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Home My WebLink About17-18596 `_ CITY OF ZEPHYRHILLS ' � 5335-8TH STREET � ` " (sispso-oo20 18596 ' ' FIRE WORfCS PERMIT 1� - PERMIT INFORMATION `� LOCATION INFORMATION � Permit Number: 18596 Address: 4241 SKYDIVE LN i , Permit Type: FIRE WORKS ZEPHYRHILLS, FL. Class of Work: FIRE WORKS Township: Range: Book: Proposed Use: COMMERCIAL 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: 6/27/2017 Name: CITY OF ZEPHYRHILLS Total Fees: 505.00 Address: 4241 SKYDIVE LANE Amount Paid: 505.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/27/2017 Phone: (813)780-0000 Work Desc: SPECIAL EVENT FIREWORK SHOW JULY 1, 2017 (SKYDIVE) � CONTRACTOR S APPLICATION FEES � HAYES,JOHN DAVID FIRE PERMIT FEES 500.00 SPECIAL EVENT 5.00 � � i I � I� � � I -� 2�� - , �� Ins ections Re uired FIRE WORKS SITE INSPECTION Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fire I prevention and protection related activities such as inspections, plan review,administrative fees,and other � costs related to the aforementioned. i 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 i 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 combustion,explosion,deflagration,or detonation. I c � ! I CO RAC R GNATURE PERMIT OFFICER '�, i P RMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION � I CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED � � ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 ! � � � . � . �i �� K� � � � . .� T . City of Zephyrhills 5335 8`�Street i Zephyrhills,Fl.33542 � Phone:813-780-0020/Fax:813-780-0021 • REQUIItEMENTS Detailed Plot Plan showing setup of location. Refer to Ord 1038-09, Sec 5 Notarized letter from property owner stating their approval. A flame retardant certificate is required lF a tent is involved.Inspection required once tent ' is erected and prior 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 i 2 exits. i , 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 Liabihty msurance. - I � 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 $ 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) � Property Owner: � ��/ � c� ��L�-s J �/ � � �� l� /� C Applicant: � ��-� �� 5 Phone Contact: _�� ` �j T � � Address Site: 2`� ' S �� D�� L-� , � � � Date(s) of� 5(�e9-w � j��`� l 2�s ( �-- Ordinance No. 1038-09(for additional requirements) �� I � , � .. - i , • ', � _` �.'./ i �� . < < � �;,_�DRIVER UCENSE CLASS E � �. � ` � _ ��H2OQ-464-61—D05-0 �° . �`� � ' ' JOHl1 DAViD HAYES P ' 3EE01 FEATtf�Ri�JG WAY ' ' 7�pHRYF3ATLS,Fl 33542-7U!i � � ., , poB:04-06-' 9fi4 SEx:M_, , `� -24ilfiaHG�:ti-02 ^ � � �.� 6'2025� F� �' � y�� ' y- • 3Y'- - ��A..i:xs4� - s ' _i-'/� . ,h�"�i�_`_� �' .,.e.. � � .r�. Tf.. .�.�++ ' . ! , ��H� �.. . . . _j` _ - �r -•—_ � � SAFE"DRTV�R , msi cwne.a nr_w�. I � Qperauon ol a mot�rolncta conaWu'ss conscrt co artY soMwiY._ / t - a _ •'#� I - � �� 6 � �� 1 � � i i i � i o i i� � _ �Y�`�� - „ - `^�, k I • �"r- �"�� ', � � ' _ E ','��R`��v `��M..;Y�f��t I ,�.t r � � � . r�LL � ..U... I '�� ' �� :�" �s s. "' ' #'a" :�:,,�� .: J J� .0 : : �'rr� �► � . . . _ -�- - �� I - � ti � : � s.. :ii �f I � � June 19, 2017 � RE: Fireworks Permit for John David Hayes � I I Dear City of Zephyrhills: ' I To accompany our permit application for fireworks display, I submit the list of fireworks � we plan to use. • A-943 Legendscake • G-288 Rhythm and Rock cake • G-362 American Celebration cake • G-818 Crackling Brocade cake • G-910 Night Vision Cake • G-917 Magical Carpet cake • G-941 Triple Whaminy cake • G-187 Vulcan Mortar Kit � � All are 1.4G consumer grade fireworks, not professional or commercial grade. Let me know if you need anything else. I Sincerely, � � I j " f I � J David Hayes President/General Manager ,�;�,�;��•y. .,�11 r.,�f� ��,F �9 , ,��i��y�` � � �R es , , � ; I � i I � � ; v�� £ �� ;� � � � � ', � �; �r"� s , `:, �� ,,;y �,�,� Skydive CitylJ�David Hayes � � �� a �'` � � '�."�� " �--�, Fireworks Dis�fa� Site � `� �� - ,� ,,. �� p Y._ ��.�,� .��:�� _ .�.. �„� � n�_ ��,. s ; � July 1�, 2017�= � _�.t �� _ ,y: ,,. � , :., � - .� � ..-_�" � �� " L, � _ " � �`� • :�z, _ s � � � . y � � . � � • , . � �,, .. k x. ,. �:+� -. .. dL .r � ,t ; �� . * '�r � �Cs` ��. :3� � '�3j .�ar� � . .� � '�,�� 5 . . .. ��,� �.M., y...�C u�..' ,�0� .. . . , , i: # # j , . �. . �� y�� a t� N� tiiw L�� ' ! i�� "; � � 4� �� ''� `'° � � �� ; �.��„�}� ;g "',�� r �+1�r��,,,� .. .'� ��: ��`.�� ~ be' �. ' �. � �`� �1 ��aw ?=9�' � � - � ' .,� "� ., , , ,, � � . •. �.` �`�. - -�� ' !�� ; r _ � r �- ,_ � s�+ � � � � � , - > .. � < , : � � � �'� •,�'.-.�r ... . � � �s . � � _ �- . a , , � . � . � �s.,,� , �. � �� . , � � _ r. � y ,. •. � 4 4 � r,: 'h� t.. . . _ . . 1- •�e,, •y,,,� , _4 , a : ..,� .. ' s x, � . �' . ,? y .. , . ' � �� i..� , � . - a .. i� �� . - . } .. � . . � . � . "'aa. „ �1 . �. q, _�{� . �`� � � . .� n �.�. `� , � � � , , - � . . ::��-�„"",.,. `"` p� � *'a p? '� ;�'{ . � , . . �. . . ��`�, �' ` �� -A �,_ , '`,,,�; , , .., � _ � , s� . < �:�� . , � � . .: . . -- �� ,. � _ e f �,; ,�� ,. . . ' . ,� . . ,� x � _.. „�- +� �, -��: � ;..� � � � _� .� � x � � . ;,�y . � -� .. : � ��, ,- . � 3 r�� :E � � ,,,, � � � � ,/'� ' � � � �� ;�� . .-. � ��. � ��= �:" � r# , . Launch Site ' � =� : {.• . . �� m _ u � � � "'°�:...'�`� '� :��` ..:� ' ' ' �! ' .. , � ,. �� . � .. � � , � � � , o:� ��,_� ; �" •� � �� c�'� � � ` �+��F_�,� , �., ' . � : y _: ■ q � Spectator Line � � ;�. � � ` � ' . �� -_ � � �� 4 � �� _ �� ,._ � ��_ �� S`'r , � � �- � �_� � _ • , •�� =�, ,.� � - �. ��- � � � ar . a -r . a �. ''t -� � ��.�� a�� 4=�:: _ � ' . { . ,� . � � ��+,Is�fMSk�iv�,1��«n � �i +.� . � _ Y � .G 20�52 Goog!e . �"i`� .. _ r ��Ox��+V l.�I �1 1 . ., . ..._ . . . � . � , x�, . �.� Imagery Date.4l25+2012 '��79�a; 28-13'09 90".N 82'09'03 36"W elev 80 f� . . �� - �` Eye alt 2240 ft � AIRPORT LIABILITY POLICY DECLARATIONS -PART ONE j Company: G U.S. SPECIALTY INSURANCE COMPANY Your Policy Number: UA00167344-07 • Administrative offices: 13403 Northwest Freeway, Prior Policy Number: UA00167344-06 • Houston, TX 77040 ITEM NAMED INSURED AND ADDRESS YOUR AGENT'S NAME AND ADDRESS � � Skydive City, Inc. Falcon Insurance Agency, Inc. Individual P. O. Box 291388 Q Partnership Kerrville,TX 78029 or Joint 4241 Sky Dive Lane Venture Zephyrhills, FL 33542 Q Other 2 POLICY PERIOD: 12:01 a.m. standard time at our above address FROM: 02/18/2017 TO: 02/18/2018 3 BUSINESS OF NAMED INSURED: 4 , . PART OCCUPIED BY NAMED INSURED'S L:OCATION OF AIRPORT INSURED BY THIS POLICY NAMED INSURED INTEREST -- -. ZEPHYRHILLS MUNI,ZEPHYRHILLS, FL Portion Tenant 5 LIMITS OF INSURANCE, COVERAGES AND PREMIUMS This insurance is only with respect to the following coverage(s) for which a premium charge is shown in the premium column.Absence of a premium charge means that no insurance is provided by the policy for that coverage. , LIMITS OF INSURANCE " COVERAGES PREMIUM- $ 100,000 Each Person AIRPORT $ 1,000,000 Each Occurrence - A gODILY INJURY AND PROPERTY DAMAGE LIABILITY $ 2,000,000 A re ate 1,200 $ Any One Aircraft $ Each Occurrence C HANGARKEEPER'S LIABILITY $ Deductible COVERAGES APPLICABLE TO ALL AIRPORT(S) INSURED BY THIS POLIGY - � � LIMITS OF INSURANCE,COVERAGES AND PREMIUMS:This insurance is only with respect to the following coverage(s) 5 for which a premium charge is shown in the premium column.Absence of a premium charge means that no insurance is rovided b the olic for that covera e. LIMITS OF INSURANCE - - • � COVERAGES _ PREMIUM $ Each Person PRODUCTS COMPLETED OPERATIONS HAZARD $ Each Occurrence B BODILY INJURY AND PROPERTY DAMAGE LIABILITY $ A re ate $ Each Person p MEDICAL PAYMENTS $ Each Occurrence 6 Premium for Endorsement s $ 0 Forms and Endorsements attached: TOTAL POLICY PREMIUM 1,200 Form Name Form Version Form Title Form Premium 20702 (04/11) ASBESTOS EXCLUSION 20001 (08/10) AIRPORT POLICY CONDITIONS i - 20003 (OS/10) AIRPORT LIABILITY POLICY JACKET I 20080 (08/10) PROTECTING THE PRIVACY OF INFORMATION I I 20002 (08/10) Document Number: 1212021 CA Page 1 of 2 � � i � AIRPORT LIABILITY POLICY DECLARATIONS -PART ONE Company: U.S. SPECIALTY INSURANCE COMPANY Your Policy Number: UA00167344-07 • Administrative offices: 13403 Northwest Freeway, Prior Policy Number: UA00167344-06 • Houston, TX 77040 � 20806 (01/15) CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM ! 20030 (OS/10) EXTENSION-AIRPORT OPERATIONS ADDITIONAL INSURED - 20031 (08/10) EXTENSION-LANDLORD ADDITIONAL INSURED 20053 (08/10) EXTENSION-PARACHUTING ACTIVITIES,LIMITED 20210 (01/16) FLORIDA AMENDATORY ENDORSEMENT � PRODUCTS-COMPLETED OPERATIONS PREMIUM RATE Covera e A licable Onl With Res ect To The Followin Classification BASIS er$1,000 Flat Charge ' I � � Minimum Premium $ Countersigned: Authorized Representative � � I � i �I i 20002 (08/10) Document Number: 1212021 CA Page 2 of 2 I , � � I Jacqueline Boges i i From: Nathan Coleman Sent: Wednesday, June 21, 2017 8:05 AM To: Jacqueline Boges i Subject: RE:fire work show � � Good morning, that is fine as long as he files the NOTAM. He his familiar with the process. I Thank you, 1 i Nathan Coleman Airport Manager 39450 South Avenue I Zephyrhills, Fl 33542 813-780-0030 Office I 813-780-0032 Fax � -- --___r__.__.___�_�---__e_�..�--------------___.____.__.____._..__._____________.._________�---------- - � From:Jacqueline Boges Sent:Wednesday,June 21,2017 8:03 AM � To: Nathan Coleman<ncoleman@ci.zephyrhills.fl.us> Subject:fire work show Good morning Nate, TK Hayes will be having a firework show on July 1 Bill wanted me to check with you to see if this was approved by airport Thank you ... --, - �,��.: �.. ; � � "� - .� � � �� :i � i .� dackic Boges " -- --��'� 813-780-0020 ext 3513 "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 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. ; I � i, i � 1 �I I � .. . - . � �&�� , - .�,:�:'.;��. �:-,.. - -�-}. �_ `- ... �_; -..�.�� . _;y:- . :,:.'�° ,._. ,ri f, r,x ..., ^„=r - i_ p..� _ . .�-_, . «e�a�-,p�.>� r,y. - a'�-' . � ..7N� _ p. '`'^�,'r�,`�i.,;J!.�:��`��'•",g� '•��[�� , , . } � J ' •'�i �'''f t' - - ' ��' �� - - - r i _ ' 4. $ �` 4� .s,': �«�'' �� • , ;� ;� _ ��° .�I!': - �; - � . _; .:g., -. . ;�,�i;:� -�� V _ ��4�� :`�<, ;�' c�'° - S�;;lll�� — s..�s',. ��,�•i, �. -r-�i.' :� , . ,j: � _�. — — — — — F� _� �� .,%� �;/ .j" rY'� .r. �v�=� . . 1 1 a c• M. :�� I I I June 19, 2017 �� I RE: Fireworks Permit for John David Hayes j I i� Dear City of Zephyrhills: I To accompany our pernut application for fireworks display, I submit the list of fireworks i we plan to use. I • A-943 Legends cake � • G-288 Rhythm and Rock cake f • G-362 American Celebration cake I • G-818 Crackling Brocade cake � • G-910 Night Vision Cake • G-917 Magical Carpet cake • G-941 Triple Whaintny cake ' • G-187 Vulcan Mortar Kit All axe 1.4G consumer grade fireworks, not professional or commercial grade. Let me know if you need anything else. Sincerely, 1 J David Hayes President/General Manager ;;.�,�1��.`_ ----- ------�.—•,--–U'� v�� ---- — -------- -- --- ._.;1;��k��,�,�� <'9 � ' '�i��ys<�� / , , j I I i '� ' I I , �r. .r�. . ��- � . _ c ,� � Yf � . � ry � �` °k 5�� `�� '� a, � ,�>� Skydiue City/J D vid F-layes , � _�' • ' ��` 't �: � � � �:. - � � �� . . n. � , �� . , . . � :. . ,.� �, �, � � �� . . • Firewa�ks [7is�play�ite- �' �� .;:� •� -�; ° �� .s . . - �� .� 1 a - J�rty 1��2�}1�� - .��„ �� :..�.�- ' . . °� � � , n �� , .� .1. . • .�4.� �y.• } �� J . . f �� 1 �` � � �'�� `t + �'` ��''�� d��tj. ,� � � * � � , J �� . �i � � . .. � . ~� �'�VF. 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' � . �� ,��p ,", i ,�'r . � . . . � .. � ..� . , � . , yy�Yr 3� - y ... �) ... � . • .. . . , ..'. . 1'�' � '. !� � . . .,. . � * .. 4} . Launch Si�e ; � �_ � - -,�*�� ,. _ k , „ � �. �,Q r� � �... � _ "°` ( . :a�� `�` �. ;'"r � # . ,-�erMR�pi� ,w z �n. � �: � ' y �'i'�s�el.!+R. � � .. . �� . . �T� � � a��3BCf�tOt Zi118 r�� a4 . " . � � •a„, �� _ Y � � *�r,. : � .,. � - , _ . r _ ,�`��t�� ..F,� , i4 # � � � ,.. ��,�;�� i��•q. �' . �'r.�t5k�„![��,e��; �l� �a �y � � � � . . . i- ... fi . ;�:.lOt2 Goog'.e: y � � , � . �oo��e�eart . - . �'{ � - ImageryDaie ar25;yp12 '��y9�a� 2a i3'q990�rr 82 0��0336"W elev 80 h _ Eye alt 2240 ft � ____ _ c;ity ot Lephyrtulls , i BUILDING PLAN REVIEW COMMENTS I ' � I ContractorlHameawner: ��,/�� I fi �I ,i Date Received: t0�_1-�.-�� Site: � c � l� 1 Permit T e: ��2`.d�.� 1 ��°��fTr� ` Approved /no comments:❑ Approved w/the belaw commen.ts: � Denied w/the below comments: ❑ n .� ,�, � �y- - ��/� ' �+�t t b� j � � ,E E � i � i ; I . I 1 I � . . � 1 � I This comm t sheet shall be kept with the permit andlor plans. �< � � �� B' Burges —B `' ' g Qfficial Date Cantractor andlor Hame�wner (Required when comments aze present) r i ' ; _ �� I) `` i , I � 1 � i � � � � � � # � '� _ .. .---._ � _: ._-...�.__.� .. _,__. �a_.�r.� — __ I