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Home My WebLink About17-18325 CITY OF ZEPHYRHILLS ' � �� 5335-8TH STREET (813)780-0020 18325 BUILDING PERMIT PERMIT INFORMATION - LOCATION INFORMATION Permit Number: 18325 Address: 6402 SILVERADO RANCH BLVD Permit Type: IRRIGATION ZEPHYRHILLS, FL. Class of Work: IRRIGATION Township: Range: Book: � Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: SILVERADO Est. Value: Parcel Number: 04-26-21-0070-00100-0040 Improv. Cost: 1,200.00 OWNER INFORMATION � Date Issued: 4/05/2017 Name: DUNE FL LAND I SUB LLC C/O HAWK Total Fees: 40.00 Address: 2502 N ROCKY POINT DR STE 1050 Amount Paid: 40.00 ROCKY POINT, FL. 33607-5995 Date Paid: 4/05/2017 Phone: (813)574-5700 Work Desc: IRRIGATION CONNECT ONLY'`******** CONTRACTOR S APPLICATION FEES HENDERSON IRRIGATION INC IRRIGATION CONNECTION 40.00 t '�:. Ins ections Re uired PLUMBING FINAL 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 frst reinspection,whichever is greater,for each such subsequent reinspection. NOTICE: In addition to the requirements of this permit, there maybe 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 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 Plan , pecifications Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. . CO OR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER i . s��-�o-002o City of Zephyrhills Permit Application Fax�13-780-0021 Building Department Date Received 4/5/2017 Phone Contact for Permitting �� — � 1 � � � � � I � � � � � Owner's Name LENNAR HOMES Owner Phone Number 813-907-8578 Owner's Address 4600 WEST CYPRESS STREET, TAMPA, 33607 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number ', Fee Simple Titleholder Address � JOBADDRESS 6402 SILVERADO RANCH BLVD, ZEPHYRHILLS, FL 33541 LOT# 4� ' suBoivisiont SILVERADO RANCH PARCELID# 04-26-21-0070-00100-0040 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH x INSTALL REPAIR PROPOSED USE � SFR Q COMM 0 OTHER TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � DESCRIPTION OF WORK IRRIGATION INSTALLATION BUILDING SIZE SQ FOOTAGE� HEIGHT �BUILDING $ VALUATION OF TOTAL CONSTRUCTION DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. �x PLUMBING $ 1200.00 �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �GAS Q ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ■ � ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ �_■ �-�_LL� ■ ■ ■ T• BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRET Y/N Address License# PLUMBER COMPANY HENDERSON IRRIGATION SIGNATURE REGISTERED Y! N FEE CURRE� Y/N Address 4511 BETHLEHEM RD, PLANT CITY, FL 33566 License# LSS-09232 MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREI� Y/N Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# 1111111111111111111111111111111111111111111111111111111111111111111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans,(1)set of Energy Forms, R-0-W Permit for new construction, Minimum ten(10)working days after submittal dafe. Required onsite,Construcfion Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities 8�1 dumpster,Site Work Permit for subdivisions/large projects � COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page,(1)set of Energy Forms. R-0-W Permit for new construction. I Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities 8�1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. **•'PROPERTY SURVEY required for all NEW construction. ■ _■ ■ ■_a-�-�-�� L Directions: Fill out application completely Owner 8�Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) �I Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW i \ I 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 Building 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 contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES INiPACT 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 Water/Sewer 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 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 "owner"prior to commencement. CONTRACTOR'S/OWNER'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 performed 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 government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterMlastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - 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, I 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 I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, 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. WARfVING 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 FINp►NCING, CONSULT VIlITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N C F COMMENCEMENT. FLORIDA JURAT(F.S 117.03) � OWNER OR AGENT . CONTRACTOR , Subscribed and sworn to(or affirmed)before me this Sub cn e nd swor' affir ed fore me thfis by t`/ by ' f � Who is/are personally known to me or has/have produced Wh is are personally known to e or haslhave produced as identification. ��/(/�-�' �(�� as identification. � Notary Public Notary Public Commission No. Commission No l.�'C-� (/!� ✓ ��A ��,Q//(l� �QG��L.E_ Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped GIOL•58E-008�uvnsu�uie��SalN�papuog a,�;o;�•., OZOZ'L�aqwanoNsa�idx3:;° `�;: EbESbO JJ#Lo�ssiwwo�;��o; 173��f1?i?M4113t21930 "'�;�;�:;.. IYrr:^..CJv4�..:r'tr•'.na�.�`\,., .�x�f?^��.�..-�.�r:w Henderson Irr�iation, Inc. www.HendersonIrrigation.com � 4511 Bethlehem Road Plant City FL, 33566 Service@HendersonIrrigation.com April 4, 2017 City of Zephyrh(Ils From: Henderson Irrigation, Inc. Re: Authorized Letter(Authorized Agents) To Whom It May Concern Pasco County No: LSS-09232 Print Qualifiers Name: Russie E. Henderson Business Name: Henderson Irrigation, Inc. *THIS AUTHORIZATION SUPERSEDES ALL PREVIOUS SUBMITTED AUTHORIZATIONS* � I authorize the following individuals to sign for and obtain permits: (Please print names clearly) Leanne Henderson Julie Weisensee Vivette Smith / Signature of Qualifier: �j ' ' Date: 4/4/2017 � �; � State of Florida County of Hillsborough Sworn to and subscribed before this day •�M "''� DEBRAELAINE RUFFEl6 �Z�� ;��r�';:Commission#GG 045343 (Stamp) .w; � �� My commisslon expires ;;�o�,;Q�:�Pires November T,2020 L/�� Bonded ilpu Troy Fain Insurance 80D385-7019 ��b�f �� " Pa elof3 ' 9 i '„�r��„1,-••, Paymerrt Confirmation :'�; • ��: Recelpt Number 16-604003226 • � - �� 09l07l2D1611:42AM - Cashier:PLO -.��e,.,,�-`. �0�� r-�,�.r_oii.��oxz P.1�"O C'C)G:1TYI�L�RTD:\ � � HENDERSON IRRIGATfON INC 4511 BEfHLAHEM RD PLANT CIlY,FL 33566 Name On Card: HENDERSON IRRIGATION INC Credit Card Type: MasterCard , Credit Card Number. "��n*4735 Confirmation Num6er. 03532807496 Credit Card services are provided by PaymentExpress and are assessed a convenience fee.This change will appear on your bill as:PaymentExpress. Transaction Total $31.25 Convenience Fee $1.50 Grand Total $32.75 'TFiank you for ailowing us to serve you" Customer COPY � "� - �- - — - - _ __..._ _ ..,:-.-w -:-, . : - .,_ _ _-. ,- _ ._ . _ „ ... , _. �.�.��-�Q��`��:T��S�� ..��' -. . . - , '2�'�7-.� _ : : � . #ssued.pursvanE and�suToject�to Florida Statute;s and.Pasco�Goi,rn4ty.t?rdinances. Issuance daes riot certify ,��ire�Se�#erra��r�� compiiance witit xoning or ather laws; This,receipt mus#be.posfed'conspicuously in ptace af buslness. � �;��•., ' _ . - - 4': : - �' , • �^ `��/�,��(��/�� ` � . ��, �' � � . - A�COLlN1'#.. ' ; 92238 , � . IYPE OF`BUSINESS � ' .- .`'�..'�,w•p?;:. " , - � , ` . - _ ,��.��,��i�(��- SPRINKLIhiG'SYSTEMS CC1N;fR{Ut�CIERGRQt1ND). ; ` � ��5!C Cb[?�: � 17_19.06 " ..P,c�SCQ�CUT.INTY FI.QIZIDA :'��STA7E LICENSE"� - , ' - . . i ' � ' _ - .. _ - . . - . LSS-09232 =, - . � . __ � - . ' � ' - _ - ° � . , - . -- , - -QWNER/QUA�.IFYIT�IG AGENT . " - � � � " - .- ` . MENbEF�SON:RUSSIE EARL JR' :.; • � - H�t�DEE2SC?N.IRRI�ATION-lfVG' . - -- � _ �` � - ' - . ' . � ` ' - - . _- - - tOCATIt.7N ADDf�ESS: - ' . -� 45'!1 SE7HLAHEN!RQ .� � " . ' - ' - � 4591 8Ei'HI.AAIIEM RD � - • - . - ; :PLANT C�TY;FL- 3358B ._ -�, ��" , - :. PtANT C!'fY..Ft' ;33565 _. - `.. • �. . .. , ' " -. - ` - . " - DATE. .: ," REC�IPT` � AMOUNT°- - ` • - ." - , ., •� . ' _ : ., . 091Q7/2415_�'� . 16-B44-04322fi-� 99.25 , . _____-.___--,--------------------------------..__---------------_______-------------- I Dear Business Owner: Your 2017 Pasco County Susiness T.ax Receipt is printed above. Please detach the receipt and disp(ay it'sn a place that is visibie to the pubiic and available for inspection. Th�Fasco County Business Tax Receipt is in addition to any other license or certificate that may be required by Iaw and does not signify compliance with zoning,hea(th,c�r regulatory requiretnents.The Pasca County Susir�ess Tax Receipt is non-reguiatory and is not meant to be a certification af the holder's ability to perform the seruice for v►rhich it is registered. � i Business Tax Receipts ex�ire 5eptemher 30th.Annua! r.enewais are mailed in June to the ad�ress af record � at that time. Please contact our offi�e if there are any chang�s to yaur business name�awnership, physica! ; address, or closing of your btisiness. � _ � Thank you for allo�ing us to serve yov� � ! MII<E FASA�lU i PASCO CUUNTI'TAX COLLECTt)R � f � ; � ; . . � EAST AA5C0 60VERidMENT CEN7£R WEST PASCO GOVERNMENT CENTER TAX COLLECTQR BUlLDiNG �. DADE CITY NEW PORT RtCHEY GULF HARB�RS � CENTRAl.PASCO GOVERNNiENS GENTfiR CDMPAftK 75 Bti5iNFS5 FARK � IAND O'LAKES WESlEY CHAPEL CALC CENTER:MONDAY-FRIDAY 8:30 AM-5:00 PM (352j 521-4338 a (727}847-$032 � (813�235-6076 i A�� CERTIFICATE OF LIABILITY INSURANCE �4/04 2017rn 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 CONTAC A.KILBRIDE INSURANCE INC. NaMe: EfIC M8 12S 1401 W.Busch Blvd. a�c°NN e�c: 813-931-7467 ac N,: 813-932-7336 Tampa,FI 33612 a oREss: certificate akilbride.com 813.931.7467 Phone 813.932.7336 Fax INSURER S AFFORDING COVERAGE NAIC# �r,su�Ra:'Ma fre Insurance Co of Florida 34932 INSURED INSURERB:Ma fl"e Insurance Co of Florida 34932 Henderson Irrigation Inc 4511 Bethlehem Road INSURER C: Plant City,FL 33566 INSURERD: F�OC'l CId Ci trus Busi ness & IndS U11d �r,suReRe: Ameri can Zuri ch Insurance Co INSURER F: COVERAGES CERTIFICATE NUMBER: 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, 'i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �� TYPE OF INSURANCE ADDL SUBR pOIICY NUMBER MMIDDY EFF M�DpY EXP LIMITS GENERALLIABILITY EACHOCCURRENCE $ 'I,OOO,OOO ✓ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 'I OO,OOO PREMISES Ea occurrence $ A CLAIMS-MADE � OCCUR 4250170025113 Q2�1Q�1] QZ�1Q�],$ MED IXP(Any ane person). $ 5,00� �/ ContractualLiability PERSONALBADVINJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 ✓ POLICY PR�� LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT �,OOO,OOO Ea acddent $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED � SCHEDULED 4150170013651 02/14/17 �2��.4�1$ gODILY INJURY(Peracadent) $ B AUTOS AUTOS ✓ HIRED AUTOS � NON-OWNED PROPERTY DAMAGE $ AUTOS Per acadent Personallnjury $ 10,000 UMBRELLA LIAB OCCUR � EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION � WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N E.L.EACH ACCIDENT $ 'I,OOO,OOO � OFFICER/MEMBEREXCLUDED7 � N�A 10654109 - Florida 02�14�1� �2�14�18 1,0��,000 I (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ � Inland Marine/Contractor's Equipment coverage limit: $ 84,393 E Equipment Policy Equipment Coverage deductible: $ 1,000 EC05650793 06/05/16 06/05/17 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 101,Addltlonal Remarks Schedule,if more space Is requlred) Russie E. Henderson Jr Contractor#25527 Irrigation contractor License SP13989 CERTIFICATE HOLDER CANCELLATION City of Zephryhills-Building Department 5335 8th Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Z@ Il Il1IIS, FL 33542 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P rY ACCORDANCE WITH THE POLICY PROVISIONS. 813-780-0021 Fax AUTHORIZED REPRESENTATIVE O - 010 ACORD CORPORATION. All rig s reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD � � i (r�1 �� . � �:.��g� Policy number: 4150170013651 � Thll� E�lDOR�E�l�t�T �i��iG�� 7'Ei� P��l��. �L��E R��,D iT CAR��ULLY En1F9A�VC�� (�1��A�� $�3��E11��Aa�' This endorsement rnodifies insur�nce provided under the foflowing: BUSlR1E�S A�lTO COi/�I�AGE �O�N� With respect to coverage provided by this endorsement, the provisions of the BUSIIVESS AUTO COVERAGE FORM app(y unless modified by the endorsemen#. �. BR��l� FOffZtlPi hlAilsYED 1P�SUREID SECTION ii - LIA8ILITY COVERAGE, A.R., U�1h�o t� Ar� l��ur�d is amended by adding the �ollowing paragraph: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entiiy and the business entity is not otherwise insured for Business Auto Coverage. Coverage is extended up to a maximum period of 180 days folfowing completion of acquisition or the legal formation of the business entity. 6. E{UlP�OYE�� AS ACDD9YIORI,�L �N�LP€2ED SECTION 1! - LIABILITY COVERAGE, A.'�., �ilho ls Aca 9s�surer� is amended by adding the folfoaving paragraph: e. An "employee" of yours is an "insured" while using a covered "auto", w�ich you do not own, hire or borrow, in yaur business or your personal aftairs. C. ADDiTICDNA,L tR9 sU�ED BY CQ�lTRACT Under SECTION II — LIABILITY COVERAGE, A.9., �V'f�o !s �n lnsured is amended by adding the following paragraph: f. Any person or organization, with whom you hat�e a written contract, but only for "bodily injury" or"property damage° resufting from the acts or omissions or": 1. You, while using a covered "auto." 2. Rny ofher person,while using a cov�red "auto"with your permission. �. COVE�Afs� EX'fE{�S10NS -Sl1PPLEt�!'iEi�TARY PAR�'r�3Ei+9�S _ .2. Cov�ra e Ext�nsi+�n� a. Sea tementar �ECYION I! LlABIUTY COVERAGE, A g , pp� y Payma�nts, paragraphs (2� and 4�} are r�placed by the fiollowing: ��) Up to $2,500 for cost of bail bonds (including bonds for reiated traffic 1aw violations) required b�cause af an "accident"we cover. W�do not have to fiurnish these bonds. � �� rred b the Insured at our re uest includin actual loss of 4 All reasonable ex enses incu q , 9 , $ � P Y earning up to$300 a day because oT time off from work. ' E. PHYSICp►L DAtIAA�� -�'62y4P�S�'OR`TATIO�i EXPEN�E SECTION (!I - PMYSICAL DAi1liAGE C01fERAGE, A.�, Cov�rag� gxtensions a. Transportatia�n �xpee�ses is replaced by the fiollowing: , MAP EE (06/12) FLORlDA Page 1 0�3 ' �We wilf pay up to $30 per day to a maximum af �900 fior temporary transportation expense incurred by you as a result ofi a totai theft of a ccvered "auto" of the private passeng�r type. We will pay only foc covered "autos" for which you carry Comprehensive or Specifisd Causes of Lass Coverage. We will pay for temporary trans}aortation expenses incurred during the period beginning 48 hours a�ter the theft and ending, regardless of policy �xpiration, when the covered "auto" is returned to use or we pay for its"loss". If the temporary transporEation expense incurred arises from your rental of an "auto" ofi the private passenger type, the most w� will pay 'ss the amount it costs to rent an auto of the private ,� „ � passenger type which is of the same like kind and quality as the stolen covered"auto". F. HlRED AUTO PHYS9CAL �Ai�Af��—LOS� �F USE , SECTI�N !II — PHYSICAL DAMAGE COVERAGE, F►.4. Ga�v�rag� Extens'tmns �. l�oss of l9se Exp�n�� is amend�d es fiollows: However, the most we will pay far any expenses for foss of use is �65 per day subject to a maximum fimit of$975. �. F��R��PdAL E��5 CC3V��GE SECTlON lll - PHYSICAL DAN�AGE CQVERAGE, A�. C�verag� is amended by addir�c� the following: �. P�rsonal Eff�cY.� The most we w�ll pay is up to $400 for {oss of wearing a�parel and o�her personal effects which are: �. owned by an "insured'; and �. in or an your covered "auto". � This coverage applies only in #he event of a total theft of your covered "auta", or a total loss caus�d by fire, windstorm, vandalism or flood. We wilf pay only for covered "autos" far whicn you carry either Comprehensive or Specified Ca�ses of Loss Coverage. Rlo deductibles apply to this cove�age. H. �4lR��iG C4VERACs� SECTION II1 - PHYSICAL DA�VlAGE CoVEFtAGE, �i. E:cclaasions, paragraph 3.a. is replaced by fhe following: a. Wear and fear, freezing, mechanical or electrical breakdown. The mechanical breakdown exclusion does nat appiy to the repair of an airbag due to accidental discharge. t. l�OYICE �� lD K�f01l41LEDCE O� C�CCl9l�RENCE SECTION IV - BUStNESS AUTO CORlDITIONS, A.2. Dctti�s !n The Event Of�►�cident, Claim, Suit Or ��ss, paragraph a. is am�nded by a�ding �he fo{lowing: Your duty to give us or our autharizetl representativ� prompfi notice of the "accident" or "loss" applies only when the "accident"or"loss" is a<nown ta: �6. You, if you are an individual, 2. an� partner, if you are a partnership; or 3. any ex�cuti�e ofificer or insurance manager, if you are a corporatiarc. J. ��Afdt�ET V9lA91/ER �F SU�h'OGATlf7�9 SECTI�N iV - gUSINESS AUTO CONDITtONS, ,4.�. 'Trartsf�� f�� F2ig��.s Of 3��covery A�aie�st Others 1'o Us is amended by adding the fiollowing: We waive any right of recavery we may have against any person or organization becaus� a•� i payments we mak� for "bodily injury" or "property damage" arising out of 4he operation of a MAP EE {06112} FLORlDA Page 2 of 3 • 'covered "auto" when yvu have ass�im�d ii2bilify �or s�;ch "bodiiy injury" or "praperty dan�age" under an insured cantract. �C. UNi�STE6dTB67NAL ERRBR� ��t �i�1�SlCrS��; t�R ��4�.L��'d� i3��L�S� F!l��ARD� SECTION IV - BUSINESS Al�TO CONDITIO�JS, E�. ��n�r�6 �onclitions, 2. Concealrnen�, INisrepr�ser�tation Or�raucl, is amended b�,� adtling the to1lowing: The unintentional omission of, ar unintentional error in, any infc�rmatiar, given by you shai! not prejudice your rights under this insurance. However tE�is pro�ision does not affect our right to collect additional premium or exercise our right of�anc�lla�ian or non-renewal. L. 6ili�ED �AEt -URl�RL�1NiL7E C��/ERAC��'�RRiT�tiY SECTIOiV IV - BUSWESS �4UT0 CONDI�I�NS, B. t3e�erat Coe��itions, 7. PoOicy Peraod, Coverag�Territory is amended by adding th� fioflow:ng: We wifl pay those sums an "lnsured" ler�aily must pay as �amage because of "bodily injury" or "property damage" to which this insur�r�ce a�piies, caused k�y an "accident"which occurs oufiside fihe United Sta4es of America, the �erritaries and aasse�sions flr the United States of �merica, Puerta 4�ico and Canada r�sulfina from �he operation, n�iaint�nance, or use of any covered "auto" of the private passenger#ype yo�� lease, nire, renfi or borrow without a driver fo�30 days or fess. With respect to any claim made or "sui�" insfifuted autside the Unified States of America, tfie territories and possessions of the United States of,ym�rica, Pu�rto Rico and Canada: ��) You shall undertake the investigation, settiement and der'ense af such claims and "suits" ane� �Ceep us advised of ail proceedings and actions; (�� You wil! not make any ssttlement v�ithout our consent; and �3, We will reimburse you for: (a) fhe amount of damages because of liabi�ity imposed upon you by law an account of "'bodily injury"or"property damage"to v+�hich this policy applies; (b) all reasonable expenses incurred wi�t1� our consenf in cor�nection with the investigation, s�ttfement or defense of suc!-� ciaims or"sui4s"; and Our reimbursement obliga�ion for the sui�n ot afl clamages imposed on you and expenses incurred by you shall be limit�:d to the amount stated in ihe poli�y as the applicable limit of aur liabilify fior damages. MAP EE (06/12) 1=LORIQA Page 3 of 3 WO'RKERS COMPEN$ATION AND�EMPLOYERS LIABILITY INSURANCE�OUCY WC 00 p313 I WAIVER OF OUR RIGHT TO REC�VER FROM OTHERS ENDORSEMENT V1le have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the�3chedule. This agreement applies only to the extent�that you pertorm work under a written contract that requires you to obtain this agreement from us. This agreernent shall not operate directly or indirec�ly to benefit anyone not.named in the Schedule. � " SCHEDULE . ; Any person or organization for whom th�Named Insured has agreed by written contract to furnish#his waiver � i � � ; . � � i: � j , , . , " �: - , , • i , , ; . j � - , - . � . � � ,. . .. i: . . � �: , � . � . ' _ , � �� ' � '- � , Policy Effective � �� 02/147�7 Policy Expirafion "� 02/�4H8 ' � Carrier Code 39259 Endorsement Effective 02/14/�7 Policy Number �0654�09 Endorsemer�t No. 2 ' ' Insured HENDERSON IRRIGATION INC . � General Notes 1 Any work or items not specifically included are excluded. I 2 All work shall require an ORIGINAL signed and notarized N.O.C. (notice of commencement) 2 weeks prior to start date, and a minimum 3 working days (36 hrs) for locates, required by law, and permitting, before any digging shall occur. 3 Henderson Irrigation, Inc. and its Partners are not responsible for damages to unmarked water, electric, gas and/or other mechanical or underground utilities (including cable and conduit) and obstructions, including without limitation to existing sprinkler systems and utility lines on property, that are not included in locate provided by Sunshine 811. 4 Irrigation per plan or agreed upon written agreement. 5 All irrigation materials wiil carry a one (1) year warranty, does not cover acts of God, vandalism or damages caused by other. 6 Henderson lrrigation is not responsible for erosion resulting in uncovered or displaced pipe, heads or other components caused by raln, weather, or improper erosion control by others. 7 All Boundaries, property Ifnes, easements, common areas, future sidewalks, structures, future improvement that effect irrigation component placement, ect. Shall be marked by owner prior to start in related installation areas. 8 Henderson irrigation reserves the right to pass onto the Customer any additional actual costs it incurs if unusual or unanticipated ground conditions such as rock formations or other underground obstructions impede the installation contemplated under this contract, as well as additional labor hours due to improperly marked sleeves under crossin . 9 9 Henderson Irrigation and its partners are bound by local water restrictions which may in fact result in irreparable stress and or demise of landscape plant material and or turf. Henderson Irrigation and its partners can not be held responsible for long or short term drought related to stress, damage, or demise of landscape plant material and turt. 10 Henderson irrigation is not responsible for vandalism or theft of any installed or staged equipment or parts. li Clean up of site is limited to debris and waste created by our operations. 12 Payments for services are expected within 30 days of completion of job or phase (unless specified otherwise). 13 These notes become part of any contract or agreement entered into unless speciflc exceptions are made in writing stating otherwise, adding to or deleting from scope of work. 14 All sleeving, bores, crossing are to be located and marked by contractor prior to installation. Any additional labor/cost will be billed to contractor if not located/installed properly. 15 All water sources, meters, wells, pumps etc. are to in place and marked before install unless otherwise noted in the agreement prior to install. 16 This proposal and price is valid for 45 days from date of quote, prices subject to change after that. 17 Exclusions: Tree relocation, root pruning, barricades, pavers, asphalt cutting and patching, paving, fences, concrete work, curbing, tree wells, tree aeration systems, retaining walls, berms, drains and drainage systems, and other hardscapes items not specifically included are excluded. 18 Sod totals are approximate. Field measurements will be used at the close of the project to determine exact amounts used and then Qty to be adjusted accordingly. ' 19 Proposal does not include water source, electric to irrigation controller, well, conduit into building for wires, no jack and bores, patching, removal or replacement of asphalt, concrete or sub base. 2� Material without proper irrfgation will not be guarenteed. 21 Guarantee does not include replacement of material due to inclement weather, damaged and missing during warranty period. ZZ We must have access for heavy equipment into area where berms are to be built. Henderson Irrigation, Inc. cannot be responsible for berms intertering with or obstructing of existing right of ways, easements, buried utilities, etc. 23 Customer is solely responsible for all underground utilities and obstructions, including without limitation to existing sprinkler systems and utility lines. Henderson Irrigation, Inc. reserves the right to pass onto the Customer any additional actual costs it incurs if unusual or unanticipated ground conditions such as rock formations or other underground obstructions impede the installation contemplated under this contrect. 24 This proposal and price is valid for 45 days from date of quote, prlces subject to change after that. ' Page 2 of 3 � Z5 Removal of invasive, exotic species not in contract but can be done on a Time and Material basis. 26 All plants, trees, shrubs and sod is subject to availability throughout market, 27 Clean up of site is limited to debris and waste created by our operations. zg The Owner shall properly maintain all trees, plant materials and sod after final acceptance in order to maintain unobstructed visibility for pedestrians and vehicles. 29 These notes become part of any contract or agreement entered into unless specific exceptions are made in writing stating otherwise, adding to or deleting from scope of work. 30 Henderson Irrigation, Inc. is bound by local water restrictions which may in fact result in irreparable stress and or demise of landscape plant material and or turf. Henderson Irrigation, Inc. can not be held responsible for long or short term drought related to stress, damage, or demise of landscape plant material and turt. Page 3 of 3 . � ' City of Zephyrhills CONTRACTOR CERTIFICATE Requirements In order to be registered in our system we will need the below information: 1) State Certified License, OR �� 2) State Registered License with County Competency ''�^ � 3) Business TaY Receipt(formerly known as "Occupational License") 4) Worker's Compensation � 5) General Liability with the---**City of Zephyrhills as certificate holder*** 6) Fictitious Name (unless the business is LLC, DBA, Inc.) 7) Authorization Letter on your business stationery/notarized listing person or persons who are authorized to sign/pick up permits. 8) Address, Business phone and fax numbers 9) $30.00 charge for contractors who axe not Department of Professional Licensee. If you carry a Department of Professional License whether certificate or registered you will only need to supply items 1-8. Documents can be faxed to 813-780-0021 but will not become valid until all the above requirements are met. ***Certificate Holder Information City of Zephyrhills-Building Dept. 5335 8�' Street, Zephyrhills, FL 33542 Phone: 813-780-0020