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HomeMy WebLinkAbout20-1183 D Q - f FAA City of Zephyrhills EReniT NunnBER 5335 Eighth Street Zephyrhills, FL 33542 FIRE-001183-2020 Phone: (813)780-0020 f Fax: (813)780-0021 Issue Date: 12/12/2020 Permit Type: Fire k' _ Propift' "Numtier= - �A Street°Address r . 34 25 210110 00000 0010 7631 Gall Boulevard :,I low ,., a Permitinformatlon � , 3 a-.,<�Contractorinformatton Name: TNT FIREWORKS WALMART Permit Type:Fire Contractor:TNT FIREWORKS WALMAR' Class of Work:Sparklers Address: 7631 Gall Blvd Building Valuation:$0.00 ZEPHYRHILLS,FL 33542 Electrical Valuation: Phone: (813)782-1957 Mechanical Valuation: Plumbing Valuation: _ J Total Valuation:$0.00 0�/(/Jkl Total Fees:$100.00 Amount Paid:$100.00 Date Paid:12/15/2020 12:10:39PM n• yr,n - w-a+� - � - *rr�•�: ... --- - y.. -. .•6. `,u ;} y t - ProjectDescription _ { _ , ' u: SALE SPARKLER INSIDE WALMART Application�Fees Sparklers Permit Fee $100.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(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. CONTRACTOR SIGNATURE PEf IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION -. 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit Owner's Name Wal-Mart#706 Owner's Phone Number Owners Address 7631 Gall Blvd, Zephyrhills, FL 33541 Fee Simple Titleholder Name' Titleholder Phone Number Fee Simple Titleholder Address Job Address 7631 Gall Blvd Lot# Sub Division Parcel# Bic-Hazard Waste Storage-ANNUAL Hazardous Material(Tier 11 or RQ Facility)ANNUAL Comm Exhaust Kitchen Hood/Duct Hood Installation Controlled 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 Burn FM Try Te 7m, F79 79 Sprinkler 0 0 El Fx_� Sparklers Inside Retail Sales of State Approved Sparklers Fire Alarm 0 0 11 7 Sprinkler System Installations Hood Cleaning 0 0 0 E] Standpipes(Sprinkler Sys) Hood Suppression 0 0 0 F7 Torch RoofinglTar Kettle Fire Alarm Installation Waste Tire Storage ANNUAL Fj Fire Pumps Fx7x Fire Works-SPARKLERS Flammable Application-ANNUAL Valuation of Project Fuel Tanks CJ Other: 7- 7 71'1� Contractor Company Signature Registered Y/ N Fee Current Y/N Address 7 License# E_ ELECTRICIAN Company I Signature Registered Y/N Fee Current Y/N Address License# F_ PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License# F_ Vendor Company ITNT Fireworks Signature Registered Y/N Fee Current LI/NJ 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(http://appraiser.pascogov.com) -Site plan at store-placement dictated by Fire Marshals office -State Sparkler Licence attached -Product List attached Jimmy Patronis Casia Sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas Keith McCarthy DIVISION DIRECTOR SAFETY PROGRAM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East G4ines Street -Tallahassee,Florida 32344-0342 Tel.850-413-3644 Fax.850-410-2467 CERTIFICATE OF REGISTRATION RETAILER LOCATION PERMIT THIS.CERTIFIES THAT: Wal-Mart Stores Inc. 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: Wal-Mart#706 7631 Gall Blvd Zephyrhills FL 33541 Pasco Issue Date: 02/01/2020 Type: 07 Class: 66 County: Marion License/Permit#: 565026-0018-2005 Expiration Date: 01/31/2021 Chief Financial Officer TNT® FIREWORKS Site Plan Worksheet STORE NAME 1 LOCATION#LAYOUT OF WAL-MART LOCATION'S TYPE OF EVENT: In-store sales of Consumer Fireworks Walmart 706 Zophyrhills, FL REAR OF BUILDING 177777,7,777 .r Action Allay(Seasonal Able) Registers t.+,xava ern r, FRONT INSTURCTIONS:Wal-Mart generally places the sales displays of consumer fireworks products In the front of the stores on the front side aisles(Action Ailey)near the.entrancelexit which Is known as the seasonal aisle This is a general overview of a typical Wal-Mart Super Center and product placement may/should be dictated by Instruction of the Lector depending on the individual locations needs and or store setup REVIEW DATE 3 ro a� CITY OF.ZEPHYRHILLS FIRE AND LIFE SAFETY EXAMINER ALL WORK SHALL COMPLY WITH NFFA CODES AND STANDARDS AC 40® DATE(MM/DD/YYYY) , CERTIFICATE OF LIABILITY INSURANCE 11/1/2021 11/2i2020 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 Lockton Companies CONTACT 3280 Peachtree Road NE,Suite#250 PHONE FAX A/C No Ext: A/C No): Atlanta GA 30305 EMAIL (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 INSURER E Florence AL 35630 INSURER F: COVERAGES CERTIFICATE NUMBER: 12067057 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 EFF POLICY EXP LIMITS LTR YYY POLICY NUMBER MMIDD/Y MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000 000 A X Y N SI8GL00242-201 11/1/2020 11/1/2021 DA AGE ORE TED CLAIMS-MADE F OCCUR PREMISES Ea occurrence $ 500 000 MED EXP(Any one person) $ 5,000 t PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: d GENERAL AGGREGATE $ 2,000,000 POLICY❑JECTPRO- ❑ 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 SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ �S XXXXXXX AUTOS ONLY AUTOS ONLY Per accident $ XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DIED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? ❑ N/A (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) City of Zephyrhills and Certificate holder is an additional insured on the General Liability as required by written contract subject to policy terns,conditions, and exclusions. I I CERTIFICATE HOLDER CANCELLATION 12067057 Wal-Mart SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE #0706 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7631 GALL BOULEVARD ACCORDANCE WITH THE POLICY PROVISIONS. ZEPHYRHILLS FL 33541 �I�� AUTHORIZED REPRESENTE ' '�' , ' r ©1988401 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <03002422> 03002422 REPRINT TNT FIREWORKS PACK LIST - REPRINT - 21362 Order #: 3002422-53-00002 Chain Store Sales-FL Chains Order Date: 11/2/20 Terms : Net 60 Days CUST PO: 1916040293 SCAC: EXLA PRO #: 0469202309 SLSMN: Chain Stores - East SHIPMENT NBR: 647452 Sold To: 1410002 Ship To: 1056090 - WAL0706 WALMART - CORPORATE 00001 WALMART 0706 702 SW 8TH STREET 7631 GALL BLVD BENTONVILLE, AR 72716 ZEPHYRHILLS, FL 33541 SFM # : Desc/Case Packing Item . Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- *************************** Assortments *********************** FUN BLAST SS COM W/PDQ J12 102205 2 CS 48 EA 9 . 9700 24/1 550437037 PATRIOT BOOM ALL SS J18 102549 2 CS 16 EA 49 . 9700 8/1 27736037674 BACKYARD SHOW USA SS J20 102647 1 CS 16 EA 19 . 9700 16/1 27736025565 BLAST ZONE USA SS J20 102648 4 CS 40 EA 29 . 9700 10/1 27736007677 *************************** Base Fountains *********************** JUMBO FINALE 4 PAK 200566 2 CS 10 EA 29 . 9700 5/4 783462 COUNT DOWN SS W/YP NY10 200784A 1 CS 24 EA 6 . 0000 24/1 70017565 JUMBO 20 RKT FTN PDQ J09 200815 1 CS 48 EA 5 . 0000 48/3 550503486 THE 3 EMIGOS 201219 1 CS 24 EA 5 . 0000 24/1 563137906 *************************** Ground Spinners *********************** GROUND BLOOM FLOWER 20 CT BOX 290157A 1 CS 40 EA 5 . 0000 2/20/20 551358833 *************************** .Novelties *********************** 2PK CONFETTI CANNON28X18 PAPE 320651 1 CS 18 EA 5 . 0000 3/6/2 27736039937 *************************** Sparklers *********************** #20 NEON SPARKLERS J19 380321 1 CS 48 EA 5 . 0000 48/5 27736040278 #8 SPARKLERS ASST 2 PDQS J19 380322 5 CS 420 EA 2 . 0000 2/42/6/5 27736040285 *************************** Counter Cases *********************** Page No 1 ` - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - Order #: 3002422-53-00002 Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- PPK BCKYRD SHW BLASTZON SS FL 673636K 1 CS 1 EA 1548 . 0500 1/1 Containing: BACKYARD SHOW USA SS J20 102647 40 EA 40 EA 19 . 97 16/1 27736025565 BLAST ZONE USA SS J20 102648 25 EA 25 EA 29 . 97 10/1 27736007677 Case Totals : 23 CS Page No 2 <S3.-3002422> <0469202309> S3-3002422 TNT Fireworks 0469202309 Bill of Lading - REPRINT SCAC: EXLA PRO # : 0469202309 Shipment # : 647452 Shipper: Sales Assoc : Chain Stores - East TNT WAREHOUSE - OCALA, FL Cust PO #: 1916040293 6255 SE 78TH STREET Order #: 3002422 OCALA, FL 34472 RBU: 21362 WLSL Lic # : Transfer: Sold To: Ship To: 1056090 WALMART - COMPANY 00002 WALMART 0706 702 SW 8TH STREET 7631 GALL BLVD BENTONVILLE, AR 72716 ZEPHYRHILLS, FL 33541 SFM #: ****** DELIVER DATE: 12/14/20****** - ******************************************************************************** Emergency Response Nbr: (800) 255-3924 Payment Terms : Collect Contract Number: MIS0006877 HM Description of Articles Weight Shipping # of Cases Class Pieces X UN0336, FIREWORKS 1 . 4G 763 LBS 85 16 [X] NOVELTIES - NMFC 56290-4 131 LBS 175 7 [X] Totals : 894 LBS 23 ******************************************************************************** Net Explosive Mass : 191 LBS ******************************************************************************** Checked By: Received By: Received Date: _ Delivered By: Placards Tendered By: Delivery Instructions Order: Ship To. Sold To: Page No 1- F li L VF November 30, 2020 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 New Year's season: If there is any additional information you need please contact me at 1-800-243-1189. You may also contact Kelly Alley in our Ocala office at 1-877-74076180. Thanks again for all of your help. Sincerely, Corey Howard TNT@ Fireworks howardc@tntfireworks.com AMERICAN PROMOTIONAL EVENTS, INC. P.O. BOX 1318 • FLORENCE,AL 35631 (256) 764-6131 www.tntfireworks.com REORDER 905•U.S.PATENT NO.5538290,5575508,5641183,5785353,5984364,60300! C GL Cost Center: 21362 - - ------ - -----------------------------------------------------------............-'.....---------------- - - ---------------.---------..-------- --- ------------------------------------------------------------------------------------- - - ........ 4 e / ® EAST ICAN PROMOTIONAL EVENTS Check No. - 10176422 dba TNT Fireworks PO BOX1318 Check Date - 11/30/2020 4511 Helton Drive Industrial Park Florence,AL 35630 Stub - 1 of 1 INVOICE • DESCRIPTION �• • • 112420ZEPFL 11/24/20 PERMIT FEES 260.00 260.00 260.00 260.00 S , a 13 _ . _ il',J,t$_ tp „_ a @«it'„a < 0 iF,`� < ., _ ...,., TORT ... ..t THIS €'a _ _ t= -- „ '�; .` .�§.# �3 _ - ,. ".,�?- �'�'"$�'-�.,ry r... _ `„ ;T .b i "i ABLE - 'y'e„��G KNOWN b-".3 "g<" $",a..,7 , g,.p_ Y . s-�-i e � .. ,�.: -.,. .. , a..__..�a�.,. , ..".<.« ,<.r f ,. .- --;s 4 ..,..< r-,., Y u ,.s'r`v'. ., < .< ..�< d ,_,. ..,a €z � „�i'a >..1 PORTION �,�r.���,} 9t�`y*.p $:� ;z_ _ F '€ `.a. ._, THIS F, `_a !"!'is;t�? 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ZEPHYRHILLS FL 33541 Zephyrhills WEEK OF NOV 30TH Wal-Mart WAL0706 7631 GALL BOULEVARD ZEPHYRHILLS FL 33541 Zephyrhills WEEK OF DEC 14TH Page 1 of 1 n Jimmy Pmoa,tl Ji(S.6 stt� m Nuw k t'11IY.F F'IxAM.1 At,OFFICER , � ft11RE.a11011r.F CHIEF►IXAN('IAI.U FFt(:ER RIJRE.\1=CIIIEF Jnau.11.bf ;" Jutiu.11.b. K, _ Kdth McCarthy DIVISION'UIttkl.'Il1R RIYISIU\DIItEC1Uit FS � SAFFII t•RUCIL\\I TIA�AGEIt SAF►:rl'NNOCR.\11 M,\N,\t'ER r •^ ' FLORIDA DEPAIMMENT OF FINANCIAL SERVICES FLORIDA DEPARTM ENT OF F1NANCIAL SERVICES DIVISION OF STATE FIRE MARSIIAL DIVISION OF STATE FIRE V ARSIM. 2tr rx t G.iw%Saco-htisla w.•lonb 3:3M437_ 2W rvt G..Lv,Sum-T31LJ sxa.I toritrt 32)"4}43 10.850-413-W-1 Fa..85U410.2467 'Td.JSU-113.36ti Fn\.85tHI0-2467 CERTIFICATE OF REGISTRATION CERTIFICATE OF REGISTRATION DISTRIBUTOR OF SPARKLERS WHOLESALER OF SPARKLERS THIS CERTIFIES THAT: American Promotional Events dhi TNT Fireworks THIS CERTIFIES THAT: American Promotional Events dba TNT Fireworks 6255 SE 78th Street 6255 S E.78th Si Ocala FL 34472 Ocala FL 34472 Has registered pursuant to the provisions of Florida Staples to engage in the business of selling sparklers to a Has reeisicied pursuant to the provisions of Florida Statues to cngagc in the business of selling sparkles. to a wholesaler, retailer. Issue Date: 02/012020 Issue Date: 02/012020 Type: 07 tr?4 Type: 07 zuc.st Class: 61 4 Class: 62 ? 'i=..'. County: Marion1< 5-1 County: Marion 5� = License/Permitf.: 565066 0001-2005 s'x Licenseftimit Ph 565065-0001-2005 CS f Expiration Date: 01/312021 j Expiration Date: 0 1/3 1 202 1 \ e ��yln1 Y�rJh:t,a- l�yh,rry��7�,a- Chief Financial Officer chief Financial Officer