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HomeMy WebLinkAbout20-22544 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 22544 BUILDING PERMIT Permit Number: 22544 Address: 6512 GALL BLVD Permit Type: SIGN ZEPHYRHILLS, FL. Class of Work: WALL SIGN Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02-26-21-001A-00000-0010 Improv. Cost: 2,400.00 Date Issued: 9/25/2020 Name: RADIANT GROUP LLC Total Fees: 225.00 Address: 6512 GALL BLVD Amount Paid: 225.00 ZEPHYRHILLS, FL. 33542 Date Paid: 9/25/2020 Phone: (813)247-4731 Work Desc: INSTALLATION WALL SIGN W/ ELECTRIC (reinstate x1) --A R-MMT ..... IC ,T-JON WESWNIMP .Ndl Mt DIXIE SIGNSJNC, SIGN 82.50 DIXIE SIGNSJNC, ELECTRICAL FEE 67.50 SIGN 75.00 c. 'i eIre & FOTER ELECTRICAL ROUGH FINAL REINSPECTION FEES: (c)With respect to Reinspectlon 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. ,ONTFCACTOR SIGNATURE PERMIT OFFItYR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS 5335-EITH STREET (813)780-0020 22544 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 22544 Address: 6512 GALL BLVD Permit Type: SIGN ZEPHYRHILLS, FL. Class of Work: WALL SIGN Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est.Value: Parcel Number: 02-26-21-001A-00000-0010 Improv. Cost: 2,400.00 OWNER INFORMATION Date Issued: 3/02/2020 Name: RADIANT GROUP LLC Total Fees: 150.00 Address: 6512 GALL BLVD Amount Paid: 150.00 ZEPHYRHILLS, FL. 33542 Date Paid: 3/02/2020 Phone: (813)247-4731 Work Desc: INSTALLATION WALL SIGN W/ ELECTRIC CONTRACTOR(S) APPLICATION FEES DIXIE SIGNSJNC, SIGN 82.50 DIXIE SIGNSJNC, ELECTRICAL FEE 67.50 FOUTER Ins pectio s Required ELECTRICAL ROUGH 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 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 OFFICZR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-7E0-0020 City of Zephyrhills Permit Application Fax-813-780-0021 -, Building Department Date-Received 1 Phone Contact for Perm ( s itting -- ' # 1111It Owner's Name Radiant:Group LLC Owner Phone Number: _ Owner's Address 1320 East 9th Ave, Tampa, FL Owner Phone Number Fee Simple Titleholder Name Owner Phone:Number Fee Simple Titleholder Address JOB ADDRESS 6216 Gall Blvd LOT# . SUBDIVISION PARCEL ID# .02-26-21-001A-00000-0010 :(OBTAINED'FROM PROPERTY TAX NOTICE)': WORK-PROPOSED e NEWCONSTR= ADD/ALT 0 SIGN. ®'.' _ DEMOLISH INSTALL REPAIR . PROPOSED USE_ Q. SFR 0 COMM OTHER; TYPE OF CONSTRUCTION BLOCK 0 FRAME = STEEL DESCRIPTION OF WORK' Install Wall Sign to building front �. (_ ... . . .... _-. BUILDING SI ZE 88.66' SQ FOOTAGE " HEIGHT 20.16 =BUILDING $ 2300 VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL_ $ AMP,SERVICE- _ PROGRESS ENERGY = W.R.E.C. 1.00 =PLUMBING $ _ =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION - - y(,� 1 =GAS ROOFING 0 SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE:AREA =YES NO BUILDER COMPANY Dixie Signs Inc. . 22-- SIGNATURE REGISTERED. Y/N FEE CURREN Address 2930 D'ane:Field Lakeland FL eS0000073 License.# , ELECTRICIAN .��-� COMPANY Dixie Signs'Inc SIGNATURE REGISTERED Y/N FEE CURREN Y/N Address 293 Drane Fie Rd, Lakeland, FL 33811. . License# es0000on: . PLUMBER COMPANY . SIGNATURE REGISTERED : _ Y/N : FEE CURREN _ Y/N Address _ License# : MECHANICALF7 COMPANY SIGNATURE: REGISTERED Y/N - ..: FEE CURREN Address License# OTHER: COMPANY _.. .: SIGNATURE REGISTERED Y/N FEE CURREN Address License# --1 1E 4 f 1-4 1 1% . : ..I 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 w/Silt Fence installed, Sanitary Facilities&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-O-W Perm- new construction. .:... Minimum ten(10)working days after submittal date.'Required onsite,Construction Plans,.Storinwater 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. .: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 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€kisting 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, 1 UastewaterTreatment, 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 Abi ATTORNEYO C DINQ YOUR NQTICE OF COMMENQJ9MENT., FLORIDA JURAT(F.S..117.03) OWNER OR AGENT CONTRACTOR Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to affirmed)b o me this by r 0 t- by Who is/are personally known to me or has/have produced 'Who it/ a y nown f o as/have Oduced as identification. as identification. Notary Public I Notary Public Commission No. Commissi l� Name of Notary typed,printed or stamped Name o otary typed,printed or stampe Rig State of Florida manon GG 91sms /2023 To Whom-It May Concern: This is to give Dixie Signs, Inc. permission to obtain Permits and erect sign(s) located at: 6512-Gall Blvd,.Zephyrhills. Property ID#02-26-21-001A-00000-0010 .. . w . Owned by::Radiant Group,.LLC . Owners address: 1320 East 9 h Ave,Tampa; FL 33605. Owners Phone#: Sincerely, i ax\ � N e Title Date use (4, KC_)11X.. Print or e Namel STATE OF FLORIDA, COUNTY.OF O rCUI M)` The foregoing instrument was,acknowledged before me this l��h day of Jan Ua 1 20Z0 ,by h (A��7 �� ,who is personally known to me or wh had produced as identification and who did take an oath. Notary Public RENEE E RALEY. Notary Public-State of:iorida. �s ` •s Commission=GG 146CSO My commission expires: 9yf._ ",• My Comm.Expires Dec15,2021 Bonded through hatioral hotaryAssr.. (Printed;typed or stamped—commissioned name of notary) DIXIE SIGNS. 1 N C C:> :R. P 2930-DRANE FIELD ROAD • LAKELAND, FL 33811 •-(863) 644-3521 ' F_AX(863) 644-3524 qs To Whom It May:Concem: Please be advised.that I Roger A Snyder; qualifier,for Dixie Signs=Inc..do hereby grant permission for: p� Gif4 and Sarah Abichid:of Dixie Signs Inc to pull permits in' � Their respective' signatures are.as follows: . ry� ... . . . . . . . . gnature Printed Name.: ignatu. Printed-Name Signature : Printed-Name Qualifi ` s Signatu Print Name State'Of Florida County Of -Sworn to scrib beck ore me byd4-w is.p.: ",thisday '-. me or prod d . . .. as identificati of j19 Nota ignature, Notary Public State of Florida : o H Ily M Lowman My Commission GG 915946 (Print, Type or Stamp Commissioned °"` 2/14/2020 Gary Joiner 02-26-21-001 A-00000-001 C X Q, Show search results for 02—... # 4 �.a <'reh 7 ZEPVIYRHILLS E%ECl(TWE PARK y i w4 I * PF i �• �` .. _ LE LS COLONY tjEEEjT =z �aa1� J a.- ..♦ Y i s-' f _ maps.pascopa.com/?find=02-26-21-001A-00000-0010 • 1/1 All TTII^Mr� APEC. J ... . Job Name: TTi,urtltstt. ' NA® NALCTR C( CO WING COD .. FLOR 13 Job Adt#ress AND THE 0W.OF ZEPHYRHILLS t ferO_q Dartl�tft ORDINANCES:` � " � .Job#: QJD34 r DDrt n ORQ1N r New Kmatr Et Yl r,r Dates t'3s1 Wt 23 . Fi PLT!'Ftles1201& 1 i G1 �'vRRESS, ' S{rtalI1AP „ �trta'Ef1oEAt€rg7h'tts�ts��''1- oD 6 : I '- '' 9'''t.•., - �I€1g ik'l�R3}arl3fl L'X#rf.��.�i I. r.' 1.. .a I 4 i W , {{I +C'�i I: SSj I� •� � � € � 9 ''i .. '��^,i ,'i I - I ,i rl .. .. .. .. .. i'I Bui 161. I R SheetlNo" ;',< I 1 P I td aidPMn { �� �' r•. Sete_NTS l— s• I I i I: i.: I dS101�rS I E i i' ,:- i I r f € I ti 3' 1 I I I I i€ I,I s 3. y�`f,� ^.y S I.i' i3 «M. - 'ii''.• "Y; 'x',t:r; - - i�.i'S']YU�L.'�r'.'tr g`• . A vY.r, _ AM '+ice• .� .. arX3i:i53 tDT, Front Building,Elevation ��fp $� q �(g P�ot�a�sfing Ccarldi#a©t� Cabins#: ul inumextrus€ JMth 71%a �e Iaers. � t�M'0M 2 .. .. _-- --——--------- —-;I: dace; Paris forined WhRe acrylic � G L _ _ a�ifi�����rla�a�tplied digifally�. i printed and lavin!ated graphics. f.igfafilig: Inter qUy 9Its€rrindled Varies ,I. �TMri��,�tife CDs. '�•: _, I'I Colors: �� E PMS200 Red.Yellow&€lack I -Q "All electrical components will be UL Footage: = u listed and approved as per 2014NEC 600:3. . r— "� and,marked as per NEC 600.4 the �► �dslin Dunkin DdnUls: installation of the wiring will be done as 293D:Deaate F"t�Rd. per FBC 4505.4 and designed to UL 48.All T-4 .k T-T = 25.67 sf. Lakefastd•FL 33811 signs are to be grounded and bonded per New M garoo Express: 863.644-3521 lax' _3525 co 600.7 and 50.122, wiring side letters aatw�rd'uciescgr ¢s� area 0 7 n 2 AII wEr m tt ! will be hi h.tension GTO per UL sin $'X 7`-( = 4�:5$Sf' � 0 :. Srgta is I6�w1re�,acid fr 9 . p 9 o accessories manual(sam)E242084. NOME—aWSISA*tDRMNAL d UL ag,� i a Total 75.25 Sf Primary electrical source to be supplied b (:�:�Bt3S'�ADRfiat`.6'G Qd'a S�aTs,Ina � customer to within six(T)of sign.All Y ��Oi� f Sf per��Of�U#�t�Fll `�BYGMESIOZ QC_ If4 E733a'44 - primary wiring will be#12THWN:This sign �' 9 ES SUE:=`==%TEED FORY4a R " will be built and installed in compliance SfrrIBX) PFR�rUSE aCis�crst� -- �'�• .. A.Cr :F3GI� fhHrS,� with NEC article 600 UL 48 and FBC" Fim.dt]EDr03t Y0i16k'Oa(tt = SMS=C.THIS DRAMIG IS NOT. (�a7zsft7�a�ECIdLC C�D� S ���1(�EY[E[t�t@d��i� Sign . . Sigh u oNECSESt:awNTOANYME i n Grounding is compliant with N C 600.3 ' u g. . . . . , OUTz�YOUR ram.MIZATION, Scale:l le=1'-f� e • • • • s • • . - • • • • ' NOR IS IT TO BE USEt3; - I HAVE REVIEWED.THE ABOVE SPECIFICATIONS.,FIJEEY UNDERSTAND THE WORK TO BE PERFORMED;AND HEREBY;AUTHORIZE THIS PROJECT TO BEGIN. REPRODUCED.COPED OR . ❑_Q �,N�eaaAti6E8 ❑DK to p ,a�NO CKAN�Es ExaEra3I T O M MY FASHOT. CLIENTAPPROVAL: DATE. d B LANDLORD APPROVAL: DATE: P p. ❑lu'a +xq. a,.9 SHOW ACt07Hr'"'ta PROOF ❑ktemcee@a3ag.sar4Sti0IMNIO-I HER PROOF : 4'�iTaaD4tiW.idPT�fl9F�R@tlSS44?a SIGNED: SIGNED: $€ ti• ❑ONC Cm Rn e�ed'A NOTED CiiR GES ❑OK to pureed with NOTE€?CHANGES FRO�tD9.Y€£ GNS€N^ - TOGBORN DIXISIG 01. DATE(MMIDDIY.YYY) AaRD`.. CERTIFICATE OF LIABILITY INSURANCE �.��.-✓ 12/23/2019 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 have ADDITIONAL INSURED.provisions or 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 CONTACT :. Snellings"Walters Insurance Agency PHONE 77 Fax 1117.Perimeter Center West (AIC,.No,.Ext:{ 0)396-960Q.: Arc;No:(770)399-9886 E-MAIL— Suite W101 ADDRESS: Atlanta,GA..30338 INSURERS AFFORDING COVERAGE - NAtC# INSURERA:The Charter Oak Fire Insurance Co. 25615 wsuRE6:' INSURER B:The Phoenix Insurance Company 25623 INSURER c:Travelers Property Casualty Company of Afnerica 25674 Dixie Signs,Inc. INSURER D:Brid efield Em to e'rs Insurance Companv 1070- INSURER E: " - .. INSURERF: "' 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.: INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR _ INSD WVD M /DD/YYY MM/D /YYY A X COMMERCIAL EACH OCCURRENCE $GENERAL LIABILITY -1,000,000 . RENc ED $nce CLAIMS-MADE a'OCCUR 630-9M767560 1/1/2020 1/1/2021' 'DAMAGE REMI .S TOEa o T 300,000 � MED EXP(Any one p erson $ 6J',000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:: :..' GENERAL AGGREGATE $ X POLICYI X JE O X LOC PRODUCTS-COMP/OP AGG. $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE OBINEDSINGLE LIMIT $ 1,000,000 accident), X ANY-AUTO 810-9M763597-20 1/112020, 1/1/2021 BODILY INJURY PerPerson) $ OWNED SCHEDULED AUTOS ONLY AUTOS - -BODILY INJURY Per accident $ X HIRED X NON-OWNED PPe°aca I)IAMAGE :- $ AUTOS ONLY - AUTOS ONLY $ C X, UMBREL_A UAB X ,OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE CUP-9M768913-20 1/1/2020 1/1/2021 AGGREGATE $ 5,000,000 . ..DED. X RETENTION$ 10,000 $ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY - " T T TE ER t N 83022687- 1/1/2020' 1/112021 600,000 ANY PROPRIETOR/PARTNER/EXECUTIVE .Y E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? a NIA (Mandatory in NH) 'E.L.DISEASE-EA EMPLOYEE $ 600,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.C.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES'(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF.THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City ofZe h rhilis Attn:Building Department THE EXPIRATION -DATE THEREOF, NOTICE WILL BE DELIVERED.IN tY P Y 9 P ACCORDANCE WITH-THE POLICY PROVISIONS. 5335 8th Street Zephyrhills;FL 33542-4312 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD