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CITY OF ZEPHYRHILLS
5335-8TH STREET
` (813)780-0020 21217
FIRE SPARKLERS PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 21217 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: I OWNER INFORMATION
Date Issued: 5/20/2019 Name: SF ZEPHYR COMMONS LP
Total Fees: 130.00 Address: 400 CLEMATIS ST STE 201
Amount Paid: 130.00 WEST PALM BEACH FL 33401-5322
Date Paid: 5/20/2019 Phone:
Work Desc: SET UP SPARKLER SALE ( PUBLIX)
CONTRACTORS APPLICATION FEES
TNT FIREWORKS P BL FIRE PERMIT FEE 00.00 CONTRACTOR CERTIFICATE 30.00
FIRE INVENTORY NSITE IN P Ins ections Reied
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.
&---
CON/RACTOR SIGNATURE PERMIT OFFIC
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION -8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE - 813-780-0041
City of Zephyrhills Fire Fax-813-780-0021
813-780-0020
Permit Application
Phone contact for Permit F-6180
Date Received
Owner's Name Publix#1245 Owner's Phone Number 813 DE 1957
Owners Address 7838 Gall Boulevard,Zephyrhills, FL 33541
Fee Simple'Titleholder Name Titleholder Phone Number
Fee Simple Titleholder Address
7--
5�7
Job Address 7838 Gall Boulevard Lot#
C�
Sub Division Parcel#
Hazardous Material(Tier 11 or RQ Facility)ANNUAL
Blo-Hazard Waste Storage-ANNUAL
Comm Exhaust Kitchen Hood/Duct Hood Installation
Controlled Burn Q LP/Natural Gas-Installatiop
Emergency Generator<30 kw LP/Natural Gas-ANNUAL Sale
Emergency Generator>30 kw Places of Assembly-ANNUAL
Fire Protection Maintenance-ANNUAL Recreational Burn
P Mry Pe—mli F9 MtTeW7
Sprinkler F-1 0 0 0 F-1 Sparklers Inside Retail Sales of State Approved Sparklers
Fire Alarm F-1 0 0 0 7 Sprinkler System Installations
Hood Cleaning 0 11 0 El = F-1 Standpipes(Sprinkler Sys) 17
Hood Suppression F 1 0 0 0 F-1 Torch Roofing/Tar Kettle-
F-1 Fire Alarm Installation Waste Tire Storage ANNUAL
Fire Pumps
Fire Works -SPARKLERS
F-1 Flammable Application-ANNUAL r Valuation of Project
F-1 Fuel Tanks
Other:
Contractor Company
Signature F Registered Y/N Fee Current -=/N
Address License# 71
ELECTRICIAN Company
Signature Registered Y/N Fee Current
Address License#
PLUMBER Company
Signature Registered Y/_N_ Fee Current �IN
Address E_ License
MECHANICAL Company T_Y/N I
Signature Registered Y/N Fee Current
Address License
Vendor Company ITNT Fireworks
Signature Registered I Y/N Fee Current I Y/N
Address [6255 SE 78th Street,Ocala, FL 34474 License
Directions: Fill outapplication 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(http://appraiser.pascogov.com)
-Site plan at store-placement dictated by Fire Marshals office
-State Sparkler Licence attached
-Product List attached
TNT° FIREWORKS
�
Site Plan Worksheet
I �
ADDRESS T6 g G- ,-t 1 ( 6 A
` �eI1+� t I I� STATE FL Z1P J `�`� PHONE 113`7-
CITY
STORE NAME)LOCATION.# Bib IX -- I z I h
TYPE OF EVENT: In-store salesi of Florida State-approved sparklers
NORTH
REVIEW DATE .' >/ ,a
CITY OF 2EPHYRNfLCs
FIREAND LIFE SAFETY EXAMINER_,L '�_,o
ALL WORK SHALL COMALY WITH
NFFA CODES AND STANDARDS
1
SOUTH
SPECIAL INSTURCTIONS located approximately 75ft from an exit
<02,708624>
02708624
- REPRINT - TNT FIREWORKS PACK LIST - REPRINT -
21362 Order #: 2708624-S3-00002
Chain Store Sales-FL Chains Order Date: 4/8/19
Terms : Net 30 Days OUST PO:
SCAC: PRO #: SLSMN: Chain Stores - East
SHIPMENT NBR: 458688
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 ********** ************
DSP ALT MASS FL SS HALF J19 673822 1 CS 1 EA 1691 .4200
1/1 27736039609
Containing:
SUPER VALUE PACK REV J09 200722 8 EA 8 EA 10 . 00
12/3 912288
CRACKLING SALUTE J07 320474 24 EA 24 EA 2 . 00
4/24/10 958451
STORM SHOCK USA PDQ SS J10 102023 27 EA 27 EA 9. 99
24/1 939667
SMOKE BALLS BOX OF 8 J12 351052 48 EA 48 EA 2 . 00
4/24/8 807590
SIGN NFPA SM FRWKS NO SMOK 730644E 2 EA 2 EA 0 . 00
1/1
PALLET WRAP RED J13 730659 1 EA 1 EA 0 . 00
1/1
GROUND BLOOM ,FLOWER 20 CT 290157A 20 EA 20 EA 5 . 00
2/20/20 958450
JALAPENO POPPER YP PDQ 201183 16 EA 16 EA 2 . 00
3/16 973644
SHORT STACK 200924F 28 EA 28 EA 1. 00
4/28 27736028054
LASER RAINBOW W/YP 200573U 18 EA 18 EA 5 . 00
16/1 944810
HAPPY TROLLS J18 201251 6 EA 6 EA 10 . 00
15/1 27736039074
KOOL KAT 201253 24 EA 24 EA 2 . 00
72/1 27736039081
THUNDER BOOM ALL-CT SS J18 102533 21 EA 21 EA 19. 99
10/1 27736025992
LIGHTNING BLAST ALL-CT SS 102535 10 EA 10 EA 29 . 99
12/1 27736023745
#8 SPARKLERS ASST 1 PDQ J1 380296 40 EA 40 EA 2 . 00
1/42/6/5 27736022755
Page No 1
- REPRINT - TNT F IREWUKK6 YAC:K Ll�'1' - xr rally 1 -
Order #: 2708624-S3-00002
Desc/'Casee Packing Item Quantity Selling Suggested
CP # Ordered Units Sell Price
--------------------------------------------------------------------------------
2 PAK SNAP 4 PDQS J19 320676 40 EA 40 EA 1 . 00
4/40/2/50 27736040377
Case Totals: 1 CS
Page No 2