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HomeMy WebLinkAbout19-21366 CITY OF ZEPHYRHILLS 5335-8TH STREET e, 2�1366 (813)780-0020 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION-" Permit Number: 21366 Address: 37943 EILAND BLVD Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD/ALT COMMERCIAL Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est.Value: Parcel Number: 03-26-21-0010-06400-0030 Improv. Cost: 52,750.00 OWNER INFORMATION Date Issued: 6/19/2019 Name: FEDJO REALTY CORP C/O CVS PHARMA Total Fees: 577.50 Address: ONE CVS DR Amount Paid: 577.50 WOONSOCKET, Rl. 02895-6146 Date Paid: 6/19/2019 Phone: (401)770-5784 Work Desc: RENOVATE PHARMACY GLR INC CONTRACTOR(S) BUILDING FEE APPLICATION FEES 397.50 RJ MARTIN NATIONAL CONTRACTING I ELECTRICAL FEE 112.50 RED CAP PLUMBING &AIR INC PLUMBING FEE 67.50 1 K^ Ins pectio s Reauired F TER 2ND ROUGH PLUMB MIS C INSULATION CEILING FOOTER BOND DUCTS INSULATED SEWER— misc. ROUGH ELECTRIC LINTEL misc misc. 1ST ROUGH PLUMB PRE-METER INSULATION WALL misc. DUCTS INSTALLED WATER misc DRIVEWAY PRE-SLAB SHEATHING misc. misc. CONSTRUCTION POLE FRAME misc. misc, 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 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 Plans,Specifications 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. CONTRACTOR SIGNATURE PERMIT OFFICOR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 0 c,�v City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: U Date Received: Site: Permit Type: Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ This co707 heet shall be kept with the permit and/or plans. P D 05 Kalvi 'Sw' r_—Plans Examiner Date Contractor and/or Homeowner (Required when comments are present) INSTR#20191032GS OR BK 9924 PG 3157 Page 1 of 1 06/18/2019 01:15 PM Rcpt:2064678 Rec:10.00 DS:0.00 IT:0.00 Paula S.O'Neil Ph.D., Pasco County Clerk&Comptroller Permit No. Parcel ID No NOTICE OF COMMENCEMENT fC',"L!/,�,, State o} 1�' County of - I ,.,.t THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property,and In accordance with Chapter 713,Flodde the following information is provided in this Nodes of Commencement /��t,,,,,. (�/✓ 1. Description of Property: Parcel Identification No.-02'a Street Address: 01g4 pj4WDsoT,rW�i�. 2. General Description of Improvement iN r�r'i'Gt , kgrk AAA e-leay 3. Owner Information or Li�e information N the Lessee contracted for the Improvement cto Q � Address Cily State Cry _ Interest In Property: I� TBntAr r W z U O F-" o 1.- Name of Fee Simple Titleholder � ��a !' fly,. (>G g QLLI � � 0- y If d�ifi nt from Owner listed above) dkl"f,e.. {ary,� A �Z N (L p Address y7N City vwY 1'lirLF 7�y� o O it Q Q O 4. Contractor. /� F- wILTYU U 374SN�"11VCP QA(�� 17a I,�• _ z = O o 06V Address (� �My'� /yam' C� State ® f~- W p Y Contractor'sTelephone No.: 9 � y"'-v�� 0 =O U p�W 5. Sursty: Q F F- -� Q cU Name ® >_ UMp U_ u- w =) Z OJ Address City state 0 of iY a ll > 1 tYtYL� = Q Amount of Bond: S Telephone No.: J WOO 0 O 8. Lender. LL. O Q Name O.H Z.0 U to Address city state w cn Q J w g wu_ z Lender's Telephone No.: Fa, _ � z f= Q } 7. Persons within the Stem of Florida designated by the owner upon whom notices or other documents may be served as provided by U ~ F-O � n- m Section 713.13(1)(e)(7),Florida Statutes: Name ®�. 'o Address city Stain ® 6( Telephone Number of Designated Person: 'tom 8. In addition to himself,the owner designates Of— to receive a copy of the Llenot's Notice as provided In Section 713.13(1)(b),Florida Statutes l� ®` Telephone Number of Person or Entity Designated by Owner. 8. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the contractor,but will be one year from the data of recording unless a different date Is specified): ��`�� a p • � ENT AREwCONSIDERED NG TO OWNER: IMPROPER PAYMENTS UNDER HAPTER 71�3,P ART 1,THE SECTION 713.3IRATION OF TMFLOR DAESTATUTES OF ,ANDMCAN s}$ RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICEr OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SiTE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WiTH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of per)ury,I declare that I hove read the foregoing notice of commencement en t the facts stated therein era true to the beat of my knowledge and belief. STATE OF FLORIDA COUNTY OF PASCO Signature of Owner or Lessee,or Owner's or Lessee's Authorized rpirector artner/Manager SI n tary's Titled The foregoing lnsbu nent was acknowledgedfarelne this b day of 20 1 AN C1 08 ortty,e.g., car,tnmtee,attomey in fact)for (ne t arty behalf of o I m ntwes executed). Personally Known Produced Identification❑ Notary Signature Type of Identification Produced Name(Print) TatnldLwyTP -- NotaN State of Rhode 15118rd 1 - t?1y Commission E1tpt wpdatEuWnoticewmmencement,pc053048 1-1.k-1.. ,,.,,y, y. UOLU. 1.oyu11aU vrraao,wrrbuucuun rranb,Owirnwater Trans wi mir rence insralleo, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects OMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten-(I )working days after submittal date. Required onsite, Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&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. �1-I..��I..f~I-I..LEI-1..(✓1-I.dL�1J-�1..4�1--�1-1--1--4.f--1-a-.f-1..�1..4�1-�1-4.f.�1--��f--1-1-4-��{..f-f~I--1--1-I..f-�f--1--1-1..4. Directions: Fill out application completely. Owner&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) Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW- 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department ,t •sue. ' .. 1 _,.L._; _ • 4 7 .� 1 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 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 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 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, Water/Wastewater 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 W" 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. 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 ATTIORNEY BEFORE RECORDING YOU5 NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S. 117.0 ) --- OWNER OR AGENT CONTRACTOR Sub cribed a r o G r r b e�this Subscribed and sworn to(or affirmed)before me this ��� f t= .. a/4�!_a__by by lit rl 2I2J( S Whdi r personally known o o�a"YI5-0&&Vtf Who is/are personally known to me or has/have produced as identification. as identification. i i �, NotarvPublic Notary Public om 'ssion No. Commission No. Taml-Lynn Whft Notary Public WySong Name of Notary typed,printedcRrPW ¢iode Island Name of Notary typed,printed or stamped My 09Mmission Expires:6/18/22 • '' '813-780.0020 City of Zephyrhills Permit Application Fax-e13-780-0021 (. Building Department Date Received --G _6y(-✓ ) 'G'r/ - l!�X`%'/ s Phone Contact for Permitting "i - 1 -7; A y Owner's Name (� r I� r+l'i Owner Phone Number "la j 7�©� 0 J e k �1��Gye MVVi�t1K11t1 Owner s Address /{ Owner Phone Number Fee Simple Titleholder Name !C/Y _pptmf't Owner Phone Number Fee Simple Titleholder Address ,}�}��t ,[��7 gVt��r�/r /J�pp f`+• iW� r/r� !IZ T/ JOB ADDRESS LOT If t SUBDIVISION PARCEL tD# i (OBTAINED FROM PROPERTY TAX NOTICE) ( WORK PROPOSED B NEW CONST'R 8 ADDlALT M SIGN Q O DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM OTHER tt� TYPE OF CONSTRUCTION ® BLOCK�} Q .{F�R�AMEE 0 STEEL Q t DESCRIPTION OF WORK �2�fWATe, C'/ rp ; trtqr•t[ k BUILDING SIZE i 10b90 SO FOOTAGE HT r T-rTr r rt t r r r rr r r r 1 r t e-t-7-t e t r !47 7 r!z-1 7 1-r'r ti 7R 7lrr'T'r-r 1 r•7-r r-r-�-rrr BUILDING s Poo VALUATION OF TOTAL CONSTRUCTION ®ELECTRICAL $ /�/ O AMP S�ERV19E 1- _' PROGRES ENERGY Q W.R.E.C. �. ®PLUMBING 1 QMECHANICAL $ VALUATION 01• !ECHANICAL INSTALLATION~,,•'' GAS ROOFING SPECIALTY ` t hog = [� OTHER l i(1 FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA t)xN =YES CO V° i.4» ._..�_._�. BUILDER COMPANY SIGNATURE r REGISTERED I YIN FEECURREh Y!N Address License# l ELECTRICIAN I COMPANY SIGNATURE 1 REGISTERED YIN FEE CURREN Y l N Address _ !!cerise# F � PLUMBER v f f COMPANY ED C. L1/ " t ltP4J SIGNATURE '" '"'.;:-' REGISTERED I Y/N I rEE CURREI, Y/N Address-I,-- t yr �' 'License# t F ""` F MECHANICAL COMPANY FEECURREN YtN I SIGNATURE REGISTERED YIN Address License# I # OTHER E „� COMSIGNATURE REGISTERED I Y!N FEE ruruu n L Y/N ii ! Address M _ License fit 13 i111tii111Elllltiilllitllililitllillilf11111111 'tI1111111111t1111'lll l RESIDENTIAL Attach(2)Pot Plans;(2)sets of Buildina Plans;(1)set of Energy Forms;R-O-W Permit for new Construction, 1 _ Minimum ten(10)working days after submittal date. Required onsite.Construction Plans,Stormwater Plans a/Sill Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivislonsllarge projects OMMERCIAL Attach(2)complete sets of Building Plans plus a LHo Safely Page;(1)sat of Energy Forms.R-O•W Permit for new construction. Minimum ten(io)working days after submittal date. Required onsile.Construction Plans,Stormwater Plans w!Silt Fence installed, { Sanitary Facilities&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. «i-i-4J•-i�t.J-i-M.i..l.-I.i-1h.1d-./-.1-.1-1.-1..1 i-i-1-1..16- Directmils: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A!C upgrades over$7600) Agent(tor the contractor)or Power of Attorney(tot the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW i I t i 813J80.0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department �y1 �qpJ s} Date Received 3 - Phone Contact for Permitting ( <f ` 9J� -(D rlo X MO/' Owner's Name t/Y✓�T�I/1t 71*f+v t r+�J Owner Phone Number 'tfl li/�7tti�l Owner's Address % '� J�pply!f Owner Phone Number Fee Simple Titleholder Name �tVY a wH Owner Phone Number Fee Simple Titleholder Address O�DDRE `r""�'n'r�t-� { W�jj&? !p`+� A "�C*FeW(Jrn A7-POW ` JS LOT# SUBDIVISION le PARCELIDd (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADDtALT r><l SIGN CJ = DEMOLISH e INSTALL 8 REPAIR PROPOSED USE = SFR = COMM P5< OTHER TYPE OF CONSTRUCTION [® BLOCK Q FR��AMMEEjy�G= STEEL DESCRIPTION OF WORK P-OVATe &fl+ 1 " BUILDING SIZE SO FOOTAGE � A.HEIGHT t. ;i . rr 1 art rr s rr-t r �y BUtLD1NG $ 'p(J�j VALUATION OF TOTAL CONSTRUCTION ©ELECTRICAL $ AMPS ERV7C '�_P___'tS51ENERGY Q W.R.E,C. ROGR PLUMBING S 1 10190 =MECHANICAL $ VALUATION O MCHANICAL INSTALLATION =GAS = ROOFING Q SPECIALTY OTHER R FINISHED FLOOR ELEVATIONS I-�- FLOOD ZONE AREA'AxH =YES NO 1 . . . . . . „•- - R- . . . �. . . . . . ILDER COMPANY J M SIGNATURE REGISTERED G R I! ' FEE CURREN Y/N Address 3'195 wyse Rd. Dajitn10N 4!&,' 4 Licensed CBGo59�iOCj-� ELECTRICIAN r COMPANY SIGNATURE REGISTERED I Y/N FEE Cuftftet, Y/N Address ) 1� License# PLUMBER ( COMPANY �^ SIGNATURE REGISTERED I Y/ N FEE CURREJ, Address I Licensed 1 MECHANICAL COMPANY SIGNATURE r REGISTERED Y/N FEE CURREN Y l N Address J License d OTHER COMPANY SIGNATURE l RFGisTER[n I Y! N FEE CURREN I YIN Address Licensed 1111111111111111111111111111111111111111111111111111111111111111111 � RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)Set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wf Silt Fence installed. Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsAarge projects ` OMM-RCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R•O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite.Construction Plans,Stormwaler Plans w/Silt Fence installed, Sanitary Facilities&I 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. -i--i i.i i{ i i-i r -- li Directions: Fill out application completely. t Owner&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 II on public roadways..needs ROW i E13.7e1YDD20 City of Zephyrhills Permit Application Fax-313.73D.OD21 ' Building Department •Dat%Recoived "'3 -l � , _� 6 !r/�/ Phone Contact for Permitting }( Ovrneh Nerilo VY%�r,�i/r/, ��,,r� �(�y�yy p Ownoi Phone Number -77Q�7�.i7 Owrior's Address E/<J�i✓r% pr vf,-,Apu'dr�"�"/"cur,r�'�' Owner Phono Number Fee Simple Titleholder Name r�/l� F'u'r Vl-1 Wl�l ' Owner.Phone Number �I Fee Simple nileholderAdddrrosss,},� "�i,�"n�-(I �/�-���f"�"Q"�}� JOB ADDRESS 'g1411V /`1/•fTlv�W """' f nn ✓ram `1 11 ,T11 SUBDIVISION th PARCELIOA t7 v ��°'f (OBTAINED FROM PROPERTY TAIL NOTICE) WORK PROPOSED e NEW CONSTRR ADDIALT SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR Q Comm OTHER TYPE OF CONSTRUCTION ® BLOCK G nn Q FRAMME = STEEL = DESCRIPTION OF WORKMM Pgovne, & BUILOINGSRE IO blv%1" SO FOOTAGE HEIGHT ®BUILDING VALUATION OF TOTAL CONSTRUCTION QELECTRICAL $ CJ lP AMP SERVr��I E i ROGRES FSIERGY ®PLUMBING �� ` =MECHANICAL VALUATION 0 1ECHANICAL INSTALLATION ' © � frt1f' =GAS = ROOFING = SPECIALTY= OTHER 11111� `� T 1U FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA M xH=YES NO ® "J BUILDER 3 �'COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y/N Address Q V1 Liicceenrseeq ELECTRICIAN ` COMPANY ,3 r1R49T IN 1711OIJ� CO SIGNATURE ! r REGISTERED Sic.N FEE DURRREA Y/N w Address 6 SIL IM _ �- 1y d License 0 G C e I M O� r PLUMBER COMPANY SIGNATURE REGISTERED Y!N FEE CURREN 'YIN Address I License a MECHANICAL COMPANY SIGNATURE REGISTERED I YIN FEECURREh Y!N Address License C OTHER COMPANY SIGNATURE REGISTERED I Y/N FEECURRr7. I Y I N Address License 0 IIIIIIIIIIIIIIIIItlllf'I IIltllllllltllllllllllltlllll111111111111111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Budding Plans;(1)set of Energy Forms;R-O•W Permit for new construction, Minimum ten(10)vmrldng days after submittal date.Required onsile,Construction Plans,Slammaler Plans w!Sit Fence installed, Sanitary FadEDas&1 dumpster,Site Work Permit for subdivisignsllarge projects OMMF1iCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten-CIO)working days after submitted date.Required onsite,Construction Plans,Stomlwater Plans w/Silt Fence Installed, Sanitary Facilities&1 dumpster.Site Wares Permit for all new projects.Ali commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. —PROPERTY SURVEY�rsqulred for all NEW construction. .&.4 --r-it. .... . ..I .....Lit 1 1 1' `1` OlrOCDame: FBI out application completely. Owner 3 Contractor sign back of application,notarized U over$2500,a Notice of Commencement is required. (AtC upgrades over$7590) 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 contrdcd required) Remofs if shingles Sewers Service Upgrades A!C Fences(PloYSunmy/Foolage) Driveways-Not over Counter 6 on public roadways-needs ROW 813-78"qO City of Zephyrhills Permit Application Fax-813-780-0021 Buildirig Department Date Re Phone Contact for Permitting ' "ZI Owner's Name Owner Phone Number Owner Phone Number Owner's Address J066V41.PPV-e,,- Fee Simple Titleholder Name Ow4ner Phone Number Foe Simple Titleholder Address 1 110 JOB ADDRESS 0 1,+/,y glow-VNPI I-Mm LOT P SUBDIVISION PARCEL ID# big g JOBTACNED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CON5rR ADD/ALT SIGN Q r .1 bEMOLISH R INSTALL REPAIR PROPOSED USE Q SFR Q COMM OTHER t TYPE OF CONSTRUCTION BLOCK 0FRAME STEEL L DESCRIPTION OF WORK Ww—vogTe, eXwiJ* rm n" t. 1040 4*BUILDING SIZE 110 SQ FOOTAGE HT [5Z)BUILDING VALUATION OF TOTAL CONSTRUCTION ©ELECTRICAL AMP SERV12E � tFSqENERGY Q W.R.E.C. ®PLUMBING 0 =MECHANICAL F VALUATION OF ANICAL INSTALLATION =GAS Q ROOFING Q SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA X" =YES NO 1 11-4-4 . . . . . . . . . . . . . . . . . . . . I ........... BUILDER COMPANY SIGNATURE REGISTEAW Y/ N FEE CURRrh Y/N Address License 4 ELECTRICIAN 6OMPANY F RE REGISTERED U2_N SIGNATURE _J FEE Wrikfih -F Y _N7 Address License PLUMBER Ln 4PANY 2K-�Jg ep COA SIGNATUREk,-" REGISTERED Y/N _114Y Adc Z 01:;Lire.se# rl( MECHANICAL COMPANY SIGNATURE REGISTERED I Y/N FEEGUnREA Lelk Address License# OTHER COMPANY SIGNATURE REGISTERS) Y N —'7ac—CVMEG- Address �rvLicense# RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans:(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsile.Construction Plans,Slormwater Plans w/Silt Fence Installed, Sanitary Facilities&I clumpster,Site Work Permit for subdivislonsfiarge projects OMMEWAD Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required oinsite.Construction Plans,Stormwater Planswl Silt Fence Installed, Sanitary Facilities&I clumpster.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. . . . . . . ii, - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Olrectionsi Fdf out application completely. Owner&Contractor sign back of application,notarized It over$2600,a Notice of Commencement is required. (A/C upgrades over$7600) 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) Reroofs if shingles Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW, s C� RObert Reid Wedding Reset / Audiology I ADA Scope of Work Nrnon.a Flarvr6M0.bC. CVS Store No. 0651 CVS Project 127501 Number Location 37943 Eiland Blvd, Project Type RXE City, State Zeph rhills, FL 33541 Cap Code 116) 63 Walk-Thru date October 3, 2018 Store Phone 813 788-0224 Attendees: Pat Malone CVS Senior Project Manager Rob Kantrowitz RRW Architects, Project Manager, Tampa GENERAL INFORMATION: CONTRACTOR TO PROVIDE/COORDINATE THE FOLLOWING: 1. CONSTRUCTION SUPERINTENDENT TO BE ON—SITE DURING ALL CONSTRUCTION ACTIVITIES. 2. PAY PERMIT FEE AND PROVIDE BUILDING DEPARTMENT WITH ALL PERTINENT INFORMATION AS REQUIRED, COORDINATE WITH AOR AS NECESSARY. OBTAIN SUB—PERMITS AS REQUIRED. 3. SECURE NECESSARY PERMITS, INCLUDING PERMIT(S) FOR STORE.SET—UP TRAILERS, PRIOR TO START OF CONSTRUCTION. 4. PROVIDE SUB—CONTRACTOR TRADES AS REQUIRED. 5. STORAGE TRAILER AND CONTAINERS ARE THE RESPONSIBILITY OF THE GC/STORE SET—UP MANAGER. 6. GC TO PROVIDE LIGHTING IN CONTAINERS FOR NIGHT TIME VISIBILITY. 7. COORDINATE LOCATION OF STORAGE CONTAINER AND DUMPSTER WITH STORE MANAGER. (NO ITEMS ARE TO BE LEFT IN THE BACKROOM). 8. OFFLOAD& PROPERLY STORE ALL CONSTRUCTION MATERIAL. 9. DEVELOP CONSTRUCTION TIMELINE AND PHASING PLAN WITH CVS CPM AND STORE OPERATIONS. STORE IS OPEN 24 HOURS. GC IS TO PROPOSE HOURLY SCHEDULE FOR CONSTRUCTION OVERNIGHT AND COORDINATE WITH CVS CPM. 10. PROPOSED WORK WILL BE COMPLETED OVERNIGHT AND DISCUSSED IN PRE—BID. FOLLOW SCHEDULING NIGHT WORK CRITERIA 2011 DOCUMENT. 11. PROVIDE DUMPSTER FOR ALL CONSTRUCTION DEBRIS, SECURE PERMIT IF REQUIRED. 12. COORDINATE ALL INSPECTIONS WITH THE COUNTY AS REQUIRED. 13. STORE PERSONNEL AND/OR STORE SETUP ARE RESPONSIBLE FOR ALL MERCHANDISE MOVES INCLUDING PHARMACY. 14. RELOCATE, LEVEL,AND STRAIGHTEN MERCHANDISING GONDOLAS/FIXTURES(ONLY IF GC HAS GONDOLA TRAIN). COORDINATE WITH STORE SETUP CREW LEAD. 15. PATCH AND REPAIR CARPET WITH THE RELOCATION OF ALL MERCHANDISING GONDOLAS. PATCH CARPET UNDER GONDOLAS AS NECESSARY TO AVOID TRIP HAZARDS. 16. FULL CARPET REPLACEMENT TO BE ORDERED AS DIRECTED BY CPM IN RETAIL ONLY. 17. NEW CARPET SCOPE OF WORK INCLUDES RETAIL, HALLWAY, PHOTO, CHECKOUT, DRIVE AISLE AND PHARMACY. 18. GC RESPONSIBLE FOR CARPET INSTALLATION IN THE PHARMACY,AND BEHIND CHECKOUT. VENDOR IS RESPONSIBLE FOR RETAIL AND INSTALLATION OF SOFT GRID AT ENTRY. 19. INSTALL FURRING STRIPS FOR WALL FIXTURES AS NEEDED. 20. COORDINATE AND INSTALL ALL COMMUNICATION WIRING(EAS, PHONES, POS). 21. COORDINATE BURGLAR AND FIRE ALARM RELOCATION/INSTALLATION WITH CVS ASSOCIATED PROTECTION SERVICES(APS) DEPARTMENT. 22. COORDINATE AND PAY FOR CCTV CAMERA RELOCATION. 23. REPAIR ALL BURNT OUT LAMPS AND BALLASTS IN PHARMACY. LIGHTING TO BE 100% OPERATIONAL UPON LEAVING. 24. CLEAN ALL AIR SUPPLY AND RETURN GRILLES AND CEILING PANELS IN PHARMACY. 25. RELOCATE EXISTING FIRE EXTINGUISHERS AS REQUIRED. 26. RELOCATE AND ADD CASH BOXES PER PLAN. 27. VERIFY EACH FIRE EXTINGUISHER HAS SIGNAGE IDENTIFYING LOCATION PER NFPA 1-SECTION 6.1.3. INSTALL NEW SIGN TO MATCH EXISTING IF SIGN IS MISSING. 28. GC IS RESPONSIBLE FOR CONTACTING JURISDICTION AND PROVIDE ACTUAL PERMITTING FEES INCLUSIVE IN BID. 29. GC'S TO INCLUDE IN THEIR BID QUALIFICATIONS ANY ADDENDUMS AND PRE-BID NOTES. PHARMACY EXPANSION SCOPE OF WORK PHARMACY- 1. EXISTING DIFFUSERS, CAMERAS,AND SPEAKERS TO REMAIN. 2. EXISTING LIGHT FIXTURES TO REMAIN. 3. EXISTING VALANCE TO REMAIN. 4. EXISTING PHARMACY CEILING GRID TO REMAIN. 5. EXISTING CEILING TILES TO REMAIN. 6. EXISTING PHARMACY CARPET TO REMAIN. 7. REMOVE EXISTING FILLMASTER. 8. REMOVE EXISTING WALLS AT PHARMACY AS SHOWN. PATCH AND REPAIR WALLS AS REQUIRED. 9. REMOVE (1) EXISTING QMI GRILLES&TRACKS. OTHER TO REMAIN. 10. REMOVE EXISTING 2'-8"PHARMACY DOOR&FRAME. 11. REMOVE EXISTING QMI WINDOW. 12. REMOVE EXISTING 9'-6"Q.A.WORKBENCH. SAVE WAITING SCRIPT FOR RELOCATION. SAVE VIAL 13. DRAWERS FOR RELOCATION. RELOCATE EQUIPMENT. 14. REMOVE EXISTING 10'-10"PRODUCTION STATION. SAVE WAITING SCRIPT AND VIAL DRAWERS FOR RELOCATION. RELOCATE EQUIPMENT. 15. RELOCATE EXISTING POWER POLES. 16. REMOVE EXISTING 11'-4" PICK-UP (CHECKOUT). SAVE (3) POS REGISTERS, EAS PADS AND CREDIT CARD READERS FOR RELOCATION. 17. RELOCATE EXISTING CONSULTATION, DROP-OFF, &PICK-UP HANGING GRAPHICS AS REQUIRED. 18. REMOVE&RETAIN EXISTING UNIWEB SHELVING AS SHOWN. SAVE FOR RELOCATION (MOST SHELVING TO REMAIN). 19. RELOCATE EXISTING TALL STANDING RX SAFE. 20. REMOVE&RETAIN ALL EXISTING EQUIPMENT AS SHOWN. SAVE FOR RELOCATION (MOST EQUIPMENT TO REMAIN). 4112 W. Cypress Street,Tampa, Florida 33607 2 813.879.6996 fax 813.871.5203 21. REMOVE AND RETAIN EXISTING FIRE EXTINGUISHER. SAVE FOR RELOCATION. 22. REMOVE AND RETAIN EXISTING QMI GRILL SWITCHES. SAVE FOR RELOCATION. 23. REMOVE&RETAIN (2) EXISTING LARGE SAFE. SAVE FOR RELOCATION. 24. REMOVE AND RETAIN EXISTING FAST MOVERS. SAVE FOR RELOCATION. 25. REMOVE FREEZER. 26. REMOVE SHELVING BEHIND (2) EXISTING REFRIGERATORS AND SHIFT REFRIGERATORS TO WALL. 27. EXISTING DT WORKBENCH TO REMAIN. REPAIR(2) EXISTING HALF DOORS AND LAMINATE. 28. INSTALL NEW WALLS AS SHOWN. SOME EXISTING WALLS TO REMAIN. 29. INSTALL NEW SECTIONS OF VALANCE AS SHOWN. 30. INSTALL NEW&RELOCATE UNIWEB SHELVING, SPACERS&TRIM. 31. REINSTALL EXISTING AND INSTALL NEW FAST MOVER UNIWEB SHELVING AS SHOWN. 32. INSTALL(2) NEW 4'-0" UNIWEB SHELVING. 33. INSTALL NEW 15'4'BAGWELL CHECKOUTS WITH 4'-0"ADA SECTION. USE PROTOTYPE COLORS. 34. REINSTALL(3) EXISTING EAS SYSTEMS AT CHECKOUT COUNTERS. INSTALL(1) NEW EAS PAD. 35. REINSTALL(3) EXISTING AND(1) NEW PHARMACY POS REGISTERS,AND CREDIT CARD READERS. 36. INSTALL NEW T-0" DOOR&FRAME. 37. INSTALL(1) NEW QMI GRILLE. 38. INSTALL SLIDES ON BOTTOM (2)SHELVES BY QMI 39. INSTALL NEW FILLER COUNTERTOP PIECES AS SHOWN. 40. RELOCATE ALL NEOWARE BOXES WITH THE COMPUTER MONITORS AS REQUIRED. 41. INSTALL NEW UNIWEB 12'-2"QA STATION&UNIWEB WITH WAITING SCRIPT BASKETS (54" HIGH)AS SHOWN, USE PROTOTYPE COLORS. 42. INSTALL NEW UNIWEB 12'-2" PRODUCTION STATION & UNIWEB WITH WAITING SCRIPT BASKETS (54" HIGH)AS SHOWN, USE PROTOTYPE COLORS. 43. RELOCATE EXISTING AND INSTALL NEW VIAL DRAWERS AND WAITING SCRIPTS AS SHOWN. 44. RELOCATE LATCH ON EXISTING GATE AND REPAIR DOOR CLOSER. 45. RELOCATE EXISTING PHOTO FRAMES AND LICENSE FRAME TO NEW WALL. 46. REPURPOSE(1) EXISTING AND INSTALL(1) NEW(84" HIGH)WAITING SCRIPTS WITH 12" BASE DECKS. 47. REINSTALL EXISTING (2) LARGE SAFE AT QA STATION. 48. INSTALL(2) NEW UNDERCOUNTER DOORS WHERE LARGE SAFE WAS REMOVED. 49. REINSTALL EXISTING TALL STANDING RX SAFE AT WAITING SCRIPTS. 50. REINSTALL EXISTING AND INSTALL NEW FREE STANDING WAITING SCRIPTS AND FAST MOVERS AS SHOWN. 51. REINSTALL EXISTING FIRE EXTINGUISHER. 52. INSTALL NEW FILLMASTER. 53. INSTALL NEW PIN LETTERS. 54. REPLACE ALL WASTE RECEPTACLES WITH NEW SLIMLINE MODELS. 55. INSTALL NEW FFR WAITING BIN PRIVACY. 56. REINSTALL ACROBINS. 57. REINSTALL COMPUTERS, PRINTERS AND EQUIPMENT. 58. INSTALL(1) NEW COMPUTER WORKSTATION AT PRODUCTION WORKBENCH. 59. INSTALL NEW LOW VOLTAGE CABLING FOR IT SYSTEM AS REQUIRED. 60. INSTALL ADDITIONAL CUSHION-BACKED CARPET TILE AT PHARMACY AS REQUIRED WITH NEW BENCHES AND RELOCATED SHELVING AND NEW WALL LOCATIONS. INSTALL NEW VINYL BASE AS REQUIRED. 61. REINSTALL EXISTING DROP-OFF, PICKUP, CONSULTATION SIGNS AS REQUIRED. 4112 W. Cypress Street, Tampa, Florida 33607 3 813.879.6996 fax 813.871.5203 62. PHARMACY TO BE PAINTED BM 779 FAIRVIEW BLUE, PT-23. SEE FINISH PLAN AND ELEVATIONS. 63. RELOCATE EXISTING UNIWEB POWER POLES AS SHOWN. 64. EXTEND CEILING GRID AS REQUIRED AT NEW WALL LOCATIONS. 65. RELOCATE EXISTING LIGHT FIXTURES AS REQUIRED AND INSTALL COOL BULBS THROUGHOUT. 66. INSTALL NEW CEILING TILES TO MATCH EXISTING AS REQUIRED. 67. REPLACE DAMAGED CEILING TILES AS REQUIRED. 68. CLEAN EXISTING AIR DUCT SUPPLY AND RETURN GRILLES. 69. REINSTALL EXISTING QMI GRILLE SWITCHES. 70. PATCH/REPAIR/PAINT WALLS, CARPET, &CEILING AS NEEDED. 71. CAMERA RELOCATION (CCTV) BY CVS LOSS PREVENTION REPRESENTATIVES; GC TO COORDINATE. 72. GC TO COORDINATE CAMERA POSITION WITH LP/AFA(CPM TO INVESTIGATE NEW CAMERA SYSTEM WITH LP AS AN UPGRADE TO EXISTING). 73. HVAC IN PHARMACY TO BE EVALUATED THRU CVS HVAC ASSESSMENT PROGRAM AFTER THE RENOVATION. HALLWAY: 1. RELOCATE EXISTING BLOOD PRESSURE MACHINE IN HALLWAY. PROVIDE POWER AS REQUIRED. 2. RELOCATE MEDICAL DISPOSAL BOX AS REQUIRED. 3. PATCH CARPET AS REQUIRED. 4. REMOVE PORTION OF EXISTING CEILING GRID&CEILING TILES AS REQUIRED WITH NEW PHARMACY WALLS. 5. RELOCATE EXISTING SUPPLY GRILL WITH INSTALLATION OF NEW PHARMACY WALLS. 6. PATCH, REPAIR AND PAINT WALLS AND VALANCE TO MATCH EXISTING AS REQUIRED. RETAIL: 1. ,PAINT PHARMACY VALANCE&TRIM ON RETAIL SIDE RUBY RED, PT24. PAINT UNDERSIDE OF VALANCE RUBY RED, PT24 AS REQUIRED. 2. RELOCATE BIR PIN LETTERS AS REQUIRED. 3. PATCH DRIVE-AISLE CARPET AS REQUIRED. 4. INSTALL NEW VINYL BASE AT NEW WALLS AT PHARMACY ON RETAIL SIDE. 5. RE-ADJUST MERCHANDISE/MERCHANDISE FIXTURES IN FRONT OF RXAS REQUIRED. 6. RELOCATE, LEVEL,AND STRAIGHTEN MERCHANDISING GONDOLAS/FIXTURES PER LATEST MERCHANDISE PLAN. 7. PATCH AND REPAIR CARPET WITH THE RELOCATION OF ALL MERCHANDISING GONDOLAS. PATCH CARPET UNDER GONDOLAS AS NECESSARY TO AVOID TRIP HAZARDS. ADDITIONALJOUTSTANDING ITEMS: N/A PERMITTING APPLICATION: BY ARCHITECT Key Dates below are based on the MS Server Update dated 10/04/18: Plans & NAI Bid Form Post Date 10/29/18 4112 W. Cypress Street, Tampa, Florida 33607 4 813.879.6996 fax 813.871.5203 Merchandising Start Date 06/10/19 Construction Start Date 06/17/19 In-Service Date 07/12/19 Prepared by RRW Architects 10-04-18 Prepared I 4112 W. Cypress Street, Tampa, Florida 33607 5 813.879.6996 fax 813.871.5203 CVS Pharmacy One CVS Drive Woonsocket, RI 02895 November 2, 2018 Building Official City of Zephyrhills Planning Department 5335 8th Street Zephyrhills, FL 33542 813-780-0020 RE: CVS Store#651 —37943 Eiland Boulevard, Zephyrhills, Florida 33542 PID#03-26-21-0010-06400-0030 I Dear Planning Official: I, MATT &WA of CVS Pharmacy certify that I am an authorized representative for CVS Pharmacy, the Lease Tenant of the property described above. I hereby authorize the firm of Robert Reid Wedding Architects and Planners, AIA, Inc. (Ashlee Basey, project coordinator) to act as Agent for the plans review process for Construction Documents related to the interior renovation of the existing pharmacy. Should you have any questions, please do not hesitate to contact me at 401-770-5635. Sincerely, CVS Pharmacy STATE OF RHODE ISLAND COUNTY O &*1flC-1L Sworn to an subscribed before me this day of 2018 by ( Personally known to me ( ) Produced Identification Type of Identification: A) ID E ATH&(u-J-DID NOT TAKE OATH — tate d My Commission Expires Tami•Lynn WhIte' Notary Public A State o4 Rhode Island _ P",l Commission Expires:6/18122 - 1= GLR, Inc. 3795 Wyse Rd Dayton, Ohio 45414 November 30, 2018 Building Official City of Zephyrhills Planning Department 5335 8" Street Zephyrhills, FL 33542 813-780-0020 RE: CVS Store#651 —37943 Eiland Boulevard, Zephyrhills, Florida 33542 PI D#03-26-21-0010-06400-0030 Dear Planning Official: I, Heath 'Q2.ketrs of GLR, Inc., General Contractors hereby authorize the firm of Robert Reid Wedding Architects and Planners, AIA, Inc. (Ashlee Basey, project coordinator/Susan Bradley, project manager) to act as Agent(s)for GLR, Inc. General Contractors, for the plans review submittal process for Construction Documents related to the interior renovation of the existing pharmacy. Should you have any questions, please do not hesitate to contact me at 937-890-0510. Sincerely, G ---- Hea W. Peters STATE OF—�Z cp COUNTY OF Manio►om2�l Sworn to and subscribed before me this 4 day of 'Necemb4W 12018 b Heath Pettxs y(WPersonally known to me ( ) Produced Identification Type of Identification: 0 T9��-o��, ( ) DID TAKE OATH ( ) DID NOT TAKE OATH Notary Public— ate deb-I.—d My Commission Expires ''���o*�H`IO��EXP�FE5�9�``� 2018076829 0 RELEASE OF LIEN UPON REAL PROPERTY FOR SERVICES (Weeds, trash,mowing, etc.) Rcpt:1954959 Rec: 10.00 Owner: Nick Holquin, Jr. and Richard A. Dilly DS: 0.00 I T: 0.00 05/07/2018 K. R. M. , Dpty Clerk KNOW ALL MEN BY THESE PRESENTS, That the City of Zephyrhills, a municipal corporation, organized and existing under the laws of the State of Florida, in consideration of Ten Dollars and O.V.C., hereby on this lst day of May, 2018,releases from the Lien of Real Property for Services (Grass Mowing), in the principal amount of$120.00, recorded October 24, 2007 in O.R. Book 7669, Page 1991, Public Records of Pasco County, Florida, the real property in that county described as follows: Lands described in said Lien Upon Real Property for Services PAULA S.0'NEIL,Ph.D.PASC0 CLERK a COPJPTROLLER (Grass Mowing) 05/07/2018 01:19 m 1 of 1 OR BK 9726 PG -3020 EXECUTED this 1st day of May, A.D., 2018. .p.V ` ' • STEVEN F. SPINA City Manager ILLMAN, City Clerk . t'Q��z'Nja'I'.Y�•" STATE OF FLORIDA COUNTY OF PASCO The foregoing instrument was acknowledged before me this I"day of May, 2018,by Steven F. Spina, City Manager, who is personally known to me and who Aid not take an oath. Seal/Expiration: /air/ Uh �Wf NOTARY PUBLIC 11 �� Commission# I('S S I C0� v- l+ff •'«':�P�'' JESSICACARTER Print, Type, or Stamp Name MY COMMISSION#GG 016467 "• o`= EXPIRES:July28,2020 '••;oF Fro•'Sonded ThN Notary Pubk Undemitem Record and Return to: City Clerk's Office 5335 8th Street Zephyrhills, FL 33542