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Home My WebLink About01-0701 BUILDING PERMITN~ 0701 CITY OF ZEPHYRHILLS (813) 788-6611 Permit Date Ie? - $/-0 I Property Owner: Job Address: Parcell.D, # ELE~L PL~,~"G---' MECHANICAL ~;J~i1- 7!J>>~~ <?t~ Sewer Conn B~-' Water Conn: Water Meter: T,I.F.'s: Zoning: DescriPtion of NO OCCUPANCY BEFORE C.O. FINAL DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, c.o. DATE Inspector BUILDIN~-- ~ ELECTRI~ --- r-- Company Address ~Ph~~13 ~qRn ,- _:SZRZ e9f l~J~63p~ r--- ./~. PLU~ MECHANiCAL -- Valuation or Contract Price ,-?/ ~1~ ' City License Registration # ~f? 19 State Certified License# J'l;) Ftr, Pre SLB Lintel FRM, Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five and 00/100 Dollars ($25.00) shall be made for each trip for each trade: a, Wrong Address b, Condemned work resulting from faulty construction. C. Repairs or corrections not made when inspection called. d, Work not ready for inspection when called. e. Permit not posted on job site, f. Plans not at job site. g. Work not accessible, The payment of inspection fees shall be made before any further permits will be issued to the person owning same, APPLlCATl:OllI .-oR PBlUa'l' CITY 01' ZJU>HYIUIILLS BUIWDIG OBP~ DA~ ltZCBrvm> / () - ,2.)- D I PLARS R&VDnr DB C~'3{) ~ol {9js- ~. OWNER'S NAME t~ \u \" \ cD JOB ADDRESS ,)'8 \ .3~ (nf-d \( (j \ t \ \ f1 \ ( m(Ar-'K.e ~ Srtl xlrQ PHONE LEGAL DESCRI~TION: LOT(S) BLOCK SUBDIVISION PARCEL 10 II WORK PROPBED: DNEW CONSTRUCTION lJSIGN' o ADDITION o MOVE 'Q~T~T~ ~QH PROPF.RTV TAX NOTTCF.1 efu:TEAATION 0 REPAIR 0 INSTALL o DEMOLIsH PROPOSED USE: DSGL FAMILY tNELI,ING o COMMERCIAL OMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SkIMMING POOL o MOBILE HOME o OTHfR o RESTAURANT & HEALTH DEPARTMENT Al'PROVAL DESCRIPTION OF WORK 1:;::>EO'\O E')(, ISTIN&- F:S..'P'-PIJ\1(,- & RflDC.Ai:E1o NEWE~IDtJ BUILDING SUE SQUARE FOOTAGE HEIGHT RESIDENTIAL: COMMERCIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANs & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. AMP SERVICE o FLORIDA POWER l-J1otf.~~ ......0. I~~I PERMITS REQUESTED o BUILDING o ELECTRICAL o PLUMBING o MECHANICAL $ VALUATION OF TOTAL CONSTRUCTION o $ >,453. ~ECIALTY 00 - o GA.S o ROOFING 'J1U.UATION OF MECHANCIAL INSTALLATION o OTHER TYPE OF CONS'l'RUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR EL~TIONS IS PROJECT IN FLOOD ZONE AREA.O YES 0 NO BUJ:LDJ:1l COMPANY STATE CER'l' OR REGIST # CITY PROCESSING IL SIGNATURE ***.....************.*.....**.**....***.***;....******.**......... II:LJlC1'lUCXAJIl' SIGNATURE COMPANY. STATE CERT OR REGIsT * CITY PROCESSING * .**..***.***.....***....****...***....***.******.**.**......*****. PLUMBII:R COHP~ STATE CERT OR REGIST # CITY PROCESSING * SIGNA.TUR!i MECHAlaCAL ....******~****...*****.******.w.**.**.*....*..*...**....***_***** COMPANy STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE F= \~E: .***-******..******...***...********....***..***...***.*.*.***... 0'rBD ~ PR.\ f\l ~Lt;.: Q.. SIGNATURE COMPlINY Cnt.. t=\Rc ~\E.G\)6,.J IN(. STATE CERT OR REGIST # O'lD,~;z,OOOlg5 _'./7 J. /)09 CITY PROCESSING # :; ~~,.~ ~ ,~'" tJ ************************.***...*****.****.**~~*~~t9 .~1~ ~ ad- . :/ IP''3t~( ~~: l tOOl '6 . PO 1901 ' oN SllIH~AHd3Z jO A1IJ E 'd ~~,\Wl.:t"" ~'>;f.tj?""'~~i \'-~. j . ...:1..".1 ~ !I11 :;;i"..J: i~u - ~ ~ >0 ~ CONDITIONS OF PEPMcrT AFFIDAVIT A. NOTICE or DEED RESTRICTIONS The undersignea understands that this permit may be subject to ~deea restrictionsM which ~y be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable daea restrictions. 11. 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 City of Zephyrhills Building Department, 813-788-6611. furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the ~Contractor SectionsH of this application tor which they will be responsible. If you, as the owner signs as the contractor, you are indicat~ng that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indication that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES ,D. CONSTRUCTUION LIEN I.Jl..W (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture and Conaumer Affairs. If the applicant is someone other that the "owner", r cerify 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. E. 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 pe~t to do work and installation aa inaicated. 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, City codes, zoning regulations, and land development regulations in the jurisdiction. I alao certify that I understand that the regulations of other governmontal agencies may apply to the intended work, and that it ia my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: .Department of Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment .Southwest Florida Water Management District-Wella, Cypreas 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 .U.S. Environmental Protection Agency-Asbestos abatement I also certify that. if fill materLal is to be used in FlOod Zone ~A" or "A,etc.N, it is understood that a drainage plan addressing a ~compensating volumeH will be aubmitted which is prepared by a professional engineer registered in the State of Florida prior to p~Dmit issuance. 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 iasuance of a pe~t prevent the Building OffiCial from thereafter requiring a correction of errors in piano, construction, or violations of any code. every permit issued shall become invalid unless the work authorized by such pe~t is commenced within six months of issuance, or if work authorized by the permit is suspended or abandoned for a period of six months after the time the work 1a commenced. One 90 day extension of.time may be allowed for the permit with fee charge of $15.00. The extension ahall be requested in writing to the Building Official. An approved inspection must be logged during each six month period, or the project Will be 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. JOllS UNDER $2,500 IN v.ALUE DO NOT NEED TO RECORD AND POST A ~NOTIcE OF COKMENCEMENTH. j~~ ~~ STATE OF FLORIDA D r CO COUNTY OF r a .. The foregoing i2(~rument was acknowledged Before me this day of ()(l:h,J-py, ~, by:-Tl(\4 0.1' II -or. (name of person acknowledged) ~WhO is personally known to me, or o who has produced (type Ddid not STATE OF FLORIDA '7) COUNTY OJ!' r ~ (.tl The foregoing instrument was a~~wledged Before ,III! this ~r. of t!Jr __r" , N~' by ~(jnf\~1'\ ...r.~ (name of person acknowledqed) ~o is personally known to me, or o who has produced (type of identificatLon) o 0 did Dlid not take an 0 h 711. ignature of taking acknowledgement ,'~~'~"'" Debra M. Howard Name ti8~~". ~'a~~/I~~ miRES o",,~. :~g Septembe 20, 2002 -.,7i......"~<i',~ BONDED THRU fROY FAIN INSURANCE,INC. '~',H~.,~~,"~ (L ignature of ,ffl~pn takin!t>Eftim~nt ~f'-"'''~~; MY COMMISSION fI CC871443 EXPIRES Name typecV."...,.~d ~5Nri YFAlNINsuRANCE,INC. "'-H;,;,tt,',.. v 'd I ~ 0 I '0 N SlliH~AHd3Z ~O AIIJ NdH: t 100&'6 'PO STATE OF FLORIDA OFFICE OF TREASURER DEPARTMENT OF INSURANCE TALLAHASSEE, FLORIDA STATE FIRE MARSHAL CERTIFICATE OF COMPETENCY FMO' THIS CERTIFIES THAT: BUSINESS ORGANIZATION: RONALD EARL COX 7910 PROFESSIONAL PLACE TAMPA, FL 33637 COX FIRE PROTECTION INC CONTRACTOR II IS LIMITED TO THE EXECUTION QF CONTRACTS REQUIRING THE ABILITY TO LAYOUT, FABRICATE. INSTALL. INSPECT, ALTER, OR SERVICE WATER SPRINKLER SYSTEMS. WATER SPRAY SYSTEMS, FOAM-~ATER SPRI~KLER SYSTEMS. FOAM-WATER SPRAY SYSTEMS . STANDPIPES. CDM~INATION STANDPIPES AND SPRINKLER RISERS. EXCLUDING PRE-ENGINEERED SYSTEMS. . to NIf#'rl.-. ISSUE DATE TYPE CLASS COUNTY LICENSE OR PERMIT NUMBER APPLlCA TlON T~X~S _&..:'~ _~~o"ctEN_Y_ TREASURER INSURANCE COMMISSIONER FIRE MARSHAL 07 1 6 03 016982000185 1282300001 250.00' OLC REV 00 2000-2001 HILLSBOROUGH COUNTY OCCUPATIONAL LICENSE EXPIRES 9-30-2001 FOLIO NO. FACILITIES OR MACHINES ROOMS SEATS EMPLOYEES 1 0 RENEWAL 1 669. OU 00 OCC. CODE BUSINESS TYPE 090.015 CONTRACTOR - F IRE SPRINKLERS H. WASTE SURCHARGE 4 O. OU TAX 1 8. 00 BUSINESS LOCATION 7910 PROFESSIONAL PL TAMP A 33637 NAME MAILING ADDRESS COX RONALD EARL/DBA/COX fIRE PROTECTION HIe 791D PROFES~lONAL PLACE TAr-JPA FL 33637 LICENSE IS HEREBY LICENSED TO ENGAGE IN BUSINESS. PROFESSION, OR OCCUPATION SPECIFIED HEREON. DOUG BELDEN, TAX COLLECTOR 81 3-307-6538 THIS BECOMES A TAX RECEIPT WHEN VALIDATED. (SEE REVERSE SIDE) i ; i I i f ; i i PAID-00017 3 -0015 09002000/ ******58.00 \ ,1f)ph\ .~ ~ 4 " f/ I / / I I , i \ \~ CITY OF ZEPHYRBlLLS BUILDING & LICENSING DEPARTMENT 5335 - 8TH STREET ZEPHYRBlLLS, FLORIDA 33540 PHONE (813) 788-6611 FAX (813) 788-5262 THE FOLLOWING FORM SHALL BE m,J ,ED OUT IN ITS ENTIRETY! ANY OMISSIONS l\1.A Y RESULT IN THE DELAY OF ISSUANCE OF YOUR UCENSE OR REGISTRATION. BUSINESS NAME Co'l... ~IRE PRDT€GTlO~ I INc... I q l 0 PRDF"ESSI O"-l A.L ?LAC.E BUSINESS ADDRESS TA.MPA. "FLOR\DA. 3~<O3( MAn.ING ADDRESS s...q vY\ E BUSINESS PHONE # (~I ~ ") 9 ~o - '3 Z ~ 2.. EMERGENCY PHONE #1 ~ SA YYl E. OWNERS NAME RONJ\LD E. C O'f.,. - OWNERS ADDRESS -, 9 '0 'PRO~ESS \ ON~L 'PL ,TAW\PA ,-=L 33~3l OWNERS PHONE # IF DIFFERENT THAN BUSINESS NUMBER I SOCIAL SECURITY J Zlo 3 .. 3 S - 1959 I FEIN# I OUALIFIER n< DllfFERENT THAN OWNER. I IFAX# I CONTACT PERSON IF DD'FERENT THAN OWNER H:,r,>/U:C?'H:~)'U.Hi*#K~##rw~.P#;r%#.p~#~~'~i:~~#€##~i#=!#W##~}U>)<E:U.U'.~.:U:// .:':;~4i:&~dJ~:~:~: :::::::;@#~~~ri;~&ii&i~::::~.i.4i'~~~~rig i#':::::::::;~;::~:~:::::J~~~~~~~i:i :.iigl~4t1@~.t~M'H~~~&;~1Mi;l&6.i1fii~~;~6:~~~~~m;Uf;'~~~'~~;bWTh~J&!~i ~W6::;:::::::::::::::~ti@j~~::.::::~;::::::;~;riliik~:::::::: ;f~ik.:::::'1::::::gaJ&: :~'~!:j:~~'!':j~:::i:;:::::::::;:::~::;::::b~::Glii6JWt;:~:~:::!:i:~:);::! SIGNATURE OF APPLICANT DATE: PRlNT APPLICANTS NAME Z 'd 19D['ON SlllH~AHd3Z iO All:) Wd88:[ [DDZ '6 'PO ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYY) 01/Z2/2001 PRODUCER 813-637-8877 FAX 813-637-8484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 26005 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33623 INSURERS AFFORDING COVERAGE ir:~D Cox Fi re Protection, Inc. INSURER A: United National 7910-Professional Place INSURER B: St. Paul Fire & Marine Ins. Co Tampa, FL 33637-6746 INSURER c: Scottsdale Insurance Company -- INSURER D: I INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER P~l-+~~~~6g~E Pg~~l,~';~N LIMITS LTR ~ERAl LIABILITY L7118779 01/21/2001 01/21/2002 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 50,000 - :J CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ excluded A X Per Proj.Aggregate PERSONAL & ADV INJURY $ 1,000,000 f-- GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 n .nPRO. n POLICY JECT LOC ~OMOBILE LIABILITY BAOO777469 01/21/2001 01/21/2002 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 - ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) B - HIRED AUTOS BODILY INJURY - (Per accident) $ NON-0WNED AUTOS - - PROPERTY DAMAGE $ (. (Per accident) :.. :'.ARAGE LIABILITY AUTO ONLY - EA ACCIDENT S .~ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY ~MSOO05887 01/21/2001 01/21/2002 EACH OCCURRENCE $ 1,000,000 t:~rOCCUR D CLAIMS MADE AGGREGATE $ 1,000,000 C s ~ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TORY LIMITS I IOJ~- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ EL DISEASE. EA EMPLOYEE $ EL. DISEASE - POLICY LIMIT $ OTHER L7118779 01/21/2001 01/21/2002 Independent Contractors Covera A ~Emera 1 Liability Contractual Li abi 1 ity DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 'Florida Operations Only" CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL - ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Zephyrhills BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY "-.; 5335 - 8th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Zephyrhills, FL 33540 AUTHORIZED REPRESENTATIVE 7Ul fi/-~. William Massaro, Jr ./CYNDI ACORD 25-5 (7/97) @ACORDCORPORATION 1988 Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and dDes not amend, extend, or alter the coverage afforded by the policies listed below. .00 Insured(s): Staff Leasing, LP, By Staff Acquisition, Inc., The General Partner, And The Affiliated Limited Partnerships Of Which Staff Acquisition, Inc. Is The General Partner And Staff Leasing, Inc. Is The Limited Partner including Staff Leasing of Texas, LP, Staff Leasing of Texas II, LP, Staff Leasing IV, LP 600 301 Boulevard West, Suite 202 Bradenton, Rorida 34205 C'NA RISK MANACEMENT - Insurer Affording Coverage Coverages: Continental Casualty Company The policy(ies) of insurance listed below have been issued to the insured named above for the policy period indildted. The insurance afforded by the pDlicy(ies) described herein is subject to all the terms, exclusions and conditions of such policy(ies). Certificate Exp. Date Type of Insurance o ContinuDus Policy Number Limits o Extended * ~ Policy Term Workers' 1-1-2002 we 189165165 Employer's Liability Compensation we 189165182 Bodily Injury By Accident we 247848874 $1,000,000 Each Accident we 247848888 Bodily Injury By Disease $1,000,000 Policy Limit l~ Bodily Injury By Disease $1,000,000 Each PersDn - Other: Employees Leased To: Effective Date: 1/1/01 2464 Cox Fire Protection Inc Cox Fire Protection Inc The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(les), not to the employees of any other employer. *If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Notice of Cancellation: (Not applicable unless a number of days are entered below) Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above policy(ies) until at least 30 days notice of such cancellation has been mailed to: Certificate Holder: l. " l . J City of Zephyrhills Building Department 5335 8th St Zephyrhills, Fl 33540-4312 ~ a/.~~ ~ Martin Oosterbaan Authorized Representative Office: S1. Louis, MO 12/15/00 Phone: (877) 427-5567 Date Issued