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Home My WebLink About08-7986 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 7986 FIRE STANDPIPES PERMIT Permit Number: 7986 Address: 6548 GALL BLVD 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: 02-26-21-0010-05600-0010 Improv. Cost: 2,000.00 , ' Date Issued: 6/23/2008 Name: PIZZA HUT Total Fees: 130.00 Address: 6548 GALL BLVD Amount Paid: 130.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/23/2008 Phone: Work Desc: INSTALL FIRE SYSTEM SUPPRESSION 1S UbJIUPIJcArIC I & FIREMASTER FIRE SUPPRESSION ti 50.00 FIRE PLAN REVIEW FEES 50.00 FIRE INSPECTION FEES ✓ 30.00 2 qO � .. ..-. E ...:, .rP .. ,. .... ., a- �P ....r.':In s'� a'•..s.. ,y, :.. .::.• .'.. .a ,..M Wnm...r�.: 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 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, CO ULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOR Y R OTI OF COMMENCEMENT." a., CON TO IGNATURE I IC R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041 813-780-0020 City of Zephyrhills"Fire j- q 8 i Fax-813-780-0021 Permit Application 1 Date Received /'?-. "t Phone Contact for Permit '6c/ ...."..... _ .,...."4.c ,a« _.G... -i..., ,.34 T.s+.S3 .a � ,,.nss ... Owner's Name Owner's Phone Number Owner's Address Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address / Job Address l�s G'CA V'L Lot# I� Sub Division Parcel# Bio-Hazard Waste Storage-ANNUAL Fumigation Tent Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL Controlled Bum Hood Installation Emergency Generator<30 kw LP/Natural Gas-Installation Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL r y emi ®nLittler Sprinkler ❑ O ❑ Recreational Bum Fire Alarm E ❑ ❑ ❑ I Sparklers Hood Cleaning ❑ ❑ ❑ I Sprinkler System Installations Hood Suppression ❑ ❑ ❑ I Standpipes(Sprinkler Sys) Fire Alarm Installation Torch Roofing/Tar Kettle Fire Pumps Waste Tire Storage ANNUAL Fire Works Flammable Application-ANNUAL -'°- V Valuation of Project Fuel Tanks Other: J fr7t (( K Contractor Company G. e,h.J,ri PO4-F+rt Signature Registered I Y/N I Fee Current Y/N Address License# 74'5/ L ELECTRICIAN Company Signature Registered F Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N 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) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may 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(Chapter713, 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 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS T YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN O N BEFORE RECORDING YOUR NOT CE F MENCEMENT. FLORIDA JURAT(F S. 117. OWNER OR AGENT CONTRACTOR Subscribed and sworn (or a ed) efore me this Subscribed an om r a ed)before me this by by Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as identification, as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams Bus (813)780-0041 Fax (813)780-0044 FIRE SERVICE USER FEES Occupancy No.: Plan No.: Contractor. I:l.5i &rjo Business Name: i Billing Address: b ? I S1i≤S4A 7Z Business Address: 5`14 Business Phone No.: Billing Phone No.: U te.. %.-do f— (c Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE eSite Plan N/C Annual ,N/C Sprinkler $50 1st Alarm N/C Multi-Family/Commercial .06 Si 1st Re-inspection N/C Standpipes $50 2nd Alarm N/C (Minimum Charge$25.00 2nd Re-inspection $100 Fire Pump 3rd Alarm N/C Plan Revisions DBL 3rd Re-inspection $250 Hoods' 4th Alarm $100 4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Alarm $200 8 0-25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- per tank $50 STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100 Per Riser $50 Hydrostatic Test $65 per system Fire Works $500 FIRE PUMP Acceptance Test $45 per system Camp Fire $25 El Per Pump $100 Hydrant Flow $75 Controlled Bum $100 FIRE ALARM SYSTEM Hood/Duct $50 8 0-25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $50 Annual 26 plus Devices $100 System Acceptance $50 Fire Protection $25 SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $50 Annual Wet $50 OTHER Waste Tire Storage $50 Annual Dry $50 Fire Wall/Smoke Wan $15 per wan Generator<KW $100 CO2 $50 LP Gas $25 per tank Generator>30 KW 150 Other Natural Gas $25 per system Bio-Hazard Waste $100 Annual KITCHEN EXHAUST �r•� Fumigation Tenting $50 El Hood/Ducts $50 Tent 10'x10 or greater $15 portent Torch Pot/Applied $50 OTHER Fire Pump $45 Haz.Materials $100 Annual LP Installation per tank $50 Fire Suppression Fuel Tank Installation $50 System Acceptance ❑ (Per Tank) $50 Exhaust Hood/Duct $30 Natural Gas Installation $50 Re-inspection DBL (Per System) (other than annual) El Spray Booth $50 0 Inspection scheduled DBL and cancelled less than 24 hours Construction Insp. N/C Emergency Vehicle A0 $50 FALSE ALARM PLANS TOTAL INSPECTION TOTAL _ PERMIT TOTAL�— TOTAL GRAND TOTAL Comments: Date: l� lnsrctor rAey't/ f IYIUL Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Bus (813) 780-0041 Kerry Barnett Fax (813) 780-0044 June 19, 2008 I have reviewed and approved the plans for a commercial hood suppression system located at 6548 Gall Blvd. I have attached the comments for the plan approval. If there are any questions please contact my office at 813-780-0041. 1. System shall be UL300 compliant. 2. Class K extinguisher required on site. 3. System shall be connected to building fire alarm system. If no fire alarm system, a horn/strobe or bell shall be connected to system to notify occupants of system activation. 4. All electric/gas shall shut off under hood. 5. Make up air shall shut down. 6. Exhaust shall remain on. 7. Permit required by electrical contractor. Inspections Required 1. Acceptance test. STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL TALLAHASSEE,FLORIDA FIRE EQUIPMENT DEALER LICENSE THIS CERTIFIES THAT: MASTER PROTECTION CORP DBA F1RFiMASTER 3071 N ORANGE BLOSSOM TRAIL STE W ORLANDO, FL 32806- QUALIFIER: ROBERT G RICE HAS COMPLIED WITI3 FLORIDA STATUTES AND HAS QUALIFIED FOR THE TYPE AND CLASS SHOWN HEREON TO SERVICE,REPAI INSTALL OR INSPECT ALL TYPES OF PRE-ENGINEERED FIRE EXTINGLTHE NG SYSTEMS. Chief Financial Ofli:er 01 01 2008 07 04 Orange % 74518600012006 9867870001 12 31 2009 Issue Date Type Class County License/Permit Number Application II Expire Date CERTIFICATE OF INSURANCE N UR/►N E CERTIFICATE NUMBER II�[�!'it ' 431760 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. Marsh, Inc. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. 1166 Avenue of the Americas New York,NY 10036 COMPANIES AFFORDING COVERAGE Telephone(212)345-5000 COMPANY A: Al South Insurance Co. COMPANY B: American Home Assurance Co. INSURED COMPANY C: Commerce&Industry Ins Co COMPANY D: Illinois National Insurance Co. Sister l,LP COMPANY E: Insurance Company of the State of PA Master Protection Corp.dba FireMaster, 13050 Metro Parkway, Unit 1 Fort Myers,FL 33966 COMPANY F• New HamDshire Ins.Co United States COMPANY G: New York Marine&General Insurance Co.(Lead) COMPANY H: White Mountain Insurance Co. COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRMENTS,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY LIMITS LTR DATE(MM/DD/YY) EXPIRATION B GENERAL LIABILITY GL 1595415 6/29/2007 10/1/2008 GENERAL AGGREGATE $15,000,000.00 X COMMERCIAL GENERAL PRODUCTS-COMP/OP AGG $15 000 000.00 CLAIMS MADE OCCU PERSONAL&ADV INJURY $7,500,000.00 OWNER'S&CONTRACTOR'S EACH OCCURRENCE $7,500,000.00 FIRE DAMAGE(Any one fire) $1,000,000.00 MED EXP(Any one person) $10,000.00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B CA 1606992(MA) 6/29/2007 10/1/2008 $7,500,000.00 B X ANY AUTO CA 1606993(VA) 6/29/2007 10/1/2008 B ALLOWED AUTOS CA 1606994(AOS) 6/29/2007 10/1/2008 BODILY INJURY(Per person) SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY(Per X NON-OWNED AUTOS accident) PROPERTY DAMAGE PROPERTY B EXCESS LIABILITY BE 9835073 6/29/2007 10/1/2008 EACH OCCURRENCE $10,000,000.00 UMBRELLA FORM AGGREGATE $10,000,000.00 OTHER THAN UMBRELLA FORM B WORKERS COMPENSATION AND SEE PAGE TWO SEE PAGE TWO SEE PAGE TWO X I WC STATUTORY OTHE D EMPLOYERS'LIABILITY A THE PROPRIETOR/ EL EACH ACCIDENT $2,000,000.00 F PARTNERS/EXECUTIVE INCL EL DISEASE-POLICY LIMIT $2,000,000.00 C OFFICERS ARE: EXC EL DISEASE-EACH $2,000,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Please see page 2 for additional insureds and any additional language. CERTIFICATE HOLDER CANCELLATION City of Zephyrhills SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE 5335 Eighth Street INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER 9 NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH Zephyrhills,FL 33540-4312 E INCI IRFR AFFORDING COVFRAGF ITS AGENTS OR RFPRFCFNTATIVFC OR THE ICCI IFR OF THIS r'FRTIPIrATF MARSH USA INC.BY: David Kong,Casualty Program .. -� 1 VALID AS OF:8/18/2008 ADDITIONAL. INFORMATION CER1]FICATETENUMBER PRODUCER COMPANIES AFFORDING COVERAGE Marsh, Inc. 1166 Avenue of the Americas New York,NY 10036 Telephone(212)345-5000 INSURED SimplexGrinnell,LP Master Protection Corp.dba FireMaster, 13050 Metro Parkway,Unit 1 Fort Myers,FL 33966 United States TEXT WORKERS COMPENSATION POLICIES Carrier Policy Number Eff. Date Exp. Date State (B) American Home Assurance Co. WC 1616576 6/29/2007 6/29/2008 CA (D) Illinois National Insurance Co. WC 1616577 6/29/2007 6/29/2008 MI (A) AI South Insurance Co. WC 1616578 6/29/2007 6/29/2008 GA (B) American Home Assurance Co. WC 1616579 6/29/2007 6/29/2008 PA (F) New Hampshire Ins. Co. WC 1616580 6/29/2007 6/29/2008 NY,OH,WI (B) American Home Assurance Co. WC 1616581 6/29/2007 6/29/2008 NJ (C) Commerce & Industr Ins Co 6 29 2007 6 29 2008 FL ( surance Company of the State of PA WC 1616583 6/29/2007 6/29/2008 ,MA,VA (B) American Home Assurance Co. WC 1616584 6/29/2007 6/29/2008 AOS (B) American Home Assurance Co. WC 1616585 6/29/2007 6/29/2008 OR (B) American Home Assurance Co. WC 1616749 6/29/2008 10/1/2008 CA (D) Illinois National Insurance Co. WC 1616750 6/29/2008 10/1/2008 MI (A) AI South Insurance Co. WC 1616751 6/29/2008 10/1/2008 GA (B) American Home Assurance Co. WC 1616752 6/29/2008 10/1/2008 PA (F) New Hampshire Ins. Co. WC 1616753 6/29/2008 10/1/2008 NY,OH,WI (B) American Home Assurance Co. WC 1616754 6/29/2008 10/1/2008 NJ (C) Commerce & Industry Ins Co WC 1616755 6/29/2008 10/1/2008 FL (E) Insurance Company of the State of PA WC 1616756 6/29/2008 10/1/2008 AR,MA,VA (B) American Home Assurance Co. WC 1616757 6/29/2008 10/1/2008 OR (B) American Home Assurance Co. WC 1616758 6/29/2008 10/1/2008 AOS (B) American Home Assurance Co. WC 1616759 6/29/2008 10/1/2008 TX LIABILITY PROGRAM Project: City of Zephyrhills If there is a question regarding this certificate please contact Mary Vogt (Email: marvogt@simplexgrinnell.com Phone: 239-896-1683) CERTIFICATE HOLDER City of Zephyrhills 5335 Eighth Street Zephyrhills,FL 33540-4312 LIMITED POWER OF ATTORNEY All Florida Counties and Cities Date: 05/13/08 I hereby name and appoint: Michael Snyder an agent of:_Master Protection Corp DBA FireMaster (Name of Company) to be my lawful attorney-in-fact to act for me to apply for, receipt for, sign for and do all things necessary to this appointment for(check only one option): EV All permits and applications submitted by this contractor. O The specific permit and application for work located at: (Street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: Robert G Rice State License Number: 74518600012006 Signature of License Holder: /f 6 Tt STATE OF FLORIDA COUNTY OF Lee. The foregoing instrument was acknowledged before me this_13th day of May__, 2008___,by_Robert G Rice who is m-personally known to me or o who has produced as identification and who did(did not)take an oath. ?t/4 , Signatur (Notary Seal) y 2 l4 .� Print or type name Mary L.Vogt Commission#DD386833 Notary Public- State of_Florida Expires:Jan 17,2009 Commission No. y'a; e`°; Bonded Thru Atlantic Bonding Co.,Inc. My Commission Expires: (Rev.3/27/07) •,pr 7' ,�I S uri �i @6/17/2008 13:42 2399852122 PAGE 01 N Q a ao a.. co .$ z S ux . a " z N o 0 W w x d r_ Q W z z (J) m Wad a O p W 00 C) LU LL tN a w w Wtj5 < 0 • U N o J � � ^ w I- 0 z z 0) z° w Cl, • W z • .s a w m �k�