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HomeMy WebLinkAbout10-10516 CITY OF ZEPHYRHILLS 5335 - 8TH STREET • (813)780 -0020 10516 FIRE WORKS PERMIT Permit Number: 10516 Address: 5943 GALL BLVD Permit Type: FIRE WORKS ZEPHYRHILLS, FL. Class of Work: FIRE WORKS Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 10- 26 -21- 0020 - 0000 -0030 Improv. Cost: , :- x s -fw. , 7xr 9 Date Issued: 6/02/2010 Name: ZEPHYR LLC Total Fees: 524.00 Address: 5943 GALL BLVD Amount Paid: 524.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/16/2010 Phone: (813)927 -2426 Work Desc: TEMPORARY SALE FIREWORKS- JUNE17, 2010 THRU JULY 7. 2010 (17 DAYS) ALAXY I TSR INC FIE IN - IAN 0.00 F1= P - M S 500.00 FIRE PLAN REVIEW FEES 0.00 TEMPORARY SALES 20.00 TEMPORARY SALES 4.00 C (65 (° 1 ' a g, FIR WORKS TE IN P TION 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. "FIREWORKS" per Section 791.01, Florida Statutes are considered as any combustible or explosive composition or substance or combination of substances or, except as hereinafter provided, any article prepared for the purpose of producing visible or audible effect by combustion, explosion, deflagration, or detonation. GcN env- CONTRACTOR SIG ISTURE • I • IC R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813- 780 -0041 Temporary Sales Checklist City of Zephyrhills 5335 8 Street Zephyrhills, F1.33542 Phone: 813 - 780-0020 ! Fax: 813- 780 -0021 REQUIREMENTS Plot Plan showing setup of location. VC kait Notarized letter from property owner stating their approval. '�Q` ` fi - • LA flame retardant certificate is required IF a tent is involved. Inspection is required once tent is erected and prior to opening for business. N Approved certified fire extinguishers per NFPA 10. A/ .7 NoSmoking signs must be placed outside entrances. SUBMITTED PLAN(S) HAVE BEEN REVIE BY ZEPHYRHILLS FIRE MARSHAL'S 0 "it E IF there is a wire fence or chain link fencing must have atIligutt 5 Ft setback from tent and at ?- exits. $sesriewer. �jC����` (-Z IF tent has sides, the sides shall be in the up position unless there is inclement weather, then 2 sides must be in the up position. FIREWORK R.QQUIREMENTS - (In addition to t1ie above) Proof of State License L 1 - k `b - tkj c' / Proof of Liability insurance. ce. �tl ✓/ List of items to be sold at site. ✓ Copy of Drivers License and Social Security Number of all personnel dealing with the sale of fireworks at the tent location. FEEs $ 30.00 - City Re a stratio . ! : - = • • P BPR - Fee is Waived) .11 - Fireworks fee - Fire Department fee . s emporary Sales Fee for 1 two days $ 1.00 - Temporary Sales Fee per day for each consecutive day thereafter, not to exceed duration of 30 consecutive days and no more than one occurrence per calendar year per Ordinance #408. $ 50.00 - Tent Fee (35.00BD, 15.00 * /FD) - (*$15.00 waived for Fireworks) $ 35.00 - Electrical Fee (if applicable) Property Owner: _ - Applicant: O \ Wr Phone Contact: • % P Address Site 5 Date of -.' 1 - J <7, 2dty ie J)xl 7, 20/0 6R 1 4,4g ee L b.r.c f 5 6 -/6 -« • � } 0,61!6/211C 9:36 AM "eceapt Nn. 918976,7 CR 4.00 _________ _____________________________ ."tau; 4.00 �� Cash: 4.0C ^ �� / � �� Check/ 0.00 e ~� � '�� 3 � Other: Change: �, � V.OD Customer 4: OO8OOO Cas hier: '0c:thos CAgHl | . -- ' �� `\ ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044 FIRE SERVICE USER FEES j Occupancy No.: Plan No.: /b -6Y(o Contractor: 1 c'X 1cr__ Scs t —�S Business Name: Gve.- -A-f 1 a r- ( -S Billing Address: Business Address: l` ,off Business Phone No.: Billing Phone No.: Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES _ _ INSPECTION FEES PERMIT FEE FALSE ALARM FEE _ Site Plan N/C _ Annual N/C Sprinkler $50 1st Alarm N/C _ Muni - Family /Commercial . 06 sf _ 1st Re- inspection N/C Standpipes $50 -- 2nd Alarm N/C (Minimum Charge $25.00 _ 2nd Re- inspection $100 Fire Pump $50 _ 3rd Alarm N/C El Plan Revisions DBL _ 3rd Re- inspection $250 Hoods $50 _ 4th Alarm $100 _ 4th Re- Inspection $500 Fire Alarm $50 _ .5th Alarm $150 SPRINKLER SYSTEMS (Business closed until LP Gas $50 — 6th Alarm $200 — 0 - 25 Heads $50 violations corrected) Natural Gas $50 _ NON COMPLIANCE $150 _ 26 plus Heads $100 _ SPRINKLER SYSTEMS Fuel Tanks per tank $50 STANDPIPE SYSTEM _ Hydro Undergrounds $45 parklers $100 0 Per Riser $50 _ Hydrostatic Test $65 per system ire Works $500 FIRE PUMP _ Acceptance Test $45 per system Camp Fire 51 0 Per Pump $100 _ Hydrant Flow $75 Controlled Bum $100 FIRE ALARM SYSTEM Hood/Duct $501 — 0 - 25 Devices $5 _ FIRE ALARM SYSTEM Place of Assembly $50 Annual _ 26 plus Devices $100 _System Acceptance $50 Fire Protection - $25' SUPPRESSION SYSTEMS _ Recall Acceptance $50 Flammable Application $501 Annual — Wet $50 OTHER Waste Tire Storage $501 Anneal _ Dry $50 _ Fire Wall /Smoke Wall $15 per wall Generator < KW $100 CO2 $50 _ LP Gas $25 per tank Generator >30 KW 150 Other $50 _ Natural Gas $25 per system Bio-Hazard Waste 5100 Annual KITCHEN EXHAUST _ Fumigation Tenting $50 E Hood/Ducts $50 ^ Tent 10'x10' or greater $15 per tent Torch Pot/Applied $50 i OTHER _ Fire Pump $45 Haz. Materials $100 Annual _ LP Installation per tank 550 _ Fire Suppression $30 _ Fuel Tank Installation $50 _ System Acceptance (Per Tank) $50 _ Exhaust Hood/Duct $30 0 Natural Gas Installation 550 _ Re DBL (Per System) (other than annual) 0 Spray Booth $50 El Inspection scheduled DBL — and cancelled less than — 24 hours Construction Insp. N/C ' Emergency Vehicle AG $50 FALSE ALARM PLANS TOTAL' I INSPECTION TOTAL' 1 PERMIT TOTAL1) TOTALI 1 GRAND TOTAL t � 52)0 - I Comments: Date: .5f - InsA ctor: d✓ L/ f j?e y • STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES n DIVISION OF STATE FIRE MARSHAL .' ' TALLAHASSEE, FLORIDA ' 4 CERTIFICATE OF REGISTRATION WHOLESALED OF SPARKLERS THIS CERTIFIES THAT: GALAXY FIREWORKS INC 204E MARTIN LUTHER KING BLVD TAMPA; FL 33603 HAS REGISTERED PURSUANT TO THE. PROVISIONS OF FLORIDA STATUTES TO ENGAGE IN THEBUSINESS OF SELLING SPARKLERS TO A RETAILER. _, ti .. b .74. 4 Chief Financial Officer 02! 0112010 07 62 Hillsborough 72584000012006 1767700001 1000.00 0113112011 Issue Date Type Class County License/Perrnit Number Application # Taxes & Fees Expire Date ADDITIONAL INFORMATION ISSUE DATE 12/01/2009 PRODUCER CERTIFICATE HOLDER MCGRIFF, SEIBELS & WILLIAMS, INC. Pasco Board of County Commissioners and Zephyr Mark Rider P.O. Box 10265 5953 Gall Boulevard Birmingham, AL 35202 Zephyrhills, FL 33542 800 - 476-2211 INSURED Galaxy Fireworks, Inc. 204 East Martin Luther King Drive Tampa, FL 33603 (continued from previous page) Stand Location: 5953 Gall Boulevard, Zephyrhills, FL 33542 Pasco Board of County Commissioners and Zephyr Mark Rider The above listed are Additional Insured respects to General Liability policy as required by written contract subject to policy terms, conditions and exclusions. Page 2 of 2 Certificate ID* 98QMK1 Y9 C ERTIFICATE OF INSURANCE I SSUE DATE ACORD 12ro1/2009 PRODUCER This certificate is issued as a matter of information only and confers no rights MCGRIFF, SEIBELS & WILLIAMS, INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the P.O. Box 10265 coverage afforded by the policies below. Birmingham, AL 35202 COMPANIES AFFORDING COVERAGE 800 -476 -2211 ConY Columbia Casualty Company INSURED Company James River Insurance Company Galaxy Fireworks, Inc. B 204 East Martin Luther King Drive Tampa, FL 33603 Company C Company D Company E This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding any requirement, term or condition of 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, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. CO TYPE OF INSURANCE POUCY NUMBER EFFECTIVE LIMITS OF LIABIUTY LT EXPIRATION A GENERAL LIABIUTY 4015647136 O6j10/260EACH OCCURRENCE $ 1,000,000 ® Conenefp81 General pia ' .'06/10/2010 FIRE DAMAGE 50,000 D arms Made ® ooamence t $ Crenate' aid . Prot MEDICAL EXPENSE $ EXCLUDED 03 Deductible 112.500 PERS. AND ADVERTISING INJURY $ 1,000,000 D GENERAL AGGREGATE $ 2,000,000 General Aguregale Limit applies per PRODUCTS AND COMP.OPER.AGG. $ 2,000,000 D F scy D Filed ®1-acaoa AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ 0 My Automobile mobiles BODILY INJURY (Per person) $ D Scheduled Automobiles BODILY INJURY (Per accident) $ D Heed aIIOrnobaes PROPERTY DAMAGE (Per accident) $ D Non -owned Automobiles COMPREHENSIVE 0 COLLISION AND WORKERS' &�Ry WC Statutory Limit I 1 Other 1 1 EL EACH ACCIDENT $ EL DISEASE (Each employee) $ EL DISEASE (Policy Limit) $ B EXCESS UABIUTY 000319131 06/10/2009 EACH OCCURRENCE $ 4,000,000 ® Oearrence Daam's Made 06 /10/2010 AGGREGATE $ 4,000,000 $ $ $ $ $ Please Note, Excess Umbrella Policy shown on certificate will extend coverage to the underlying: Automobile Liability Policy # M8VF3034, Limit $1,000,000 CSL,; 11/18/09 to 11/18/10; Insured with T.H.E. Insurance Company, Agent: Allied Specialty Ins.; Treasure Island, FL (1 -800- 237 -3355) call direct for COI 4. Sc Florida Workers Compensation Coverage Policy# WC093035; Limit: $1,000,000; 11/18/09 to 11/18/10 is provided by T.H.E. Insurance Company, Agent: Allied Specialty Ins.; Treasure Island, FL (1-800-237-3355); Call direct for COI (continued next page) CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Pasco Board of County Commissioners and Zephyr Mark Authorized Representative Rider 5953 Gall Boulevard F Zephyrhills, FL 33542 .,s9 4.4.. s. _ Page 1 of 2 Certificate ID 98QMK1Y9 t A w9 # ilrgi k 5 ro.Mw. 4,,. € i iiJ ti k$t�, 3 3 f Yy ' il •Pi. ("(.. t �w p v Page 1 of 1 i i ili tom, °!� ,g,: - - il i zi r .0 .. :1' \ 6 * it . r ' � =�1 • E 4 °lei - - - --It . ,.% . , - --..,, . . . : * ;1 Ewa F qS 1 . EIG ER. R . o ., -`"� - --•R.. t. ...... ^'-... 3 ..-411:1001a,........„ ORTH.A 4 .. N . a - q '' ' " 9''. ` irf Y ' e ,' w t 4 t b r ' ' . Wf \ 1 1 y. -\C---AX: C. http: // maps. pascogov. com /mapdata/442116543020399.jpg 4/14/2010 Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL. 33542 Fire Marshal Bus (813) 780 -0041 Kerry Barnett Fax (813) 780 -0044 E -mail: kbarnett@ fire.zephyrhills.fl.us Plan Review #: 10 -056 Project: Fireworks Tent Sales Number of Pages: Packet May 24, 2010 I have received and reviewed the plans for the fireworks tent sales located at 5943 Gall Blvd and will allow the project to move forward. Please note that this review does not eliminate any further requirements as the project continues moving forward. By receiving permit, contractor acknowledges to comply with the items listed below. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. 1. Site shall be inspected after setup and prior to any sales. 2. Copies of all sales shall be given to this office every couple of days. 3. Attached guideline sheet shall be followed. 4. In addition to the certified ABC fire extinguisher, a minimum of 1 pressurized water extinguisher shall be present. Inspections Required: 1. Site Inspe t gr i KERRY BA t i' ETT, FIRE MARSHAL ** *Please be advised this review of plans submitted is a cursory review to assist the contractor in compliance with applicable fire safety codes. This review is not intended to be a final approval of the submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance with all applicable NFPA codes and local ordinances. In the event that further examination or site inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure to be in compliance with all applicable NFPA codes and local ordinances. R P(OZC4 bc) `� Jacqueline Boges 426 1 to From: Jacqueline Boges Sent: Thursday, May 20, 2010 11:06 AM iT# To: Kerry Barnett Subject: PLANS IN YOUR BOX Hey Kerry, Placed in your box a permit for sale of fireworks. Galaxy at 5943 Gall blvd Jackie Boges Code Support Specialist ext. 3513 1 , Temporary Sales Checklist City of Zephyrhills 5335 8 Street Zephyrhills, FI. 33542 Phone: 813 - 780 -0020 / Fax: 813- 780-0021 REQUIREMENTS t, / / Plot Plan showing setup of location. N Li---- Notarized letter from property owner stating their approval. 1- 411-St � ' �-' A flame retardant certificate is required IF a tent is involved. Inspection is required q uired once tent ,,,,i erected and prior to opening for business. .Z Approved certified fire extinguishers per NFPA 10. (, K i / Smoking signs must be placed outside entrances. i IF there is a wire fence or chain link fencing must have at least 5 Ft setback from tent and at least / 2- exits. C _ IF tent has sides, the sides shall be in the up position unless there is inclement weather, then 2 sides must be in the up position. FIREWORK �t��Q'UIREMENTS - (In addition to the above) / Proof of State License/ 1- 31 .Ab • lb (6 roof of Liability insurance. ce. i1 Litt of items to be sold at site. ✓ Copy of Drivers License and Social Security Number of all personnel dealing with the sale of fireworks at the tent location. FEEs $ 30.00 - City Re strati • i 1 : - , • • R BPR - Fee is Waived) t +.11 - Fireworks fee - Fire Department fee :,► . - emporary Sales Fee for 1 two days $ 1.00 - Temporary Sales Fee per day for each consecutive day thereafter, not to exceed duration of 30 consecutive days and no more than one occurrence per calendar year per Ordinance #408. $ 50.00 - Tent Fee (35.00BD, 15.00 * /FD) -( *$15.00 waived for Fireworks) $ 35.00 - Electrical Fee (if applicable) Property Owner: \_,A.....Q.._ � Applicant: • 0. - �Z'• Q Z� 2 C U._._ �YNSC>11 Phone Contact: 4 \ b R 4 Address Site: - -- -- � r._r� � � ` — - \--\ - Date of , -i -: . i A R D CERTIFICATE OF DATE (MMIDDIYYYY) �... -- LIABILITY INSURANCE 6/9/2010 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 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 CON TACT Britton - Gallagher and Associates, Inc. NAME: PHONE FAX 6240 SOM Center Rd. (A/C. No, Ext): 4 4 0 - 24 8 - 4 7 1 1 (A/C, No):440- 248 -5406 Cleveland OH 44139 A ADD DREDRE SS: PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A :Lexington Insurance Co Galaxy Fireworks Inc. 204 E. Martin Luther King Blvd INSURERB:Axis Surplus Ins Company Tampa FL 33603 INSURERC:New Hampshire Insurance Co. 23841 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 821771136 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 ADDL SUBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MMIDD/YYYY) LIMITS A GENERAL LIABILITY 64200908 6/10/2010 6/10/2011 EACH OCCURRENCE $1,000,000 DAMAGE RENTED X COMMERCIAL GENERAL LIABILITY PREM SES occurrence) $50, 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ PERSONAL BADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP /OP AGG $ , 000,000 POLICY a X LOC C AUTOMOBILE LIABILITY CA66144430 6/10/2010 6/10/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE X HIRED AUTOS $ (Per accident) X NON -OWNED AUTOS $ UMBRELLA LIAB X OCCUR EAU753159 6/10/2010 6/10/2011 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $4,000,000 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY ¥ / N TORY LIMITS ER ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Stand Location: 5943 -5953 Gall Boulevard, Zephyrhills, FL 33542 Additional Insured: City of Zephyrhills, Pasco County Board of County Commisioners, Zephyr Mark Rider all their agents, representatives and subsidiaries. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Zephyrhills, Pasco County Board of County Commisioners and Zephyr Mark Rider AUTHORIZED REPRESENTATIVE 5335 8th Street Zephyrhills, FL 33542 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD