HomeMy WebLinkAbout16-17513 i
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. - �-' CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis)�so-oo20 1 7 3
FIRE WORKS PERMIT .��
PERMIT INFORMATION � � LOCATION INFORMATION
Permit Number: 17513 Address: 4241 SKYDIVE LN
Permit Type: FIRE WORKS ZEPHYRHILLS, FL.
Class of Work: FIRE WORKS Township: Range: Book:
Proposed Use: NOT APPLICABLE - Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 18-26-22-0010-08600-0000 ,
Improv. Cost: OWNER INFORMATION �
Date Issued: 6/23/2016 Name: 'CITY OF ZEPHYHRILLS
Total Fees: 505.00 Address: 4241 SKYDIVE LANE
Amount Paid: 505.00 �ZEPHYRHILLS, FL. 33542
Date Paid: 6/23/2016 Phone:
Work Desc: FIREWORK SPECIAL EVENT- MONDAY JULY 4, 2016
CONTRACTOR S _ � APPLICATION FEES
HAYES,JOHN DAVID FIRE PERMIT FEES 500.00 PECIAL EVENT 5.00
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Ins ections Re uired I
FIRE WORKS ITE INSPECTION I
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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 DepartmenYs 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.
"FIREWORKS" per Section 791.01, Florida Statutes are considered as any combustible or explosive
composition or substance or combination of substances or,except as hereinafter provided,any article
prepared for the purpose of producing visible or audible effect by i ombustion,explosion,deflagration,or
detonation.
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C T CTOR SIGNATURE PERMIT OFFIC
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041
Temporary Sales Checklist
City of Zephyrhills
5335 8`h Street
Zephyrhills,Fl.33542
Phone:813-780-0020/Fax:813-780-0021
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REQUIRE,MENTS �
���Detailed Plot Plan showing setup of location. Refer to Ord 1038-OA9��S��S K SHALL '
R COMPLY WITH
PREVAILING CODES "
Notarized letter from property owner stating their approval. FLORIDA BUtLDiNG CODE,
NATIONAL ELECTRIC CODE,AND
A flame retardant certificate is required IF a tent is involved.Insp�c� i�ix��e'�j����i���p���ES � �
. is erected and prior to opening for business. .,�
. . . REiIIEVV DA?E���
Approved certified fire extmguishers per NFPA 10. I CI� �F Z��E � ,
PLAI�6 � ,� ��.
No Smoking signs must be placed outside entrances.
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. IF there is a wire fence or chain link fencing must have at leist 5�����ud at least
2 exits.
IF tent has sides,the sides shall be in the up position unless there is inclement weather,
then 2 sides must be in the up position.
FIREWORK REQUIREMENTS—(In addition to'the above) I
' Proof of State License. i
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Proof of_I,iabili , insurance: _ �t ° f . �� : � ,,�r , '� �
<_✓ h'"�,.�.: . : - `
��. . S�-e�t� fl-S b�Lo c.,v ,
Li"st o.f items,to.,be s , , ;�--
� Co�. ',of Drivers License:and.Social..Securit ;Number of.all ,ersonnel dealin
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with the sale of fireworks at the tent location. ��� � ��- � � "" � �� `
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FEEs �
$30.00—City Registration(If Regulated by DBPR—Fee is Waived)
, �' $500.00—Fireworks fee-Fire Department fee
✓ $ 5.00—Temporary Sales Fee for 1 St two days
$ 1.00—Temporary Sales Fee per day for each consecutive day thereafter,not to
' exceed duration of 7 consecutive days and no more than two occurrences
during a 12 month period on same property Ord#1038-09,Sec 6
$ 55.00—Tent Fee 40.00BD 15.00*/FD * '
( , )� $15.00 waived for Fireworks)
$40.00—Electrical Fee(if applicable)
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Property Owner: � ( �� � 1�I ��
`Applioantt V I � � � �0��C�S ��
Phone Contact: � � — � � �
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Address Site: � �-�2 ti � S�`�1' �U��� Z� Z --%{l L LS F L
Date(s)of Sale:
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Ordinance No. 1038-09(for additional requirements)
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' � ` �;;�;DRNER LICEN&E CLASS�Ey � �
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I i ' � - �--JOHN DAY{D . I
`aa,;. ' HAYES • I
� 38801 FEATtiERiNG WAY
' ZEPHRYHiLLS,FL 33542-7194 ; ,
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DATE(MMlDLVYYI'1�
.dt����� CERTIFICATE OF AVIATION LIABILITY INSURANCE oJ,r�rs
i THI�ICATE IS ISSUEDAS A fVIATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND,IXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED ,
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER I
IMPORTANT:If the certlflcate holder Is an ADDITIONAL INSURED,the policy(les)must be endors�.If SUBROGATION IS WAIVED,subJect to I
the tertns and condftlons ofthe pollcy,cerlain policles may requlre an endorsement A statementon thls certlflcate does not confer righis to the
certificate holder in lieu ofsuch endorseme s. �
CONTACT �
PRODUCER NAME. �
Falcon Insurance Agency,I�C. PHONE F� '
P.O.Box 291388 ac.No.�a. ac,No:
Kerrville,TX 78029 E-MAIL PDDRESS:
RODUCER CUSTOMERIDhb.
INSURED INSURER(S)AFFORDING COVER4GE % NAIC No. I
5kydive City,Inc. wsuReR n.U.S.SPECIALT'INSURANCE COMPANY ioo�, I
4241 Sky Dive Lane INSURER B '
Zephyrhilis,FL 33542 INSURERC
INSURER D
INSURER E
INSURER F
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.NONVITHSTANDING ANY REQUIREAAENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT UYITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
AIRPORT&FBO LIABILITY COVERAGES CERTIFlCATE tdUMBER: REVISION NUMBER:
INSURER LETTER POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE ADDITIONAL INSURED7(Y/N) SUBROGATION WAI ED7(Y/N)
UA00167344-06 02/18/2016 02/'18/2017 Y N
COVERAGE OPTIONS LIMIT APPLIESTO LIMIT APPLIESTO
$ 100,000 BIEnPER $ PD
PREMISIS LIABILITY
$ 1,000,000 �,OCC $ 2,000,000 AGGR
PREMISES MEDICAL PAYMENT $ EA PER $ EA OCC
$ BIEAPER $ AGGR
PRODUCTS LIABILITY EXTENDED
$ EA OCC
COMPLETED $ BIEAPER $ AGGR
OPERATIONS F�C7ENDE0
LIP,BILITY $ EA OCC
INCLUDI NG TAXI
HANGERKEEPERS
LEGAL LIABILITY IN FLIGHT $ EAAIRCRAFT $ EA OCC
$
$ FA OCC $ AGGR
, $ FA OCC $ AGGR
INCLUDED EXCLUDED
COVERAGE
CODE DESCRIPTION OPTIONS LIMIT APPLIESTO LIMIT APPLIESTO
$ $
DESCRIPTION OF OPERATIONS!REMARKS(Attach ACORD 101,Addftlonal Remarks Schedule,If more space Is requlred)
ZEPHYRHILLS MUNI,ZEPHYRHILLS, FL
Certificate Holder is included as an Additional Insured.
CERTIFICATE HOLDER CANCELLATION
City of Zephyrhills and Zephyrhills Municipal Airport SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE
39450 SouthAve EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Zephyrhills,FL 33542 CCORDANCE WITH THE POLICY PROVISIONS.
urHowzEo a�ar�serrrnnvE
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O 2009 ACORD CORPORATION.All rigMs reserved.
ACORD 20(2009112j The ACORD name and logo are registered marks of ACORD
DATE(MM1DdYYYYJ
.4C[7R�� CERTIFICATE OF AVIATION LIABILITY INSURANCE o1,1�fB
��
THIS CERTIFICATE IS ISSUEDAS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEIW�I THE ISSUING INSURER(S),AUTHORIZED
REPRESQVTATNE OR PRODUCER,AND THE CERTIFICATE HOL.�R.
IMPORTANT:If the certlflcate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subJectto
the terms and condttlons of the policy,certaln pol�les may requlre an endorsement A s�tement on this certtflcate does not confer rigMs to the
certificate holder in lieu ofsuch endorseme s.
CONTACT
PRODUCER NAME.
Falcon Insurance Agency,II1C. PHONE F�
P.O.Box 291388 WC,No.F�d: P/C.No:
Kerrville,TX 78029 E-MAILPDDRESS:
RODUCER CUSTOMERIDt�h.
INSURED INSURER(S)AFFORDING COVERAGE % NAIC No.
Skydive City, Inc.
INSURERA.U.S.SPECIALIY INSURANCE COMPANY 10096
4241 Sky Dive Lane INSURER B
Zephyrhills,FL 33542 INSURER C
INSURER D
INSURER E
' INSURER F
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAAAED,4BOVE FOR THE POLICY PERIOD
INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERAA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT UNTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
AIRPORT&FBO LIABILITY COVERAGES CERTIFlCATE NUMBER: REVISION NUMBER:
INSURER LETTER POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE ADDITIONAL INSURED7(Y/N) SUBROGATION WAIVED9(Y/N)
UA00167344-06 02/18l2016 02/1 Sl2017 Y N
COVERAGE OPTIONS LIMIT APPLIESTO LIMIT APPLIESTO
$ 100,000 BI e,a PER $ PD
PREMISIS LIABILITY
$ 1,000,000 ea,OCC $ Z,OOO,OOO AGGR
PREMISES MEDICAL PAYMENT $ EA PER $ E4 OCC
$ BIEAPER $ AGGR
PRODUCTS LIABILITY EXTENDm
$ EA OCC
COMPLEiED $ BIEAPER � AGGR
OPERATIONS EMENDED
LIABILITY $ EA OCC
INCLUDING TAXI
HANGERKEEPERS
LEGAL LIABILITY IN FLIGHT $ EA NRCRAFT $ EA OCC
$
$ EA OCC $ AGGR
$ EAOCC $ AGGR
INCLUDED EXCLUDED
COVERAGE
CODE DESCRIPTION OPTIONS LIMIT APPLIESTO LIMIT APPLIESTO
$ $
DESCRIPTION OF OPERATIONS I REMARKS(Attach ACORD 101,Additlonal Remarks Schedule,If more space Is requlred)
ZEPHYRHILLS MUNI,ZEPHYRHILLS, FL
Certificate Holder is included as an Additional Insured.
CERTIFICATE HOLDER CANCELLATION
Pasco County SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE
8731 Citizens Dr. EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
New Port Richey,FL 34654 CCORDANCE WITH THE POLICY PROVISIONS.
UTHORIZE�REPRESENTATIVE ,
.�� �����'.
O 2009 ACORD CORPORATION.All rights reserved.
ACORD 20(20�112) The ACORD name and logo are registered marks of ACORD
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Jacqueline Boges
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From: Marcus Price<marcus@gpbrands.com>
Sent: Friday, June 17, 2016 9:21 AM
To: Jacqueline Boges
Subject: RE: Fireworks location picture& permit
Attachments: 20160616_174815.jpg; 20160616_174828.jpg; 20160616 174832.jpg; 20160616 174845.jpg;
20160616 174900.jpg; 20160616 174921.jpg; 20160616_174926.jpg; 20160616 174959.jpg;
20160616 175007.jpg; 20160616 175039.jpg; 20160616 175043.jpg; 20160616 175058.jpg;
20160616_175122.jpg; 20160616_175129.jpg; 20160616 175145.jpg; 20160616_175156.jpg
1x GF7564-"The New Frontier" 25 shot 500g cake
1x LC3549 -"Keep Calm and God Bless America"49 shot 500g cake
1x LC9539-"The Seals"38 shot 500g cake
1x KM15159-"Black Dynamite" 150 shot 500g cake
1x GRL-63-029-"Winter Blast 200 shot 500g cake
1x P5345G -"USA Conqueror" 192 shot 500g cake
1x MWC0118-"The Instigator"84 shell mortar pack with launch tubes
Thank you
Marcus Price
CEO, GP Brands, Inc. _
49414th Street, Zephyrhills, FL 33542
Toll Free: (800) 504-6040 Phone: (813) 782-1500
Cell: (813)486-3160 Fax: (813) 782-1599
Skype: goinpostalmarcus
Website: www.�oinpostal.com ,
_ _w_..__.---- _.___....__..-----___.----.________�
From:Jacqueline Boges [mailto:jboges@ci.zephyrhills.fl.us]
Sent:Thursday,June 16, 2016 3:25 PM
To: Marcus Price<marcus@gpbrands.com>
Subject: RE: Fireworks location picture &permit
Sorry you about that!!
Marcus I need in a list form what items you will be using see attachment as idea of what Is needed for review.The
pictures are awesome...
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[�IIC�Zl6 BO�CS �- -S,;:._. :�:t-,'
8>3-780-0020 ext 3�13
"A rule I have had for years is:to treat the Lord Jesus Christ as a personal friend. His is not a creed,a mere doctrine, but it is He
Himself we have."Dwight L. Moody
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7 p
!
Florida has a very broad public records law. Electronic communications regarding most City
of Zephyrhills business are public records and available upon request. Your e-mail
communications may therefore be subject to public disclosure. If you received this message in
error, please do not read, forward, copy, etc. and delete immediately.
� _____._.____---__..________�___._..---------_____._.._.---_._.________��.-------_�....___�------.__...._.-----------. ._.__._._.__.---___._.._._..�____...--
From: Marcus Price mailto:marcus brands.com]
[ @�p
Sent:Thursday,June 16, 2016 2:47 PM
' To:Jacqueline Boges<Ibo�es@ci.zephyrhills.fl.us>; 'David TK Hayes'<tk@skvdivecitv.com>; 'Laurie Clark'
<laurie@skydivecity.com>; 'Joannie Murphy'<loannie@sunshine-factory.com>
Subject: RE: Fireworks location picture &permit
I
Been out all morning.
All consumer grade fireworks.
"The New Frontier"25 shot cake
"Keep Calm and God Bless America"49 shot cake
"The Seals"38 shot cake
"Black Dynamite" 150 shot cake
"Winter Blast 200 shot cake
"USA Conqueror" 192 shot cake
"The Instigator"84 shell mortar pack with launch tubes
Thankyou
Marcus Price
CEO, GP Brands, Inc.
49414th Street, Zephyrhills, FL 33542
Toll Free: (800) 504-6040 Phone: (813) 782-1500
Cell: (813)486-3160 Fax: (813)782-1599
Skype: goinpostalmarcus .
Website: www.�oinpostal.com
From:Jacqueline Boges [mailto:ibo�es@ci.zephyrhills.fl.us]
Sent:Thursday,June 16, 2016 9:04 AM
To: David TK Hayes<tk@skydivecitv.com>; Marcus Price<marcus@�pbrands.com>; Laurie Clark
<laurie@skydivecity.com>;Joannie Murphy<loannie@sunshine-factory.com>
Subject: RE: Fireworks location picture & permit
Thank you waiting on list.
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