NASSAU COUNTY FIRE PROTECTION PERMIT APPLICATION

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BUILDING PERMIT# Revised 6/30/15 AP# PERMIT # Cost $ Check# Receipt# NASSAU COUNTY FIRE PROTECTION PERMIT APPLICATION 5 TH EDITION (2014) OF THE FLORIDA BUILDING CODE IS IN EFFECT THE 2012 FLORIDA FIRE PREVENTION CODE 5 TH EDITION IS IN EFFECT Owner s Name (Please Print) Signature Phone: Day ( ) Alternate ( ) Owner s Address: City: State: Zip Code Contractor(Please Print) Signature Business Name (Please Print) Business Address: City: State: Zip Code: State Certification or Registration # Phone # ( ) Mobile/Beeper ( ) Fax # ( ) PROPERTY INFORMATION Property Identification Number: - - - - - Subdivision Block Lot Physical Address (Project Site): City: State: Zip Code: SPECIFIC DIRECTIONS TO SITE: Specific Description of Work: Residential Commercial New Repair/Maintenance Number of Sprinkler Heads Alarm System Number of Fire Hose Cabinets Wet/Dry Standpipes Fire (Range/Grease Hood) Suppression System Estimated Construction Cost $ If the estimated cost of construction of this job is greater than $2,500 and not related to a Building Permit, a certified copy of the recorded Notice of Commencement must be submitted to the Building Department prior to scheduling your first inspection (FS 713.135(d).

NOTICE OF COMMENCEMENT FS 713.13 REVISED 1/3/12 MUST BE RECORDED AT THE NASSAU COUNTY CLERK S OFFICE Property Appraisers Parcel Identification: NOTICE OF COMMENCEMENT State of Florida County of Nassau The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes the following information is provided in this Notice of Commencement. Legal description of property (include street address, if available) General description of improvements Owner s Name Address Owner s Interest in site of the improvement Fee Simple Title holder (if other than owner) Address Phone: Fax: Contractor Address Phone: Fax: Surety Phone: Fax: Address Amount of Bond $ Lender s Name Address Phone: Fax: Expiration date of notice of commencement (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified),.20 WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. Signature of Owner or Owner s Authorized Officer/Director/Partner/Manager Print Name and Provide Signatory s Title/Office State of Florida County of Nassau I have relied upon the following identification of the Affiant Sworn to and subscribed before me this day of Notary Signature Printed Name

NOTICE OF COMMENCEMENT FS 713.13 REVISED 1/3/12 MUST BE RECORDED AT THE NASSAU COUNTY CLERK S OFFICE Property Appraisers Parcel Identification: NOTICE OF COMMENCEMENT State of Florida County of Nassau The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes the following information is provided in this Notice of Commencement. Legal description of property (include street address, if available) General description of improvements Owner s Name Address Owner s Interest in site of the improvement Fee Simple Title holder (if other than owner) Address Phone: Fax: Contractor Address Phone: Fax: Surety Phone: Fax: Address Amount of Bond $ Lender s Name Address Phone: Fax: Expiration date of notice of commencement (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified),.20 WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. Signature of Owner or Owner s Authorized Officer/Director/Partner/Manager Print Name and Provide Signatory s Title/Office State of Florida County of Nassau I have relied upon the following identification of the Affiant Sworn to and subscribed before me this day of Notary Signature Printed Name

NASSAU COUNTY BOARD OF COUNTY COMMISSIONERS NASSAU COUNTY FIRE RESCUE DEPARTMENT FIRE PREVENTION 96160 Nassau Place, Yulee, Florida 32097 (904) 491-7525 Fax (904) 321-5748 PLANS SUBMITTAL FIRE ALARM PERMITTING REQUIREMENTS Two sets of plans and at least one set of manufacturer's specifications for all components, including wire, shall be submitted to the Building Department for approval by the Fire Department. Plans shall indicate, among other things, the project address, and the suite number if applicable. Submittal shall clearly indicate; scale, location of all devices (including EOL' s), panels, power supplies, and risers. A copy of the battery backup calculations shall be submitted for all systems. Voltage Drop calculations for indicating circuits when required. The voltage drop to the farthest outlet should not exceed 5% of the supply voltage. For systems with voice evacuation capabilities, amplifier calculations shall be submitted. Florida Statute 553.79 (6)(e) requires that systems over $5000.00 of value shall bear the seal of a Florida registered Professional Engineer. Provide a copy of the signed contract for proof of valuation. Fire alarm work shall not begin until the electrical permit is issued. INSPECTION PROCEDURE To receive a satisfactory final inspection the following is required: Installing contractor shall request an inspection by calling the Building Department at (904) 491-7337. A minimum of 24 hours advanced notice is required. An approved set of plans shall be available on the site at all times. The contractor shall have the Certificate of Completion & Inspection Testing & Maintenance forms, provided in NFPA 72 (2010 Edition). The Fire Alarm Control Panel shall have the certification tag affixed in accordance with the State Fire Marshal Rule 69A-48. The Contractor shall have adequate staffing available to perform the required tests. Information provided here shall be used only as a guide. Fire Prevention Plans Review reserves the, right to request more information if deemed necessary in order to assure proper system installation and testing.

NASSAU COUNTY BOARD OF COUNTY COMMISSIONERS NASSAU COUNTY FIRE RESCUE DEPARTMENT FIRE PREVENTION 96160 Nassau Place, Yulee, Florida 32097 (904) 491-7525 Fax (904) 321-5748 RANGE HOOD FIRE SUPPRESSION PERMITTING REQUIREMENTS PLANS SUBMITTAL PROCESS * Two sets of plans and two sets of manufacturers specification for all components, including wiring, shall be submitted to the Nassau County Building Department for review, and departmental approval by Nassau County Fire Rescue, Fire Prevention. * Plans shall indicate among other things, the correct project address, suite number if applicable, and current edition of NFPA 1 Chapter 50, NFPA 17A, and NFPA 96 as adopted by the Florida Fire Prevention Code. * Submittal shall clearly indicate: scale, approximate location of all kitchen equipment, heads, and piping. * For systems tied to the fire alarm panel, the fire alarm contractor must tie in the wiring to the fire alarm. * For systems not tied to the fire alarm system, upon activation of the automatic fire-extinguishing system, an audible alarm or visual indicator shall be provided to show that the system has activated. * Hood suppression work shall not begin until the permit is issued or the hood suppression contractor will be charged four (4) times the fee for the permit. INSPECTION PROCEDURE To receive an inspection and final the following is required: * Certified installing contractor shall request an inspection by calling the Nassau County Building Department at (904) 491-7337. You must call in by 4:00 pm the day before to schedule an inspection for the following day. * The approved stamped set of plans shall be available on site at all times for review. * The contractor shall provide any documentation required by NFPA 96 and the hood and pull station shall have the certification tag affixed in accordance with the State Fire Marshal rules. * The contractor shall have adequate staffing available to perform the required tests and inspections. * Movable cooking equipment shall be provided with a means to ensure that it is correctly positioned in relation to the appliance discharge nozzle during cooking operations. Alignment devices are required. * Movable cooking equipment shall be provided with restraints so as not to pull gas connections from device. The information provided herein shall only be used as a guide for review and inspection(s). Fire Prevention reserves the right upon the plans review process to request more information if deemed necessary in order to assure proper system installing and testing. Upon any hood suppression inspection(s), if design specifications do not meet reviewed set of plans or the inspection fails for any other reason a re-inspection fee may be charged and would have to be paid before a re-inspections is set up through the Nassau County Building Department. REV 1/1/15

Nassau County Fire Rescue Fire Prevention Inspection Types February 6, 2001(5/14/13) ALL INSPECTION REQUESTS ARE REQUIRED TO BE INITIATED BY THE PERMIT HOLDER, ALL REQUESTED INSPECTIONS SHALL HAVE THE PERMIT NUMBER UPON RQUEST, THE TYPE OF INSPECTION, THE NAME OF THE INDIVIDUAL MAKING THE REQUEST AND A TELEPHONE NUMBER WHERE THE INDIVIDUAL CAN BE REACHED IF NECESSARY. THE FOLLOWING IS A LIST OF FIRE PROTECTIONAND LIFE SAFETY INSPECTIONS PERFORMED BY NASSAU COUNTY FIRE RESCUE, FIRE PREVENTION WITH A BRIEF DESCRIPTION OF THE PURPOSE FOR THE INSPECTION INSPECTIONS REQUESTED FOR THE FOLLOWING WORK DAY MUST BE CALLED IN PRIOR TO 4:00 P.M. THE DAY BEFORE INSPECTION IS REQUIRED. TYPE DESCRIPTION 700 - FIRE ALARM INSPECTION: This inspection is made after all installation of the alarm components have been installed and the contractor has completed the certificate form provided in NFPA 72 (as applicable on the job site) and the fire alarm control panel has the certification tag affixed in accordance with the State Fire Marshal Rule 69-48. (must also Set up a 799 for final) 705 - FIRE ALARM ROUGH INSPECTION: This inspection is made after all wiring is installed and before any cover up is completed or building framing is completed. This inspection is to verify that the wiring is properly sized, installed and fastened within the building walls and concealed spaces. 710 FIRE SPRINKLER HYDRO AND ROUGH: The Fire Inspector shall witness a water hydro pressure test that has been pressurized for a minimum of two (2) hours at 200 PSI on the fire sprinkler system. 715 FIRE SPRINKLER FINAL: This inspection is made after all fire sprinkler system components are installed and have been tested by the installing contractor. The installing contractor shall furnish the Contractors Material & Test Certificate for Above Ground Piping to the Fire Inspector as proof of completion. (must also set up a 799 for final) 720 FIRE STANDPIPE ROUGH: This inspection is made after all standpipe system components have been installed. The inspector shall witness a pressure test of 200 PSI on the system. (must also set up a 799 for final) 730 FIRE HOSE CABINET ROUGH: This inspection is a portion of the Fire Standpipe Inspection (720) and is only required when Class II and Class III Standpipe Systems are required. (must also set up a 799 for final) 740 RANGE HOOD FIRE SUPPRESSION SYSTEM This inspection is made after all components are installed and are operational. All gas and electric items must shut off under the hood system and not reactivate until manually reset. This will also test the electronic gas shut off valve that shall be installed. (must also set up a 799 for final) 750 UNDERGROUND FIRE PIPING AND COMPONENTS ROUGH - This inspection is made after all components of the private water based fire suppression system have been installed underground and are ready for inspection by the Fire Inspector. The Fire Inspector shall witness a water hydro pressure test that has been pressurized for a minimum of two (2) hours at 200 PSI on the system. This rough may require one or more inspections. (Must also set up a 799 for final) 760 TENT INSPECTION: This inspection is made after the tent(s) are in place and exit signs and fire extinguishers are in place. (must also set up a 999 for final) 799 - FINAL INSPECTION FOR 700, 715, 720, 730 and 740, 750 Both rough and final (799) are to be set up at the same time. FINAL INSPECTIONS ARE REQUIRED ON ALL PERMITS. FAILURE TO OBTAIN FINAL INSPECTION MAY RESULT IN ADDITIONAL FEES