HomeMy WebLinkAbout09-9386 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9386
FIRE STANDPIPES PERMIT
Permit Number: 9386 Address: 5214 GALL BLVD
Permit Type: FIRE HOOD SUPPRESSION SYS ZEPHYRHILLS, FL.
Class of Work: FIRE -HOOD SUPPRESSION SYS Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11- 26 -21- 0010 - 16600 -0250
Improv. Cost: ,- = �• �:.
Date Issued: 7/31/2009 Name: VICHRIS INC
Total Fees: 50.00 Address: 5214 GALL BLVD
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/31/2009 Phone: (813)782 -9556
Work Desc: SUPPRESSION RE -PIPE
SECURITY FIRE EQUIPMENT LLC FIRE SUPPRESSION 50.00
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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, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
• - =U► OUR NOTICE OF COMMENCEMENT."
0t
CONT'.• CTOR SIGNATURE 74 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 # q386 Fax- 813 - 780 -0021 ' Permit Application
Date Received J l' 21 09 I Permit Contact for Pert I l
Owner's Name aess, . to S4,0161/7" e/' Owner's Phone Number V 1 2I',.Z 9.<-3Z
Owner's Address .-C—s?/( -4z '7i..v?) 7 ,7Aftii�� le
Fee Simple Titleholder Name / / Titleholder Phone Number
Fee Simple Titleholder Address I I
. ",`.,' . ..: ::.re:,',.s ;"...:. t o e la% "`ONME1 tatelt 7 "E,M „ / rl �; !� t ,:. ":4 ,� . ,°°s .», 'Zr:, , , RIZtl ...::, i ,.,,.V :: ... t,.�?? 5 s:
Job Address Save/ 6/ti -- ,7 ,, G 7 ,A y/ / - Lot #
Sub Division 1 ( Parcel # l / -02( .21 - oak , /6z..67-0.25-0
.'•x Y.'.., s., ,' :z : :,' , M..a. rZ •0WfitiaaR,i 400.43 4 ;% ..5 ...,_¢3r:h,' +t,. .a ..x.aa "A s....,' `„ z.:ms,wa...:,:z..om, aa'tv.omai .._..�. em.i_.ts,oc: ,,,.,..r?r 4.0 pA at".xiara ...,,a...
El Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL
n Controlled Bum n Hood Installation
I I Emergency Generator < 30 kw n LP /Natural Gas - Installation
I — I Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale
n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
IUtriyI (Semis Other
Sprinkler n ❑ ❑ ❑ I I Recreational Bum
Fire Alarm n ❑ ❑ ❑ I I I 1 Sparklers
Hood Cleaning n ❑ ❑ ❑ I 1 n Sprinkler System Installations
Hood Suppression D ❑ J I n Standpipes (Sprinkler Sys)
n Fire Alarm Installation n Torch Roofing/Tar Kettle
n Fire Pumps n Waste Tire Storage ANNUAL
n Fire Works
n Flammable Application- ANNUAL
1 I Valuation of Project
El Fuel Tanks
Other: I
mom a_15:z,u. Nge ., uua:. ,aklia.' . �'"" KfilfaaSaalaMEZEM.Zgan a a , ..... ';o.. '�..K.. ._..,_...,.a..d1xe3... d'&ntR Z? M5/MMIw,: "e:'.,,, "' ?'`k ...geM MI `f aie,;s:.
Contractor Company S'LU 3/ 1.339 I
Signature O Registered Y / N / Fee Current I Y / N
Address I I License # I
ELECTRICIAN Company I
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License # I I
PLUMBER Company I
Signature Registered Y / N I Fee Current I Y/ N J
Address I I License # I I
MECHANICAL Company
Signature Registered Y/ N I Fee Current I Y/ N I
Address I I License #
OTHER Company I
Signature Registered Y/ N j Fee Current I Y/ N I
Address J License #
Directions:
,.w.....su�..:.;;u �..w.....,. w.. .�..axv:v , ,.u....a,>.3.i..s .whssxv.w:o .+a..,„..........o., s..v3.aws .n.ue•' ....,.w.ca. s:...a..,v�Td.a: u,3�'' _....w ., to ?..x. .<.,";c e.,.e.u:aae. ..e._....aw:. 1 w...aa....t..:: ...aa,�s;; xxt :. t'
ns:
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 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 (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 TO YOUR PROPERTY. IF YO INTEND OF COMMENCEMENT. FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORD!
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR .�
Subscribed and sworn to (or affirmed) before me this Subscribed and wom 0 (or =ffirme efore me this
by by ,al/Irt 4-1 L7 �2R
Who is /are personally known to me or has /have produced Who is /are personal y 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
z.v---400 �L � A / *-o?
SECURITY FIRE EQUIPMENT 1. All appliances protected with correct nozzles: ® N
18330 Lawrence Rd 2. Duct & Plenum protected with correct nozzles No
Dade City, FL 33523 3. Position of all nozzles correct 400 No
. (352) 567 -7340
4. System installed in accord with Man. — UL listing 46 No
5. Hood — Duct penetrations sealed No
Fire Suppression System Report 6. Has system been discharged or damaged Yes CRS7
f 7. What is the cylinder pressure
\lame: / G� a � , 1A , .oc ii41erl7
8. What is the cartridge weight
Address: 1 � 2� /� 9. Gas Valve 41-Mechanical Electrical / 10. Hydrostatic test Date /. /�
Zity: - `yell g " State: FL. Zip:
11. Operate system from fosibie link Yes No
Dwner — Manager 12. Operate system from remote release Yes No
13. Did micro- switch function Yes No
'hone: ( )
14. Did gas shut -off valve function
Yes No
15. Clear all nozzles Yes No
Date of Service Time 16. Nozzle covers in place
7,7 ,a,a1040. AM 614 _ Yes No
Type of Service 17. Check & clean fusible links Yes No
Semi Annual New Recharge 18. Replaced. fusible links Qty Yes No
�� Model 19. Piping securely bracketed
Yes No
Master Cylinder Slave Cylinder' 20. Exhaust fan operating Yes No
Link Temp Type of Link 21. All grease filters in place & clean Yes No
ML - B — K 22. Personnel instructed on use of system Yes No
Fuel Shut -Off Valve Size 23. Exhaust hood — duct clean
Yes No
Serial Nbr DOM 24. Alarm Actuation Yes No
�ppI1811Ces Comments or discrepancies: i % o-we-C ..r y1. -�
• '/ , _0. / v o &tv_ - 64., sir !t
Length Width Appliance Type
Gas - Electric aZa_ A ' 4 / 11,sc a �1 r Gt,, t/
Gas - Electric
Gas - Electric
Gas - Electric "
On the above date, this system was inspected & tested in accordance with procedures of the
Gas - Elect preswdy adopted editions of NFPA 17, I7A and the mamdact rer's manual and was operated
Gas - Electric among to these procedure with results indicated above.
Gas - Electric Disclaimer
Gas Electric Owner — Mgr understands that all discrepancies mu stbe addressed within 10 days of this report
and twills equipment must be re- inspected after discrepancies are conected. Security Fire
Gras -Electric
Equipment will not be held liable for any pre- engiieered fire suppression system failure. Owner —
Mgr understands that this is a fee suooression syst++ and that operation of this system may not
Gas - Electric extinguish a fire or a fire may initially be suppressed bid can re- igriite. Owner — Mgr will be
responsible for in nediatey notifying emergency services to respond to these premises in the
Gas - Electric event of a fore. Owner — Manager assumes ail responsibility for doge andlor ip'ury due to a fire
rate Exhaust System Cleaned: or fire suppression system failure on these premises
leaned by: Operator Instructed: -
Owner — Mgr: A / ,'c'Sr,v..°
SUBMITTED PLAN(S) HAVE BEEN REVIEWED Service Technician: 7
BY ZEP • 11 / I : ; ARSHAL'S OFFICE •
Date: //"Y.' _
Reviewer: �r�% _ �
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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.: 297 0 0 2 _ Contractor: :..,, / lL
Business Name: / ! - : _ ; ror Billing Address: �4Mr-,' a.Aey 44 ` ,.
Business Address: .S C ' ,<- ,;, ei-.v, „<--Z- ,...s. ,.
Business Phone No.: Billing Phone No.:
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FEES _ INSPECTION FEES _ PERMIT FEE _ FALSE ALARM FEE
^ Site Plan N/C _ Annual N/C _ Sprinkler $50 — 1st Alarm N/C
Multi Family /Commercial .06 sf _ 1st Re- inspection N/C _ Standpipes $50 _ 2nd Alarm N/C
(Minimum Charge $25.00 _ 2nd Re- inspection $100 Fire Pump $50 _ 3rd Alarm N/C
0 Plan Revisions DBL _ 3rd Re- inspection $250 )Hoods 4 f � $50 _ 4th Alarm $100
4th Re- Inspection $500 _ Fire Alarm $50 _ 5th Alarm $150
SPRINKLER SYSTEMS (Business closed until _ LP Gas $50 _ 6th Alarm $200
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
0 Per Riser $50 _ Hydrostatic Test $65 per system _ Fire Works $500
FIRE PUMP _ Acceptance Test $45 pe system _ Camp Fire $25
El Per Pump $100 Hydrant Flow $75 _ Controlled Bum $100
_ FIRE ALARM SYSTEM _ Hood/Duct $50
0 - 25 Devices $50 _ FIRE ALARM SYSTEM — Place of Assembly $50 Annual
26 plus Devices $100 _ System Acceptance 550 _ Fire Protection $25
_ SUPPRESSION SYSTEMS _ Recall Acceptance 550 _ Flammable Application $50 Annual
— Wet $50 _ OTHER — Waste Tire Storage $50 Annual
_ Dry $50 — Fire Wall/Smoke Wall $15 per wal Generator < KW $100 —
_ CO2 550 _ LP Gas $25 per tank Generator >30 KW 150
Other $50 _ Natural Gas $25 per system _ Bio-Hazard Waste 5100 Annual
KITCHEN EXHAUST _ _ Fumigation Tenting $50
0 Hood/Ducts $50 ` Tent 10x10' or greater $15 per tent _ Torch Pot/Applied $50
OTHER _ Fire Pump $45 _ Haz. Materials $100 Annual
LP Installation per tank $50 _ Fire Suppression 530
Fuel Tank Installation 550 _ System Acceptance
(Per Tank) $50 Exhaust Hood/Duct $30
Ei Natural Gas Installation $50 _ Re- inspection DBL
(Per System) (other than annual) _
❑ Spray Booth $50 El Inspection scheduled DBL
and cancelled less than _
24 hours
El Construction Insp. N/C
Emergency Vehicle MI $50 — ' FALSE ALARM
PLANS TOTAL r_7,1! INSPECTION TOTAL PERMIT TOTAL I TOTAL
GRAND TOTAL I • ..> I
Comments:
Date: . 7467
InsRactor: % 9 f i-G'' ” !
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus (813) 780 -0041
Kerry Barnett Fax (813) 780 -0044
E -mail: kbarnett@fire.zephyrhills.fl.us
Plan Review #: 09 -062
Project: Suppression System Re -pipe — Village Inn
Number of Pages: 3
July 27, 2009
I have received and reviewed the plan for the suppression re -pipe located at 5214 Gall
Blvd and will allow this to move forward. Obtaining permit, the applicant acknowledges
complying with the items listed below.
Should anyone have any questions, please do not hesitate to contact the Fire Marshal's
office.
1. This was a re -pipe due to appliance change by occupant. System was not
compliant after change and required a change in nozzle placement. This shall
be done in compliance with NFPA 96 and 17A.
Inspections Required:
1. Call for site inspection.
KERRY t , ve TT, FIRE MARSHAL
***Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance with applicable fire safety codes. This review is not intended to be a final approval of the
submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance
with all applicable NFPA codes and local ordinances. In the event that further examination or site
insQection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole
expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure
to be in compliance with all applicable NFPA codes and local ordinances.