Loading...
HomeMy WebLinkAbout20-350 ►��������� - City Of Zephyrhilis PERMIT NUMBER 5335 Eighth Street Zephyrhills, FL 33542 BGR-000350-2020 Phone: (813)780-0020 Fax: (813)780-0021 Issue Date: 07/08/2020 � rr Permit Type: Building General (Residential) Property Number Street Address 02 26 210080 00200 0340 6125 10Th Street Owner Information Permit Information Contractor Information Name: ALFONSO HERNANDEZ Permit Type:Building General(Residential) Contractor:ACREE AIR CONDITIONING Class of Work:HVAC Changeout INC Address: 6125 10Th St Building Valuation:$0.00 ZEPHYRHILLS,FL 33542 Electrical Valuation:$0.00 Phone: (813)317-1336 Mechanical Valuation:$7,412.00 Plumbing Valuation:$0.00 Total Valuation:$7,412.00 Total Fees:$77.06 Amount Paid:$77.06 Date Paid:7/8/2020 12:48:43PM /L Project Description A/C CHANGE OUT 3 TON Application Fees Mechanical Permit Fee $77.06 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 subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit 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 add fee 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. 61z" Joo;tl CONTRACTOR SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Ole $So -7 s1317sa-ao2a City of Zephyrhills Permit ApplicatioT � �7 f Fax-813-780-0021 Building Department Date Received r7 Phone Contact for Permitting tr Owner's Name 4 L ��r�� � l_ Owner Phone Number (�1 )— j�\S31� Owner's Address Owner,Phane Number Fee Simple Titleholder Name Owner Phone Number �. Fee Simple Titleholder Address y JOB ADDRESS 1 �' i L LOT# SUBDIVISION PARCEL ID# )- i\ CL2QC)_,�`l 0 6 {OBTAINED FROM PROPERTY[TAX NOTICE) WORK PROPOSED R NEW CONSTR e ADD/ALT SIGN Q MOVE Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM Q OTHER TYPE OF CONSTRUCTION BLOCK (r Q FRAME STEEL Q OTHER DESCRIPTION OF WORK �'C� O 0� \LP �C 1 �Y�l{1 � <<1 C�OS{-� BUILDING SIZE F SQ FOOTAGE —� HEIGHT 0 BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION I Q ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. 0 PLUMBING 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION Q GAS Q ROOFING SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES QNO i BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRENT Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRENT Address License# �— i PLUMBER COMPANY SIGNATURE REGISTERED L_Y/ 11._j FEE CURRENT Address I � License# 1i � MECHANICAL \ j �— COMPANY Ion'11'�an Ln I r SIGNATURE v ✓ter �� REGISTERED I Y/ N I FEE CURRENT I Y!,N Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRENT _ _Address _ _ _License# i 1 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms I Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach(2)sets of Engineered Plans. i ****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$5000) I ** 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 (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW ! 7 j 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 fora 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—Lice,sing 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 b� 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-haveobtained 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 not 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 i 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 includelbut 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. 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,Ifor 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 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S1. 117.03) OWNER OR AGENT V�1 CONTRACTOR ub Its by and sworn to(or armed)be��e this Subscribed and sworn to(or affirmed)before me this I!f� y U� Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as identification. as identification. Notary Public State of Florida Sabrina Sherd ;Y) My Commission GG 974098 N Expires 04/os/ao24 Notary Public C�9 7goq q Commission Commission No. ! in arz� Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped a _ j Replacement Agreement Client Name Becky"and Angel Hernandez Date 0310212020 Phone# 8133171336 Address 61251 Oth Street,Zephyrhilis FL 33542 Email jamba855@yahoo.com ■ Single e e d d' al i e.• ✓: at :✓ i e 0 ae %• Sensi WIPI"T-Stat e r , •. Indoor Air Quality Options ❑Single UVC ❑ Dual UCV 0 Oxidizer 0 Air Cleaner !MANUFACTURER WARRANTY(under terms of warranty,routine scheduled service must be performed on systems) J2_Years on parts 1 Years on labor_.2_Years on compressor ACRE 6UAMTEES(Ali Guarantees are explained on the reverse side of this agreement) � O ♦ O if. !!i ;25t! NO- � M ro !! +is O l 11 1 c:o a is G'a g.F R. o na h tr i d - e;era ro ees. accessories = iag2000 and duct cleaning System investment $ 7,412.00 Accessories $ Other $ Total Amount $ Not included-Materials in excess to those outlined above as well as any drywall and wood work if there is no accessible space for installation. ACCEPT E-DEUVERY;I agree that you can provide me with electronic copies of the contract,including the Special Terms and APR Information,that I sign on this device,and all accompanying paperwork and documents related to this contract,by email at the email address I have provided and verified above.If I want to receive paper copies of my signed contract and accompanying paperwork at my home,i can request such copies at no charge by sending an email to Customercare@acreeair.com. Terms INSTALLATION IS COMPLETE AT START-UP AND ALL FINANCIAL PAPERWORK AND COD PAYMENT RENDERED AT THAT TIME. Price includes all coupons and discounts unless otherwise noted.Buyer hereby declares that buyer holds title to property In which merchandise Is being Installed and has legal authority to order the work outlined.Buyer and seller agree that any controversy or claim arising out of or relating to this agreement,,or performance of it,shall be settled by binding arbitration,except that seller reserves the right to sue buyer in a court of law for any amount due them from the buyer,with all other matters including defense to payment being resolved by arbitration. Such arbitration will be conducted in accordance with the arbitration rules,then in force of the American Arbitration Association.The arbitration award cannot exceed the amount of the agreement and will be final and binding on both parties.Judgment upon such arbitration award may be entered in any court of competent jurisdiction.Each party bears its own costs for arbitration,including attorney fees. Buyer agrees to have city or county inspection within 14 days of install. Payment Terms:0Financed GreenSky Plan # Intrest Rate ` OCredit Card (E)Check 50%Down 50%Upon Start Up. Months Estimated Payment$ a, Acceptance(Client) - `P'7'f a Acceptance(Company) p t •i• 'r '�.t;.:�.}.�E11"t.1..t.�:Sys ti.�_".T fir.'^ rx}n.,rik¢:-;.?�`�`t,,,l•^`"r sY � "t `4 <�F d•t•��"Z''� t..dJ�r.# S^��.»` .,}'"' 43^,"'''-c�,il.�:%Y�x"�.`4�.;�, ,Y e,�� « : , .�,.. _ y, .,•k';.. J..r'r`F�•n,'\+,?r '�r. i` '�,.i `"^y 'S)y„\\\\ °"a,"{,^,�•r! •;.,, �'"„f:,;1 i� �`'•'`4 f / :-�' }i`�A 'F'` ;.1',}, ''s.\�" �` ,a `t"J`.. '}'(eay+.ti'7,:��•y�p,,,;'f 4y, J'..1 �,} �y.�� � .�"� . :\ r,�;.='t �',wi'�`'',- niA. �C���" .'S` } +.r+.^*'P f.^� _ .C'"i '`�i '� r 3 'S'+- .�.1%�',, ��w�`3�a>s Fes'',;�',? `'4,r:.,4,�,•y ,x:�y..��+�y �,t+ Y �y r �•''�-t p� 1�..y�. ��a � !tom �y� y 's r,�, ',,-'r'�7.',y\^t f.�'tA�57K�1}a'�''�/Y,�� 6�7�',`,'y-��,{''D�tl t�����;R1��#•, LS � "�itJ`: �•�.�.i.-x �� ��q��� 4 . �.�A3.+�� __� - .r}�.} .u F�,X.*'s .�t9¢�'f,?s�S•t,,a�,J"?� ,�ir� t,�_..�a �:. �'J�v-� L,. ''$,� '� .5^� �L;�F ''S�.:��j.,:':��, _:"t- •'�,'-,�::5. a. t•e.''r,.M";-'`�,',"�, y�,,yp�'�-: +�y,,�4:.5 , '` #yp!) �`�� t '�,t1� •s%yd'�i.,'�:.'�.t �"r;�r�` ;"' ; ':r-. ' �.''l�. ";1;r'+,,�(.p K`"r'•`, V'Y+"7�',J_,Y ,4b ����rt,.✓,";�' i, y �.,., `�.y..��;.+rf>rt'�t..,t�,'a ;,n'"'./ ��,,yr�•' �;,• - - .ate\,-', t p' `ae-. "w, i r l\ s%'t'+��1''��`?}q.-,.:+Ys•:{, - •:`-w . rat r it�:;.:.. " � J Y�, f:t..:�� •',�`,a..,�y F,l�f, �_. .i�4, +r;.»�t�18}•f F�c Pa -3 �'flklJ L' � �l}� k�` �,{'�j '' {,:±,sl +� ,`���d •�,,,`" .�� s' t s." •}. ;t\-�'•i`'� '�,�1.,', :,^"i4�^;r F"�;"4y�'``\r� t'ln�� r t"•-�� �'r'r 1�;��� '�. ��y jr�"+,.�_,�.,f�,,-�.t` �•, `y . - " � ,}:, -rf",�r�"�4 � " '.r'�'trt„c�'3.` S'•�,,f^'7,;'�.�' a.•i rC' a a r '`, u•,Y't'"�, ..i "'�r:..''�1''-� � 3.<..`. �.; .r', '+ E A rr",fi'"�• "t,." ,� ':. 1�r�4 ♦ '4 t,,`•r,�*...., �..}- �`',�'. �' . �' 't ••>'.r' ,n.�3y\.'�S'i,�:�' r+'°%,,*'•{'`�,_1�ut`.ts"t",t "'�•�i..'�'r�,1�,`:`�y�{�l",. ','R � �^wr",,��';l.j' �5�, •,,{' `'Y`-•�.,. '^�^r d..,_s. __ : is �,�: s i ...`�`a.. .�$ .•t�€0.`Ys. $.i..r`,.Y";.f,X/:t ", �f�,¢}'�� S � f;.X{4'4.2 � l#-R��...'{%�...t. + .. , - :r', -�..y5'i`;'''`*,r ps�•.a^F,,..:'�=a'�•.�{S��`'# I..S fr 4 +`��{ �" �' Jh'r�tt` ,,, }�'�t' �:i„�� '�."'`y '..t,.:'i , `"�,> ,�= .'�.:; - .4-` �:i:�\/�°.f°'I. .'i�,l:,«w.;d,r���,�f �.i�,fJF'rt„�.;«,��',r��,� t'i.:�'1 ��♦-le'"�yt' "t•,Lr:;y;�k"f"'A :j.' a ;' "". `� •A; .'y�a. t;qN � #¢'a� .�-?� ({�,J(;�' .y�rt_ 1��!'ij"�Y i� �y�j�1�i `t�f y�'` �`" , g� �•✓*y:1 y.} y'qe r�V�!�`^.�,,.!`,.•`•� ,it•. .�ej'�� ^',�,,,fi�pV'"M�,1+1� ,S �1 � �' Vr"' \ �+' � �'. ., '�M1 1 ,yi.`^I s .. ✓ 1 - .• ? .,�;i., ,1„ %i q,.- �',J y, 'J"«"YYY ';« ti y,',l(`.��,tr�t./'e.e 4 / k• ";.Sti 4_'t`ijI's�:sr"��.fr�,A��.�.'�,� �/�`�:e�'t•�,w :��1''� ` ly.'�'4 � 't �• g��}�:;* .;,d`u._Y+' ���f g�,�4.`: ',r' _ - . yt � - `t:'`�'ss�'; "+': ��; :;"'e: + �� the C��� �jj����''(������v',,, �� `R��d �•'�r..;� ,-.'{�.`'�.:�,;;` £'r" 4 ��,+ .7}'iat r y,�.S'` +'c.� t• �`�"" �� W� �r�F�,y y"i � :.. t� �,' � ,Y : b.���:'•Y,: t,:/ .Sn `.k�>,'�)}� � )l� �:"` a"i- ..�''l�:�Tti`b y" t«... •«k Js."h/' '4- Y...� �t✓` 9 ;,,y �.d- i4E.' .6 wd ,` {' '.. '.r f,:�.i-✓;�•� 'b�`;�a1�.�li�:,.,f ,."` 8.,,�1 ,E�}}�, .`,�,�;7.n-.fs-„{^�' -•:<"�r'; 1 `\�' . , "� ..y'`_ ar3f,, ':L,;,rp rF^tr`-%i{r '^� �" 'W"''k'c,1. 'K� .." �'.a"�h�'`•,:.�i..':'t..r"y`,.x'.. _ . ... - ,F_ ,,�+�.rr• i�.4 jf e}` 'rf •\- Y' i t:� a". .f,a'� .., r ', ii, {•iM'.s^r'r,� _ , , '�f ' , tt. ,.�", .'*"r"Y f+. '^"°r^_:,'�g: ;� j/ 14.a y,k��:,•'�.+ri,-y, �'J `.a. `t 4" :••V'�f,,Vr'+' r.?` �` .u{'i:,s.�l.{.�`A,4`i t�T.'�rr�' 4. lau �go � '.r ^•i�,'�i�„�•.'�1�'i �,.��f;I�' FS`ti.%.'�1y'1^aA:�.lY.,�.y:�F.-''�F.\3;{•"b.:,}r F_ a. ,.} \ ' `%iv'r' f ,`�- `��i/'.Y`,', .. •t: ,,'l*. ./'J i �"*S�"4.l,' f {:.1 r•A � E' �� dF ' w � `"`� p" /' ��"I ,7'"'r".:. "� it •. ti� .r',;, ,,, ,��' ,5.- �r,i� �,` ` "G:'.�•f 1' F''1.�, ' "� f�,.f/•�'�.S,,,�h�:;�n^'4�C;�L'•f,(�'{,.t`��''�; r' J'4{ t•t'*�._.�i .,�.'^ ,,:,Cr: � ;t'."', F•r^� �`�� f,` p �r�y* .t�[it 1. �L i.'�.�,,"�r.,�'- r,.f•t'y,,, �s':•�1^, '` _ .. '''�;; �'" :'n.L;f«ti,�`y' .?..t";?c._`;','�.`"ro�/4*.t�c'�-s°"^''' b`' a^:%�`.� °`�•. r:+';ati },j'"'�y�,t�`'�, ,\'{'''.>7 ti:�..;``�'�� ;.,..;-,' <h �y :i' �• �` ra '-!- tia a ft'1'1 fy6 �3r,+ ✓i.£��� l^r'.4�w.��✓""�,�ZE. 6''{l�;`r' �t {i ..,T i,^., t ...� „ s '1 �. .+ "t" ` 1fi VA .. .'�. , ,.1 ,, b•„%:J +,�,..,*4 sti - rf„ � h x1 '.r4 .�><',✓'r ,o..."4. .:w 4.,s, , "�...' .,s � ��fit, �I���r-• - - j. }',i.-. .;"}. »�e''y,+' �d•L t1 .�"4=�i, f { � -ry.r" �•'$,,,q 'i'''''.t j{, t,t e - i': •._ �- 1:"i t4_ f1;�t` . h-'",n 'y1,1 a ' .y,": r',`y'• `i,�',,�•✓••" 'i 1J}'br,. }' f',x^ F.;•; "',. t .a A".r,'<i'lgg t'w,'� p_ ks `•n � =E;v�• .u:" w:E", ;,.'b "u.' �' ,)R `ti..a ...a -r r°���...«� +, I' 't.`' t..t�` iw:+�_ „"r, .�,.;`("� y','r,l"tn. 9t• d -rJE '.�",,f h,s`!. ^"'".� >'� ,ti_:,' �!_ tt'< '_� `..E ,.,`,'�'f;:�.�..-• �,� �., ;'', r'�`�=' .d' -.a ."r �:'•§��t�.y�.�f• ..r..;r a.",�.i' �•f: ,°�� '�,. .;+..1• ,r,". 't i-,, t•4 'yi ,i" '960. d``}.k.t"d i^' \. •,..,. .+, ,,fFr. 't + t =.i, ,,c?"<.'; - 1',<'-�.fl ,:1 P,.\ _''t. .t .1. �'w'y,�,;' �'"^';,'1'J,".'}l ^, �t,I'.+t',i;7�``':w`' '»'•ti'. 'iq,';} '�✓�tw �°f. :T ',:' t... ? c� ti. •;,_'✓�,,� !. r.- fr•'J 'd. � ✓a^ :�, *_`;'`,rt^. ^r �,• ��r '; 41 ,'�,- :'i1' t 1'r,�.. -\ 0 "✓: •',r. ��,.'�J,,:L/�.,r'J•X. .}'X""y� �'r.j; ';t,'C't., ;q+f'.'.•�.'�_ .`�. ..r...d 'i, ', _� F'`.;• �,y` { l ,a f :a ru(,:;r.r,a•4•,+.+t,`t g:a1 r•3 r0., r.n 1: v'.r" �_''' ,,r: `r` a\- _ "��'� >t '�_•F ,^'a`.•t'f: .'',.a6 �✓ � .ti.,.^.✓.�. .,! °;�t .�_,..r #` f"z,,.�\��: ..P,, �r+.'..t fr,�.,.�„'�_1=1:y.�'.''�t�," n.,' 3., . 53, ' -lea B Z r �i.• .. '1�y t't :;1 ";<...i r�r '�:.a~ e of,.r J3 ,., �t :,,�t b'.3 x. .'�„ �' �,, ,s., �,_.,�. {liffi�it�{�t .5���13' 8 ��.,�+�:,� ,..:.:fit;:w,.',,�a� �.�;�.-:.� r�, F�, �`� ,�.�,.-r � .. :�`��.. ,';.;,. °=�. , ,�:.•:a� _ . , 'r ;, t `t.,�,,. trY.,. .'`4�:'';.,o'.. '>'s.T.+"n 1"',.,{'`"t,.�'""-„'�'r/^''�•,`\'It�f'•.?^`',a' ^1 ?�.�} i� -1,;i r ..r: f'►`R 0® CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) 04/30/2020 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 endorsers t(s). PRODUCER CONTACT H By Counts NAME: K&S Insurance Agency PHONE FAX2 4695; c No):ICNo EXt: ( ) 2255 Ridge Road,Ste.333 E-MAADDRIESS: h unts@kandsins.com P.O.BOX 277 INSURER(S)AFFORDING COVERAGE NAIC# Rockwall TX 75087 INSURERA: F�CI Insurance Co. INSURED INSURERB: B�erfield Insurance Company 10993 Acree Air Conditioning,Inc INSURER C: Ntional Union Fire Ins Co of Pittsburgh 3801 COrporeX Park Dr INSURER D #130&150 INSURER E: Tampa FL 33619 INSURERF: I COVERAGES CERTIFICATE NUMBER: :.j 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 ORO HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DdS� IBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY._PAJD'CIAIMS. INSR POLIqY�BFF rd.POLICY EXP LTR TYPE OF INSURANCE IN SD WVD POLICY NUMBER MM/Db/YY3'Y s MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY S,• •5=~ EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR ' - PREMISES Ea l 00,000 . occurrence $ y' - MED EXP(Any,one person S 5,000 A CPP100045343-01 05/0112020_F 5/01/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: t GENERAL AGGREGATE S 2,000,000 POLICY[g PRO- ❑ 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO '� BODILY INJURY(Per person) $ B OWNED X SCHEDULED CA100054173 01/04/2020. AUTOS ONLY AUTOS ;Q,1/04/2021 BODILY INJURY(Per accident) $ - HIRED NON-OWNED ! _ PROPERTY DAMAGE $ IX AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAR X OCCUR - � i';'; EACH OCCURRENCE S 3,000,000 C EXCESS LIAR BE015824662 05/01/2020,1-05131/2021 3,000,000 CLAIMS-MADE t,. AGGREGATE S DED RETENTION$ - '.?t-; $ WORKERS COMPENSATION `'+;.. PER OTH- AND EMPLOYERS'LIABILITY Y!N - _ i-. ,j STATUTE ER �/� { ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA - ] E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under ' DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Leased/Rented Equipment Limit/Deductible 100,000'/1,000 A Installation Floater CPP100045343-01 05/04%02Q, '.65/01/2021 Limit/Deductible 10,000/1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if inoreyhq,t@,required) 'Additional Insured,Waiver of Subrogation and Primary&Non-Contributory forms#CGL088 1/15,CGL08410r/43,CG2001 04/13 apply to the General Liability Policy.'Additional Insured,Waiver of Subrogation and Primary&Non-Contributory forms#CAUO,08 6 /gip and CAU082 05/15 apply to the Business Auto Policy. iry 'ALWAYS REFER TO THE ATTACHED POLICY FORMS FOR SPECIFIC WORDING OF SUCH COV , GE,LIMITS,CONDITIONS&EXCLUSIONS. CERTIFICATE HOLDER CANCELLATION E1 SHOULD At y OF:TtflVABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAjIOIJ j}A'{THEREOF,NOTICE WILL BE DELIVERED IN City of Zephryhills ACCORDANE.+E WI H-t 'POLICY PROVISIONS. 5335 8th Street AUTHORIZED REPRESENTATIVE Zephryhills FL 35240 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD P , 0 �r ACORD' -- ------ CERTIFICATE OF LIABILITY INSURANCE UATE(MMIDDIYYYIr, ovo3/2o20 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 polil:y(ies)must"tie enddr6 d: 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 (COaNTA�:CT ` PHO E - - - - FAX- Baldwin Krystyn Sherman(iPEO) Arc"Ne: - 4010 W Boy Seoul Blvd ADnR1Ess. Suite 200 LNSURkSI AFFORDING COVERAGE _NAIC# Tampa,FL 33607 - -- - !INsur:Erta:Technology Insurance Company,Inc- 42376 INSURED - - -- - -- --- - 'INSURER B: - Choice Employer Solutions,Inc.dba Fourth HR and Choice Employer INSURER C: Solutions III,Inc.dba Fourth HR INSURERD o-- _- — 9007 Brittany Way -. - Tampa,FL 33619 INsuRER E o- - - - fINSURERF:. _ - - COVERAGF.S __---- _-------CERTIFICATENUMBER: 10.1.68_-- ____ ___—.__._.. _- __-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 F SUCH POLICIES.-LIMITS SHOWN MAY HAVE BEEN,REDUCED.BY PAID CLAIMS._ INSR -= -- -- L BR POLICY EFF- Polley EtP-. - - - - -- ------ --_ "LTR._--_-= TYPE OF-INSURANCE _---- -_--POLICY NUMBER-------MMIDO MMIDO ---- LIMITS UMTTS" _ { COMMERCIAL GENERALL_1A91UTY .Not Applicable .FACHOCCURRENCE-__.._— Y-_XXXXXX =. CLAIMS-MADE Q.00CUR !P�ISES,tC-accuureilceY - ` 1 _ MED EXP(M"one personi"-..,"S, XXXXXX TERSONAL&AUVINJURY S_ xxXXXX GEN'LAGGREGATE LIMIT APPLIES PER: j 'GENERAL AGGREGATE-__.S Xi000(X_ POLICY ECT LOC ;PRODUCTS-COMP/OPAGG S_ XXXXXX "OTHER:: S XXXXXX j AUTOMOBILE LIABILITY Not Appruable - - S xxxxxx -- ` F�alAaBie�nISINGL611M1. ANY AUTO 1 BODILY INJURY(Pot person) i$ XXXXXX IALL OWNED -- SCHEDULED `BODILY INJURY(Per_acrid f) S XXXXxX 1 AUTOS AUTOS - NON-0WNED "PROPERTY DAMAGE S xxxxxx i, !HIREDAUTOS AUTOS 1.1per,aorJdml UMBRELLA LIAR OCCUR" - - Not Applicable-- - - --- EACH OCCURRENCE S XXXXXX - EXCESS LIAB CLAIMS-MADE AGGREGATE --- S XXXXXX DED I .. RETENTIONS 's XXxxxx .,.WORKERS COMPENSATION - - - --- i' -" _- _ ---------------- - --- _-- -- - - ---- - PER——'-- OT}F"- ----- -—-- - - --- AND EMPLOYERS'LIABILITY TWC3850452 01/19/2020 01/19/2021 X STAil17E ER _ A Yra. --- ANY PROPRIETORIPARTNERIEXECUTrvE El-EACH ACCIDENT S 1,000,000.00 OFFICERIMEMBER EXCLUDED? a,NIA (Mandatory inNHI EL DISEASE-A.EMPLOY .$1,000,000.00 II es describe under POLC - 1.000,OQO:OODSCIPTIONOFOPERATIONSbelow EL LIMIT- L i i DESCRIPTION OF OPERA11ONS i LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached if more space is required) THIS CERTIFICATE CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER.Coverage is extended to the leased employees,not subcontractors,of Alternate Employer.Acree Air Condifloning,Inc.(#CHR-895)at 3801 Corporex Park Drive#130 Tampa,FL 33619 effective 01/19/2020 as by contract. CERTIFICATE HOL-DEK CHR-895 'CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Zephyrhills - 5335 8th Street AUTHORIZED REPRESEAITATIVE Zephyrhills,FL 33542 ©1988-2014 ACORD-CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Z019 -z020 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2020 1972 OCC.CODE IRENEWAL 097;10.001000 AIR CONDITIONING CONTRACTOR 20 Employees Receipt Fee 38.00 Hazardous Waste Surcharge 40.00 Law Library Fee 0.00 CAC050424 BUSINESS TRINO VICTOR ANTHONY DBA ACREE AIR COND INC 3801 CORPOREX PARK DR 130 Nil TAMPA, FL 33619 ilk TRINO VICTOR ANTHONY DBA ACREE AIR COND INC NAME 3801 CORPOREX PARK DR STE 130 MAILING TAMPA, FL 33619 ADDRESS Paid 18-655-002087 07/18/2019 76.00 BUSINESS TAX RECEIPT DOUG BELDEW;7'AX COLLECTOR HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 89.3=6355200 IN BUSINESS.PROFESSION,OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED. tits r MVVVUNI NV. 2019 -2020 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2020 1252 OCC.CODE RENEWAL 090.008002 ELECTRICAL CONTRACTOR ;'r`: 20 Employees Receipt Fee 36.00 Hazardous Waste Surcharge 0.00 Law Library Fee 0.00 EC13005935 TRINO SUZANNE BUSINESS 3801 CORPOREX PARK DR 130 TAMPA, FL 336192020 _. TRINO SUZANNE NAME ACREE AIR COND INC MAILING 3801 CORPOREX PARK OR STE 130 ADDRESS TAMPA, FL 33619 Paid 18-655-002087 07/18/2019 36.00 BUSINESS TAX RECEIPT DOUG BELDEkJAX COLLECTOR HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813,-635-5200 IN BUSINESS,PROFESSION,OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED. 3801 Corporex 130 - lTampa, Florida 33619-1136 �� b Every Time! • 50424 blow www.weropen.com Al July 8, 2020 I,Victor Trino, hereby authorize the following to sign for and acquire permits and licenses using my State of Florida License No. CAC050424: -� Michael Trino DL#T650-550-67-332-0 -{ . Darrell Webster DL#W123-163-84-026-0 Chantz Renner DL#R560-104-89-421-0 Dakota Renner DL#D-560-170-91-371-0 Dylan Nisse DL#N200-170-99-043-0 Devin Hall DL#H400-173-92-454-0 John Phillips DL#P412-463-89-099-0 Skyler Owens DL#0520-784-93-270-0 '°'} Cesar Ortiz DL#0632-101-93-304-0 Noel Ortiz DL#0632-623-95-212-0 Norbert Perez DL#P620-634-87-470-0 Jahn Gonzalez DL#G524-423-97-267-0 Thomas Porter DL#P636-838-81-241-0 This should supersede any other letter of authorization. _04i Y If you should have any questions, please feel free to contact me at(813) 620-1666. Victor Trino Acree Air Conditioning, Inc. Lic:CAC050424 ' City of Plant City This foregoing instrument was acknowledged before me this 8 day of 3 V' 2020. gy V �CSY � 1'1� who is personally known tome. No ary Signature Q ' My Commission expires SEAL �00 Notary Pubk State of Florida Sabrina Sherd My Corrnroasion GG 974009 OF � Expires 041 2024 Service Anytime I lam- 11 pm, 7 Days a Week No Overtime Charges...EVER! Pinellas 727-447-0508 • Tampa 813-620-1666 • Polk 863-683-3437 Toll Free 1-800-783-8154/ 1-800-WE-R-OPEN 10-7