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HomeMy WebLinkAbout17-18088 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 180 8� • " BUILDING PERMIT PERMIT INFORMATION LOCATION�INFORMATION Permit Number: 18088 Address: 5200 AIRPORT RD Permit Type: SPECIAL EVENT ZEPHYRHILLS, FL. Class of Work: SPECIAL EVENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Squa,�e Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcei Number: 12-26-21-0000-04900-0000 Improv. Cost: \� OWNER INFORMATION Date�lssued: 1/18/2017 . p��,l Name: CITY OF ZEPHYRHILLS Total Fees: 0 '��"' - Address: 5335 8TH ST Amount Paid: 6�. 0 ZEPHYRHILLS FL Date Paid: 1/18/201 Phone: Wo�k Desc: PIGZ IN Z'HILLS BBQ & BLUES JANUARY 20TH -21ST 2017- FEE WAIVED ' CONTRACTOR S APPLICATION FEES OWNER SPECIAL�EVENT 5.00 , FIRE TENT INSPECTION 15.00 TENTS 40.00 � � / �^ � '� l � Ins ections Re uired � REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or � first reinspection,whichever is greater,for each such subsequent reinspection. NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney ,� before recording your notice of commencement." Complete Plans,Specifications Must Accompany Application.All work shall be pertormed in accordance with � City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. �I NO OCCUPANCY BEFORE C.O. ,� � � 'I N RACTOR SIGNATURE PERMIT OFFI R ' PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION � CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED � PROTECT CARD FROM WEATHER I R ;• . • . �emporary Sale� Che�klist '� . � ' City of Zephyrhills � ���� 5335 8`�Street � I Zephyrhills,FI.33542 Phone:813-780-0020/Fax:813-780-0021 ' , REQUIRE1VdENTS ✓ Detailed Plot Plan showing setup of location. Refer to Ord 1038-09, Sec 5 ,/� Notarized letter from properiy owner stating their approval. ✓ A flame retarda.nt certificate is required 1F a tent is involved.Inspection required once tenf ; is erected and rior to opening for business. ,� Approved certified fire extinguishers per NFPA 10. � � No Smoking signs must be placed outside entrances. �✓ IF there is a wire fence or chain link fencing must have at least 5 Ft setback from tent and at least 2 e�ts. � � 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) Proof of State License. Proof of Liabili insurance. � List of items to be sold at site. Copy of Drivers License and Social Security Number of all personnel dealing � with the sale of fireworks at the tent location. FEEs $30.00—City Registration(If Regulated by DBPR=Fee is Waived) � $500.00—Fireworks fee-Fire Department fee i $ 5.00—Temporary Sales Fee for 1 St two days $ 1.00—Temporary Sales Fee per day for each consecutive day thereafter,not to i exceed duration of 7 consecutive days and no ffiore th�n 4wo occurrences � during a 12 ffionth period on sa�ae property Ord#1038-09,Sec 6 � $55.00—Tent Fee(40.00BD, 15.00*/FD)—{*$15.00 waived for Fueworks) � $40.00—Electrical Fee(if applicable) • PropertyOwner: �E� �� � /L j''12.f 'l� r Applicant: � � Y��2..1 � 5 /� � I � Pi one Contact: ��Oy1, p� I Address Site: �� �J�Q -rj�'� �I�Pe, �72D f2�/>'�u5 �. ,���'�7��, ' �26v R��,�J/�T Date(s) of Sale: � � Q�� �� �' �� �' ' O�rdinance No. 1038-09(for additional requirements) �, �.-el1 �d� '���7 • ���� i ��'1� �!� � '7�2 � lq L� � A ' y� ' • �� �������9 � • ' .' � - _ _ ������� � �---� P ��a����� �� ����r��e� s � Greater Zephyrhills Chamber of Commerce 38550 Fifth Ave.,Zephyrhills, Florida 33542 Phone: (813)782-1913 Fax: (813) 783-6060 � www.zephyrhilischainber.org December 28, 2016 Steve Spina ' � Crty,l Manager Ciry�of Zephyrhills 533,�5 Eighth Street Zephyrhills,FL 33542-4312 RE:i equesting waiver of tent permit fees for Pigz in Z'Hills BBQ&Blues 2017 � Dear Dr.Spina, � Thank you for your support of Pigz in Z'Hills BBQ&Blues.We'd like to request consideration of a waiver of per'�mit fees for tents at this year's event to be held January 21, 2017. I I'vejincluded copies of tent certifications from our event rental company as supplemental documentation.Our completed event application has been reviewed and is on file with the Planning Department. i Thank you Steve,and I'll look forward to talldng with you or Chief Swartout in regards to further fire and i safety requirements at this event. � Kin�d regards, ,, I L, W�� .-�'u-�-�� ��t' G�25C��� i ,� Mel;onie Monson Exe�cutive Director � ��v��`x�ar�: r 7 2.�s'7 ' c��r�r������� � ��ri����c o��ciA — i �` ,I ,� � �T � ' CUMENT-. �� � .. _ _ _ � , .. _.IMPO;RTANT;-DO,.:�:_:_.:.:._ . . - - _ - - - � _ _ - . : ,. _ - :,��:...:,. ....:::..... . . .:... . . . .. .. . . , . � .. :::. _ � _:. , . .. .. .. .. . . . . - - Cext.i __ate:�o Flame;`�szstdnce� _.. - - . .; , . . �.�_ ��`..._::;;,x�;�;�:;:.;-- - . .-.. � . nt, - _ . _ �- _. =Date of.St�ipme: ��'� . . ' • ':ISSU�D..BY ' - �:4/4/20.14���� ,- . .. ... . � :�"�:",. ._:� . -- - - - - ;� Registration�Numbe� � ��'���:_: Sa[es�Order# ��- ..�. �..,... ,�...;IiVDUSTRIES;:�-ii�1C: F='F40:01 ' - . , . _ - . . .... _ :.:. • - ,. .50=602�30.:' - ,. .,... . . :.. - � < = - . -.. . _ - : .i. • _ -.EVANSV.�LLE;.:INDIANA.`.,47.725 , • -� �� '� � • � _ , - , .__. ; . . .. . . ,. _ . .... .::. .. : ..... ... . _ _ : .. . .... ... .... . . .... � __. MANUFAGTURERS;OF THE:F.INISHED TENT pRODUCTS_D:ESCRIBED�=H�REIN � Tfiis is;:to:�cettify that�the,matetials descfi6ed are inherently flame refa�dant arid were supplied to:- � - �.. _. -� _ °�. . ._. _ .. . :. ._ - � "83233 �" ,. _ . _. � . . TIL,LMAC .,.,.,,: , : _ _ . �- ., - " � '� �DBA.FREIUIIER:FARTY:RENTALSAND_SUPPL.Y. , - _ _ � � �- �- _ _. � � 553�IN BRANNEN�,RD �'� = � - - • � ��� . - � " �.� �LAKEL�4ND FL.33813. - -� � � � - ., =�USA�� � � . - • „� ... " " - , - :� - - - - - , _- , - . � ._ _. -_. , .. ,. ., . _ ._ . . - . . . _. .,_. . .... :.. .. .. ... . . _�..._._. __.:.. _.- . ---• - _ - .- - - Cs1� 5 T�E:�::� -.- . . :p�,C��ir • . - . _ 4 - - - .:-�� �`�, _ . ,`4r;�;�`- �Ay - r �Q ''. � . • - - _ y .:- �� � _ - ,� � _ . _. F��"����-'�� Q'� - � ._ . - • '�:� "y ..�. , - - - � ''�� �I�:,�MP q�- ::: _- - - � - � '��,�� - - - - ' • - • . �R.S�p'4 . 1 . . - . ._ . �.. - . - _ `� Certification is hereby-made that: - - -- - - .,- .. : . .. The':arficles ciescribed on�this Gertificat�.have.beeri:treated witli:a flame-ret�ardant appro.v..ed.: - - : chemical�and that the application.o�said clierriical was done in conformance with�Galifornia Fire � .a. : .. Marshall Code. -All:fati:r'ic has_been�tested:�ahd `p�asses NFPA��01;�ULG 1Q9:�� - _- � � - - ,t .- . _ : . ._. ... _ _. �� � � .. $erial# 810$985 2) - . - . , - . . _._.. .. .:. -v^2�.:Fi�3t1G�-c?rr Itc^in C21i1t12�: -•- CEPl��RY i�M,T�:E�CF?AN��eLE-E{�Fp�b�^,Fn2-0 SNY`J-ER:IEV�ITE VIfVY� . .. _._....---..._ ._ .� . . _ � . ... . - .. . -. . .,. . � �= _:Flame Retardant= P:.r_ocess Used WiII..Nof_Be;=:Rem.ove;d:��:B.y _ - .,.- .. :.�:- _. .� : . :. : �.. ...:-... ... .: . . -: _ . . ..,. _ .. ..:�:.. .;.._... � - Washin.g And;.ls Effe.ctive:�F:orThe:;Life,_�.Of.�The Fa:bric _ , _ :. ._ . . - . .. - - - - .� .. _ -� ' � : �����' SNYDER MANUFACTURING INC.�FNILADEL!'HIA.PA . _ _, . . . :, . . .. . _. . . ..... . _ - . . . ... ... : ,_.�f' .. ' ' ' - ��, Name of Applicatot of Flame.Resistatit Finisli Signecl: ANCHOR IND.USTRIES,;INC - _ �. "= _ � • . r . - _ - �. . ":� " - . _. � � �. . r � �. : � - _ � .IIV�PORTANT:.D:a_C:UME:�1T - - : .. �_ � _ - _ - - = � . .._ _ ._ .. _ - _. f . . . /:� / � _ - _ I�., .. . .: . _ -. - _ - �e��o :��me�=� �es�stance���.=:.. _ _ �� . -_ _ , . :s. . Certti cczt _ - .,. , . ._ : -- . . _ - � - .. . :. .,:: .... _ .. . _ _., . . . _� - �- _ -. . � . _ . _ : .. .:..; .. : :: :;Date of:Shipmeht. , : _.. .. : .. . . . .: _- - � . .: ..�:..... :��: ..... .. .. . : . . : ._.:.,.:. . .......�... .:. � �.. .:. �: . ,�= :. : ` '. .. ":. �.,,�.-.�.:�S.S.. ..ED�B: .,=: - `:':017Q3/13::� :..���:'._:: - -���` .. . - , ,_ • °';:�':°::i=~ - � __ _. -. -. _ :_. _� ._. �- ": _. �i _ _. _�����-�.:`. -� :Tent;ldeiififcation. , -� -- � ._Registration.Number . _ _ - _ __ _ . _ ., �: :.�.� : ..,,;, : _.�. ..�<.::,� _ _ _ _ �- .. _ ,.�....t,; . . .- , . lNC3CTSTF{�ES:,:IiVC::,: . � .� .. F7'6'I'Q'l': ._. r .:. " ': .�. �.;_ , `15'1:40623�;:';�' _ ... _ �_.: �.:a`.. .. .. - - _ •�_ �..._. . .:. ... ..:.:::... . .: . �... �. •� �- - � . .. . �.... . ... .... ' , � �=EVAN..S,VILLE3�;IN,D(ANA::�7725.. :. .. . . ::.:. '.. .:` .:`'�� �- - -. .. .. ......... ... ....... .. :.... ...:....:.:..,......:. :.....;=_r:... :._.: ..:........,.. :� _ . . . _ . ... ..... ... ... - " - ,: RE1N.,: .. 1!ltANUFAC:TURERS.:OF:THE�`FW[SHEp�TENT�PRODU�TS:DESCRIBED�.HE.:;..,_...:...: -. _. �. . . :.. . .........: . . .. .:..�.::.: ..; . . .,:.:;.. - ' . .. ,..,. .,;::: ..,... _ .. . ;.��-.. : _ - �This.is�to,certi�y.#hat.ttie�inaterials described�are:m}iererflyflame retardaritJaricl:were supp ied to - .. _ _. . _ _,I ; .�,. . .-. . _ -. - . �- _. : : _ - _ .. ,� TILLMAC� .:. ,.- � � � =.. _ _ ,. _. . _ - ._ � . .. .. . .... � � � _ �... - 'k. DBA�PRENIIER:PAF2T1(,FtEN-'i'A[:S ... - _. :� _ -. ,. _ : � - ` . - _ . . ":�i: .ANp SUPFLY �- : .: "_ • .. ; _ . .-. _ _. - -- ,. - l. :553_IfV`.B�tANNEN RD. " .� �. ' � . �: �_ - - , � �: :LAKELAND;��FC��3813 - - -. , _ , _ . - _ _ . - -. - .. +. -. -. - ._. - -.�i _ - .. -: _ _ �- - ,: �. � . :,k .. .. _ � : _ .. _ . - : . -� _. _ -. �,:.. _ - ._. _ � ._. .. � -_ � . _ - _ . � _ . : _ �- . _. - = - -_ ---- �- - - ---- --� . ... _ _. , ._ . _ .. . _�: _ _ __ _ - - -- . � � � - - � -- . -- � - _., ._. ......�,._�. _.�.�__ ._.. .. .- - - . . . ..:�; � � �s:_, -:�;_. :-•.;:._:: _ _. __._..�... �..c; �,: ;:°=� _ - , ..�, _ -= - ..- ��.. o�:.._c,�c-,� ,� .,��_,� ., _ __- . .- ._ __ _ . . - - .. ;� _ _ `_4►,`�:..::..:.:::::!o,p� , :_ __ ' _ ..� � ��.�_ _ - 4' . _ _;$' � _-. - - -- ._. - . _ u, , '� - . - • � , '11 �� - :'y�`��' _ _ .- - - � _ . _ �- - "� .. - ` �: • _ _.� �`�,l.... ..-,Ma� .4.._ -_ .. ._ - ., :. _ .. � _ � `- �4 . RE: _ , 7. .. '� P, - _ : _ .. .- , , ._ �`:: _, ., _ ... .. _ . ,. . . . .�14:�"� _ -. �- ._ - _ _. - - .f:� _ . . _ .. . ... : _ - __- - _ .-� - �_ , .. , � . .:. ..{: _ � _ . .. ... . . - ._ : - _ . �; .. - . � - _. � _ .;�. - ` _. - _ - .. " _ � _� . - _ ' ,-- - � - _. ._ _ _. = - ::'.icatton�is:hereby:made ttiat: -- - - � - -- -- -. -_ - Cer�if.. � . . � : . ... . � :_ :., ���- � � ,. , �. a:..�:... .:.. .�� . . . .. .,. . .. . . . .. . . es;descnb�d�on this Certifcate:have;.been:treated`irvitti_a::ffame:=retardanf.:apPto�ed ..,. .. ��The.�:articl... ,...... .. .:.: �::....,...,._. ._:, - :. :>. :. _. �° � . . : , , ... _ _., . ... �.chemical.:and:th�af��the applicat[on.;�of sa�d chern'ical was:;done tn confo�mance:with Caf�fqrnia;Frre .,_: ..�;._..1: =: .:. , . , : .:... � ... :_ . :..: . .. :.:. . _. .=. .. .. � �IVlarshall:Coae._�All:fabric has�:bec�n t'estecl arid�:� asses NFPA 70'1-04,.�U.LG='109:-: __��_, - .,� � _ : . �. , p . _ _. -. - � �. " .� _ �k. _ � � - .. - .._ _ - - :. . . - . - - :�_ - . _ ,_ - - - - • _. � . - - - - Serial.#. - ' . -� • ' � - . • � - ... �- $003100.(1) " � � • - _ : � _. �. � ' - - ' - - �-� - - - - - �._. .,, .� .__ _._. � . . . � � : - - ..,_ . ..�..__._. , ..._. ...� �.:. , .. , . - -- � --. , ' _ _-� , ' . _._.. �.. : . - ' . • ' � - "� _. . . .. . . : : . . _ . . .. Deseriptioii of:iferri certified: .:, - '. .- _ ... .. � . : _ - _ _ . . - • , , . � � .. , . -. :-. .� � -� CENTURY.FRAIGIE'fOR 201NX30-V1/HITE _. �- � . _ ,. - ._ - � ' - BURLAN VII�IYL�. , . - :- � ' -. ., ., . -_ . _. ' : -� - :�} _ - . . -- _ ._ , _ -:. , � -- ` - �C� _ ' :, - � - �� - _ - � . ' - - - . ' �• - . ,� .. . .. _ - . .. . .. -: .... ,. _ . - _ _ - -_ - ::. ... ... ....: . ._ . .,. �. .: . . .. ; .. .. _ . . . � � :..e - ve�!::By= , _ . ,. ' � ed::VV'i11;:��1o�;,B��°:;Re_r�o::. - � -:,. �Iatne:::Retard.ant P:ro.c,.ss.�rJs..._ , _ _ _ _ _ - _ � - -- -- -_ _ _- ::�:_�,;:::;::_::._ .r_.. _ ., . _..... . ,:.... ... . . � . _ - = .. ,. . _ . _. . . : ,. :. -:_.._. . _ _ ,,,.. .: �t . ._ . � .. ..:.... . . . . ...: ..: .....,..:. -.._ .:_..::��.:::.:._. ,... ...... ,;.;. - _ .. .. . . . ,: .:.... _.,..... :_.:�:� _ _ ..::.: :� -. .: ...,... .... . ....,.: , - ; _ : - ��ricV.:... . r::�:ti:e:�Life=���O:f�:Tiie;:F,ab _ �� �Wash.rn � ��►nd:�::1s�Ef.f.ective:,F ., . . _ _ - _ .. _ _ ...,.. .,:. .......... ....,,:.t... :.,> _ �,::: _ -- �::i:�, . _ , _ g. ,�i� - .y,�� -:i;.i _ ;.4-:•:::� _ ';i:'?��:>.;i::S,.r' , _ , _ . .... ' - . . .� .....,: �•_ .�e,�.:..;..�..,...,-._.o- _ ,._- .. - - i - � . . , '._' . - - . . ...- - - - . _ ,. . .. . � .. ._. , _ _ . , ._ .. . ���. � �?; .. - ' , ' ' ; ... .,.. .,, .;. iti'' � •• '�1��•., . � . •. . "' ' ' ., . _. - . .� .. . _ . _ . -. _ .' i''t� .� .;. . ,- _"::r .r,. ��.�., '::i .;;-' .� .. �. _. ' -.. � -' - ' • 5��::'. �n'.�. ,. '_.. .. � . " '- .. ' °�y,� BUR�. .. - - . . -. ' - - " - . . .. ...:.: ... . . ....... . .. . .. .. .. . - ' : - _ - r:, - N:'12&.:140Z..GASTONIA NG, . ,„...=.. . �.; � : .� . . :. _: .:_. . , _ .. . . . .. . .- . ..,: .;�.._.. . . .:. _... : ' _ . ... _.:.... . .. .. .............. :....... .. Name;of Applicator of:Ffame�.Resistant Finish _. � �-.Signed::=- _ :ANCHOR;INDUSTRIES,INC.. �: _: : - _, ,.... � ._.... - _ : - ' . � - .,� . -. -. � _ k . - -�r _. - • -_ . -� � - . 1: , : . . _ � : . _. _ ' _ _. ; � , __Wi?:3���u E,:,,��-/3;;:;.;-�%l i, � _ _ _ _ - _. ' - �'��,��:�;;�;�:����°���'��:� - - . - � - _. _ - :���=��. ,,.:.,:...�... __ - - _: - - = - _ • .. - . - . .� .- ... _ r., "0:".;: . : . _ - � .o = - - :°,�` g °��a.'�.��. -- . -. , . _ ::,-�.::., �.:�:,����E ���'�;5..:_. - - 'o . .,. ....: ........�°. :� _ _"_. ��� �' .� �_. , V � . _ ,����� _ _ - _. : �DaCe of Shipm�rit� _ �`,'� _ , .. - - � � � - IS5L1�C�=.�'� -_ ,. - �:1�715/'i 0 __ , .. _ �,:.;-�.x:,� _: -___. . _ . , �., .:, �, . .�." ; -. , �-r: �". �r� _- :c:; , - -. -. i'ent ltletitif�afion. . �. _. . _ � Reyistiatioii_Nusnber �- - � .�'�;IN�fDItS�f�1.ES':ING:_ .. , � �d�23140 �_ - . - �- F=�2'110 - _ � �: .. . . � ._. -. _: . _ _ - . .'�ilAP�SVILLE;.���i�e��. a7�2� . . .. - _ _ • MANUF�C�URERS.OF-THE;�INlSHEp 7'E�l.i PRQDLtCTS`�ES�'R SED`HE ohin lanir;�abl�) anu � � This is to certiiy tiiat the materials.described have..been:�larrie�retartla�t,tre�ted.�(ot:ar . _.�.:�. .... 1 . .._ - _. �°rer�supp{iEa to: . - " - _ "� - . _ - - _- - ' , T{LLT�JIF�C -. - - . ._ � �: _ .. -' - - _ - .. .DBA PRE�JII.ER I�AR I Y F'.EN7FiL5: - - . - -� - � HND SUPPLY - � _ - __ ._ _ , - _ _ .._ �G �s72.cr��v��a���r�r�Nrs �Lv� _ .,_ �. � - - .. ._. � � L�kELAND, Ft 33813 - - • . _ � . _ . ��.i • . . � - ,. -: ..- _ -. . _ ._ -. _ - ;� ' _ - _ �.,Y`.� - - - _ . : , . �� �.: .". ` . _ i. - - ���;% ��' -. - .- _ _- . F : - t��::',, ::. .� � _ � . - • , ��- - ;I _ ���''�` � �-:��. - " ;;. _ -_ � g,. .. : _ - _. .� : �:.,- -'� -� _ - : , _. ,�, ,�.: _ ���.� �. : - . .. - . �I. �. :�-=.,;.-:.:�=� , � :t �; ����t�,-:�'�'����-_. " --_ � - _: _- _ �- . ;�. - - ��. � _ - ._ _ - . � .. - - �.:���:�. � . , ,,,I , . _ . . - - _ _ , �i_ _: - - - _ - _ :r - .- " �. � . - _ , - _ .. , r , � .. _ :. :: - . .- � .Certiiicaiion is hereby ma�P fhat: _. -" • � : 1 . � _� �- ro�ed _.. Th1e-articfes.ci:escr�l�ed on_this Certifica�e have:;been treated,wi�ti a flarr.me-reta.rdan�_ap:�,,:, ` . . -. : � - ��that.tne ap p li c a t�i o r i.o f�s�i d .c h e m i c al was-aone in cotifo..rmaYice w�th California.F.+re chtle1�iical and _ . __ .. . - . 1liiai�stial.i.Co�{e. P,(I fabric.�fias been tested,aiid_passes .�l�iPA 7a1; CPAi_$�... . � . ;f, _. - _ .. _ - , _ _ .. - _ :4 _ _ , . _ , _ �. . .. � _- . - � _ - Seri�l.# _ " , . - - . _ . . - ' _ ., _ :i - . soos000.(4) - - . - - -� - . . .. - .. ,� . . - _. , ,. � - � � . . - - -_. _. " .. ' - . .. _ :�. . - .'- _ . - - - � " �� - �_. ��� . - - . �Y� . . ... " . _ . d: - .. - . .. e , certi�t jTE _ , itern VVH _. o . 0 . i tion . . , V1/X2 . . . _ cr , "20 . es c�F . . �D . ;IE 7 . _ - � _ �,ENTURY.�RAf_ ._ . , , ., �}: � VINYL:TRIVANTfiCES.,BLOCKOUT = - __ • _ I . `_. . :-., - _ - . - _ " - , . . • . :�: ' � _ .. ,- - - - - . ,._ - - ' ��: ;.. . - �. - - _ ` . ., ,:. ,:: , . . , . . .. ., . ._ '� � ���������,�����-,�������������:�����.,�c��.;�:�..���c�.��c��: .:�. l �-i . . ... . - ��1�: .;.= �������.� ��d _��`,.�����:�i����.�.�r.��� -L,��e_:��..`���,���.���_:. . _ � y� � � -.,.. . _ " � . - - .. � . . - �4 - _ . ... -.. . ' .. , ,. �`� TRI 1/ANT�GE STaT�SVILLE tiC - _ .� - ,_- _" .- . : : = / � � �'i�caiYie of App(icator of:'F;Iamp;Resistant Finisti _ • - • S�gned:��- � _ �" .''�''�fJG- . � .. . ,..�., _. . � : . _ . . AN NOR 11�DUSTRIES . .. � - - . , . __ ,. . - f _ _ . , / I • � � � DATE(MMIDDlYYYY) I ���R� CERTIFICi4TE OF LIABILITY�.INS.URANCE ` � �,.;.; 01/03/2017. ..... 4 . . .. . . .. . . . . . . . .. TIiIS CEIZTIFICATE.IS 1$SUED AS A MATTEft_OF INFORMATION ONLY,AND CONFERS NO RIGI-1T$_UPON THE CERTIFICATE,HOLDER: THIS CERTIFICATE.DOES NOT AFFIRMATIVELY.;OR NEGATIVELY AMEND, EXTEND OR. ALTER THE;COVERAGE>AFFORDED BY.THE:POLICIES BELOW:;l'FIIS CERTIFICATE OF: 1NSURANCE DOE$,NOT CONBl'ITUTE A CONTI2ACT BETINEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE NOLDER. _ _ , -� - � - • : IMPORTANT:.(f the certificate.holde:r is an ADDITIONAL:INSURED, the policy(ies) musf be:endorsed...lf SUBROG,4TION IS WAIVED, subject to the terms and conditions of the.policy,,certain.pblicies.may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). �• . � . . ... .. . . . . . .. . ... PRODUCER 1 � ' � CONTACT "� �" � �" � � � � � . . NAME: AfiCI�/MIII@f� Lee Reed Insurance . , ��NN �: (813)782-5502 a�No: (813)788-1996. . 38511 5th'Avenue � . no��ss: andy@leereedins.com ` � ; - INSURER(S)AFFOR➢ING COVERAGE NAIC# Zephyrhills FL 33542. �NsuReRa:..Owners Insurarice Company 09386. INSURED ,. INSURER B• Zephyrhilis Chamber of Commerce Inc INSURERC: 38550 5th Ave iNsuaeR�: ' � INSURER E� Zephyrhills FL 33542-4331. iNsu�zF:_:. COVERAGES _..- . - _..CERTIFICATE NUMBER: �. • REVISION NUMBER: THIS'IS TO CERTIFY THAT THE POLICIES OF.INSURANCE LISTED;BELOWHAVE BEEN,ISSUED TO THE INSURED NF,MEp ABOVE FOR THE.POLIGY PERIOD INDICATED. NOTIMTHSTANDING ANY�REQUIREMENT, TERM'OR`.GONDITION OF,ANY.CONl'RACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIGATE MAY BE ISSUED OR MAY PERTAIN, THE.INSURANCE�AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, IXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMIT.S SHOWN:MAY HAVE BEEN REDUCED BY PAID CLAIMS.• ; , ' INSR I ADDL SUBR . --��•- '� ' POLICY EFF POLJCY EXP_ � - � � ' ' � . L7R TYPE OF INSURANCE INSD NlVD -= ,.• � POLICY�NUMBER . : MMIDD MMIDD , LIMITS X COMMERCIALGENERALLIABILITY • EACHOCCURRENCE $ "I,OOO,000 :� ClA1MS-MADE ❑X OCCUR DAMAGE O RENTED. ' PREMISES a occurrence S 50,000 � MED IXP(My one person) $ 5,000 A ��: Y 864612-20343749 03/03/2016 03/03/2017 PERSONALBADVINJURY $ 1,000,000 GEN'L i GGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY��Ea a LOC PRODUCTS-COMP/OPAGG $ 2,000,000 . OTHER: LIqUOf LlBblll�/ $ 1 Mii l.$2 Mil AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ " "" _ � I Ea accident - A�,n.q�p BODILYINJURY(Perperson) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S � AUTOS AUTOS I NON-0NMED PROPERTY DAMAGE , $ Hll EDAUfOS p�pg Peraccident S UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS-MADE AGGREGATE � '� I DED RETENTION$ S WORKERS COMPENSATION � PER OTH- , AND EMPLOYERS'LIABILITY �,�N STATUTE ER ANYPROPRIETOR/PQRTNERlIXECUTIVE ❑ N�A ELEACHACCIDENT �. $ OFFICER/MEMBER EXCLUDED? � � • (Mandatory in NHJ EL.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below . EL DISEASE-POLICY LIMIT S i DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 701,Additional Remarks Schedute,may be attached'rf more space is required) . Special Event: 2017 7th Annual Zephyrhiils Pigz in Z'Hilis BBQ&Blues Fest,January 21,2017 Ciiy of Zephyrhills is named as additional insured with respects to Liability i ' � CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Zephyrhills ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8th St. ' AUTHOR¢ED REPRESENTATIVE Zephyrhills FL 33542 = I O 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD