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HomeMy WebLinkAbout20-76 City of Zephyrhills PERMIT NUMBER 5335 Eighth Street Zephyrhills, FL 33542 FIRE-000076-2020 Phone: (813)780-0020 Fax: (813)780-0021 Issue Date: 06/0412020 Permit Type: Fire Property Number Street Address 35 25 21 0010 07200 0011 7422 Gall Blvd Owner Information Permit Information Contractor Information Name: TNT FIREWORK RURAL KING Permit Type:Fire Contractor: TNT FIREWORK RURAL Class of Work:Sparklers KING Address: 7422 Gall Blvd Building Valuation: ZEPHYRHILLS,FL 33542 Electrical Valuation: Phone: (813)782-1957 Mechanical Valuation: ,/ a-o Plumbing Valuation: � ��/ Total Valuation:$0.00 Total Fees:$100.00 Amount Paid:$100.00 Date Paid:6/4/2020 2:28:49PM jProject Description SPARKLER SALE RURAL KING jApplication Fees Sparklers Permit Fee $100.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 653.80(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 subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit 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 property.If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans,Specifications add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. --7 CONTRACTOR SIGNATURE PE IT OFFICEC) PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER S 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 r Permit Application Date Received J Phone Contact for Permitp`W 877 740 ��6180 Owner's Name Rural King#0101 Owner's Phone Number 813^ 779 0200 Owners Address 7422 Gall Blvd,Zephyrhills, Florida 33541 Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address Job Address 7422 Gall Blvd Lot# Sub Division Parcel# Bio-Hazard Waste Storage-ANNUAL Hazardous Material(Tier II or RQ Facility)ANNUAL FJComm Exhaust Kitchen Hood/Duct Hood Installation FjControlled Burn 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 riatry emi ® ter Sprinkler El ❑ ❑ ❑ B X� Sparklers Inside Retail Sales of State Approved Sparklers Fire Alarm El ❑ ❑ ❑ Sprinkler System Installations Hood Cleaning ❑ ❑ ❑ Standpipes(Sprinkler Sys) Hood Suppression El ❑ ❑ ❑ Torch Roofing/Tar Kettle Fire Alarm Installation Waste Tire Storage ANNUAL Fire Pumps I (�tu ® Fire Works-SPARKLERS Flammable Application-ANNUAL Valuation of Project Fuel Tanks 0 Other: 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# OTHER Company TNT Fireworks Signature Registered Y/N Fee Current Y/N Address 6255 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(http://appraiser.pascogov.com) -Site plan at store-placement dictated by Fire Marshals office Jimmy Patronis Casia Sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas DIVISION DIRECTOR Keith McCarthy SAFETY PROGRAM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OPSTATE FIRE MARSHAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Tel.850-413-3644 Fax.850-410-2467 CERTIFICATE OF REGISTRATION RETAILER LOCATION PERMIT OFFICIAL COPY THIS CERTIFIES THAT: TNT Fireworks 6255 SE 78th St Ocala F134472 Has registered pursuant to the provisions of Florida Statues to engage in the business of selling sparklers at the following fixed place of business: RURAL KING#101 7422 GALL BLVD. ZEPHYRHILLS FL 33541 Pasco Issue Date: 02/01/2020 Type: 07g Class: 66 County: tr X, i License/Permit#: SR17-000467 Expiration Date: 01/31/2021 Chief Financial Officer <02885858> 02885858 REPRINT - TNT FIREWORKS PACK LIST - REPRINT - 21362 Order #: 2885858-S3-00002 . Chain Store Sales-FL Chains Order Date: 4/15/20 Terms: Net 30 Days CUST PO: NEED PO SCAC: EXLA PRO #: 0469201967 SLSMN: Chain Stores - East SHIPMENT NBR: 564090 Sold To: 2670049 Ship To: 2718761 - RK 0101 RURAL KING RURAL KING #101 4216 DEWITT AVE 7422 GALL BLVD. MATTOON, IL ZEPHYRHILLS, FL 33541 SFM #: Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - *********** *************** Counter Cases *************************** PPK- COMBO:72SNP72SPK CLUB J1 673566A 1 CS 1 EA 1422 .7200 1/1 Containing: #8 SPK - FLAG BOX CLUB J19 380326 72 EA 72 EA 9 .88 6/48/5 27736040353 SNAPS CELLO CLUB J09. 320534 72 EA 72 EA 9 .88 6/40/50 27736023196 DSP AG-KKY-GROC FULL SS J20 F 673924B 1 CS 1 EA 3201. 1700 1/1 Containing: SUPER VALUE PACK REV J09 200722 8 EA 8 EA 10 . 00 12/3 27736017775 RAZZLE DAZZLER USA SS J10 102017 12 EA 12 EA 49 .99 6/1 27736025596 PROUD EAGLE SS USA 102072 17 EA 17 EA 29 .99 10/1 27736013111 COLOR BLAST SS AG J11 102016A ', 24 EA 24 EA 19 .99 10/1 27736025589 SMOKE BALLS BOX OF 8 J12 351052 96 EA 96 EA 2 . 00 4/24/8 27736028337 CAL ROCKET FOUNTAIN 3PK 200967 30 BG 30 BG 5 . 00 2/30/3 27736028450 SIGN NFPA SM FRWKS NO SMOK 730644E 1 EA 1 EA 0. 00 1/1 GROUND BLOOM FLOWER 20 CT 290157A 40 EA 40 EA 5 . 00 2/20/20 27736030255 JALAPENO POPPER YP PDQ 201183 32 EA 32 EA 2 .00 3/16 27736036110 PATRIOT PACK TRAY SS USA 102446 30 EA 30 EA 9 .99 24/1 27736013043 SHORT STACK 200924F 56 EA 56 EA 1.00 4/28 27736028054 MAD TROLLS 201247 20 EA 20 EA 5 .00 24/1 27736039005 Page No 1 J - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - Order #: 2885858-53-00002 Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - HAPPY TROLLS J18 201251 8 EA 8 EA 10 . 00 15/1 27736039074 KOOL KAT 201253 48 EA 48 EA 2 .00 72/1 27736039081 MORNING GLORY #12-8PK J19 380320 � 54 EA 54 EA 1.00 4/54/8 27736040261 #20 NEON SPARKLERS J19 380321 ' 48 EA 48 EA 5 .00 48/5 27736040278 Case Totals : 2 CS Page No 2 CERTIFICATE OF' LIABILITY INSURANCE DATE(MM/°D/YYYY) I 11/1/2020 10/31/2019 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 C No Ext: A/C No): Atlanta GA 30305 E-MAIL (404)460-3600 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Everest Indemnity Insurance Company 10851 INSURED American Promotional Events,Inc. INSURER B: 1359629 DBA TNT Fireworks,Inc. INSURER C: P.O.BOX 1318 INSURER D: 4511 Helton Drive Florence AL 35630 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 12067058 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE 10A WVD POLICY NUMBER MM/DD/YYYY) (MMIDDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY A X Y N SI8GL00242-191 I 11/1/2019 I1/1/2020 EACH OCCURRENCE. $ 1000000 CLAIMS-MADE rX_1 OCCUR PREMISES Ea occurrence $ 500,000 i 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- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT Ea accident $ XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED AUTOS ONLY AUTOSULED BODILY INJURY(Per accident) $ XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ccident $ XXXXXXX $ XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXX OFFICER/MEMBER EXCLUDED? N I A XXX (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX IT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) 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 12067058 Rural King SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE #0101 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7422 GALL BOULEVARD ACCORDANCE WITH THE POLICY PROVISIONS. ZEPHYRHILLS FL 33541 AUTHORIZED REPRESENT�(VE �_ — t, r 71 ©1988-201 ACORD CORPORATION. All rights reserved. ACORD 25(201.6103) The ACORD name and logo are registered marks of ACORD TNT® FIREWORKS Site Plan Worksheet ADDRESS 7422 GALL BLVD. CITY_,ZEPHYRHILLS STATE FL ZIP 33541 PHONE 813.7n.0200 STORE NAME I LOCATION# RURAL KING#101 TYPE OF EVENT: In-store sates of Florida State-approved sparklers NgRTH REVIEW DATE � °a`�'' CITY OF ZEPHY FIRE AND LIFE SAFETY EXAMIN ALL WORK SHALL COMPLY WITH NFFA CODES AND STANDARDS i SOUTH i SPECIAL INSTURCTIONS located approximately 75ft from an exit i SIGNATURE DATE STORE MANAGER I TNT®Representative i { TNr FIREWORKS Site Plan Worksheet ADDRESS 7422 GALL BLVD. CITY ZEPHYRHILLS STATE FL ZIP 33541 PHONE_813.771i OO STORE NAME I LOCATION# RURAL KING#101 TYPE OF EVENT: In-store sales of Florida State-approved sparklers i NORTH REIVIEW'DATE a�a" CITI'C}F ZIY It.L S 'F{RE AND, IFE SAFE Y EXAMIIN ck ALL WORK SHALL COMPLY WITH NFFA CODES AND STANDARDS C 0 LAU Liu SOUTH SPECIAL INSTURCTIONS load aapro mately 75ft from an exit SIGNATURE DATE STORE MANAGER I-MT,@ Representative April 30, 2020 Bill Burgess Building Department 5335 8th Street Zephyrhills, FL 33542 Dear Bill, Hope all is well during these unprecedented times! We are beginning to prepare for shipping our chain stores in the coming weeks. Enclosed please find all of our Zephyrhills sparkler sales locations for 2020. Most chain store locations will be getting their products beginning the second week of May. If there is any additional information you need plea ct me @ 1-800-243-1189, by email or you may also contact Kelly in our Ocala office 1-877-740-6180. elly said she would drive down and pick up permits Do when they are ready. As always, we appreciatt e t e help always provided by you and your office. Sincerely, Corey Howard TNT' Fireworks Assistant Director of Compliance AMERICAN PROMOTIONAL EVENTS, INC. P.O. BOX 1318 - FLORENCE,AL 35631 (256) 764-6131 www.tntfireworks.com REORDER 905•U.S.PATENT NO.5538290,5575508,5641183,57a5353,59M64,603001 GL Cost Center: 21362 6�01 110 0 ........................................... ................................... - ---- ------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------............. --------------------------------------- AEASMERICAN PROMOTIONAL EVENTS Check No. - 10167292 T ba TNT Fireworks PO BOX 1318 Check Date - 4/21/2020 4511 Helton Drive Industrial Park Florence AL 35630 Stub - 1 of 1 INVOICE NO. in ff 7-1� DESCRIPTION 1161110 1 04162OZEPFL 4/16/20 PERMIT FEES 260.00 260.00 260.00 260.00 i Jimmy Pattonls Cash Sinto Jimmy patmis Casie Sinco CHIEF FINANC.IALOFFICER s BUREAU CHIEF CHIEF FINANCIAL OFFICER RUREAU CHIEF Julius llalas Kcith McCarthy Julius Ilalas , Keith McCarthy DIVISION DIHE(.'101t SAFETY PROGRA?t?IANAGER UI V1510N DIRE(.101t SAFM'PROGRAJI:(IANAGER FLORIDA DEPARTMENT OF FINANCIALSERVICES FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE 11ARSHAL DIVISION OF STATE FIRE MARSHAL 200 Fast Gaines Suva.Tallalmssm.Florida 32399-0342 200 Gast Gaines Strut-Tallal,assm,Florida 32.1".0342 Tel.11ct}113-3644 Fas.850410.2467 Tel.850413-3644 Fax.850-010-2467 CERTIFICATE OF REGISTRATION CERTIFICATE OF REGISTRATION DISTRIBUTOR OF SPARKLERS WHOLESALER OF SPARKLERS THIS CERTIFIES THAT: American Promotional Events dba TNT Fireworks THIS CERTIFIES THAT: American Promotional Events dba TNT Fireworks T 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: 02/01/2020 — Issue Date: 02/01/2020 Type: 07 Stm Type: 07 Class: 61 Class: 62 sstr aZ `"moo County: Marion �Y `" ,�'". County: Marion >,�'' License/Permit#: 565066-0001-2005 License/Permit 9: 565065-0001-2005 ; Expiration Date: 01/31/2021 ate.,. Expiration Date: 01/31/2021 a IN CIT �Tnr, f�� r a- c�ryyrv, l�iJ „� Chief Financial Officer (Chief Financial Officer a 2020 TNT Fireworks Sparkler Sales Locations Chain. Store. - -Address City ST.: I Zip County Locai Jurisdidion in Store Date Publix PUB1245 7838 GALL BOULEVARD ZEPHYRHILLS FL 1 33541 IPasco IZephyrhills I Week of May llth Rural King RK 0101 7422 GALL BLVD. ZEPHYRHILLS FL 1 33541 IPasco IZephyrhills I Week of May 11th Wal-Mart WAL0706 7631 GALL BOULEVARD ZEPHYRHILLS FL 1 33541 IPasco IZephyrhills Week of May 11th s Page 1 of 1