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Home My WebLink About17-18571 CITY OF ZEPHYRHILLS , 5335-8TH STREET � (sis)�so-oo20 �8571 FIRE SPARKLERS PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 18571 Address: 7838 GALL BLVD Permit Type: FIRE SPARKLERS ZEPHYRHILLS, FL. Class of Work: FIRE-SPARKLERS Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35-25-21-0010-00700-0000 Improv. Cost: � OWNER INFORMATION Date Issued: 6/15/2017 Name: PRIMERICA GROUP ONE Total Fees: 130.00 Address: 3629 MADACA LN Amount Paid: 130.00 TAMPA, FL. 33618 Date Paid: 6/15/2017 Phone: (813)933-0629 Work Desc: TEMPORARY SALE SPARKLERS PUBLIX CONTRACTOR S APPLICATION FEES TNT FIREWORKS PUBLI FIRE PERMIT FEES 100.00 CONTRACT R CERTIFICATE 30.00 �c\`�� J `� � � � � � r //� � r� Ins ections Re uired FIRE INVENTOR ONSITE 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$100.00, whichever is greater. All work shall be perFormed in accordance with City Codes and Ordinances. "SPARKLERS" per Section 791.01, Florida Statutes, means a device which emits showers or sparks upon burning,does not contain any explosive compounds,does not detonate or explode, is handheld or ground based,can not propel itself through the air,and contains not more than 100 grams of chemical compound which produces sparks upon burning. � ` 1� Lf � CONT CTOR SIGNATURE PERMIT OFFIC R PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE - 813-780-0041 0 1S�" o - 1 • ��'V ��R1Q_� I� �. - - '�. �i� 'r: ''--..� _..�;.% City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: �� j�� Date Received: �p-�_l� site: � LJv u o�f/ �,�� t� � 1 Permit Type: � �Cl�� !�f Approved w/no comments:L�" Approved w/the below comments: ❑ Denied w/the below comments: ❑ ��j �� F�� Y � tiii,V� �,y/` •,�, This comment sheet shall be kept with the pernut andlor plans. -- - �' . j3 •iy Gene rown-Fire Safety Officer Date Contractor and/or Homeowner (Required when comments are present) , ' � 1 TNT�" FIREW�R�CS Site Plan Warksheet ADDRESS__ 1�3 g ��I I �I V�� CI'IY�� I�� S�'ATE_ FL ZIP ?�5'�� PHOPdE ��-�'$�-�$'�f STORE NAME/LOCA710N#__ �t,'��f� �'�` �Z�h TYPE OF E1r'E�ii': 9n�tore sales of FI4�it�5t�t�-�Rpraved s�arDtl�rs H � I ' k � :. �i#�,� I7.P�;.S�rc�s soun� SPECIAL 1�lSTURCTIONS t�t�d�onr�xtmat�v 75tt frem��it_ � e��-Zao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit 800 � 868 � 9151 i Owners Name PUblix#1245 Owners Phone Number 813 782 1957 � Owners Address 7838 Gall Boulevard,Zephyrhills, FL 33541 Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titleholder Address r--- ---�----:R--�- -�-----_-__---�--�--�:—.�>- S Job Address 7838 Gall Boulevard �ot# � Sub Division Parcel# . .a � ..,. ,._.._.._.._.:�.�.�':.....,��.._...� '-�___.�._._ ...._.�....__._._..s.. ..�...-------e � 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 � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale � Emergency Generator>30 kw � Places of Assembly-ANNUAL � Fire Protection Maintenance-ANNUAL � Recreational Bum �y emi �n er Sprinkler � ❑ ❑ ❑ 8 X� Sparklers Inside Retail Sales of State Approved Sparklers Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) �� 1 Hood Suppression � ❑ ❑ ❑ � � Torch RoofinglTar Kettle (�s I� V , � Fire Alarm Installation � Waste Tire Storage ANNUAL � Fire Pumps �X Fire Works -SPARKLERS � Flammable Application-ANNUAL Valuation of Project I � Fuel Tanks Q Other: ��.._ �ft-_. _._.._..��.._. .�,.�:.�,.W—.�__:.��.� ---,�_,_.��.._ - _�.r___,`__,�_._�...�..._.�.�.�_w._..�..., .Y. - -:�, Contractor Company Signature Registered Y/N Fee Current Y/N Address License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N Fee Current 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 Street, Ocala, FL 34474 License# c--�~--�--�--�,....w ._.._._....�_�.�..�._.�_.._...,_._.._L...._...��... �..__.�.._._._�..�._.�._...._____._._....._..w-�::__...._..:�_..�.:_._.w�.__ __._�� Directions: Fill out application completely Owner 8 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 �53-02325733� 53-02325733 - REFRINT - TNT FyREWORKS PACK LIST - REPRINT - 21362 Order #: 2325733-53-00002 Chain Store Sales-FL Chains Order Date: 3/22j17 Terms: Net 30 Day� CUST PQ: SCAC: SEFL PRO #: 226814522 SZSMN: Chain Stares - East SHZPMENT NBR: 229961 Sold To: 1420005 Ship To: 2056670 - PUB1245 PUBLIX - COMFANY 0002 PUBLIX 1245 PO BOX 32008 7$3$ GALL BOULEVARD LAKELAND, FL 33802 ZEPHYR COMMONS ZEPHYRHILLS, FL 3354I DesefCase Packing Item Quantity Selling Suggested CP �# Ordered Units Sell Price --------------------------------------------------------------------------------- �*��*��r��***�*��*�r*� Cou.nter Cases ��r��r�**�r��**�*� DSP PUB SS HALF PALLET J1.'7-FL 673603 I CS 1 EA 1367 .4700 1/1 Cantaina.ng: LIGHTNING BLAST SS .AM BOX 102309 11 EA 11 EA 29 , 99 12j1 27736423745 THUNDER BOOM USA SS J12 WO 102024B 15 EA 15 EA 19. 99 14f1 27736025992 , STORM SHOCK USA PDQ SS J10 102023 27 EA 27 EA 9. 99 24/1 939667 SUPER VALUE PACK REV �7'09 200722 6 EA 6 EA 10 . 00 12/3 912288 LA�uER RAINB�W Wj�P 200573U 14 EA 14 EA 5 . 40 16/1 944810 SMOKE BALLS BUX OF 8 J12 351Q52 24 EA 24 EA 2 . Q0 4/24j8 807590 2 PAK a�NAP 4 PDQS J14 320516�7' 40 EA 40 EA 1 . 00 �1�a�a/�o 2773&022922 GROUND BLOOM FLOWER 20 CT 290157A 20 EA 20 EA 5 . 00 2f20j20 27736030255 SHORT STACK J13 200924B 28 EA 28 EA 1. 00 8 f 28 27'736028054 CRACKLING SALUTE J07 320474 24 EA 24 EA 2 . 00 4f24f10 95$451 JALAPENO P(JPPER YP PDQ 201183 16 EA 16 EA 2 . aa 3/16 27736036110 CRAZY FUN PAK SS N12 PDQ 1d2126A 21 EA 21 EA 2. 00 4/21 27736027545 SIGN NFPA SM FRWK� NO SMOK 730644E 1 EA 1 EA 0 . 04 1/1 ***�*�*��r*****�*��**�*** Promotional Supplie� ��r�**��r��r�� PALLET WRAP RED J23 730559 1 CS 1 EA 0 . 0000 1/1 Page No S - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - Order #: 2325733-53-00002 , • • ' Desc/Case Packing Item Quantity Selling Suggested CP # Oxdered Units Sell Price ---------------------------------------------------------------------------------- Case Totals: 1 CS Total Pallets: PL Tatal Repack Cases: CS DECLARATION OF COMPLIANCE American Promational Even�s, Inc. , dba TNT Fireworks, certifies tha�. all. eonsumer firewarks identi£ied an this in.voice have been �.ested by the American Fireworks Standards Laboratory and found to conform with all applicable regulations, standards and bans enforced by the U.S, Cansumer Product Sa�ety Comtnission. Testing and certification for these items complies with rules, standards and bans applicable to con.sumer fireworks: Perfarmance Standards 16 CFR 1500 .17 {�.} {�} 16 CFR 1500 .1? (a} (lI) 16 CFR 150Q . 17 (a) (12) 16 GFR 1507 Powder Can�ent Bans 16 CFR 1504.1? (aa (3� 1.6 CFR 15Q0 .17 (a) (8) 16 CFR 1500 . 85 (a) (2) Cautianary Labeling 16 CFR 150Q . 14 (b) {7� 16 CFR 1500 . 83 (a) (27) Contact in�ormation far laboratory that perfarmed conformity testing. �, American Fireworks Standards Laboratory {AFSL} 7316 Wisconsin Avenue, Suite 214 ' Be�hesda, MD 2081� 301-907-9115 af�1hqQaf s 1.org _ CONTACT INFORMATION FOR INDIVIDUAL MAZNTAINING RECORDS ON WHICH DECLARATIUN IS BASED: NAME: Kathie Pendergrass ADDRESS: 4511 Heltan Drive Florence, Alabama 35630 TELEPHONE: 256-764-6131 FAX: 256-767-7200 E-MAIL: pendergra�sk@tntfireworks.com. wwvv.tntfireworks.com Page No 2