Peoria Fire Department
8401 W Monroe Ave
Peoria, Arizona 85345
623-773-7279

FIRE CODE APPEAL FORM
	
TO APPELLANT: 
* Please submit a complete APPEAL PACKET which includes:
* These forms completely filled out.  
* One (1) set of plans, which clearly indicates the areas being appealed and the conditions affecting the item(s) being appealed.   
* Plans should not be larger than 11” x 17”.
* Any photos, illustrations and other information that might further clarify your appeal.
* The details of your appeal described on the attached Information Sheet(s).
* Each issue of an appeal requires a separate Information Sheet.
* Multiple issues may be submitted under one appeal.
* A FEE OF $100.00 per hour (min 1 hour)– Make checks payable to “Peoria Fire Department”. 
MAIL or DELIVER to: Peoria Fire Department,
Attn:Fire Marshal, 8401 W Monroe Ave, Peoria AZ 85345.
We must receive payment for your Appeal by mail before the appeal process can begin.


Your written appeal will be reviewed by an Administrative Board, consisting of the Fire Marshal, Supervising Fire Protection Engineer and Senior Inspectors.   This Board will meet, as soon as is practical, after receiving your appeal, and will either grant or deny your appeal.  You will be notified of the disposition of your appeal by mail.

If you disagree with the Administrative Board ruling, you will still have the right to have the Fire Code Board of Appeal review your
Appeal.

PROJECT INFORMATION:  This appeal involves (Check One):
 Erection of a new structure
Building Permit #            ????? 
 Alteration of/addition to an existing structure
Plans Examiner Name:    ?????
 Correction of a violation 
Fire Inspector Name:       ?????
 Other, please specify  ?????
Business Name (If applicable):    ?????
Project Address: ?????
Cross Streets:  ?????
Owner’s Name: ?????
Owner’s Address:?????

In accordance with City Ordinance, I hereby make application to appeal the requirements of the Fire Code and or Policies of the City of Peoria as outlined in the attached information.
Appellant Name:	????? 
Phone Number: ?????
Firm Name:?????
Fax Number:     ?????	
Applicant Address:  ?????		  


Applicant Signature:  ?????	 
Date:	 ?????

FOR OFFICE USE ONLY
Received By:	
Appeal Date:	  
Date Received:	
Appeal Number:	  
Approved _____________                 Denied:______________
Previous Appeals: 


Peoria Fire Department
8401 W Monroe Ave
Peoria, AZ 85345
623-773-7279

FIRE CODE APPEAL INFORMATION SHEET
	
TO APPELLANT:

Each item you are appealing requires a separate appeal information sheet to be filled out.  All requested information is to be filled out completely with as much detail as possible.  Failure to do so may cause your appeal to be held over until adequate information is received. 
PLEASE ATTACH ADDITIONAL PAGES IF NECESSARY
Any modifications of the Fire Code and/or Policies requires an appeal.  A reasonable degree of EQUIVALENT LIFE SAFETY AND FIRE PROTECTION must be demonstrated before any appeal may be considered.

FIRE CODE SECTION AND/OR POLICY:     ?????		
CODE/POLICY REQUIREMENTS: 
?????


PROPOSED DESIGN: Describe the alternate methods and/or materials of construction to be used or that exist.  Be as specific and detailed as possible.	
?????


?????
REASON FOR ALTERNATE: Describe the details of the alternate design and how it will provide equivalent life safety and/or fire protection.

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