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Home My WebLink About11-12544 CITY OF ZEPHYRHILLS . 5335 - 8TH STREET � (si3)�so-oo20 12544 FIRE WORKS PERMIT Permit Number: 12544 Address: 7050 GALL BLVD Permit Type: FIRE WORKS ZEPHYRHILLS, FL. Class of Work: FIRE WORKS Township: Range: Book: Proposed Use: MEDICAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35-25-21-0010-10500-0000 Improv. Cost: Date Issued: 11/18/2011 Name: FL HOSPITAL OF ZEPHYRHILLS Total Fees: 530.00 Address: 7050 GALL BLVD Amount Paid: 530.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/18/2011 Phone: (813)783-6189 Work Desc: FIRE WORK SPECIAL EVENT DECEMBER 4, 2011 5 . . C ��- 1�� s 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. � CONTRACTOR SIGNAT RE 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 Zephyrhills Fire Rescue 6907 Dairy Road, 7ephyrhills, FL 3354? Firc Marshal Bus (813) 780-0041 (�erry Barnett Fax (813) 780-0044 E-mail: kbarnett(a),fiire.zephyrhil(s.fil.us Plan Review #: 11-129 Project: Revision — Fireworks Display Nurnber of Pages: Packet November 16, 2011 I have received and reviewed the plans for the fireworks display located at '7050 Gall Blvd and will allow the project to move forward at this time. Paying for permit, contractor acknowledges complying with the items listed below. Permit must be on site with fireworks company. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. l. NFPA 1123 shall be followed to its entirety. Failure to follow the guidelines may prohibit the show to be conducted. 2. Ensure shells have required labeling. (description, size, type, warning statement) 3. Ensure shells are inspected by the operator following their delivery to the site. 4. Preparation area for display shall be secured from public by at least 100 feet in all directions. 5. The minimum secured site for the display shall be 140 feet in all directions from location of fireworks or 280 foot diameter around fireworks area. (2" shells) Being a health care facility the distances are doubled, 280 feet in all directions or 560 foot diameter. AHJ has ability to reduce distance when favorable conditions exist and added safety precautions taken. 6. Ensure mortar racks are secured to prevent movement during the display or if a shell explodes in the mortar. 7. Racks containing mortars shall be limited to 15 mortars per unit. 8. Discharge of shells shall not come within 25 feet of any overhead obstructions. 9. No spectator or spectator parking shall be within the secured site, including fallout area. This also include employees of Florida Hospital. 10. The secured site shall be taped off showing no access. Florida Hospital and/or Pyrotecnico shall post individuals around perimeter to ensure no admittance. 11. Parking of vehicle housing fireworks shall be on the outer perimeter of the fireworks area. . 2 12. During the display, support personnel shall be positioned to visually observe roofs of any structure within the secured and fallout area. This can be done by either Florida Hospital Security personnel or fireworks personneL One person shall be on the roof top area of Florida Hospital. These people shall have communication with fire service assigned to the display. 13. Operator is responsible to have a sufficient number of assistants for the display. Assistants shall be at least 18 years of age. 14. All personnel in discharge site WILL HAVE head, eye, hearing, and foot protection. Cotton, wool or flame resistant, long sleeve, long legged clothing will be worn. 15. No smoking materials shall be within 50 feet of any fireworks 16. At least 2 pressurized water extinguishers shall be on site for the display. 17. Following the display, the firing crew shall conduct an inspection of the discharge and fallout areas. Any unexploded shells found shall not be handled for a minimum of 15 minutes and then doused with water and sit an additional 5 minutes before handled. 18. The fire marshal or his designee reserves the right to stop the display if, in his/her opinion, feels a hazardous condition exists. Inspections Required: 1. Site inspection with operator and Florida Hospital staf£ Display and fallout areas will be secured and fireworks will be in position for the display. This meeting shall be conducted under daylight conditions. Contact fire marshal with time. 2. Post site inspection. KERRY BAR , 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 ofthe 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� ��e�.�.� FiRE ��nE�� G90�T �a�ry Road Zephyrhiils, FL 33542 �_nf� (,n��f Ke»i� Will�arfis 13uS (8'1:3)7$0-�UQ1 F�x (S13)7II0-�U�< FIRE SERVICE USER FEES Occupancy No.: Pian No.: �' Contractor � - �,� Bus►ness Name Billing Address� � 8us�ness Address /�j' � � Bus�ness Phone No Billing Phone No.. Bus�ness Fax No Biiling Fax No.. Contact Contact. -- PIAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE S�te Plan N/C Annua! N/C Sprinkle� S50 1 st Alarm Mnlh.f O6 s( 1st Re-inspection N/C Stand � S NIC P � �� 2nd Atarm NIC (M�rnmum Charge a25 00 2nd Re-utspect�on �100 Fire Pump ESO 3rd Alarm � Plan Revisio�s bBl 3rd Re-�nspection 5250 H�S NiC $50 4th Alarm g�pQ 4th Re-Inspection E500 Fire Alarm a50 5th Alarm SPRINKLER SYSTEMS (Busmess Closed untU 515� lP Gas E50 6th Alarm b� 0- 25 Neads S50 v�olations corrected) Natural Gas 350 NON COMp�1ANfF 26 plus Heads $�00 SPRINKLER SYSTEMS FuelTanks- pe,r,�k ��SO S50 STANDPIPE SYSTEM Hydro Undergrounds E45 Sparklers � e+rn � Per R�ser S50 Nydrostatic Test S65 per system ire Works b FIRE PUMP Acceptance Test i45 �, syS��m Camp Fire S25 � Per Pump 310q Flydrant Flow b75 Controlled Bum y�pp FIRE AIARM SYSTEM Hood/Ouct �50 � 0-?5 Devices E50 FIRE ALARM SYSTEM Place ot Assemply $5p A ,,,,,,,� 26 plus Uevices $100 System Acceptance E50 Fae Protec(ip� s� SUPPRESSION SYSTEMS Recall Acceptance S50 F�ammable Appl;cation a5p Annual we� b50 OTHER Waste Tire Slorege ESp �,,,,,,,, ��Y �50 Fire WaIl/Smoke Wail S15 perwau Generator < KW a�pp CO2 a50 LP Gas E25 Per a�r Generator >30 KW 15p Uther $SO Natural Gas $25 �, Sys,�m Bio-Hazard Waste 5100 n��,,,i KtTCHEN EXHAUST Fumigation Tenting E50 � HoodlDucls E50 Tent 10'x10' a greater E15 pe, �eni Totch Pot/Applied $Sp OTMER Fire Pump S45 Haz Materials y100 �,,,,,, LP inslallal�qn pri tank 350 Fire Suppression y30 Fuel Tank Installation 550 System Acceptance (Per f ank) E5o 8 Exhaust HoodlDuct �30 ❑ Na�ural Gae> Inslaltation 350 ke-mspecUon DBL (Per System) (otherthanannual) � :;pray Booth $SO � Inspecfion scheduled DBL and cancelled less than 8 24 hours 8 Conslruction Insp NfC Emergency Vehicle Ac� S50 � � FAL5E ALARM PLANS TOTAL I_� tN5PECT10N TOTAL �� PERMIT TOTAI� � TOTAI I I GRANO TOTAL Commvnt� Uale / � NOV/15/2007/THU 04;59 PM ZEPHYAHILLS BUILDING FAX No,813 P,002 . , � . � � �; � . � � � � �Tempora� °Sa1e,s �C�h�c�ll;ist . , . . , .�� b�e�u� • �5395 8�' Street • . . . . . .ZophyrhfJls, �7. 83542 . . • • • Pl�one:� 813;780-0020 / �'aR: 8I3=780-0021 REQUIl�MLNTS � ' . , .P1ot Pla� showiug s�tup of location. . ' ' . � Nof.arized letter from property owner sta�ing their appxoval. •. ' A flatp.eretatflailt certificate is'requireii7I' a tent is �involved. T.nspection is required onae tent . ' is erected and:pYiox to opessing for busi.n.ess. . Appro�'�d cerEified fire �xti.�g�ishexs per Nk'PA 10. � � � No SmQking signs must be placed outside entrances.' � IF there xs a vviro �ence oz chain lir.�k fencing must 3aave at least �5 Ft setback from tent 'a�d at least • 2 exits. ' � ' . �F tent has sides, the sldes shall be in the up position utiless there is incle�no.ent w�aLl�er, . 'then 2 sides must be.in the Zxp poaition,. • ' FIREWORK REQZ7IRLa1��1'S -� (Xn a�d:itioxt to the above) , , , • . �xoof of State Y,icerase. � Proof of �.iability insuran.ce. • . �,ist o�items'to be sold afi site. �. Gopy of Thivera Liceuse and Social Security N'umber of all personnel dealin.g with the sale of fareworks at t1�e tent location. �, �.Es • ' � �$ 30,00 -- Ci{y RegisCrarion (If Regulated by.DBPR. - Fee is W'ai.o'ed} X $500.00 - Fireworlss �ee - Fire Deparbnent fee ' • • $ 5.00 - Temporary Sales Fee �ror l. tw'o days . . $ 1.00 - Temporary Sales Fec per day £or each consecutiv'e clay thereafter, not to exceed. duratioa o�30 consecuti've days an:d ho more t�an one occurlrence , . per calendar yeaar per Ordinance #�108. ' . . $ 50.00 - Tent Fec (35.00/BD, Z5.00*/FD) -{+�$15 waived for �irewarlcs) ' $ 35.00 - Electrical Fee (if applicable) � Property O'a►x�.ex: Florida Hosntial Zephyrhills � Applicant: Pyrotecnico Phone'Contact: • Marsha LeFebvre — 800-854-4705 • ' Address Site: 7050 Gall , Blvd. Zephyrhills, FL `33541 � � Date of Salc: • ��' �' j�� Ordinance No. 40S dated 1/26/1987 (£or additional rcquirements) • Nov 30 04 12�36p Pu�lio Relaticns 81�-7�9�6108 p.6 SITE L�tFORMATION FOR FIREWORKS DISPLAY Organfzation sponsori.ng event Florida Hosnital Ze�hyrhills, 7050 Gall Blvd. , Zephyrhills, FL 33541 — Brenda Welcher — 813.783.6192 I3at� rind time ofpxoduction 12�4 / 1 1 (d annrox _ 7: OOPM Locationofproduction Florida Hosnital Zenhyrhills 5e�ur-h A4r�K� —SAme. /�-S /-�St y � a-vz.. Nam�o£malnoperator: Charles Flana�an - 813.312.3391 CELL N'umt►er and ages ofall asslstants: Cont'irmation ofLic�nse held by opar�ior. see attached Evide�ce ofp�rnutze's insurance �earier See attached Numhez and typ�s of pyrotechnic devices and materials to be ��" See atta�ed �4iSUSfOrps+rotec�sttsed: See attached Extingttishers qn site (pressurizoed wat�r — at Ieast �): 2 D�agsatu of wl�re pxodttetion to be condueted (ta include point a� fui�ag fall out radius, � aUdit�riCe �.oCF1tTOn�: S P a ached Firin�; sa�'egu�rds in pl�ca: • circuzt tcstcrs no morc than 25 mA s pow�r £or firing sources be restricted tA batteriea or isolated power sugplies • firi�g systems et�sures against accident�l P�ring (2-steg int�rlock) • not to be left unattended • smoking probibued within 25' of the firing/handlitlg area � appropriate distance from audicncc (not less tban twice the faIlout radius} • aIl access poi�ts ar� blocked off into f�ringJF.andlin.p area ; � .�1.�.--�..�. r �L� ;t--e '� � �1-' �l -! � -- �l � aDp m a�a 7so,00zo (;ity oi 7eE�i�y�hilis PermitApp{icatiort ra��ot�.7eo �n2 i �u�SJ:ny Oepa�tnu�ni - - -- Dalo RctoMod Plwne Con{aci far Pormlllln4 I �?^: .� ;.... .- -r.:� .::... ....,. ._.�., L�'.�sis�= a.t:<3u"�?'�.. _ .. � -- �- O�vncr's tJaroB Ir1oZ • �.l j ry ~,� � "t1 � �__ �(TsnorPhaeeNuntber �I �� ' ( �� '� 1 � o,vnersnaaross LZ(}�p Gall I�.,LY41 � 3 e�N;� e r pi�ourM�i�nber �� _, �oc S�m�+lc Tltioholdor Naino - V -^-_�� __._._.. ._. 1 __� Oenet Pha�e Nuintrer � �---- __._ .. ._. ._. ."' —' _ � Poe9tmpis7ltizltoiJarAddress _ �_ �ounnor:ess [ 7050 Ga2I t31v<t. ,'Lepl�yrh:i.11s, I'I� �3541 �—� �ors ��_ _� C_.�_ W___ � ---- -..- _... _...._ � SUo[?tVISIOtt `_��,_.. . _ PnRCECInBL_ (OtlTR11:20 iROt.1 Pf(OVERTY TA%IiO110E� T tvortK rr�orosea (_-j taewc�ris e rooin� r � sirN (� ti�vvt � n::r; rn isi� �] iNSrni_t ncrnin �'ROPOS�F3USF. [� srrt [� coair,t � oT�ea —� IYPE OF C0715TRUL'TIG>7 � DLOC�C � FRr�i:� [� ;;TtEI �.. � OTHfR ��.. ._. ... DESCitIP'tiqN OF 1VURI( j� 1,1 CL701;,1�5__ '�,�,�,�� ^ -.-_�.. .'^ '- Y � fiUILD[t!G 51Zf SQ FOOTAGE �� NE1GIli � � n�n-�z srx�-r.-a�t rr<.-ea�r -:. s.�,.� � t r :�aa,zz2.�;s.saC�� <s.L-s��-:3-.-: t- �-;. , Y`.: o`it:".'$^.� :rvi?4.l�sp!R;XT!?is.;:?3�-'!f•'t�=t� "iF 1 i I: .t .- . n 4UILqIRG �� VALUR"(i01J UF T6TAL CONSTRUCT�ON U LLCCTRIC�L $ /st.11� SERVICE � HRCIGRESS CIlGRGY [� � YIR F.0 �___ _._..__� n PIUtdDit7(; (5� � !- _-.._.. __.. ..---- �� i,tECtUlk[CitL S _ �_ VAIUATlO?JOF>.SECF7MlCA�,It15TALliiTiCl�`t � GhS �� RO�FING n SPF.C.fAI.TI' � DINt;Jt FU73S�1E0 t'l.nt7R G1.C_V�1TlONS �� FIOQDLONE Ai1EA �Y[5 �NO F.�:iEF::�t-?i.�-"iS'='r:':-:r..S�+C£t:`..q.°�-°i.',9��.�il`.££53�.:�vSc"�dki ••F^s�'�•••' — Fi.a`-1`=+i?4-��?i°i'.'}::!"."" ' _ "3.'?�_ � ��5 ' ovi�oCa coraenrrr �� __� .___—__.._. --� $1(i�1RiURY" �� AEO14(EREO YI r7 (' fEECUQRFl�T Y!}a T '' — ' 1_—_i � � �Uilrots � �._,- - ___.._...�_ Ltv�nsQ s �-- � -.. � ELCCTtiIC1AM COIdPANY � ��_�� J I SI6t1�,TURE � _^� RECIS��REO ��! ti Fcecur:�e:n �� YtN � _- - ._. - --.�_....___�._._.__..._.� Address Uconsa � �— . � f'lUlJUER � � COIdPAflY ! SIGt1ATUNL REG45f�RE0 Y1 t) retcur�r.er�r� Y1�1 � -- 7 - -_ I - _—._ � ---- � Address � Citense C �-�_----. ._ _ __� �__ r"_ --------__ __.._.."_._.._.` F.1lCtIANtGAI CU61PA1lY I_ S1GtIATURE — � RECISt(qFtl Y I 1I �c[ c�.�.�aer�r �� Y/ N --- Ad�{rnss � Ucensa 0 �. _ --., � 0731GN '( ' I/ !C ' . __ �_ _.� � � ! f� . �.� � .. fl � ' - � GUtdPANY SIGIIA]UHl d /f a�n� lJ�(� Y! N reecuAA�t�r LyIN T C hAdtexs llUX �l9�j��] �2iSi:1.Y., L�censer �—_________] (d,'.�Su.'-,�='�S.tSF£�i>>',r?m,;;=i41a..3bS.:�.:.�Ti'.�L�£�i'*. Cd�TrL`Gx� a RGSEOENTIAI Atiach (7.y PtoE Plens; �2) sots ot OuiMfng !'1aos, (I) s¢I ot Enerqy Porms; R•O•V/f'onrr� far na.vtauwc�icn, PSL�fitwnllan (16) n•ork�ny Jays alter su0ntittal date. Requind nn<_Ite. ConSlmcGon Nlans, Stemrrlater Rlans w! S��l fenc^ k,sa>cd, Sanilary F�o'iUes d 1 dw�q�s{er. S1te VJm'r, Pentit {ur suLUb.i�iaist;arpe proJecls Cqhtt ,s�aan� Aslech t3� eqnqrlat0 sets ai bu� d�ny Mans p tus a �ifq Sataty Page; (t{ sat oi Energy Fo:ms. R.0-Yi Permd ter as;� cons;mctkn. RLnlnwm len (iU) �:yrfcinp days attet svbnriltal dala. Requkad w�sito, CmisGucliar ['Ians, Staur.ralur Ytans vd SiA Fm�to I�i<taled, Sanitary Pac:riNat b 1 Cumpslar. 5ite LS'RRe Porn91 tor aN uevr pra;ucts, AII toarnercbt rnq�irements musl nfeet tpm,�Ua�ca SiCN PCftldtT Attaclti j2y sets of E�y}'aeerad Pla�is ••'•Pf20F'C-RTY SUkl2Y requtred (a a7 t1C-1V eOnsWtCOn, F.r�a'. ..... ° �37'S�` ° ��3�i.L3�:�:23'd'>:'.'�`i.c"..�. . � _ ° "�Ii-15€:�;:#T.i-$ ° #r� . �: a �_ , �sxn«r.sss�"�':t'?.^F<_<.f�3"' �� II�ItCSt0f18: � = t r't o�t nE�pl:caGa� coropit�taly. pvmer d CoMractor s?gn hack of apry:ecatEOn, nolariza� I! ovor f2500, x ttqtko o(COmmoncamont ie requlrad. (R1C upg�adcs over SSOOOj '` Agaqf (for Oto conEtuetor} ot i+av:er of Albmuy (tw ltw m.�,norj Svo+Pd ba sumeone�ticU, naiorized im�er oone n�rmer awr�a�eirs9 san,e DVPft'fH@COUNTL` {FroninfAppiicaiion(Jntyy ficwots 5cvrors ScrvitaUpgrades A1C fencas{PInUSun�uyffoo;aye� Odvaways-Nut oear Cuunie� d on puhCc roa�hvays..n�eds ftC�'rV NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed° restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Buiiding Inspection Division—Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contrador, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a"certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County WateUSewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owne�' prior to commencement. CONTRACTOR'SlOWNER'S AFFIDAVIT. I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be pertormed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other govemment agencies may apply to the intended work, and that it is my responsibility to identiTy what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmentai Protection-Cypress Bayheads, Wetland Areas and Environmentaliy Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Watenvays. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone "V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, 1 certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If 1 am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this a�davit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, welis, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. 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 FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT �"C�� CONTRACTOR Subscrib d and to (or affirtned before me tty', Subscribed and swom to (or affirmed) before me this � � / / bY � o are ersona cnown o e r has/ha e pro uced Who is/are personally known to me or hasRiave produced as idenGfication. as identification. ��,/1.-'��Lt�k tX-�G.�i�..Q J �otary Public Notary Public Commission No. �� /—� a`� Commission No. Name of Notay , n VANI ame of Notary typed, printed or stamped ��otarial Seal , . • _�`�l�vre, Notary Public � � �� Lawrence County �— �`� „ �,: , � M7�y l � �012 November 11, 2011 City of Zephyrhills Attn: Jackie This is a letter of authorization for Brenda Welcher of Florida Hospital Zephyrhills or Chris Reitano of Pyrotecnico to pick up the permit for the December 4, 2011 display. Thank you �� Christopher Mele Genera! 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'.%/%��ti'�, � ��llr„�ti` P��ROTECNICO ° 4iFA F:At,t {I,� i40.! tVOAKS • i A8 i ..& " o, 5 � x. � �3u@illttCa 1 315 Shot Barrage 315 Total Opening Shells �ocfy - Speciai EfFects �3�rr�r�es 1 36 Shok 2" Barrage 3 49 Shot Barrages 4 130 Shot Barrages 1 150 Shot Barrage 817 Barrages Tatal Grand Finaie 2 2", 36 Shat Shelis 1 300 Shat Barrage 372 Total Finale Stiells 1,504 T�TAL SHELLS �'��tu� .� . ;,�� "Rock 'n Ro�l energy took tenter stage a# the world`z rnost prestigiaus fireworks venuc: laRonde in �� Rork Lou¢s Montreal, tanada. Pyratecnim's desigrt team developed "Rock lnves...`, a five-ack tliriller tha; ,,� bronght the international crowd to its feet and were awarded the coveted Gold lupiter ft ft�� y rockloves.corn - Headquarters U S Locations PO Box 149 i.�� Atlanta, GA 877 924 0102 New Castle, PA 16103 �24 652 1288 �, � Las Vegas, NV 800 956 7976 �� ' Montgomery, AL 800 255 1199 info�pyrotecnico com PYROTECNICO M III" NewOrleans,LA 800 783 2513 724 652 9555 , i i V I T A L E F A M I L Y F I R E W O R K 5 + 7 8 8 9 $p0 8r 470r www.pyrotecnico com TdRI(Jd, fL $$$ 3$2 7976 November 11, 2011 City of Zephyrhills Attn: Jackie Please see the attached permit application for Florida Hospital Zephyrhills on December 4, 2011. Please contact me if you have any questions or concerns at 800-854-4705 or email the address below. Please fax or email me a copy of the signed permit when it is issued. Thank you Pyrotecnico ��1 ��.� Marsha LeFebvre mlefebvre(a�pyrotecnico.com FX: 724-652-1288 November 11, 2011 City of Zephyrhills Attn: Jackie The show on December 4, 2011 will be shot electronically. Thankyou �� Christopher Mele General Manager I 1 � � � ��VI�JLc.J I Mater�al Safety Data Sheet � � DATE PREPARED• �atlUaCy � S 2006 P'� �ROT �' ICO ' ; YITAt9 fAY1LY FIR[WOLKS � 1��1 � � From pYROTECNICO I 299 Wilson Rd T�lephone Number: 800-854-475 M-F 8AM-5 PM i New Castle, PA 16101 Emer en g cy : CHEM•TEL INC – 800-255-3924 - 24 HR II , F I REWC] RKS 1. �G u n�335 ; Section II - Hazardous Ingredients 1 Identity Informatian ; Contains Pyrotechn'ic Compositions that are mixtures of solid oxidizers and fuels that I contained in paper and cardboard containers. No Hazard exist during normal handling � and storage. ! �SHA PEL – NIA ACGIH TLV –N/A OTHER LIMITS – NIA Section III - Physical I Chemical Characteristics ; Boiling Point: - N/A Specific Gravity: - N/A Vapor Pressure: - N/A Melting Point :- hUA I i Vapnr Qensity: - N!A Evaporation Rate: - WA � Solubility in Water: - N/A j i Appearance and Odar: - Pyratechnic Composition is contained in paper or cardboard casings that may be shaped as cylinders, balls ar tubes. Odor is not apparent. Section IV - Fire and Explosion Hazard Data �, . , Flash Pair�t: - N/A Flammable Limits: - P!/A � LEL: - N/A UEL: - N!A i � Extinguishing Media: Deluge with large quantities of water as quidcly as possible by FIRE ; HOSE from a PROTECTED location. Materials are self-oxidizing. i Special Fire Fighting Procedures: Do not attempt to fight afire in the immediate area of 1.3G I Firework� EVACUATE THE AREA. I � 1 I � 2 I � Section IV — Fire and Explosion Hazard Data- Continued � Unusual Fire and Ex I' I N�si�n Hazards: Fireworks 1.3G MAY MASS EX�LODE IN A FIRE. DO NOT ALLOW FIREWORKS TO GET WET- Hazardous Decomposition May Result in a FIRE or EXPLOSION. EXPLOSION MAY OCCUR IF EXPOSED TO SPARKS OR FLAME. i ; Section V — Reactivity Data � � I i Stability; - Stable I � Conditions to Avoid: - Open Flames, Sparks, High Temperatures, Friction or Impact. Incompatibility (Materials to AvoidJ: - Do Not Allow Fireworks to Get Wet. Hazardous Decomposition or Byproducts: - Decomposition does not occur under normal � , circumstances. Smoke Generated by Fireworks ma contain asses that are '' eyes or mucous membranes. Prolonged Exposure nd Inhalation of smoke ma ue shortness of breath or more serious problems when a chronic respiratory condition exist. Y , Hazardous Polymerization: Will Not Occur , Conditions to Avoid: - Storage in High Temperatures, Moist or Wet Conditions, Keep away I From Open Flame or Sparks. ' � i Section VI — Health Hazard Data I ' I Route(s) of Entry: - N/A Inhalation: -N/A Skin: - N/A Ingestion: - N/A i Health Hazards (Acute and Chronic :- N/A � ) , Carcinogenicity: N/A NTP?: - N/A IARC Monographs?: -N/A OSHA Regulated: - NO I Signs and Symptoms of Exposure: - Prolonged Exposure to Smoke that is Generated during Normal use of Fireworks may cause Irritation to Eyes and to Mucous Membranes. � I Medical Conditions Generally Aggravated by Exposure: - Eye Sensitivity, Respiratory i Conditions. Emergency and First Aid Procedure: - EYES Should be flushed with Water. Move to Fresh Air and avoid additional Inhalation of Smoke. � I i 2 i 3 � ; i Section VII — Precautions for Safe Handling and Use � I � Steps to Be Taken in Case Material is Released or Spilled: - If Fireworks are spilled, carefully � pick up the material and place in a Cardboard Carton. Keep OPEN FLAMES and Sparks AWAY '� and NO SMOKING. Waste Disposal Method: - Fireworks that fail to go off should be soaked in a bucket of water and I' ! returned to the source where it was obtained. Dry components or powder should be carefully swept up and piaced in a cardboard container then soaked with water. i Burning of Fireworks Waste must be pertormed in compliance with local and state laws. � Precautions in Handling and Storing: - Keep from OPEN FLAMES, NO SMOKING, AVOID i IMPACT of MATERIALS and CONTAINERS of MATERIALS, STORE FIREWORKS IN A COOL i AND DRY ENVIORMENT. FIREWORKS 1.3G MUST BE STORED AND TRANSPORTED IN COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS. Other Precautions: - Fireworks 1.3G un 0335 can cause SERIOUS INJURY or DEATH. They , Should oniy be Handled by Properly Trained and Qualified Personnel. When Shooting these Fireworks; PERSONNEL SHOULD WEAR PROPER EYE PROTECTION, HEAD PROTECTION AND NON-SYNTHETIC CLOTHING. , Section VIII — Control Measures Respiratory Protection : N/A Ventilation: - N/A Local Exhaust: - N/A Special: - N/A I � Mechanical: -N/A Other: - N/q � Protective Gloves:- N/A Eye Protection: - When Shooting Fireworks 1.3G � � Other Protective Clothing or Equipment: - Protective Head Gear and Non-Synthetic Clothing when Shooting Fireworks 1.3G. Work / Hygienic Practices: - Store Fireworks in a Cool Dry and Well Ventilated area. Protect � Against Physical Damage and Moisture. Fireworks shouid be Isolated from all Heat Sources, i Sparks and Open Fiame. No Smoking. i . � i I 3 TECHNICIAN RESUME Charles Flanagan 38809 North Avenuen Zephyrhills, FL 33541 Cell: 813.312.3391 Display Experience: Charles has been a lead technician for 5+years; he has experience with electrical fired displays and Is familiar with all safety standards Past Display experience: Lead Tech: Lakeland Christian School, Lakeland, FL —11/12/10 St. Lucie Mets, Port St. Lucie, FL — 7/17/10 Florida Marlins, Miami Gardens, FL-7/17/10 Jacqueline Boges � From: Kerry Barnett Sent: Thursday, November 17, 2011 12:34 PM To: Jacqueline Boges Subject: RE: NO STAMP Its ok. The one is more of a letter and not an assigned review Kerry - - --- -- - - - - - - - - From: Jacqueline Boges Sent: Thursday, November 17, 2011 9:53 AM To: Kerry Barnett Subject: NO STAMP Importance: High Hey Kerry looking at the permits you dropped off yesterday the recreation burn and the special event fire work your stamp is not on the permit, do you not need to stamp ? Jaclae Boges Code Support Specialist ext. 35 i