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Home My WebLink About15-16282 CITY OF ZEPHYRHILLS ' � r 5335-8TH STREET ' � (813)780-0020 162 2"� � FIRE SPARKLERS PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 16282 Address: 7631 GALL BLVD �� Permit Type: FIRE SPARKLERS ZEPHYRHILLS, FL. I Class of Work: FIRE-SPARKLERS Township: Range: Book: ' Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 34-25-21-0110-00000-0010 Improv. Cost: OWNER INFORMATION Date Issued: 5/19/2015 Name: SUPER WAL-MART Total Fees: 130.00 Address: 7631 GALL BLVD Amount Paid: 130.00 _ ZEPHYRHILLS, FL. 33542 Date Paid: 5/19/2015 Phone: (479)204-1063 Work Desc: SPARKLER SALE WALMART CONTRACTOR S APPLICATION FEES TNT FIREWORKS WALMA T FIRE PERMIT FEES 100.00 CONTRAC OR CERTIFICATE 30.00 � �l f � � I Ins ections Re uired - FIRE INVENTORY O SITE INSP 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. "SPARKLERS" per Section 791.01, Florida Statutes, means a device which emits showers or sparks upon burning,does not contain any explosive compounds,does not detonate or explode, is handheld or ground based,can not propel itself through the air,and contains not more than 100 grams of chemical compound which produces sparks upon burning. � CO CTOR SIGNATURE PERMIT OFFIC PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE - 813-780-0041 1 I _. � 813 780-0020 City of Zephyrhills Fire Fax-813-780-0021 �� Permit Application Date Received Phone Contact for Permit 800� 868 9151 i�:r-��----.,�----� �.._ �,_,_�__. .�.,._.... _.^��.�.-.�.�^�:.w._...�.._� �..�,..� ._ _.___, ..._u - __._., Owners Name Wal-Malt#706 Owner's Phone Number � 813 782 1957 Owner's Address 7631 Gall Blvd, Zephyrhills, FL 33541 Fee Simple Titleholder Name Titieholder Phone Number � � � Fee Simple Titleholder Address I _'..'_..�.�-. '....."...,_.—,-.."�"""�." - - - �.-"T'z Job Address 7631 Gall Blvd �ot# � Sub Division Parcel# �'.°'.°..' ,- .�._....,._. _.._..._...�.._...�_..�..... ......_..,.�d ..�.._.v,_..___.�___ ,_._..._�_........� _.— -�=^� � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL � Comm Exhaust Kitchen Hood/Duct � Hood Installation � Controlled Bum � LP/Natural Gas-Installation - /n Q,�� Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale l(l'/(��J � Emergency Generator>30 kw � Places of Assembly-ANNUAL � � Fire Protection Maintenance-ANNUAL � Recreational Burn tr y emi �n t er sprinkler � ❑ ❑ ❑ X❑ sparklers Inside Retail Sales of State Approved Sparklers Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) Hood Suppression � ❑ ❑ ❑ � � Torch RoofinglT Kettle � Fire Alarm Installation � Waste Tire S o ANNUAL � � Fire Pumps �i�� Fire Works-SPARKLERS s � � Flammable Application-ANNUAL Valuation of Project � Fuel Tanks Q Other: L�- ,._...... _._._�._....u.._.� ._.._. ..�..� :.....��. ,.�^-•-----°��-------� Contractor Company Signature Registered Y/N Fee Current Y/N Address License# ELECTRICIAN Company Signature Registered l�/N Fee Current Y/N Address License# " � PLUMBER Company Signature Registered Y/N Fee Curre�t Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License# � Vendor Company TNT Fireworks Signature Registered Y/N Fee Current Y/N Address 6255 SE 78th treet, Ocala, FL 34474 �icense# „r-�---_-___--�t.t��.... .._.�..< ._..,.____4_ _._.. � _�.......°~-----r°—:�..�:�u. _ - ...w,. - 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) -Site plan at store-placement dictated by Fire Marshals office , -State Sparkler Licence attached , -Product List attached TNTo FlREWORKS Site Plan Worksheet STORE NAME 1 LOCATION#lAYOUT OF INAL-MART LOCATION'S TYPE OF EVENT: In�store sales af Consumer Fireworks Walmart 706 Zephvrhllls, FL REAR OF BUILDING �".,r��:�,:�� _ , ��M `�"_a.�_:.�... :r;�°:��,��'� �� "�}fYa;r-1':�...t. .'t;`, - - .'t?;:.;.:i.-.>-:s,..�s� i:i,�'.vc:. :.'''-e'.'.'+ '�. a_ ��?'�w°;%ry"'+�f14"s%�a.`°�e ti' 't :- �":7�'is.s?•?.�' ��e�� .'ui-`°.�-:'� .: ':'r.:= __ 1:. .__ _ ; .,'• ._.�Y ;�� _ '�,�. ;��,e7<..s:;kti,�� _ t� ' .:'F:' :�`A'C�a.. r,� ', t4T� i`i ActionA�ey(&aoaalA�lej �" , ..? � �'�� a FJreworlu � ri' '�;. :,4� ��. «, ;p.�, ?�a< ' �:.t Regisfers �i; I , , ' � ' 1 , 1 , � 1 , r.� %'��-4�=;8:� �a�,��: c7��' 1`' i.c^ , . ,-?;�"s-��'A�„1�.5_,S �; � �.�"h -F'�, ':t' 'ta�;��'��G._�J�.�J� �,�� l e.�rwwR e.m �=��j l':� FRON'f INSTURCTIONS:Wal•Mart enerall laces the sales dls I s of consumer fireworks raducts in the fron of the stores on the front side alsles(Action AIlev1 nearthe entrancelexit whtch Is known as the seasonal alsle.This is a aeneral overview of a t ical Wal•Mart Su er Center and roduct lacement ma /should be dictated�b instrucfion of the ins ector de endin on the indtvidua!locations ne and or store setu . �C� S�M�b�� St 6�1 S' {�`'� 9� r?a°�'r�-� 1 4 ( �-� 1��s � '� � 1 �53-01949550 - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - 21362 Order #: 1949550-53-00002 Chain Store Sales-FL Chains Order Date: 3/13/15 Terms : Net 60 Days CUST PO: 8154565272 SLSMN: Chain Stores - East Sold To: 1410002 Ship To: 1056090 - WAL0706 � WALMART - CORPORATE 00001 WALMART 0706 702 SW 8TH STREET 7631 GALL BLVD BENTONVILLE, AR 72716 ZEPHYRHILLS, FL 33540 Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- *********�***************** Assortments *��*�****�*****�******** BACKYARD SHOW WOPDQ USA SS Jl 102015A 12 CS 120 EA 19 . 9700 10/1 70055727 BLAST ZONE USA SS J10 102018 5 CS 50 EA 29 . 9700 10/1 70046873 DUMP BIN BLAST ZONE SS J15 102018B 1 CS 48 EA 29 . 9700 � 48/1 27736007677 DUMP BIN RED WHITE BOOM BX SS 102380B 1 CS 40 EA 49 . 9700 40/1 27736023325 DUMP BIN THUNDER MAX SSCOM J1 102213B 1 CS 20 EA 79 . 9700 20/1 27736029563 FUN BLAST SS COM W/PDQ J12 102205 4 CS 96 EA 9 . 9700 24/1 550437037 RED WHITE BOOM BOX SS 102380 4 CS 24 EA 49 . 9700 6/1 27736023325 � THE ULTIMATE SHOW J14 102328 2 CS 8 EA 79 . 9700 4/1 552479743 VALOR SS USA 102388 1 CS 3 EA 99 . 9700 3/1 27736034499 ****************�*�******�* Base Fountains ********�*************� JUMBO 20 RKT FTN PDQ J09 200815 1 CS 48 EA 5 . 0000 48/3 550503486 MINI CALIFORNIA RKT 3PK J13 200849A 1 CS 144 EA 2 . 0000 6/24/3 70007715 *************************** California Candles *********************** JUMBO CALIF CANDLES 3PK SS J1 230019A 2 CS 96 EA 5 . 0000 48/3 550437032 *�************************* Ground Spinners *********************** GROUND BLOOM FLOWER 20 CT BOX 290157A 2 CS 80 EA 5 . 0000 2/20/20 551358833 �**************�*********** Novelties **********�************ TNT SNAPS 4 PAK J09 320532 1 CS 153 EA 2 . 0000 153/4/50 550503480 Page No 1 - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - , � , � Order #: 1949550-53-00002 Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- *********�****************� Smoke **��***�*************** SMOKE BALLS BOX OF 8 J12 351052 2 CS 192 EA 2 . 0000 4/24/8 550437025 **�************************ Sparklers **�***************�**** #20 NEON SPARKLERS J11 380266 3 CS 144 EA 5 . 0000 48/7 70077709 #8 SPARKLERS ASST 2 PDQS J14 380247A 3 CS 252 EA 2 . 0000 2/42/6/5 27736022755 14 IN SUPER PAK MG J12 380265 2 CS 216 EA 2 . 0000 2/54/20 70077744 *****�********************* Promotional Supplies *********************** SIGN -SPARKLERS NO SMOKING 730643E 2 CS 2 EA 0 . 0000 1/1 Case Totals : 48 CS Total Pallets : PL Total Repack Cases : CS DECLARATION OF COMPLIANCE American Promotional Events, Inc. , dba TNT Fireworks, certifies that all consumer fireworks identified on this invoice have been tested by the American Fireworks Standards Laboratory and found to conform with all applicable regulations, standards and bans enforced by the U. S . Consumer Product Safety Commission. Testing and certification for these items complies with rules, standards and bans applicable to consumer fireworks : �i Performance Standards 16 CFR 1500 . 17 (a) (9) 16 CFR 1500 . 17 (a) (11) �' 16 CFR 1500 . 17 (a) (12) 16 CFR 1507 Powder Content Bans 16 CFR 1500 . 17 (a) (3) 16 CFR 1500 . 17 (a) (8) , 16 CFR 1500 . 85 (a) (2) !� Cautionary Labeling 16 CFR 1500 . 14 (b) (7) 16 CFR 1500 . 83 (a) (27) ' Contact information for laboratory that performed conformity testing. American Fireworks Standards Laboratory (AFSL) 7316 Wisconsin Avenue, Suite 214 Bethesda, MD 20814 301-907-9115 afslhq@afsl .org � CONTACT INFORMATION FOR INDIVIDUAL MAINTAINING RECORDS ON WHICH DECLARATION IS BASED: NAME: Kathie Pendergrass � ADDRESS : 4511 Helton Drive Florence, Alabama 35630 '' TELEPHONE: 256-764-6131 Page No 2