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Home My WebLink About14-15342 ' CITY OF ZEPHYRHILLS � 5335-8TH STREET (sis)�so-oozo /� 342 FIRE SPARKLERS PERMIT ` PERMIT INFORMATION LOCATION INFORMATION Permit Number: 15342 Address: 7422 GALL BLVD Permit Type: FIRE SPARKLERS ZEPHYRHILLS, FL. Class of Work: FIRE-SPARKLERS Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: � Parcel Number: 35-25-21-0010-07200-0011 Improv. Cost: � �OWNER INFORMATION n - Date Issued: 6/03/2014 � Name: K-MART Total Fees: 1 . '0 a" �1�� Address: 7422 GALL BLVD Amount Paid: 1�0 Q ZEPHYRHILLS, FL. 33542 Date Paid. 6/03/2014 Phone: Work Desc: FIRE SPARKLER TEMPORARY SALE - KMART CONTRACTOR S APPLICATION FEES I TNT FIREWORKS KMART FIRE PERMIT FEES 100.00 G.h �� C(� �� . � ( oaG��v I Ins ections Re uired FIRE INVENTORY ONSITE INSP i h r and collect user fees to a for the costs of fire Chapter 633, Florida Statutes,authorizes the C ty to c a ge p y 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. "SPARKLERS" per Section 791.01, Florida Statutes, means a device which emits showers or sparks upon burning,does not contain any explosive compounds,does not detonate or explode, is handheld or ground based,can not propel itself through the air,and contains not more than 100 grams of chemical compound which produces sparks upon burning. " �� .��, ,�► ��.�� CONTRACTOR SIGNATURE PERMIT OFFICER PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE - 813-780-0041 � • ' alsaeo-oozo , City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Pertnit 800 Y 868 ^ 9151 � _._.. ._._. m..� Owner's Name K-Mart#3761 Owner's Phone Number 813 782 1957 Owners Address 7422 Gall Boulevard,Zephyrhills, FL 33541 Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titieholder Address ' - - ----� JobAddress 7422 Gall Boulevard � Lot# � Sub Division Parcel# E'�." -�..,._....v.__._.� ___.__ - - �__._ e - _..._"""",""'^^^--"^�� Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL � Comm Exhaust Kitchen Hood/Duct � Hood Installation � Controlled Burn � LPlNatural Gas-Installation � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale � Emergency Generator>30 kw � Places of Assembly-ANNUAL � �� 7�Y i'T � Fire Protection Maintenance-ANNUAL � Recreational Bum tr y emi �n t er Sprinkler � ❑ ❑ ❑ 8 X� Sparklers Inside Retail Sales of State Approved Sparklers Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations Hood Cleaning � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) Hood Suppression � ❑ ❑ ❑ � � Torch Roofing/Tar Kettle � Fire Alarm Installation � Waste Tire Storage ANNUAL � Fire Pumps � Fire Works SPARKLERS � � FlammableApplication-ANNUAL )`�� ° Valuation of Project � � ��.s, Fuel Tanks Q Other: �-�----� ...� _ �v--�--°� -- ,----�----------, 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# Vendor Company TNT Fireworks Signature Registered Y/N Fee Current Y/N Address 6255 SE 78th Street, Ocala, FL 34474 License# r-.-- ......_....___�_ ..._. .__.,.� -____�. ._.... _ ---, 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 � --- �4AY, 4. �Oi3 ��.32Pi+� T�lT Pr'+�Ii� flFFI�E I�i�. �9��4 ��P 2�—. ,.._. ' TN'i� F�R�'U��KS s�c�� At�aESS �t�k�ttZ'" '��'vl "7�?.�Z. l�'�et�� /.�,G irt� �'�_!��'at� F�.�.�...��_..,�.P�x� �� ?,�3 �,��r s�taR�tt�A�r l.�t�vH+� !C wa►�____�-.-_� 3?��' ��r,P�r�f' TYPE 0�'�Y�AIfi: �rr�s�d sai�re�lo�i�,�5#�f�[u�t+aved s�srk�r� aK � - , �� - �,��-.'Z;:�.� f '� !f.l�t��.\�� l�:5,i4tii,• 1�,..`� � a�+'�M �^i_i`i�lU7�.'i`.T;` ,,fYi('�yti•r:T�f1�T"-t---- � � i�=t��i �� .. �. - �:.j ��'�.� � � ��'�� .�. �� i 1r^ y� � � r / �,�1 `�'� �"�� `"}�� •, r` � / 1 � � . Gs �G 'F'�+. K v�'. aam� ` � � L� '1 �" �-�t� ��u. � co ro�a �.�- ��,�=�. � �� .� . stc�•�R�....�� y��-�' D��.,._._S��'— �? 5r't!�MANRGER!'IN7�9 Represett�hre � . �� bJ-V1 / /1411 ' - REPRINT - TNT FIREWORKS PACK LIST - REPRINT - 21362 Order #: 1771411-53-00002 Chain Store Sales-FL Chains Order Date : 3/21/14 Terms : Net 30 Days CUST PO: SLSMN: Chain Stores - East Sold To: 1420037 Ship To: 976089 - KMT3761 KMART STORES - COMPANY 0002 KMART 3761 3333 BEVERLY ROAD, C4-250A 7422 GALL BOULEVARD HOFFMAN ESTATES, IL 60179 ZEPHYRHILLS, FL 33541 Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- *************************** Counter Cases *********************** DSP 50 SS SM W/GBFSNPSPK J13T 672485 1 CS 1 EA 1723 . 6200 1/1 Containing: BOOMIN SALUTE SS J10 COM 102073 4 EA 4 EA 59 . 99 6/1 2481231 SHOW OF FREEDOM USA SS J09 101831A 6 EA ' 6 EA 39 . 99 10/1 2481234 FREEDOM RINGS SS USA J09 101832A 10 EA 10 EA 24 . 99 16/1 2459780 PAR.TY PAK SS-USA J09 101933 6 EA 6 EA 15 . 99 16/1 2459772 STARS AND STRIPES COM SS J 101833 12 EA 12 EA 9 . 99 24/1 2481229 SUPER VALUE PACK REV J09 200722 6 EA 6 EA 10 . 00 12/3 2491296 CAL ROCKET FOUNTAIN 3-PK 200967 30 BG 30 BG 5 . 00 2/30/3 27736028450 GROUND BLOOM FLOWER 20 CT 290157 20 EA 20 EA 5 . 00 4/20/20 27736030255 STRIKER J10 200862 8 EA 8 EA 5 . 00 24/1 3559589 MINI CALIFORNIA RKT 3PK J 200849A 24 EA 24 EA 2 . 00 6/24/3 27736025602 DINOSAURS FTN 3 PK SM PDQ 200816A 16 EA 16 EA 2 . 00 4/16/3 2480674 2 PAK SNAP 4 PDQS J14 320516J 80 EA 80 EA 1 . 00 4/40/2/50 27736022922 #$ SPRKLRS ASST BOX1W/PDQ 380236A 72 EA 72 EA 2 . 00 4/24/6/5 27736022755 CRAZY EYE BALLS W/ PDQ J13 290067B 42 EA 42 EA 1. 00 8/42/3 27736013210 DOUBLE PAK MORNING GLORY J 380276 54 EA 54 EA 1 . 00 4/54/8 27736029426 SIGN -NFPA SM FRWKS NO SMO 730644E 1 EA 1 EA 0 . 00 1/1 SHORT STACK J13 200924B 28 EA 28 EA 1 . 00 8/28 27736028054 Page No 1 - KC;YK11V1 - '1'N'1' t''1K�WULZKS 1'AC;K LIST - REPRINT - � '` ` Order #: 1771411-53-00�002 Desc/Case Packing Item Quantity Selling Suggested CP # Ordered Units Sell Price -------------------------------------------------------------------------------- Case Totals : 1 CS Total Pallets : PL Total Repack Cases : CS DECLARATION OF COMPLIANCE American Promotional Events, Inc . , dba TNT Fireworks, certifies that all consumer fireworks identified on this invoice have been tested by the American Fireworks Standards Laboratory and found to conform with all applicable regulations, standards and bans enforced by the U. S . Consumer � Product Safety Commission. Testing and certification for these items complies with rules, standards and bans applicable to consumer fireworks : Performance Standards 16 CFR 1500 . 17 (a) (9) 16 CFR 1500 . 17 (a) (11) 16 CFR 1500 . 17 (a) (12) 16 CFR 1507 Powder Content Bans 16 CFR 1500 . 17 (a) (3) 16 CFR 1500 . 17 (a) (8) 16 CFR 1500 . 85 (a) (2) Cautionary Labeling 16 CFR 1500 . 14 (b) (7) 16 CFR 1500 . 83 (a) (27) Contact information for laboratory that performed conformity testing. American Fireworks Standards Laboratory (AFSL) � 7316 Wisconsin Avenue, Suite 214 Bethesda, MD 20814 301-907-9115 afslhq@afsl .org CONTACT INFORMATION FOR INDIVIDUAL MAINTAINING RECORDS ON WHICH DECLARATION IS BASED: NAME: Kathie Pendergrass ADDRESS: 4511 Helton Drive Florence, Alabama 35630 TELEPHONE: 256-764-6131 FAX: 256-767-7200 E-MAIL: pendergrassk@tntfireworks . com. www. tntfireworks . com Page No 2