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HomeMy WebLinkAbout18-19713 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 19713 FIRE SPARKLERS PERMIT PERMIT INFORMATION LOCATION,INFORMATION Permit Number: 19713 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: 5/21/2018 Name: SF ZEPHYR COMMONS LP Total Fees: 100.00 Address: 400 CLEMATIS ST STE 201 Amount Paid: 100.00 WEST PALM BEACH FL 33401-5322 Date Paid: 5/21/2018 Phone: Work Desc: FIRE SPARKLER SALE-PUBLIX CONTRACTOR(S) S . APPLICATION FEES TNT FiREWZRK9_FPUBL1X) FIRE P5RW1T FE S- 100.00 C�05z---- R INVENTOR ON SITE INS 'Inspectio s Required FI 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 Departments 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. CONTIRACTOR SIGNATURE PERMIT OFFIC&A PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE- 813-780-0041 &13-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit —1 800 868 F9151 Owners Name Publix#1245 Owner's Phone Number Owners Address 7838 Gall Boulevard,Zephyrhills, FL 33541 Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address ------------ Job Address 7838 Gall Boulevard Lot# Sub Division Parcel# Bio-Hazard Waste Storage-ANNUAL Hazardous Material(Tier 11 or RQ Facility)ANNUAL 0 Comm Exhaust Kitchen Hood/Duct Hood Installation Controlled Burn LP/Natural Gas-installation F� Emergency Generator<30 kw LP/Natural Gas-ANNUAL Sale F-1 Emergency Generator>30 kw Places of Assembly-ANNUAL Fire Protection Maintenance-ANNUAL Recreational Burn F-1 r0fr yJ rTe-m"tl rA-nTl lother Sprinkler 0 0 11 X Sparklers Inside Retail Sales of State Approved Sparklers Fire Alarm 0 11 11 F7 Sprinkler System Installations Hood Cleaning F-1 0 11 0 7 Standpipes(Sprinkler Sys) all e3 Hood Suppression El 0 13 o F� Torch Roofing/Tar Kettle Fire Alarm Installation Waste Tire Storage ANNUAL Fire Pumps F"q Fire Works -SPARKLERS . N F-1 Flammable Application-ANNUAL Valuation of Project Fuel Tanks Other: Contractor Company Signature Registered Y/N Fee Current y/N J Address License# ELECTRICIANI Company Signature Registered Y/N Fee Current LI/NJ Address License# PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License# MECHANICALF Company Signature Registered Y/N Fee Current Y/N Address License# Vendor Company ITNT Fireworks Signature Registered I Y/N Fee Current Address 16255 SE 78th Street, Ocala, FL 34474 License# 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(hftp://appraiser.pascogov.com) -Site plan at store-placement dictated by Fire Marshals office -State Sparkler Licence attached -Product List attached Jinimy Patronis Casia Sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas Keith McCarthy DIVISION DIRECTOR SAFETY PROGRAM MANAGER •a�ao we FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Tel.850-413-3644 Fax.850-410-2467 CERTIFICATE OF REGISTRATION RETAILER LOCATION PERMIT THIS CERTIFIES THAT: Publix Supermarkets 6255 SE 78th Street Ocala FL 34472 Has registered pursuant to the provisions of Florida Statues to engage in the business of selling sparklers at the following fixed place of business: Publix#1245 7838 Gall Blvd Zephyrhills FL 33541 Pasco - Issue Date: 02/01/2018 Type: 07 Class: 66 County: Marion License/Permit#: 118682-0014-2008 Expiration Date: 01/31/2019 ter, Chief Financial Officer j .. TNT° FIREWORKS. Site Plart`Worksheet ' ADDRESS. ' 3.g of i CLTY Ze hy I I Gs STATE FL ZIP 3 y..t .PHONE !3 $3 STORE`NAME 1.LOCi ION;# pub 1 TYPEDF EVENT: 164tore sales'of Florida State-approved sparklers NORTH ALL WORK SHALL COMPLY WITH NFFA CODES AND STANDARDS REVIEW DATE CITY OF ZEPHYRHILLS FIRE AND LIFE SAFETY EXAMINE ;SOUTH SPECIAL INSTURCTIONS locatod approximately 75ft:from an exit <01967867> 01967867 - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - 21362 Order # : 1967867-53-00002 Chain Store Sales-FL Chains Order Date: 3/24/15 Terms : Net 30 Days CUST PO: SCAC: WTVA PRO # : 93074183 SLSMN: Chain Stores - East SHIPMENT NBR: 35582 WLSL Lic # : Sold To: 1420005 Ship To: 2056670 - PUB1245 PUBLIX - COMPANY 0002 PUBLIX 1245 PO BOX 32008 7838 GALL BOULEVARD LAKELAND, FL 33802 ZEPHYR COMMONS ZEPHYRHILLS, FL 33541 SFM # : Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- *************************** Counter Cases ********************* * FDP SNAP&SPARKLER DOM VS1 X13 673266 1 CS 1 EA 341 . 0000 1/1 Containing: #8 SPARKLERS ASST 2 PDQS J 380247A 68 EA 68 EA 2 . 00 2/42/6/5 27736022755 2 PAK SNAP 4 PDQS J14 320516J 205 EA 205 EA 1 . 00 4/40/2/50 27736022922 DSP PUB LG SSS J15-NR 673396B 1 CS 1 EA 3150 . 6500 1/1 Containing: SUPER VALUE PACK REV J09 200722 5 EA 5 EA 10 . 00 12/3 912288 CRACKLING SALUTE J07 320474 24 EA 24 EA 2 . 00 4/24/10 958451 MINI CALIFORNIA RKT FTN J 200743 36 EA 36 EA 2 . 99 4/36/4 820943 STORM SHOCK USA PDQ SS J10 102023 36 EA 36 EA 10 . 00 24/1 939667 SMOKE BALLS BOX OF 8 J12 351052 48 EA 48 EA 2 . 00 4/24/8 807590 CAL ROCKET FOUNTAIN 3PK 200967 30 BG 30 BG 5 . 00 2/30/3 188308 DOUBLE PAK MORNING GLORY J 380276 108 EA 108 EA 1 . 00 4/54/8 188305 THUNDER BOOM USA SS J12 WO 102024B 26 EA 26 EA 19 . 99 10/1 27736025992 SIGN NFPA SM FRWKS NO SMOK 730644E 1 EA 1 EA 0 . 00 1/1 LIGHTNING BLAST SS AM BOX 102309 12 EA 12 EA 29 . 99 12/1 27736023745 MEGA STORM USA SS AM BOX J 102310 8 EA 8 EA 49 . 99 8/1 27736023714 Page No 1 - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - Order #: 1967867-53-00002 Desc/Case ' Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- PARTY PAK SS USA J09 101933 17 EA 17 EA 15 . 99 16/1 804227 #20 NEON SPARKLERS J11 380266 48 EA 48 EA 5 . 00 48/7 958454 LASER RAINBOW W/YP 200573U . 12 EA 12 EA 5 . 00 16/1 944810 CRAZY FUN PAK SS N12 PDQ 102126A 24 EA 24 EA 2 . 00 4/21 27736027545 SHORT STACK J13 200924B 28 EA 28 EA 1 . 00 8/28 27736028054 #8 SPARKLERS ASST 2 PDQS J 380247A 42 EA 42 EA 2 . 00 2/42/6/5 27736022755 2 PAK SNAP 4 PDQS J14 320516J 120 EA 120 EA 1 . 00 4/40/2/50 27736022922 GROUND BLOOM FLOWER 20 CT 290157A 20 EA 20 EA 5 . 00 2/20/20 27736030255 ******* ************** **** Promotional Supplies *********************** PALLET WRAP, RED J13 730659 1 CS 1 EA 0 . 0000 1/1 Case Totals : 2 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 : 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 Page No 2 I ® DATE(MM/DD/YYYY) AC40 o' CERTIFICATE OF LIABILITY INSURANCE 11/1/2018 5/8/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Lockton Companies NAME: 3280 Peachtree Road NE Suite#250 PHONE FAX A/C No Ext: A/C No): Atlanta GA 30305 E-MAIL (404)460-3600 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Everest Indemnity Insurance Company 10851 INSURED INSURER B: 1359629 American Promotional Events,Inc. DBA TNT Fireworks,Inc. INSURER C: P.O.Box 1318 INSURER D: 4511 Helton Drive INSURER E: Florence AL 35630 INSURER F COVERAGES CERTIFICATE NUMBER: 12067055 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDPOLICY/YYYY MM/DD EFF Y EXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY Y N SI8GL00242-171 11/1/2017 11/1/2018 EACH OCCURRENCE $ 1 000 000 CLAIMS-MADE FX_I OCCUR PREMISES Ea occu ence $ 500 OOO MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 21000,000 JECT OTHER: $ AUTOMOBILE LIABILITY NOT APPLICABLE (CMEa aBINEDLSINGLE LIMIT $ XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY a c DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY $ XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAR CLAIMS-MADE AGGREGATE $ XXXXXXX DED I I RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE STATUTE ER H AND EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVED? Y XXX N/A E.L.EACH ACCIDENT $ XXXX OFFICERIMEMBER EXCLUDE (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER,APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S)REFERENCED. City of Zephyrhills and Certificate holder is an additional insured on the General Liability as required by written contract subject to policy terms,conditions, and exclusions. CERTIFICATE HOLDER CANCELLATION 12067055 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PU1)11X Publi THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7838 GALL BOULEVARD ACCORDANCE WITH THE POLICY PROVISIONS. ZEPHYRHILLS FL 33541 AUTHORIZED REPRESENT T E , 2� ©1988-201 ACORD CORPOFIATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ' ® DATE(MM/DD/YYYY) ACORN CERTIFICATE OF LIABILITY INSURANCE 5/31/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER p CONTACT Ste hens Insurance, LLC NAME: 111 Center Street, Suite 100 PHONE o xt: 1-800-643-9691 A/C No: 501-377-2317 Little Rock,AR 72201 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# www.stephens.com INSURER A: Navigators Insurance Company AM Best A XI 1) 36056 INSURED INSURERS: Safety National Casualty CO A+X 15105 Red Knight Transportation LLC dba R. K. INSURERC: Liberty Insurance Corporation AM Best A X 42404 Transportation, LLC; RK Transportation R. K. Transportation INSURERD: Travelers Property Casualty Ins.Co AM Best A++XV 36161 4216 Dewitt Avenue INSURERE: Mattoon IL 61838 INSURER F COVERAGES CERTIFICATE NUMBER: 42266980 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. INSR TYPE OF INSURANCE ADDLSUBR POLICYNUMBER POLICY/YYYY MMIDDIYWY LIMITS LTR A �/ COMMERCIAL GENERAL LIABILITY GAI8CGL1255871C 3/31/2018 3/31/2019 EACH OCCURRENCE $1000000 DAWAGE CLAIMS-MADE �✓ OCCUR PREM SESOEa oNccurrence $30O 000 MED EXP(Any one person) $0 PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 ✓ POLICY 0 jE LOC PRODUCTS-COMP/OP AGG s2,000,000 OTHER: $ B AUTOMOBILE LIABILITY CAF4058384 3/31/2018 3/31/2019 (Ea accident) $1,000,000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident $ C ✓ UMBRELLALIAB �/ OCCUR TH7-691-462275-028 3/31/2018 3/31/2019 EACHOCCURRENCE $10000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1 O 00O 000 DED I ✓ RETENTION50 $ B WORKERS COMPENSATION LDC4052725 3/31/2018 3/31/2019 ✓ STATUTE oRH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1 000 000 OFFICER/MEMBEREXCLUDED? ❑N NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1 ,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000 000 D Motor Truck Cargo QT-660-OH82105A-TIL-18 3/31/2018 3/31/2019 Cargo $300,000 Cargo Ded $5,000 B Trailer Interchange CAF4058384 3/31/2018 3/31/2019 Trailer Interchange Limit$25,000 5 000 deductible Comp&Collision DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: 7422 Gall Blvd Zephyrhills,FL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FOR INFORMATION ONLY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ted Grace ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 42266980 1 2018.19 Cargo Certificate I brittney.mullaney®stephens.com 1 5/31/2018 3:35:16 PM (CDT) Page 1 of 1 Jacqueline Boges From: Jacqueline Boges Sent: Monday, May 21, 2018 1:22 PM To: 'Chrissie Hamner' Subject: sparkler sale for zephyrhills florida Hello Chrissie, I am finishing up the permits for the sparkler sale for Walmart, Publix and Rural King sites. I need a site plan for the rural king set up I also need workman comp the last one I have is 3/2018 which has expired. If you could notate---the contractor fee$30.00 is due once a year the dates) are from July 1st expiring on Sept 30th you only have to include the$30.00 within these times.So I will request refund for$90. Thank you o� 1 claekk Boges - 513-790-0020 ext 35,3 "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. 1 City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: Date Received: —ltu Site: [I- Permit Type: Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. Gene Brown—Fire Safety Officer Date Contractor and/or Homeowner (Required when comments are present) May 8, 2018 Jackie Boges Building Dept. 5335 8th Street Zephyrhills, FL 33542 Dear Jackie, Enclosed please find all permitting information for the locations that we will be furnishing with state approved sparklers this 4t" of July season. If there is any additional information you need please contact me at 1-800-243-1189. You may also contact Kelly Alley Niehaus in our Ocala office at 1-800-868-9151. Thanks again for all of your help. Sincerely, ck �1_._ Chrissie Hamner TNT® Fireworks Assistant Director of Compliance chrissie.hanmer@tntfireworks.com AMERICAN PROMOTIONAL EVENTS, INC. P.O.BOX 1318•4511 HELTON DRIVE•FLORENCE,AL 35630 PHONE(256)764-6131 •FAX(256)760-0154 www.tntfireworks.com REORDER 905•U.S.PATENT NO.5538290,5575508,5641183,5785353,598434 603001 GL Cost Center: 21362 ® AAMSRICAN PROMOTIONAL EVENTS Check No. - 10134407 EAT dba TNT Fireworks Check Date - 5/3/2018 PO BOX 1318 4511 Helton Drive Industrial Park Stub 1 of 1 Florence,AL 35630 • • DESCRIPTION 71TITTOW97, • 050218ZEPFL 5/2/2018 PERMIT FEES 390.00 390.00 390.00 390.00 ........... �. ,i•. .''S ..c.:�1, ............_-........__...... _ . ., ..........._ ............. + : . _ r e ta[ A C Q OVE 'Tills a Nff Ut,K . :i_ C)—s i A 6 L}E c b�`,y„ d e s �� , .. .� '"" "'n �a�d:_ KY4��'�✓� s .r§°. a��„ p�V 4,}�.�sq l� z gL�"P _ � ,} R dy� "T.{t 4:�� q"h- §� ,, tin 1 _ _�.. , € r i AO.. .. = 3 ��E4��_ t i '_t, ___. § r"#i D .st``. _- n .0 . -r .. _ N11, r', :+ � t, + _ °--- � s� .•v°. , ._ ._ _ '7 _ e-B_i)'� } � �' a,, C�F� . ,^i'�J :i.:4 t'� W d � n, ,.i'�", ° :d ss __ . I! 9 1 - ° riON •_ } 2018 TNT Fireworks ~ Sparkler Sales Locations �Chd_In Store _ MRIMIMMENOWARdaress Cit �ST�7335411 Zi Coun__ Loc_al Jurisdici_ion I_n Stor_e Date Publix PUB1245 7838 GALL BOULEVARD ZEPHYRHILLS FL 541 Pasco Ze h rhills Week of May 14th Rural King RK O1O1 7422 GALL BLVD. ZEPHYRHILLS FL 54 Pasco Ze h rhills Week of Ma 14th Wal-Mart WAL0706 7631 GALL BOULEVARD ZEPHYRHILLS FL Pasco Ze h rhills Week of Ma 14th Page 1-of 1 Jimmy patrords Cada Since Jlmmy pattanis Casia Since CHIEF FINANCIALOFFICER BUREAU CHIEF CHIEF FINANCIAL OFFICER _ BUREAU CHIEF Judos Halal Keith NfeCarthy Julius Halal Keith mtCarchy DIVISION DIRECTOR SAF'E'iY RA PROGRAM MANAGER DIVISION DIRECTOR SAFETY PROGM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL DIVISION OF STATE FIRE MARSHAL 200 Cut Games Street•Tallahassee,Florida 32399.OM2 200 rot"nes Street:-Tailahmm,Florida 32399.0342 Tel.850413.3644 Fas.950410.2467 Tel.850413-3644 F=850-410.2467 CERTIFICATE OF REGISTRATION CERTIFICATE OF REGISTRATION DISTRIBUTOR OF SPARKLERS WHOLESALER OF SPARKLERS OFFICIAL COPY OFFICIAL COPY THIS CERTIFIES THAT: American Promotional Events dba TNT Fireworks THIS CERTIFIES THAT: American Promotional Events dba TNT Fireworks 6255 SE 78th Street 6255 S E 78th St Ocala FL 34472 Ocala FL 34472 Has registered pursuant to the provisions of Florida Statues to engage in the business of selling sparklers to a Has registered pursuant to the provisions of Florida Statues to engage in the business of selling sparklers to a wholesaler. retailer. Issue Date: 02/01/2018 Issue Date: 02/01/2018 Type: 07 Type: 07 6an,.a+ Class: 61 , Class: 62 County: Marion County: Marion License/Permit#: 565066-000I-2005 R" License/Permit#: 565065-0001-2005 Expiration Date: 01/31/2019 , w*fi� Expiration Date: 01/31/2019 ' Chief Financial Officer 4Chief Financial Officer