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HomeMy WebLinkAbout16-17419 CITY OF ZEPHYRHILLS �-= I 5335-8th Street � i (813)780-0020 y7419 ELECTRICAL PERMIT �� � PERMIT INFORMATION LOCATION INFORMATION � Permit#:17419 Issued: 6/07/2016 Address: 6907 DAIRY RD Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL. Class of Work: ELECTRICAL MISC Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: ���;�,(l Book: Page: Cost: 3,500.00 Total Fees: �00 Subdivision: CITY OF ZEPHYRHILLS Amount Paid: 55.00 Date Paid: 6/07/2016 Parcel Number: 02-26-21-0010-01000-0000 CONTRACTOR INFORMATION OWNER INFORMATION Name: FIRST CLASS ELECTRIC INC Name: CITY OF ZEPHYRHILLS Addr: 7141 BERRY RD. Address: 6907 DAIRY RD ZEPHYRHILLS, FL 33540 ZEPHYRHILLS, FL. 33542 Phone: (813)782-7861 Lic: Phone: Work Desc: INSTALLATION 100AMP CIRCUIT& SUB PANEL SHED-FEE WAIVED STATION 1 APPLICATION FEES - ELECTRICAL FEE 55.00 C�C��l�E�' ✓ INSPECTIONS REQUIRED ROUGH ELECTRIC CONSTRUCTION POLE PRE-METER FINAL , -�i��'� _ , D 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 such 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 permits required from other governmental I 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 and Fee Must Accompany Application. All work shall be pertormed in accordance with City i Codes and Ordinances. CON T R PER OFFI PE XPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER il 813aeo-ooao City of Zephyrhilis Permit Application Fax 613-780-0021 Buitding Dapartrnent Dats t2ea�ived . - � � . " . , ���A i - � - Ation�=Contact�,fi�r Per�mittin Owner's Name � . . , Owe�et Pbone Number - .. ' • ' Ow�er's Address � C►wnerPhane-Number �- � Fee SImp1�71tlehalder;Name` � ' " '" Orwner phone.Number :� ,!�� : r � , t =,�� . „ > . � , , , , . Fee Simpla Tltleholdeel�ddre�� ''•� �� "' � JO�ADDRESS LOT# �� , , _ SUBDIiIISIQN , �� . ""��: P14RCEL ID#i ' "- ` °: . : � � � :�`(OBTAINED'FROM�PROPERTYTAX'NOTICEj, =,., . >.._ .. _ . WORK PRdR05Ed 1' NEW�CONSTR��°`� �•` ADD/ACT �� ' SIGN " `�[� `[�'„ DEMOCISH � - ..- >: . INSTAL•1: �:; . -�;�:�..:REPAIR . �.. ,.,; _ . ... - PROPOSEQ<USf•' , Q� 8FR � _COMM`�`, � OTEi�t2" .. _ . TYPE OF GONSTRUCTION�� ` �Q ''9LOCK•' ,`Q`_. �F�RAflAE �� STEBL. �Q, ..s DESCRIPTIQN�OF WORK :� .•Y S L�" l (�f7 ��'w �[✓G Gc v 4v�..d2 , �Vl.?� ; , . BUILDING�SIZE,`,� � �"SQ.FOQTAGE�� , . �� ,>;HEIGH��-:: ' ` ... �_;. _ - s.• - �. QBU1LDitVG ($�''— -:x:�;.� u..�=-�,�:.. � ,. I , ^-�; •VALUATION bF'�tOTAL`GONSTRCICTION t�..� �1 ;, , n EI.ECTRiCAI $ ��� ,....-- ,'AMP BERViGE ��` PROGR�SS ENERGY', C] {W.R.E.C, QPL:t1M81NG $ . ` _ � - ,.. '� �r' ` .. _ .. �~/ , QMEGNRNtGAC ' � $ ` �'VAl:Ili4TtON OF MECliANtCAL_INSTALl1:1T10A! +�[ �( l ��� _ f QGAS Q. ; ROQFlNG:;.;r°�, SP.EGIALTY'-'Q", OTHEft. � FINISHED FLOOR ELEVA710NS � � FLOOD ZONE AREA .L�YES- NO �-a� - _- BUiL�ER COMP7INY -` � _` � � - SIGWAYU�� REGISTERED Y/ N. �E CuwzEn' :.. :":Y/_N..:., , , AcJdre�� " , ' Glcense# - ` ' ,,.. ..1 � ,4. , : ,,.. ,... � . . �;� . , °` �-.... ,��j � ELECTRICIAN;�� .. � � '�,' COIIAPANY i- .`.;`�'( � C.�L�-.�.5 ...�.� _:�, � SI(3NATURE � REGISTERED Y/ N FEE GURREK " "Y/'N.. ' �'� -�—^— Addre�� . , -0 ,�, �r.Ucense,#:='.''( ��=t'��0;;,�',`�y j�`� Ptt1MBER � 'CQMPANI(.> � _ ' - � " SIGNATURE ` � .� ` ,RE41S7EFtED:;- r,,y :::Y.�I=xN,,,- +..-.F.EEiCU�ten.� ,. `Y/N::. � . Addres� ,. - ;' , , ..License#�� ' ..� , IWECk#A�PO�At.: a . . :. � . ; -� - �;��� .GOMPAFiY;� = = :: _ -: ,z;; . - , ,�-- _ , . SIGNATURE � `.� . . ,� � �'J - - �REGISTEF3ED:�;„ ,JY/'N- ,t�FEE URREN: . <.Y. ` � � : ..,... � . . . . .. .. G /•N't::; < .-:s:;s F .��i .:� . . � . _ , _ „ , - � ..._., � � � Addre�s:; , w_. - , . � . . . � r ,:l;.lcense# � : ;:�,`�§ _r . ` �" - . , _s .. , . — . , . , ,� -- �. . � ,.. OTHER •"�`~' . . .,...,_ � . . _ ... . .< � . _ .>,GCIMPANIf' ., , _ � . _ , _,, : -.,� 31(3WATURE_ '' �.,, ,:.:, , _..,,. . . , �,:,�-'. . , . , , .�..,: . . , -' ` ,, .,_ : ,_ .... :.:... .. .. .. . . . ..... .. ..�..;.......,. . �. . , . ,, - � ,REGIS7ERED- ` Y/,.N::.`:' -���uRix�n' ;�;Y/.N;., - . .�' , . _. _. . � _ Addreas �r.. -- x;�;: , .. _ ,;���, , ,P - . . . .. .. . -r•Ucense#,: � _ � - - – - - ". :�;.zs.:, t�•.; �`--�;,.�::.:�' ,x=;,•i .t,, . .h. ._ „ .. . , _ _ ��A" -��' - c�.. .(''::'"--`�:s�:�+s. - �RESfDENt :Attacti:2 y.P,tot;Pt`ans•.$�;sets=ofi$i�tditt �P1ans�`.,:1�.set of.�Ena �Forms`-R=f}�tN:Perro'Itfor n� ;c`onstnia�on�f,..�- �;�� t:)., _ ,�.,�,, 9''.. �t )_ !'9Y ,�:,.;�.;.<_,.,r, - !�;.r.. � _ - ' �,.. ,i.Minl 'um,.ten`s.�10 'w,orlcin��`da;s{aiter,rsuti�iilHal�id"ate:i'R'�"uirecl:ans(te;?�onst'rucUon?Plans,,59�oitnwater',Planswl;SiltFenceMstalled, � _._. _„!I� �,�.}�., _ ..9, .Y.,.�. r_ .!�9. b : �`Sanita�rFa��itl�►sc�4i;�d.'u ei��$I eeiNoik'=Pe� It;. `�:subdiv1s10ii '8 e"�ro eats';:•=,=a��'�fr':=�:y=:.-'�;�� __.... - . � . rY....��,,��w�.<,�.��.�„�€!?�.��;.�;.���4.x;�,:�. M..�,F�°:,,�..-.:__.,.A>�._!`9_P.:1.�,._� . ,,.., ;.:: � � :.> .�:u,.- ,., • COMMERCIAL At�cB(3j'�comptete"sets'of'Buitaing Ptans plus a�Cife 8afety Page;(1j set of�nergy Forms.R-t}=W Pertnit for new constru�tion: Minimum ten(10).working days after submittal date. Required onsite,�Construcdon Plans,Stormwater Plans w/Sllt Fence Installed,, ; , � - • SanitaryFad![tie�st&1:.dumpster...Slte.Work-Fetmit.(ar�il�neinrrpro�ect's:^-Ali`cbmmerclai.requlrements�mu�t-rnestcampliance : StGN PERMiT AttacFi(2)sets o�Eaglrieefed;Pla�s;�;k;��»�'r� ... •• ,, _ ,. , .,_ . - , ••••PROpERT.Y_SUR�/,E.Y-required•for aJ1-NEW:const[ucdon.:~ • -� ' _ '," ` � � •�r,,:». $;- ;''e',"i.. � 'x:,,.- Dirisjctlons: ;€�,4 , ..�;.. _, ._.�. _,_ _. � �,.. _e .. _ . . ,.. �Fllt�out applicaUan completely. E}tivner 8�Contractcr�ign:badc:.of appltca#Ean,natarized If�over�6�500,,a:Notlqe of,;Commencement le required. (AlC upgrades over�7500) � � = .� - .. `'s:;�`��i4.��:.'?,�,;..�.,:.�::...: ��.t:.._, .__.M....,:�.�:,,, �,_ ,��._�. .�...,�,.. ._,.. �� . .. Age�(for�i'e contractor}pr.Fo�"ier ofAttoiney(fo�#tte:owrier)would'be someane with��otacized tetter from awner authorizing same _.., •=3,-:_:.,:..::-�. _ _.�., �. __ ... _.. __ �DVER'THE COUNT�R:P.ERMITTINi3�=' ==":�(FronE;af_Application Oniy)�� Reroafs if shingles Sewers- Service Upgredes AIC Fences(PIoUSurpey/Footage) � ___..... .. .. , -. - - ::::_.._ ~:.�..�,... ,_�_�.r.r: ��... -_._. _�.,_ :--_�-._;.,:.-:.€:�;< _ = �.,. ._. �_.. ...,;�=? _, v _� . _ ..� -...;;r:.,, .;:...� , � qNvew�ys-Nat over Counter if am public roadvi►ay&::iieeds ROW A�`' �. e. ' � ., _ . . '' . � ."' .�,.. �< .,e�. -., - ' ,.�._ .. . _.. ..e.......'"_ ..,.r. .�.._.� • � , 'OTNCE�F DEED,REBTRfCTiONS:..The-undersigraect�clnder�t�lnd.s.��#h�tttl:�i��, �.; tE;;ma .be.�sub ect:tr�." t� r1" t� � r�'�"�""`'```:'� _ - :s�-. , =, ,,., „- P� � Y,. �� Sr•�Gi�U;,r.,res Icttotts , , .. f. , , ,: y„ t,"._ ,+� "ri�r. t Y..�,.�'�.r�•..:'"��S a"�:e ,..^a-=i{"':�.'+C" a.,�. �+ioh m� ;tie�more�' 1 "e`.`;#h�fl�C�iu�i ! �ilaftoris°:°°�The�.i�ndersl"`ned��a��iuines��. ��'_ . y �re,st�ict v �ji:i�Fi , , g resp.on`�Iblllty�:tor'c�iinpiiance'wit�i�any„ = �P�` L _i, �{� �9.,;�_ �6:pYv� ,.�,: i t�il��^�Ot��?�g�VN��sr � ' :zy.k.,.<rjy,.',1.'.f:.i�.:at;�,',?r;'r �i t_ ' ' .:ti . . �.S' -�. Q �.�. �...�. `;...+ ' . J."'�^'n�r..r.�h.tu—:.:;.".'._- NLI+CENSED����t�NTRAG'fflEtSr:AND'GONTRAGT. R:=RESPti�tS� ILlTfL�r...1�-�he��oNmer'�i�s`=:hicea:"`�4;a��i#�actor ar ` m et: ,. �t _ . wlth�state��� nd;aca r$ `� <:�=,;� a�ntr�ctors to:undertake�5wo�k,.�they ey;beu{c ,q;ulre� o��be�ltceri�esl;'In�accor�a�c�:�,_ ,� C f:., �ciFaitR�ns:,;�Iftitt���:¢� .�� r�,. .,,,� :;,�.�., - .,.: v--.�,n. �.-�.v<,: „ _ .-:�.. �w,�,�:��,�,..... ._..r. n.::�.,..�.:_ r ..>. . ,,, , _ . . . - . ,,.:,:,e . ... �ntracto"r-:is_�.not<:itcensed-a`s�.cequlied.;tiry�;l�iiiv;:botli-fMeTowner•.and�:conti�actor�iiney�be°�clt�rd�:for.=a`�ri�tgcl,etneanor�vivlation nder state law. if ttie`awner or Infertd,e�1:,con�,�at��torf,<ere;h,unaer�ain es.to:what'�itcenaing.requlre�nents;may=�aPprjr�;�fo��tli�=:������N-��� � ter�ded`inrnric;�ti�ey<are=a�vlsed�tai:'i�intact Nie Paisco Cauri�iiBul�'dinjg'Inspectliin pivtsidn�-�=Lic:ensing;Seetion:at 727=847 7�Q9. F,uttFierrriore;•If°the�.oinineT"liais'°tilreiil:a �i�int��cfo'f'`ot��coritjaictciis, �ie�`is�edvl�ed #o"have.�tFre .cor�fractar(s)��18� t.w4=.t'.,'.,��'"_. j �rtlons of`the."contractoc �locl�::of;:ttils._appllcatton::for.whtch�,.they.�wlllR=be::.�sspota�l6ls.fl,-,Ifi�you;=TTas;-:#he''ovifii'e�i�sEgn':as'"�e:,,_-.� � � . _. _ ..,. ., _ u... . .,.�..� . _ - �.y.� �;_r ', mtractor,.that��inay be•an Indicatlon-�thet�=Fiia'�Is`:notrpr.ope�ly flcensed and Is°�not�eritltled`M°'permit�lr�g prtiklleges?�!n Pas,co � �. 4 ��'i,�,,.,.. oun � ��,..- i _ ._ ._. .... ..� , __, .w._�,.....:.t.:..._.: '`�,,,� , :��«::>::; ��i � . .4. . . .. . , . _ ._. % t�4N5PORTA',fiQN,alt�fPA�TJUTILittES'�fi�IPAG'fi'�A�13=1tEg�U�tCE R�COVERY FEEB:�'�Th�°t�nder�i�ried'�ur�derstands ;; � � <,r at Transportation lmpact Fees-and.Rec�.uree:Racoue.ry:Fees_.may�appty;#a,the+�nstrUction:cfi�new:;bu�dings�;change$°ofi:`:�-�,..`�;,';:;�; :; . . .....:.w:,.w_ �. .. . ►e in existing bulldings,�a�r;{expari�l�y����e�l.'s�.�;:;br�lltllrigs, as'=speclMfled.ln Pasco Courity`O�dln�nce number 89�07=and �f )-07, as amended:_,�,'fh�undersl ned �lsa,�understa�ds thgG.su�h fees��as:,tna'.be��dt�e���q�:;�e Ideri�tfted a#theittme�of`'"'� ::_�°;-;�*�� . >}�, g � ' . y�;,`,� �� � �,u �rmitting. It ls iii�rtlie�''anders`tood that Trai�sp�rtaflan'.Impaof`Fees and�Resvur�ae`.�tei:oveiy�Fees-,mu�f�be pald prtor Eo �: ce�ving,a�"ce�f�tcate�;oi>oc�uupancy"°or-flnat�.p;awer,�.release::-:l��the:proj�ct,,does`:not�'tnvolV�.Ra�.cert�tcat� of occupaney.�or��x�':�{-_'.' �ai power�r:efease;�.the=;fe�s:.mu�f:;�e►�paid--pelorta`permit iss�ance. rFW�tkiermore;;�if:Pasca�-.Coun Y��°Vllater/Se.wery<Im �ct:>-:rt:,,µ::r;�, ;- ` x,.� . � ,.� �Y. ,. _ . , P , _ es are due.�they rrtust,be pa#i!prfor to;perml��lssyance�n a+�ancsawtt�i::aPpiia�itife:Pasca;,Caunty�ordinances. ON�TRUCTI�N"I:IEN"l;AV1�-(Che�pter:'�13;Floi�il�Statntes,��maricl�dj; Ff vstuatlon.oftv�rark 1s$2�500:OO;or-:morra;,1,,,: €�-�-;;�;�.; , �rtify that.I�,Ythe.:aPpllcant;._�iaxe:,.been�,.proVlrled.,wtth�a-<:copY;:�e�f�the.�"Florlda•�'ConstRicttoit���ten'::I:aw Homeowner's �otection Guide" preparetl by:"tt�e'Flo�lda'�Departtner�t,of Agrlaultiyre and Consnm�r,,,�Af�[`s. (f the�pp!lcant Is.som�one; , , ;;-.--.� her than the'+au�mer", �certny;th�t.�.h.�ve:>opt�in"e'���F'co :of.the:�ibove.:�descrlbetl�tmciii�entsand; to.�t,se�;l".`a � } ., ...�. . . _ . . _,. m'rn - _ ,_ PY. p..,.�. n goo��,faltti�tom., a!#ver i#ta<the."owner"�-prior�=to�.+�o encemeiifi:"•���' =°` � ;7: ._ - . �.., ..`r:: ._.._:_� ._.: " , dN7'RACTQR'�laWNER'S.A��IDAYf1`:. l...c,ec:tify;�#��at..a1F„th�,ir�formeNtm:�i�?thta��aP,plicallon ia accurat�;�nd that ali�work ` , ill'be done in compliance wlth all.,app!lcable'laws��r.egula�ng constru�t�an, zoning�and�land�dev�lopmen#. Application is �reby made. tn optain�;a�.pacmitr,to;��.do��o�`k,t�nd"�.In�tallatton as Indtc�te++tl:�•;��;I;..ce�lfy tf�t rio�woik`�of Ins�atEattoii°'tia's� , rmmenced'prtar"to`Issuance`of-a�_peimlt�and�tha�'�all`work wlll be performed�to meet.;stend�rds:;of.al! I�ws regulaxing- instn�ctian, County and City codes,-zoning regutatians, and iand develapmer�t regul�tli�ns�`=tn`�th`e�junsdtctlon:����il�°al'so' ��y#h�t ! u�derstand tt�af the r�gutafbns of ather�govemment agencies may�apply��to,the,intended:work, and that it Is :. y responslblllty to fdentity�wttat.act(ons�f:must�tskg:to besln:.comR1#ancs:,,_S.uch�.agencies�l�ct�ide b�at=are:not ltmlted:_to: :--_ ; - departnient of Er�vlronmenfal.�'F►iotiec�#�ii`�Gypress�8ayti'aa��;`V1''te�ft'z�nd�ATeas and Ernrirorimerrteliy�Sensiti�e 3 �.ands,Water!lNastewatsr Treatmant. • � � �t ` - 5outhwest Flortda Water Manager�enE'�::�1lstrlct•Wells; ��Gypress.`�.Bay_h�a��; 'Wetla�►d Areas, A#tering � °�, � MNaterrAurses, . .� - � � . - Army Carps af Engineer§=S8�4W2111S�'Doi�kS��Vavigatite IlVaterways. �°� - Depar�ment.ot.Nealth;.�;..Ftetasblll#afive.,S.ervicesLEnvironmen#at:�;Fle�fth.:U�it=Welts;-..Waste.wa#ec�Treatment, . 'SepNc�Tanks::.µ_ � ' -. .. , .- . . ,. . , - US Environm�ntal�Protection:Agency-Asbestos abateme.nt., - .Federal.Avlatlon:Autlaorlty.�Rur;iways:. ..-- .. ',:; -- ndet�tand#hat fhe follovii�ng:.r�igfri�t�,ons�apply#o�#iie°use of fllt:� - - Use offil!!s nat�allawed.iii-Ftoo��Zone"V"unless expressiy:permitted. ,.. y. � _ If�the yflll�;mate�4al`'�`Is°'`�to��;'be:`=ause�=;ln:,flood-Zane. °A", it i`s'underst�otl�that � �frainage..plan �ddress#ing a "compensating:volume"wlll..be submltted at#lm�,of�permltttng vi�t�tch is prepared by a professfonat engtneer Ilcensed-by�;th'e��tate�of�Flol`Ida:-- .. � �� .� - - tf.th�_,filt:.,mate�ial"�i�'=�to:be�used in �iood Zorie 'A° in+�connection�wlth`'a����ermltted ballding ustng stem wal! ' cons#nlct�an,-I cettify#h�t�flll:�nr�lf.be�used.only.ta�II the..are�,,wtthin�the s#em_�wail. . _- - � " tf fill'�materlai�<<isu'•to=tie�=us+�if;:ln°-any ares;�1�;+certify that .use. af suct�'ftti`w11t i�ot��iivversely► aiiect adjacent pnnpertles. hlf.,use:of,�111.Is,toynd to adv,erselyr...�ffec#`��cl�i`'�ent��prc�parties�.the awner may be cifed for uio�ating• the`cond�Io�is-�of:�tFie.�ball�Ing�;p�rnilk lssued:'u�der ttie�iat�acFied.�er�n1E.=-�RFlicatlo�. far�:tots iess�t1�an.ane (1) . acre whYch,are-elievafeii�l3y;:illl;:�n engtneered dralnage�pilan'ts requlred. � _. am the AGENT,FOR:THEwOVVIENNER;?i;�ronilse`tn�gaod fatth to�lnform.the oumer�:af:the:,permitting cond�lons.set forfh!n �: s afttdavlt`prior to eommenctng constrrictlun 1 unde�t�r;id`th+at e s�ip�rate permtt may be requfted for electNcal work� � �mbing� signs, wells,:ponls�.,alr..,cond�tloning.��ts,�cr ott�er..�Itist�ll��ons=r'ia�.spec�#icatty in�iu�led-in.the-application;. .A` ... .. �,'� a , _. ;.,w...�..., . ..� - ..� _; rmit Issued"shall be:co%i�huad to'lie�;a'�license:#o:proceed wltFi'ttie;`viroik and not:.as:�uthortty to,ylotate;�;cancel;`�tter. o� r=:; , t astde any�provtslans-of ttie:#echnlcal:code�;�nor shall lssuance�df a.pe'rmtf.pr.+avent tkie 8u!ldMrig Of�lcla!from the�ea�t�� '��` :, �;; �uirin.g a correction-af errors,in�ptans;F;constivction.or vialatlons�of'any�codes:-��v�ry-,p�e1'tnitLLfssued:�hall�become inval9d� `�°` � less 4he work euthortzed by sucti permit�s.coiii�irience��`witi�in,si�c months°of;permi#lssuance� or If work authorizetl by �``y �permlt i's suspended.,or aba�do�ed fi�r_a�.er.lodYo�.,s�c_#8),moi�#isa�e�ftie tlme�the�wortr�is aammence�. An extension . {�ws ; �y be requested� In wrlNt:ig;�:from;�tfie�8t�lldl'rig�C�1clal.�for:�a perlod�nof�to.exc;ee�f>nit�ety�(9ta};:�lays�a�rd�wiil'detnon"sfrate b a ; tlfiable cause for:'the extenslon�: 'If'v+iork.cea��ea;for nlnety(90)consecutive:day�t..th��ob�ls constdered a�ba�doned. . � �At � � ��_�- � ;,... _,.. .. .....r�,_. �. . . _. � . . � .,.� . ; :,,. .. . . , .,k,, . � .. .� b 1RI�I�t� TO{OWN�i�:'=`fYOUR.�FAiI:URE':�'C1:;;R�E�D�t��;A::t�07"!_GE:fOF>=COMM6M�EMENt7':a1VFAY��RESE•1kT�=1N�,Y0UR :. . ..:...:......� .. . i YtIV�-'�MIGE;Ft)�;I�illPRA��AItEN'��r:T�3�Y1-l.C,�it,PR;t�P�RTY.<�I���Ytf.U}t�1�D"'Tt�`��8�'�AIN�fIN��lE11r11�'�C.O�IStJLT �<°± ` QU - .. � •..Q..��.,..,.,.,a�.,..: - ,..,,... ....;r..�..,,,. ._..:.. .. < < ,. . .. _, - - ---- - - -- ---- - - - - --� _ N��� O N F�R b C� ��}: ,_.;_ ►RIDA JURAT•(F.3:1:17.03} . , " - . - ;- {:,� ,� � � _ . . . , . N�R OR AOENT" '� ' . CCitt�tl'RAGTGR=: . .. -,. . . ` saibed and awam to(ar�Nlrined)'before me thla � ' ' Suaedided'gnd'swom�fio{o�afflrmedpbefoca�metfi#g' : �Y �by. . �Islare person�lly known M.m�or�haalhaue producet! Wha_i'staFe..persaialtyknawri�6b.m��.ot ttasfiave:�ttod#n�d. = as;lden6�ca8an. - �;< • ; ' •"� • aslil'e`ntlRcatlon. " Not�ry Pubtia . ` � tJotary Publlc imisstan Fia: � Comm(sslon.No. " � . �e o1 Notary typed,printed or stamped Name of Notary iyped,pdnted or st�mped � � . PURCHASE ORDER �:� �� No. 0000029328 �i�y �f Zephyrhills �'��'�0�� SHIPTU: BtLLTO: David Hayford Electric City of Zephyrhills 7141 Berry Rd 5335 Sth St, Zephyrhills,FL 33540 Zephyrhills,FL 33542 � VENDOR NQ, VEND0121'HONE IVUMBER TERMS DATE ' RE UIRED DBLIVE ' Q R1 DATE HayfordE 0 04/19/2016 SHIPPII�G INSTRUC'fIONS (none) ITEM QTY LI/M BESCRIPTION�1'ASK PRU CODE ACCOUNT UNIT PRICE AMOUNT I � �•� Labor and Installation of Electrical to 001-220Q-522-6250 3,650.00 3,650.00 Shed at STI " SUBTOTAL: 3,b50.Q0 TAX: 0.00 SHIPPING: 0.00 TAXABLE: I+lo TOTAL: 3,650,OD CONFIRMIAiG: � c.�� ' I - �.J�f� i�"Ov V AU"CHORIZED SIGNATUR$ iMPORTANT. OUR ORDER NUMBER MUST APPEAR ON EVGRY 1NVOICE A1�1D PACKAGE '[liis purchese order is yjvati upon thc representation end guaranp�ofiAc manufecturer or seRu rhat no breach otany Stafe or Fcdecol Law or Rcgulution has occuned in connection n�th thc manufacmring,proecasing,brending,labeling or transportation of the merehendise herein rocntioned. Ifsuch breach occurs or is cherged by any legelly constituted State or Federal authority, tho buycr shell bo entiUed to roscind d�o order and retum die unuscd merchsndiso end shall also ba held Larmtass by the manufacmrer or scller against any penalry incurmd and/or the cos�ofdeknse ofany proccedins deaigned io penaliu iLe buyer. ' � David Rayford Electric Inc. dba First Class Electric 7141 Berry Road Zephyrhills,FL 33540 License EC 0002570 ' Phone(813)363-2066 Fax(352)567-650b www.davidhayfordelectric.com To: Zephyrhills Fire Department#1 Invoice#1812 � June 15, 241 S Bilt for: , Labor and material to install one 100 amp 4 wire circuit from main distribution panel to shed area plus 20 ft. Totalamount due ............................................................ $3,650.00 , � I I�IIII IIIII IIIII11111 IIIII IIIlI IIIII 1��11 IIIII IIII�IIII 1111� , . 2016088976 ' c�st:1776924 Rec: 10.00 ——--- � ' - DS: 0.00 I'T: 0.00 06/08/2016 D. Ei. , Dpty Glerk � II ����'Q�C��`NC��� ' pt�ULA 5 0'NE IL,Ph D PRSCO CLERK & C0t4PTROLLEh I PezmitNo, �"ltil�� 06pR�BK 1����m 1'G �,'�� Praperty Idessti5caiion No., ��� a�- ��- a���-�o � �r,�--�o�o TfiE iJ1JDERSICiNED hexeby give infarms you that the impravement wiil be made to certain real pmperty,end ia eccordence with Sectian?23.33 of the Fiortda Stamtes,ihe fttItow'►ag informa2ion is pravidcd in tEtis NO't iCE QF CO�NCEh?E3VT, ` � 1.Description ofProP�rtY��Bat d�ccrlpNon j �l`55e.S'SE'c� - 6�. `?bL+�asl,` �o J`�l'�� C c�1 ��tS'f a}3�eetAdchsss� 7 Q. 2.Qeneral description of improvements: - - e r ' ��! 3��� 3.Owaet Info�atian p /� ;�` � �j,,� ,�j� a)Name and addccss: c` 1" �` r�i ll s Ul �t�G�.th' h`T � �+ � - b)Name aad addteas of fee simplc titieboldcc{if othei than awner) d � 33 S�{2 � e)!nlsiest m pzopesty _ 4.Con�actorinformatiz�a , �>x,����a�:. e�j,�d �--h- c 1�'�1. $��' k. ,))s �t..-33 s�3 b)Tolcphone ldo.: Fex Na(Opt.j 5.SaretyInfonmatioa � � a}Nsme and addcessc b)Aniowpt ofBorid: c)r�l�snone No..: • ' Fax No.(opr.) 6.Lender � a)Neme and address: Phoae No. �.Identity efpersan within the Staie af Fiacids des3gaaEed by awner agon rvLom aotices or othar doc�ents�asy be servu]; a)Name and address: , b)Teiephone Na.: Fm�No.{Opt.) . 8.In addiHon to himself�owner designates the follawirig person to seceiye e cppy ofthe I.ienor's Notice as provided in Section 7I3.19(I}(b},Florida Sladrtes: , e}Name and address: b)Telephone No.: t .. . Fex No.(Gpt,) • 9.F.xpusHon dste ofNokice afCammdncemsut(the e�griratioa date is one ytar frbm th�date ofxecord'mg milrss a diffe'rmi date is spacifieri}: W.ARI�IIIVG TC)OWNER: t�P1Y PAYMENI'SI4SAD�BY'!'AE d`VPN'RR��BE F..�CIPIRATION OR 7'SE NOTI(�;OF COMMEPiCEMENT ARE CONSID�RED 7MPROPER PAYD�N'd'S UNDEIt CHAFTER 713,PART 1,SEGTxON?13.X3, FT;ORII}A.STt�TiiTE3;l�IYD CAN RBSUL'P Il+t YOUIi PAYIi+7Cx TWICE I't�It IlYiPROY�NiI�:iYR'S TQ YOTS�t PROP$1tTY. A NOTICE QF Cp11lhIENCEMEN'1'11NST BE RECORDET�AND POSTED ON 1'HE JOB S1TE BEFORE THE FIRST INSPECt'ION, iE 1tOQ II�i'�END Td QBTAW FW.AI�CING,CLi1V30I.T YOY7It 7LENDEB OR AN ATTBRNEY BEFC/RE GOIV�MEIVCING'4VURK OI;RF,CtJRDINCr YOUR NOTICE QF COMMEiYCENYENT: SFA'T�OR FIA1tIDA ���p��' �p� COUNI'XOPPA5C0 W��- �,:.�-(!� � SI ofOwnvott}wna'sAufLo�sdO�calAirrdwlPufia/Mmqgc tr��`� �� , �e y � y� ��. ^t . The going ins ent a owledged he tLis day of �✓.�~��. .20�l by �t�i ` ��°"`E��tGi �tYPe of eutLortRy,o.g.officer.trustcey att�mry � �.�¢���-�----�� ��)�r_ ^ {neme of pa►iy on behalf of whom#nsavme�mk wss rJceeuted}. Fetsonally Kaowa�R Praduced Idtnt3ficatian� Notazy Si�at�tte 'I`ype af Identification Pjroduccd Namo{grimS) ��-��,�L+�N�Ct�"'� _� Yerificarion pursusat io Section 92525,Florida Slatutes.Under penetties of per,jury,I declare that I have nead the foregozng and that the facts stated in it are true w the best ofmy laiowledge end belie£ s;gnetwe'ofNetival Pusoa sigdng Above FORMSMOC.+vid2007 ��+r���rrrirrw�'�w"��r ♦9usu+�u4W��balnni2PePU0e ,�oi;pad'{��� 449b`�6�40A �_ � 9�4��LL JBQweoaa saaidx3 _ . ,__ �Z�09��3#�otis54usuto� ;��,��; - S�J48 3NIl3f1D�`d� •,.a:�',•` . �