HomeMy WebLinkAbout07-7195
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
FUMIGATION TENT PERMIT
7195
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 11/15/2007
Total Fees: 50.00
Amount Paid: 50.00
Date Paid: 11/15/2007 Phone:
Work Desc: FUMIGATION 17,000 CUBIC FT CHLOROPICRIN CLEARING/WARNING AGENT 11/19
7195
FIRE FUMIGATION TENTING
FIRE-FUMIGATION TENT
SINGLE FAMILY RESIDENTIAL
Address: 5222 20TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s}: Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MORRISON, MARK
Address: 5222 20TH ST
ZEPHYRHILLS, FL. 33542
~; naJuLd)
Il ftq 101
~
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.
r::~IG~~ - ~
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
BOL TIN PEST CONTROL, INC.
NOTICE OF FUMIGATION
LOCATION: 5222 20th Street, Zephyrhills, FL 33542
Type (House, Apt., Store):
House
Fumigant (Brom-O- Gas, Vikane): Zythor
Scheduled: Date:
11-19-07 .(Mon4ay)
*
Approx. Time: 3 pm
Exposure Period: 24 Hours
Dade City
352-567-2395
Toll Free
888-272-2871
* 3pm is approximate time we will
shoot the gas. Our technicians
will be at the site at 8am to
put up the tent.
Certified Operator in Charge:
HERBERT BOLTIN, JR.
~~~o~
15534 U.S. 301, Dade City, Florida 33523
FROM :BOLTIN PESTCONTROL
FAX NO. :352 567 7194
Nov. 14 2007 06:33PM P3
Material Safety Data Sheet
CARDINAL PROFESSIONAL PRODUCTS
ana HIGHWAY 25, HOLLISTER, CA 95023
OFfICE PHONE: (831) 637-1992
EMERGENcY PHONE NUMBERS: (800) 655-7262, CHEMTREC (800) 424-9300
Revi~~on bate: 06/30/03
SECTION I
.........
PRODUOT NAME:
SYNONYMS:
CHEMIOAL FORMUlA:
CAS NUMBER:
CHLOROPICRIN CLEARINQ/WARNING AGENT _
chloropIcrin, trlohloronttromothane. nltrO<lhlorolorm, n!trotrlchJoromethane
CCI~NOa ,- NFPA: Health-4. Flre-O, ReactlvltY-3
7e-O~2 OOT:..Inha1.ation ~azard 6,- UN 1~80
-=
,11. HAZARDOUS INGREOIENTS/lDE~l1lY INFORMA110N
..........
CHEMICAL NAME
ohloropJcrln
PERCENT
99.0
ACGIH T1.V
0,1 ppm
OSHA PEL
O.1'ppm
OlliER
tu. PHYSICAl.fCH~MICAl. CHARACTERISllOS
BOILING POINT: 2340 F (11~ OJ SPECIFIC GRAVITY:
VAPOR PRESSURE:' 18.3 mmHg at 680 F ODOR;.,., .c..,;;'~~'
VAPOR OENSiTY: 6.7 (AlR=1) A-'~~P~Ce:
PERCENTVOLAnLE: 100% ~. "'~, _,'.~.'.
SO LUBl LIlY IN WAlCR: 0.1!) grams/too mt @noF
IV.-FlRE AND EXPLOSION HAZARD DATA
.~..65" ".
Strong, IrrnaUng.
Clecr, colorlo'ss liquid.
FLASH POINT: None FlAMMABLE UMllS:Not Flamma.ble
EXTINGUISHING MEDIA: Watorfog for ooollng of flre'eXposed contalnors. All cOhvenUonal it,. exllngul$hlng _
modIs are suitable.
SPECiAl FIRE F1GHllNG PROOEDURES: If ohloroplcrln Is stored or spIlled In the area of a flre, evacuate area.
Wear self.contalned breathIng .apparatus and full protective clothing. Cool with water sprayed from a dlstanc'e
upwind. ..
UNUSUAL RRcANO EXPLOSION HAZARD: Not axplostve but heat and ultraviolet hght may produce phosgene
and olher toxic compounds. Oyllnder may rupture violently In heat of fire. _ .. . -
V. REACTIVITY DATA
STABILITY: Stable
"NCOMPA11SILllY: Magneslum, alumInum. and theIr .alloys, and PVC pIpe or PVC containers.
HAZARDOUS DECOMPOSl110N PRODUCTS: DeComposes at 234" to chlorlne4 phosg~ne, carbon monoxIde,
and oxides of nItrogen. , " .
HAZARDOUS POLYMERIZATION~ Will not occur
----,
VI. HEAL1li HAZARD DATA
.iI
GENERAL tNFO RMATI ON AND ROUTES OF ENTRY: HIghly toxic liquId and vapor. Noxious odor, aels as own.
warnIng agent agalr1$t overexposure. Exposure to hazardous levels of chloroplcrln cannot be voluntarlly .
tolerated. May be fatal If Inhaled or swallowed. Severe damagEl follows liquid c6ntact wIth eyes or skIn.
AIrborne exposure to concentrations of 0,1 .. 0.3 ppm may oause ImmedIate tearIng and IrritatIon 0' the eyes
and irritation of thcnesplratory tract or contamInated body surfaces. The FlFAA toxicity classificatIon Is
CatClgory 1 dUEl to acute lethality and sevaro Irritation.
PAGE 1 of 2
FROM :BOLTIN PESTCONTROL
FAX NO. :352 567 7194
Nov. 14 2007 06:34PM P4
CHLOROPICRIN CLEAAING/WARNING AGENT
VI. HEALn-r HAZARD DATA
-
-
CARCINOGENlellY: No component presont at greator than 0.01'l(,. Is II:Jtod by IARC, OSHA, or NlP for
oarclnogenlo1ty~
MUTAGENICITV: Has been shown to bo posltivo In somo In vitro Clost tubo1 studies Bnd negative In others.
TERATOGENICllY: In anlmallnhalaUon studIes thoro wero no treatment.telaled fetal malformatlons although
the fllcldences ot developmental varlatloRlJ Increased with doso. ,
'.RE:PRODUCllVE EFFECTS: Reprod~olive fltnass was not adversely affeclod In a two.go{leratlon Inhalation rat
study.. . . '. .
SYMPTOMS OF OVEREXPOSURE: exposure 'to va~or oauses tearing and' eye, nose. and throat Irrlt~Uon.'
EXcessive overexposure may result In coughing, nausoa, vomiting, broathlng dUffculllos, or death. '-'auld oan
caUSa severo burns to eyos and akin. Toxlo If Ingeeled. .
HEALTH HAZARDS OR RISKS FROM OVEREXPOSURE: ACUTE. Overoxposure cen be fatal. IrrftaUon of
respiratory tract causes congestion, hemorrhllglng, $e....re bronchItis, and edema. CHRONIC ~ Unknown. .
EMERGENCY FIRST AID PROCEDURES:, , .
lNHAlAll0N: Got exposed person to frO$h air. Kvep warm. Make aUre person oan breatho freely. If broathlng
hu .sto~ped, give artificial fesplraUon, pre'erably mouth.lo-moulh. 00 not glvo anything by mouth'to 8ny
Unconscious per$on. . . . . .
EYES~ Hold eyelids open and.f1ush with asteadr, gentle stream or water for.t le~t 1S minutes..
SKIN: I'mmedlately removo contamInated clothing, shoes, and othClr Items oovetlng the aktn. Waah
contaminated sldn area thoroughly with soap and water.
INGESTION: Ingestlon may cause 80vere gastrointestinal damage an<! may Include nausea, vomiting, and
abdominal paIn, collapse and death.
._.
VII. PRECAUTIONS FOA SAFE HANDUNG AND USE
SPILLAND lEAK PROCEDURE: Evaouate area. Do not breath \'apors. Wur ~eJf contained breathing apparatUs
(see Sectlon VIII. RespIratory Protection). Move leakIng or damagod containers outdoors or to an Isolated
location. Work upwInd, If possIble... .
. WASTE DISPOSAL METHODS: Small quantICl~s wID o\'aporate rapIdly, or can be absorbed onto Vermlcunt~
dry sand, earth, Or sImilar absorbent material. Such material should be disposed of on aTte or at an approved
dlsposal faclllly. ,
HANDLING AND STORAGE: Storo In a cool, dry, woll4'1entll.ted area under lock and koy. Do not contamlnate
water, food, or feed by storage or disposal. Store and shIp cyllndors In upright position only. Keep Vlf~
closed wIth bonnets and caps o~ when not In use, InclUding when empty.
VIII. CONlHOL.MEASURES
-....
RESPIRATORY PROTECTlON: Supplled-alr respIrator (MSHAlNIOSii approval number prefix TC419C) or 8
self-QOntalned breathIng apparatus (SCBA) (MSHA/NIOSH approval numbDr preffx TC-13F). . .
VENnLA110N: LOCAL EXHAUST ~ From point of origIn' of fum9$. GENERAL. Pro'lfde exhaust Inside.
building,
PAOTEcnW GLOVES: NItrile or polyethylen9 gloves ore recommend'ad when thQre ls a danger of liquId .
~~ .
evE PROTEC110~;. Full-face shield or safety 9la~es with b~ow and temple. shields (Do not wear g099Ies).
~
IX. SPECIAL PRECAUTIONS
. .'
OlliER: Read and observe all precautions on product label prior to use.
PAGE 2 of 2
Revision Date: 06/30/03
FROM :BOLTIN PESTCONTROL
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ZEPEYRH I LS BJ I 1.1) I ["IG
/ 0'-+> 813.-78(]-0020
'tl l.\/O--\ . '
\ \ '\~tT R!CeiV~ ._,I, ~.I.: li:~:'....~~~L"Jr""-
SV". OWner6 Name [Mark Morrison
Owner5 Addrellll
~AX IJ0. S:S--782-J021
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Clt<j ofZephyrhllls Fire
,Permit AppUcmion
Phone contact for Permit
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Fax-813-780-0021
l352 _.....L[-~ JJ:2~_5 _
I 813 1'1 788 'I f0896
owner's Phone NlJmber
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Lot # I
~~Ol~R~a~n go~rt, Z~phyrhil~~j ~L~33540
Tltietlolder Phone Hl.rnber '[
Fe~ Simple TitIGh9Ider N4lme
FeeSlmJlIe TjtIeI10Ider Address
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Job Add/lililS
, S'Jb Division
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5222 20th Street, Zephyrhills, FL 33542
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f'arcel ,
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, \VtlIAII'tI:.U t-KVM,t"KUt'f::J'\I.T I~ NVI ll.it;)
_I L 'II '<il'lJI 'AI : _, 'UlTTI7
In ., 1_ 1 '~. wil<-U
ElJo..~ Waste Sto,aga M ANNUAl..
Comm Extlaust Kltchen Hood/Duct
Controlled Bum
, E;m.rgeoaf Generator < 30 kw
, Em~l'gilI1C;' Generator ;> 3U ~;\"I,
Fir~ Proteoiion M~lntenance ~ ANNUAL
,0
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Sprinkler
FIre,A1arm '
Hood Cl..nlSupprelKllQl'i
,Fln;l Alarm'lnstalation
FIre Pumps
Fire Works
Flammable App"~1I0n- ANN IiAL
Fuel Tanks
Other:
. _ r
lJiM I
m FJrnigEltiQn Tent
o HaZal'dous Matertal.(ner II or RQ Facility) ANNUAl.
D - -Hood Instdatign
D l.P/Natullll G8~nsl8llalion
'0 LP/NatlJraI G8li-ANNUAL Sale
o P1ac~ of Assembly-ANNUAL
D R.E1aeatiClnal Bun
D 5parlders
o
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Spri'lkler System Inatalla\1ons
standplpe$ (Sprinkl~ Sys)
Torch ROl)lIng
Wa&le Tire ,S~rage ANNUAL
, I
Valuation of Project
*
ConinJ,,1cr
Signature
Addrells
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~ee~~~$S !"-",.~".~~~,.. 'I' ..,~,..~-~:-_~. ~_.~ ..... '" n; "",J ~ I I r;r
FIll QlJt ..pp1loatlon completl!l)'. . ' , '
Owner & COntrBI.:tor sign baok of applicatior..rlOta~ild (Or. oopy gf' $lgned contract WlttI owner)
if over S2500, ill NoliC$ of C,ornmencement is rlllll.4inld {M...e"'anlca! WtlJi,: o\ler $5000)
S\.lppJy two {2} sets of dIliVfl"~6 with owllcable dacwnenintion
.....1""" 1 0-14 ~ for r""tow ~"r "ubtn!ttal date. '
ELECTRICIAN,
Signature '
Addree8 I
PL.UMBER _I
Signature -
Address I
MECHANICALf
Sign61U1ll '. I
MdrflSS I
otHER I'
Signature .
~ '
Company
RegIstered
Ucense '#
_ Company
Registered
Fee Current
I
Y/N~) .
I
Y IN I
I
Ucemle #.
Company
Registered
Weanse #
Y / N fFee current -\
ComperlY
, R~lstered
,'- '
.y I N r Fee Current
Y INI
:J
UcenS6 #
COmpany
Registered
~
F$e Curreni I
"'N
Y/N
I nf~L:--
'17
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7V:g C! 2 : 3 =, FJ,~ ZEPF-YF:H I L~: EU I D I NC
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. .
,.NOT..&ee.QF:"DEBO.RESTRlCllONS:The' ul1derslgned.und8rstands that thle ,permit m~'be subje.Ctto ~deed"restrict;ons'
:Which may :be.more restrlctive .than County ~gulatioos. The undersigned assumes 'r@sponsibnityfor bompllance with any
applicable. dead restrlctiaoo. . . . . . . :. . . . '.' .
'UNLICENSED.CONTRACTORS AND CONTRACTOR RESPONSIf3IUTIES: . If the owner' has hired. '8 contractor or
cQntractorsto undertake work,: they may bEil -raqulred .to .bei . licensed m !IooordanC$. with '~tateBnd. local:i'egUlatlons. \f:1he
contractor is not licensed as requirm.l by law, bOth the owner and .contractor may be cited for a .misdemeanor violation
unci9r state law. If the oWner or Int~nde~ conu:actor arel:lncertain a:s to what licensing :requirements may apply fOr the
i~tended work. they afe advised to contact the Pasco .county Building Inspection Dlvlslon--!Xensing Sectlon at 7.21 ~84 7 ~ .
8000. . Furthermore, If the owner has hIred. a contractor or contractors, he is advised to have the contrar;ltor(s) sign
'portIons.of the "contractor Block" of ti11~ ~plication for whlOh they will be rElSoonsible. .lfyou, as 1t1e owner sign as the
. contraotor,that may be anlndicat10nfhat he Isoot properly neensedand is not entitled to '*"'itting privileges in Pasco
county.'. . . .
'CONSTRUCTlON'USN'LAW (Chaptar713, 'Florida Statutes"as amended): If valUation. of work ilii.$2,50D.OO or more; 'I
CertIfY that I, -the applicant, have been provided with a copy . of the . "florlda 'CorwtructlOn. Wen Law-:-Homeowner's
Protection 'Guide" pr-epeired .by the FlOrida Department of A{JicultUrEl and CO:lsumer Affai~. If the appticznt is :someone
other than'the .oWner-, I.certify that I have obtained a copy of the abov~ descrIbed docLlment and promise in goOd faith t.o
.deliver It to the "owner" prior to .commencemenl . .
.. '. . C:ONiRACTOR'S/OWNER,.g AFFIDAVIT: ! eertff'1 that all. the information in this application ,is accurate and .'
.~. ..... . ,. .:that, all.~rk .wIII. he 1:1000 In oam/Miance.with..all--appUoable..laws .regl:llati",g"ool1ttN~Gfli":-zonIAg':and..laRo..."'.:.'
developlTl$nl Application is hereby made to obtain a perm!t.to do work. and InsmDation as indicated. I t;8rt1fy
that no. work-or installation has commenced prior to Issuance of i!I permit and that all work wll be perfqnnild to
meet standards of aJI laws regulating construction. County and City codes; zoning regulations, and .Iand
develOP.mCtot regulations In the jurisdiotion, r, al~o certify .that I understand that the reg1:llations of other
government agencies may apply to the Intended work.. and that ~ Is my res.ponSlbUlty to.I~9Iltlfy what actions I
. . musttake to be. In compliance.. '. .. .
1f'1 am the A~T FO~ THE OWNeR. I promise in g~ faith to inform the owner of the permitting. conditions set forth ,In
thlsaffi,davtt prior -t6. coiinnencing construction. I undersf2nd that a separate permit may -be raqured for. electrical' 'work.
plumbing, SIgns; weJls,:pools, air conditioning, gas, or other InstaUations net ljipeclflcalLy- included in the application: A
~.r.mltj.$~a..d~ll:h~ ooiisjrued to be B'lioense to proc&ed with the work and not aSalithority to violate, can~el. alter, or
Set..asid~ 'ar.iipfoitl$lo.ns of the technical codes, nor shall issuanoe of a pBlmltprevent the BuDding OffIcIal from thereaftel .
. requjrinQ'EI' oorrection of erroI's in p~ns. construction or viqlatlons of any oodM. E;vcry permit issued shall beCOilli: Invalid
'. ~.!1W~!~~~ii{:.~~tpo.rized:'by BUch .permit IS' ~mmem:ed WithIn sbc month~ of ~erm~,I~u~nce, Diif work authorized by
the'~l~'j$ ~u$P~n~d or ~bandoned tor a penod of SIX (6) months after tf:te time the work IS ccmmenoec. An extensicn
. 'me'Y;1la reqli,lwsted, ~n -writing, from th6 BlJilding OfficIal.1or a periad not to exceed ninEtty egO) .days and'.will dlill1lOnstrate
, j~~~ ~uae Tar the extension. If work cea~es for ninety (gO) consecutive days, thejob Is considered abandoned,
WARNING TO OWNER: YOUR FAILURE TO ReCORD A NOTICE OF COMMeNCEMeNT MAY RESULT IN YOUR
;~~~~~~~:~~:~:~o."~~._~F~~!~~g'~N~LT .
~OR.A.(ENT .'. ." . CONTRACToR B i Pest Con rol Inc. ."_n._n.'
Subscribed and :tWt:rn to {or aIliImlld) beftlre mG tis Subscilbed and swom. ID (or ~ed. l. ~re me .
by '_ J!i{~~~Z1MV-4(P/
~ is/iire ~na1ly knoMl kl_ Qr l1il$Jtl8w produced M'I a ~'t,a~ Pl'fli~d
,. ~!ion" .' . n U iderllIIlt:zItigr~
Notiry Public .
--Y{(j/A ff /U'm.tl ) ~ J) d (I fJh .
,~m4;'lon No..2--J) ~.~ / J /of?
Katherine S. Daley'
to.Iame of NotllfY typed. I:lrlnlad Dr:Pmped
NcbIry PLJ:llio
CClrnmtnilX'l No.
NBrnf> of Nal8ry tfped, prtnted or ctlmpad