239-433-3030-FAX:239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030 -407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838 954-917-3030-FAX:954-917-9424
Backflow Prevention Assembly Test Report a
CUSTOMER: �i��i \ ) ; 1 �D7 j� INSPECTOR: (_ '�i _ice DATE: 'al
ADDRESS: 2Q0 .Z o l5'+l S^ LICENSE#: ✓" TIME: 0�.�0Crrr�t
CITY,ST,ZIP: R �s 1 s(j Z ISC#: 6 3 09,2
JOB LOCATION: L
ADDRESS:
LOCATION(CHECK&DESCRIBE): (' INSIDE ABOVE GROUND ( ,, PIT USAGE(CHECK ONE): IRE Fj DOMESTIC
(}DC +_, DDC (- DDC-BYPASS (-,, RPZ I(-, RPZ-DET RPZ-DET-BYPASS MFG MODEL SIZE SERIAL#
TYPE(CHECK): i)k,n5 920 DR
REDUCED PRESSURE PRINCIPLE ASSEMBLY YES al
DATE I
RELIEF PORTS ON RPZ FREE OF CONTINOUS DISCHARGE?(CHECK ONE) (`; NO INSTALLED
APPARENT PRESSURE DROP DATE
DOUBLE CHECK VALVE ASSEMBLY ACROSS FIRST CHECK VALVE REBUILT
CHECK VALVE#1 CHECK VALVE#2 RELIEF VALVE PVB/SVB
HELD AT PSID HELD AT PSID OPENED AT PSID AIR INLET
OPENED AT PSID
LEAKED rj LEAKED rl DID NOT OPEN F 71
E=
z CLOSED TIGHT CLOSED TIGHT DID NOT OPEN
CLEANED rl CLEANED F-1 CLEANED CLEANED
w
a REPLACED 711 REPLACED F-I REPLACED F7' REPLACED
Q
IL
LU I
z _ t PSID �r PSID AIR INLET PSID
PSID
aL CHECK VALVE PSID
CLOSED TIGHT _ CLOSED TIGHT [—�
ASS (1 FAIL SUPPLY PRESSURE PS
METER#: �� G y�
READING#: a v®�r✓ �� / ✓ 93 0
CERTIFICATION TAG ON BFP INSPECTOR'S SIGNATURE: BFP IN SERVICE
i
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CITY OF " NOTICE / / BUILDING
ZEPHYRHILLS p L DEPARTMENT
OFADDITION OR CORRECTION
D • NOT REMOVE
ADDRESS D TE PERMIT f
1/19;�;A e5—c (=�, i ,,,/
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
will be accepted.
f1VA- Rg ��,��s c '�ir c ��f gar
tg I - Tr-om c-lo
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It is unlawful for any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth 780-0020 FOR RE-INSPECTION
or other material,until the proper inspector has had ample time to approve
the installation.
OFFICE HOURS 7:30 AM-5 PM MON.-FRI. INSPECTOR
I!