HomeMy WebLinkAbout10-10365 CITY OF ZEPHYRHILLS
5335 - 8TH STREET 10365
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
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Permit Number: 10365 Address: 5935 GALL BLVD
Permit Type: FIRE PROTECTION MAINTENANC ZEPHYRHILLS, FL.
Class of Work: FIRE - PROTECTION MAINTENAN •E Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 10-26-21-0020-00000-0050
Improv. Cost: -r
Date Issued: 4/15/2010 Name: JOHN -MARY ENTERPRISES LTD
Total Fees: 25.00 Address: PO BOX 17072
Amount Paid: 25.00 ZEPHYRHILLS, FL. 33682
Date Paid: 4/15/2010 Phone:
Work Desc: FPM - ANNUAL FIRE ALARM FOR JOHN -MARY ENT- INSP ALRDY DONE SEE NOTES
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M ALAR IALI • " " I " , 25.00
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Fl - A PA E inal
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
COMMENCEMNT 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."
1
P ' IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041
813 - 780 -0020 1 l City of Zephyrhills Fire Fax- 813- 780 -0021
A ✓/ t: � Permit Application
Date Received t' Phone Contact for Permit F J I
Owner's Name I Y . f 1 (ti p ig P OlGr § P Number (al I ( 11 I I,(eal
Owner's Address (6Gi:35" .t r C51 „ O ( - 2 j► ych t l iS i f2— 33 52 1c•
Fee Simple Titleholder Name I I Titleholder Phone Number I I I 11 I
Fee Simple Titleholder Address I
: mTr
.,., '� s - aa�. ,..:.,,. �.i. - - . : . a. �:+® 1�Ya. rroais r ). . ,.... . . 35 Job Address • Z e , ( h t i t s ft, s--()__.. I
`-( Lot # I
Sub Division I "C Parcel #
,:' ,. , ,.,5 ,...,',..,;,7,'` : S'»* -. ;+.=wr «^SS,„r*< .' 3 :;�"' ..,.. 71 ' a;„a -4`,,, v^.ws,ikp.
E Bio- Hazard Waste Storage - ANNUAL rI Hazardous Material (Tier II or RQ Facility) ANNUAL
EJ Comm Exhaust Kitchen Hood /Duct 0 Hood Installation
E Controlled Burn 0 LP /Natural Gas - Installation
Emergency Generator < 30 kw 0 LP /Natural Gas - ANNUAL Sale
0 Emergency Generator > 30 kw n Places of Assembly- ANNUAL
II „ Fire Protection Maintenance - ANNUAL 1E Recreational Burn
El r y UM 'Other
Sprinkler ❑ ❑ ❑
Sparklers
•
( Fire Alarm_
,,, ❑ ❑ I I Sprinkler System Installati. s
Hood Cleaning Ej ❑ ❑ ❑ I I � ��
Standpipes (Sprinkler S ) -if /�7
Hood Suppression El ❑ ❑ ❑ I I ❑
Torch Roofing/Tar Kettl-
Fire Alarm Installation n Waste Tire Storage ANN • •
Fire Pumps
Fire Works
Flammable Application- ANNUAL 1 Fuel Tanks I Valuation of Project
Q Other: I
Contractor I Company
Signature I Registered Y/ N I Fee Current I Y/ N 1
Address I I License # I
ELECTRICIAN! I Company
Signature Registered Y / N J Fee Current I Y/ N
Address I I License #
PLUMBER I I Company I
Signature Registered Y/ N 1 Fee Current I Y / N 1
Address I I License # I
MECHANICAL!
I Company
Signature Registered Y/ N I Fee Current I Y / N I
Address I I License # I
OTHER I
11 I Company (z fn I
* Signature I �" �-� � i` �') ��Q.C.IIL�t Sf
Registered Y / N ( Fee Current I Y / N I
Address S -- j �l e
q•.3 License #
Directions:
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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 htt //a
. - �/ ( p: ppraiser.pascogov.com)
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:, FIRE ALARM INSPECTION AND TESTING FORM `
Alarm Specialist Corp. Date: a m CjCC.Lt ._ t 0 Time 1 0, 5
SERVICE ORGANIZATION PROPERTY NAME (USER) . r-- Name: EMG ALARM SPECIALISTS . Name: _�0) n -- m r ) Ct rt1 E 11 f er Prt5 ,e_
Address: 1375 EAST AVENUE N., SARASOTA, FL 34237 Address: 5-Q ::, C . 1 1 Njim, . 7 _ e p; y r j, i (16 Y/ ' :
Representative: A) Cf e- !tl kit is f Contact: /VI 61 j c
License No.: EF- 0000096 Telephone: a� - 5 - 6.4 r (
Monitoring Entity Approving Agency
Contact: }" C, Contact:
Telephone: (941) 366 -9130 Telephone:
Monitoring Account Ref. No.: A S -- 7 q e e7 Ticket #: Customer #:
TYPE TRANSMISSION SERVICE F.A.C.P.. r D.A.C.T.
Multiplex ❑ Monthly Panel Manufacturer: S , f ri t j 1 Le AA. e
(D/Digital ❑ Quarterly Model No.: 6 d (3 c1
D Other (Specify) 1mi Annually Circuit Styles:
An nually No. of Circuits: LI
Signaling Line Circuits 0 Other (Specify) List Dates System ad any service performed:
Qty: 'v( Style:
ALARM INITIATING DEVICES AND CIRCUIT INFORMATION
QTY OF CIRCUIT STYLE QTY OF CIRCUIT STYLE
A j p Manual Stations Heat Detectors
Ion Detectors Waterflow Switches
1 a Photo Detectors I Supervisory Switches
g Duct Detectors Other: (Specify)
ALARM INDICATING APPLIANCES AND CIRCUIT- INFORMATION
QTY OF CIRCUIT STYLE QTY OF CIRCUIT STYLE
Bells Strobes
7 P--) Horns /3t(Ob . Other: (Specify)
Chimes � �
No. of Alarm indicating circuits: �,�, Are circuits supervised? itiYes ❑ No
SYSTEM POWER SUPPLIES
a. PRIMARY (Main): Normal Voltage 1 a. ( J , Amps: / 3 b. SECONDARY (Standby)
Overcurrent Protection: Type: 6i4 -,,t , Amps: 7' C � I D (J - f" Storage Battery: Amp -Hr Rating: " 7 /1 N,
Location (Panel Number): 4. Calculated capacity to operate system, in hours y 24 60
Disconnecting Means Location: c ( c . 4 . ' r` o .,.v Engine - driven generator dedicated to fir alarm system:
Location of fuel storage:
PRIOR TO ANY TESTING
NOTIFICATIONS ARE MADE: Y�E ' NO WHO TIME
MONITORING ENTITY lq ❑
BUILDING OCCUPANTS 0 - M�, S
BUILDING MANAGEMENT (1Ac f Sa,
OTHER (Specify) ❑ ❑ `
AHJ NOTIFIED OF ANY IMPAIRMENTS ❑ 0 ly
SYSTEM TESTS AND INSPECTIONS
TYPE VISUAL FUNCTIONAL COMMENTS TYPE VISUAL FUNCTIONAL COMMENTS
Control Panel GY ( j Transient Suppressors ❑ El
Interface Equip. Y . Er Remote Annunciators ❑ ❑
Lamps /LEDs Id C� / ) / ) G
Fuses tom' Y IT Notification of Appliances: � Ci L F---
Primary Power Supply C Audible C t �
Trouble Signals
0 // � � Visual E 11/ Disconnect Switches Gd Id / Speakers Ir
Ground Fault Monitoring ,r v r y .
DEVICE SIMU �
INTERFACE EQUIPMENT: VISUAL OPERATION OPER �� , .. , �'
(SPECIFY) HVAC ❑ ❑ • ice' ° , tt,�
(SPECIFY) Elevator Recall 0 13 0 i,3 ,'� � ,f - s ' .
(SPECIFY) ❑ Li D t , ' /2 /i � „' z . ' � ' - ` Z c s ' "i'
EMERGENCY COMMUNICATIONS EQUIPMENT: ' " 4 " ' a "% '1 t , ` "S"
VISUAL FUNCTIONAL fi lls - -d� 41,',0t.,}- .,
0 Phone Jacks ❑ ❑ x e t y ' ilk , ,� }�� `,.
❑ Amplifiers 0 ❑ a �� �' : } a ' :
❑ System Performance 0 ❑ 0 , ' r sP � '' 4 k
ON /OFF PREMISES MONITORING: 1,1 , t "�`' ;tit : ' "4 }> n
ii�� 3�, drf� : ff i k X � ',,,,t z ��, 9
YES NO TIME COMMENTS ”' ' `^`. k , k ,, , F k ', � ,, 1 TIME L
Alarm Signal 0 jot(�5 1 ',.*,71,;: i i , ? . , "I /� �
£a
Alarm Restoral , C� ❑ 4 ,, k � ' t i l
Trouble Signal lfl' /O - - nom , , ' Ill
Supervisory Signal O �� .
Supervisory Restoral (0 � ' . . . ' ' - r a s s z "
; .
THE FOLLOWING DID NOT OPERATE CORRECTLY: - '`` ` f ,2
SYSTEM RESTORED TO NORMAL OPERATION DATE: TIME:
THIS TESTING WA ERFORMED N ACCORpANCE WITH APPLICABLE NFPA STANDARDS.
Name of Inspector: c fi t� f i 4 "" Name of Owner or Representative: ) �]
7g /t. y � /
Date: 2- yl • _ . — Time: Date: , - ,if , Q im- / .' :its
Signature: L/ _ * ` Signature: [ f a , , e v -