HomeMy WebLinkAbout03-2109
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2109
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
2109
COMMERCIAL
ADD/AL T COMMERCIAL
NOT APPLICABLE
40,000.00
5/29/2003
345,00
345,00
5/29/2003
INTERIOR FINISH
Address: 7749 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 34-25-21-0110-00000-0020
Name: DOLLAR TREE
Address: 7749 GALL BLVD
ZEPHYRHILLS, FL. 33542
Phone:
/" ' J 03 '
r/~ (, -(/' fUt J llyn
e,o. (, /17/tl3
!D
PRE-SLAB CONSTRUCTION POLE I DUCTS INSULATED
LINTEL PRE-METER j FINAL MECHANICAL
I! FRAME.! f;-~-fl? ~o MISC MISC
INSULATION WALL MISC ~ISC..
INSULATION CEILING ; MISC. MISC.
~~IVEWAY ! MISC. I MISC. . FIRE DEPT. FIN~_~~
REINSPEC1l0N FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) 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
'''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. It
-~----~~ . Complete Plans, Specifications and Fee Must Accompany Application,-
__ __ .,. ___ All work shall be performed in accordance with City Codes and Ordinances _____
__ __~ NOOCCUPANCYBEFOREC.O. ____ _
~ - - ---~~SPECTION - B HOUR NOTICE ~E~T OFFI
PROTECT CARD FROM WEATHER
S.A. Kennedy, Inc.
7749 Gall Blvd.
SQ. FEET PRICE
MAIN OR LIVING: - $ 60,00
OTHER AREA UNDER ROOF: - $ 25,00
OTHER: - $ 0.85
VALUATION $ 40,000,00
FEE SHEET $ 230.00
ADDRESS $ -
DRIVEWAY
BUILDING: $ 345.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 345.00
ELECTRICAL: $ -
PLUMBING: $ -
MECHANICAL: $ -
RADON: $ -
TOTAL $ 345,00
SEWER: $ -
WATER: $ -
IRRIGATION: $ -
TOTAL: $ -
WATER METER:I $
IRRIGATION METER $
I
345.00 I
I
SUB-TOTAL $
SIF'S'I $
97,5% $
2.5% $
TI F'S: $ -
99% $ - $890,50 per 1 ,000sg ft
per Kimley-Hom Analysis
1% $ -
TOTAL: $
345.00 I
3 t.f 2. ~ .!bl
tJIIO
o GJ {} tJ ({)
002-0
NOTICE OF COMMENCEMENT
Permit#
Tax #
State of Florida
County of Pasco
The undersigned hereby informs all concerned that improvements will be made to certain real
property, and in accordance the Georgia Statutes, the following information is stated in this
NOTICE OF COMMENCEMENT.
Legal Description of property (include Street Address, if available):
Street Address:
7749 Gall Road
Legal Description: Dollar Tree Store
General description of improvements:
Interior Finish
Owner:
Dollar Tree Stores Inc,
500 Volvo Parkway
Chesapeake, VA 23320
Owner's interest in site of the improvements:
Owner
Fee Simple Title holder ( if other than owner): nla
Contractor:
S.A. Kennedy, Inc, (770-667-3602)
4255 Trotters Way, Suite 1
Alpharetta, GA 30004
.r.k~
i~i
Surety (if any):
None
Any person making a loan for the construction of the improvements: None
Person within the State of Florida designated by owner upon whom notices or other
documents may be served: N/ A
Dollar Tree Stores, Inc,
Sworn to and subscribed before me
ThiS~dayof m~
Notary: ~CUru.U l..{. '-+e~
Known Personally/I.D, Shown
2003,
N=
eg=
eg=
w=
eg;;;;;;;;;;;;
(0=
....=
UI~
N-
(0=
-
-
-
-
-
-
-
-
-
-
-
-
-
egc:a
gafltn
.........'1lI
~eg:.
.......men
eg(S)ClD
Cot UI
1-6
ClD
en
:a
-.
....n
eg.
o. .
'U (S) eg
:; (S) (S)
o
-
.
.,
~
o~
:a ~c
11II eg.,.
~ ~-
tsH
UI~
W~
---....
U)~
-fit
30
o
.,. ....0
C) 0
c:::
z
....0....
(g"'~
en........
en~
1'"
r I ! r "
"c c:r'} : ~ : Z~["-' F~ :1.I.LS PBlRMT'!' APPld:CA':..".~ .,. ''''
E'\lTI:I.\):n~(1 DRIO>',R'I'MEN"l' 53"!5 eel, S'rRBlHI'l' I!.!llPHYRH:Ir.l.B, PL 3:3 S 4. 0
Fhab.'813-7aO-~020 Fa~,e13-7aO-0021
I1A'rlB RBCI!IXVSlD
PI.AFlS RIIlVUllW I'tiBt-=--=-=:~_~~,::':~~::::~.__~~
c'
.J' '8 SITIl1 ADLJRElISS
...- -- ----....-J) () I.l_'.YS.1'l.1ZS2 __.. PHONRi C(lH'l'Ar~LCfs...':/._-:=c..8.~~::9t.PL
--27!:l.Q ._Gjl~_~---11_.!~_:- _2 ~~___jJ; Ij~E~_~~_~~____. n .____ ._. _n_.. ____ _____
\ ".';'iJJJR' 8 llA~HiJ
L F" ~1\ t, lJHl8CR T 1,'>'1' ((,)1-1, [,(1T (S )
BTA.)(!K
SUBfJ1. V I B l' It!
pJ\ R' !BL [n It -3-l!-=~~::~~=-QJ~Q:-_aoJ) O_=QQ?"O___.._____~::}BTl>.:.:~_~_Rr)r-.l_~~O~~~~~~__'~~~~___~~~:~~~~_~__.
","!'If! PflOPSBltJI L]Nrnw r'ONS'l'RUCTION [J lIJJlnTIOH ){,A.L'l'ERATl.r)1'l C1IU!I1'AIR [J IUSTAl.!,
/.-.1 srm'! 0 r10VEl 0 DElMOr,J:9H
-..-,"".-----,__ n__n._'__ _...._.__.~,~.
;- ,-uH'r>F.:llliP USE:: L18C3L F'Al1I. L Y fMELlJ INr~
\j!.--CCI/"lHEl Fl.\' 1.1'. 1 .
OnUVr.T" FAfvJI LV
[J# I)\" Tn-UT8
LJ '-1USII.1ll Hor-fE
[] HIPUSTP. 1 A.IJ
[JSt'iIr.jfvIIN(,j POOL
[J rJTHlllR
lJ&:PCRIPTION OF HURK
C-=:J Fdi.18TAURANT ... I!EJAi,TH DB: t'ARTf1lilHT AI?PRI)V AL
- 'll~" 0 ~___:r- I l\\,~ It
r_.__.~__._,_..________.._.___~.~...___._____._.,___..."._,.,___........ __"_
BTJYLfHNG Sll1'iEJ
._^._.._---~._-,_._~~-
SQT./lUUll FOO'I'AGE 1Q., bt:l::!.."___
H81Jr3H'I'
, .
--.-"..--.----------.-
Rf.i:S.lf1Elt:lTIAJ,,
)r'~"1I!lRCllH, ,
ATTACH (:.J) I?U.JT PLAlIS f. (2.) SEl'!'S I)F BTJII,IJIN'3 PI.;I:>.1'IS & (11 BI!IT E1NBfl,(H! FnRf1S,
AT'['Ar"H f 3) sEl'rEi r.JF BlJILDII')(3 VLIH-1S &. (]) SET ENElfH;JY FORMs.
1?HUPEJR'T'l SfJR"BlV RElQUIRllID P"'R ALL 111!JI'J C(1NSTPUr:'rloN.
~ERMIT~~UBST~
[:1 Iii I 1 r I.DTW3
$_l.=lQr--~..D~_"___~ VAt.HATTON OF TOTAL CClNS'rHl)CrIOli
---~~U2_<2..___.._-,- AMP .SERVICE [J P'L.oflIOP< PO~1FlJP. [] W. R,!II, r).
Nt'"
$-_N--1-A_. "-.._ VAT.MATION 01" Ml!lCHANCIAL IHS'I'ALl,J\TTON
I')rt ;;;U!JC'I'R] ('AI,
LJ P!.TH-1BINn
o 1.1P" ~HANIl.'AL
[] '.;,d
L1 ROOF'lPU
[J Sl-'E1(IIAUI'Y
o OTHE;P.
'J " ;-EJ llF' (~(H~S'I'RUCTI()l-1, LJ BLor_'K
[] FRP.HEJ
[J 8TEfJlL
[J OTHER
P' Iii I BHl!IlJ E"I.,\)'JR E!f,BlVATIONS
TEl I?RO,:TI!lCT IN FU),-,r, ZQNEl AP.BJr. n YalB
o NlJ
B'i "LD!lIFl
'k . ~,~~~,~:1'1(~~;04:~~~Q~,A-~~O~W8&;i==_~==~=~
~A~. ..t'iI ~4-:r:: ~-- _..~.... C,'TY "aoc... 'NO Cr ~._..__.._____._.....~_ ...
~6~*~*~k.~~*~+**A.....~~*~~~*~~*.~k.**~A.~***~.**~.~~.*~~*~..~**~A
B 1',:iATUiHi:
Ell. FCc-'TIl. leT Inl
81 'llJ-tTUPEj ____
--.-. _^_.___'_~~m______,,~^__,_._ . __._....,.._._,____
'-:0[''1 PAl,1 'i ___.M____.___ _ ----._"h____~._h___. .... __~__.___.._.__
STATE CEflT OF RE)I3rST It
CITY PROCESSInGl #
.,.--.----- ~"."'-_._-..------ ...-.-- -.---,
+~*~~*~~..*.*~**~~.**~'~~**~+*~A4~**~.~k~~..*~~*.A4'.**~..4*A~~.*~~
---~-_. .._.._.,.....~-_._------
P I ,I ) HB!II R cc>r'lI?AHY _'_~_"_____,__~_-.. ______......___.__.___.._________.__
t.1TATIil r::1O!.R1.' OR REGIST It __-'_~'___"__'_____"""
8J"IU~T[lRH: (,I'rY I?ROCE!l8BINr3 #
-^.~,~~-..__.~". ___H.'.___~.__.......,.__ ~_"_~___"..,'_ __._.__.,_.,_.__._~"'~.._._,.._.___._
..~.~**~..~A.~.**~._*~.~*.**..*~~~~~~~~.**~.~***~.~.**.~..~~.4.~~.~
Mffir'HIU-I.tCA.r,
....--...,".--- . ---~.._._-~,-._,._--.- --.--.".--
r::nlvIPANV_________________._________..,__._ ._----..-
I3TJ!..'l'El C'ElP.'I' OP RE;t3IS'I' # '__._.______ .________.____..-..,....
1.:l~TY I?P.UC'l!ISSIN':;J #
S { HlATURBl
*~t~~....~~~~..~***,~~**.*~~*~.~+*~*A~*.*~~~..*~~~*.**k..~*.A+.*~..
---..-...-...------ -.--'--"-'.---,-.
()THElP.
-- --.-.-----'-~..----"'..---..__r~__.__,_.__.
cc>r-'JPANY
STJ\'1'1ll r:'ERT C;R-RE<1 rST -1..------.--------------
CITY PP.Or.'EBSIN'.J # -------_______..____._...___._____
._--..,,-~-.-'-----,..._----~~-----,..~---...,- .-
81- <J IATlJ!7 s;
~..***.***k.**.~~***~~~.**~..~~*~.**A..*****..**<<*..~~..4**~A~..*
-'--.~'-.-.,._------...~--------- _.~----_..-._---_._-
S'f.A'l' E: OW FLORI DA
\'0UNTY OF __,_
1'11.. r0r",goi,n9 instrl.lfllent was a<.;knoHledged
8"'1:u,.... me t,h~.. __'_._ day of _ l~
\, Y ---___ - ..____.__
(name ('~:t l"ei:sbn ..cknuwl~ctg<iOc:l)
[] ",l,o is p"L",,-'ni!llly known to '"'''' or
i:li : : 41 ~:'il; T iiF ZU~irH I LLOlNS OF PERNIT AFF':rOJWIT
-E _~~D RL~~~~'_~~'.)l~~
>1'h.. und'erailJr...d undecBcand", thqt thi:;, permit IlIay b... subject t,o "deed leatL.:l.<::l1 ionl!!" wbi.ell
may 1.>", mOL'" l:eat;riat.ive than Cit;y regulation... The 11nd;!U::Signed aS$'unea rt!oospon.:stbil~ty fOL
comp.lit-nee I'lith 'lilY €lpplic..ble deed re::st.t:icti.0ItS.
B. lJNLICEN8EfJ. i;CJH'l'RA<::''l'(lHB AND l.'ONTR.'-I.C'L'OR RESPOlJS.IBTI.I'L'IES
It tl,e owner haa hired .. ccntt:acto~ Dr contractors to undertake work, they may be required
to )"... Ij ",<>.""ed i.u accr..>.L-dan<:!e ;,J1:"h Btat~.. and looa.1 regula.t::1.01113, If' the l)ont:raol:or i., not:
J icells.::d "'... requJ.LOed by .1....", both Cl,'" Oh'neL and oc>ntrc.ctu.l: may be c:.tl:ed fQr a m1...d""n""'hor
vie,lat.Ion under S1:&t:e li"'1. It: th.., OHn.." C.r In....ended (JOntL/!tctor ...r", lHI(j~rta:1n as to Hhat
J I censJ.ng requ.i rement... may apply tor the int,l'!nded "102 k, they are advisad too .-:JoncZI,ot t.he
C1ty ~f Zephyrhill.. Buildin9 Department, B13-788-6cill_
FlJ.Ltlle.t.-Ulox.:e., Lt:.- the OWnSL- hC!!ls Jll.t.:e.d a QUnt.t.-a.=to.t: or Llontrac.:1:.cra, h~ is ac.ivised to have the
cw"C;r....'.'tOl: (e) ..ign portic.ns of tho;, "Cr~ntractol: Se.cti.oILs" of this appl.lcation for whi,~h 'ch.
l.,i) 1 be "'''''''ponsi hIe. If' you, a.. the ',Wr>er 13ignB <IS the c:ontracto1:', YQI,l a.re lndi,:~t;in9 tha
,'C'L1, l.a._her than t'he cont:raatoi, ar'" L'e"'pon",ible for th"" ~'c>rk, .If' the con1:ractor "iishea
,',," t,:, ...1.<;jn ''is cont:ract;or thac may be an j,ndioat.1.on tbat. he 1." nat prapo;.l'1.y l.:l,oerU",.d and j
",~t ",nt'i.clod to pennitt1.ng pri.vilega" in the. City of Zephyrhi.Il.8.
'I.'RAN,..,PUWl'ATIO)'1 IHP1"CT FEES AND l1TIL1T"{ COHNECTIQN FEES
1'. CONB'I'R\ICTUION LIEN LP.W (CHA.PTEF< 71::l, FLORIDA STATlJTES, AS ANEtH)El'1)
I ceLtify that :r. t:h.. appJ.1cant, have 1"Oll'1) Pl:c>v.tded wl.th a copy of' "E'lo.rJd..'s COllatr\lction
11<5:11 L..~, -- H(>lneO'HI'!:\J:' '" P.t:ot.eDt"ion Guide." prepare.d by tehe FI.orl.da VtlOpaL'tm..nt .;:,f Ag:t:1.cultur....
","d con:;OUmeL.' AffaiJ.:6. If the appl1cAr,t1... I>omeone ot.h"r that the "O\Y(JIiU:". I Gcrit'y that r
havo:. 0bt..Jn..d a copy of the abov= described document' and promise in good fa.1.th to deliv<!Ir
lot. to the '"'c"HrJer'" priDr 1:u c..=OffiIT\enCQnlent.
f:. CON'I'RAC'rofl/ S/OWNEH' B AFH'IDAVIT
I certify that all. the information ~n this appli~~tioh 1s accurate anct tl,at &l.1 WOEk will
be done in Clompliance Hit:h 0111. applioable l.aw~ regulating COl"ll:'t.rllcti':-n, :i:oning, and land
ci.C:::\J~lQpn\ent'_ .
Applioat::1.on is h",reby mIS-de to obt'aj_n Oil .pe.t:rnjt 1:0 do wo:d, and installal-,,1.on as in(~.1oat:ll>d, T
"o",:ti:fy that no "ork or in",tallatj OIl haa Gomq''''l1cl!Od p:t:.1or Co .J.aSl.lanc.e of <lI pe.Lmit and that.
011 ..10 r I\. ~Jj.ll be pc!:feorme.cl to meet Bt'.and~rdlil of' all 10111.6 i:..g\.ll...t'.i'ng OOllaCi:\lClt:Lon, City
codes, ~oning Legulationsr ahd land development regulat~Dns in th~ jlIL1sdiat~on. I al..o
ucetify LhatT understand that th~ Legulations of ather 9ove~r\mental agenciee may apply to
th", :tntended \-'lark, and that it i.oiI If\Y J.:t:lSponai.bi.Lit:.y t,o identity "~ha.t aationZl I InlUit take t
be in c<>lop.Liance - BUell agencies include but a:t:e not limited t,o I "nepar.tlnent nf
ffinvi10nm<5:1.t~l Regulation-cypress 8ayheada, Wetland Areas and Environmentally Senet~iv~
La ..des, Waca t: !W.... t.a\... t:eL T "..lit t.men t
'::;~ut'.bHe..t H"lorilJ", W...ter Han..gement Dist:..ri.ot'-We1-la, Gyp...e",... Bayheads, Wet.1.and .lu....aa,
Al teL.'lng Wat.eL.'courses
..U,lTllY COL'pS 01: Enginee.l..:::s-SeaHalls, D0'-.:ks, 1'.]a,"J.gablc!l. We..t':e.t.:1.Ja!lYs
'[Iefd.,!:'tment:: ,-,f Health & Rebabl.litative S..t:Vl.ce-'S, Envi:t:ontnent.....l Health llnlt-\ooJells,
W~st::ewateL Trea~IlIent, Septic Tanks
.'T).", EnviL'unJnental t'.t:c,t..ctian .A.gencY-Asbes1:.os ab..t.emellt
I 011"'0 ce.t:t1Ey that, if fil.1 materi"l i~ to be uaed in Flood Zone ~An or "A,8tO,u, it ~.
lIn,j".L"tood tllat a dr'd.nage pl,/!lIl add..cessing 1:9. '"colllpensatj1Jg volume" 'ui.ll be suomttted whioh
16 p,-e.pared by a p~of~$slpnal ~ngin~e~ ra9~$teEed in th~ Slate of rlorlda prior to permit
!.:;Isuanc:c.
A ~~rmit jssued shbll be construed to b.. a 1~cdns@ to pLDceed with the HOEk and not a$
outl'Dr~ty to violate. cancel, alteL, or 8~t aside any proviBipns of the technical cDdeo,
no" sh.Lll ~Bsuanc", of: .. pcrmi t_ prevent the Building Offici..l f:r:oln th",r.eaft.EiL l:ceq\.,\j.ri.ll9 iO.
COJ:,l.'e<.::t:1.on ot errorB in plans, pon"'t.Luution~ or vio,l;o,'\;tone of any oode. E1v.r:y peqn1t
1 ",sued eoha11 beoome l.nva.ti.d un 1 e,!Ul thl;i ~'Jo!>:h: aut".horized by auch permit j S <::IallDlloenaad H.tt:hin
G1>{ ""-'11th... of i....llanc<=, or if HDrk authorized by the permi.t i.l:l ~uapended "r G1handoqlil.:i fQ.r
p..riud of >::Illt month.. after I:he time the Hnrk is <onrnn1en(~ed, One 90 day 6Kt;ensiofl of \::,11116
rll"'Y be al.1DHed, fCJr the peunit: wit:h fee charge of ~l5,CJO, The extentJ1.on ",heLL be 1:til<]ue_\:e.q
j Cl \..r~t1..ng to th.. BUildi"trJ Ofeil'lial. An apf>J:ulI..d irHsp..ot1.uh must b... lugged dLl.cing ..aoh - liIi..
",,-,nth p"".L'ic.d, wI Lha pEojeGt wiLl be conl!lldered abandonect.
.~ARJnNG TO OWIH!lRI YOUR IlAILUf<l!l TO RECORD A No'rICE Olr COMMENCEMENT MAY RI!l8UL'1' IN YOUR
PAYiNG TWICE FOR IME;'ROVEHEN'l'S TO YOUR PROJ;'ElR'l'Y, If!' YOU INTEND '1.'0 .OIH'AIN EINANl:;Il\Hi, ~(lll~lJL
WITH YOIHi LENDER OR AN A'I"I'ORNEY BItFORE R!JCORDTNG YOUR NOTICE OF CO!'1HENCEI"IElH'I', -.JOB8 Ul~/)eR
~1, SUD IN VALUE PO NOT NEED TO RECORD ANL> POST A "NOTICE OF (:()Ml'IJENCEl'1EN'r".
d~... nud1~
SIGNATURE I CON'rI<ACTOk
.9'I'ATE Oir ~M'd
COUNTY or-rv{~" .' . '__
The foregoing inst~~lIrnent W-,5 aq~noHled\,J...d
8et:ore Ill.. t.his ..l:i~J"j"'!I or:~L,_, ~ ~;..__
by ___.-. ~
~J " , >i 4 1', r,
~' ,
1/1
S 1 ONATUH.E I
OWNER OR 1>.GEWf'
(name of per~on aoknowledgedl
1$ per8c.nally known to mar or
o \lh,) h..", prodlloed.____ .
(type of identjfi.cationl
dnd 'Jhc.CJ ctl.d Odict not take: an '~ath.
an
R.i.gnatul:"e or piS.! son tak~J1g a.~::.knOt/_t-=ctgelnent
lJaIl\~ tYtJ~d( pL.:j.rlt:~d uL" ~tallllped
e!:,son taki.t1g Ii nowl",,JYlOenr:
~ - g~AA/~.______~______._
,.' J..Hi.nted ~~I1P..d
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSSEE FL 32399-0783
(8.50) 487-1395
KENNEDY, STEVE ALLEN
S A KENNEDY INC
4255 TROTTERS WAY SUITE 1
ALPHARETTA GA 30201
.. STATE OF FLORIDA AC# 0453290
:. . . DEPARTMENT OF BOSINESS AND
~-, PROFESSIONALREGOLATJ:ON
CGC014861
05/Il/az 011130898
CERTIFIED GENERAL. CONTRACTOR
KENNEDY, STEVE ALI.EN:
S A KENNEDY INC
IS CERTIFIED under the provisions of Ch,4 8 9 FS,
Kxpirationdate: AUG 31, 2004 S1l:Q lI-r.OZQ.6J.~0070.8
DETACH HERE
AC# 0 45 3 2 9 0
~~::::::6~R
The GENERAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2004
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION. i
CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L0206~l007 08'1
!
II
KENNEDY, STEVE ALLEN
S A KENNEDY INC
4255 TROTTERS WAY SUITE 1
ALPHARETTA GA 30201
JEB BUSH
GOVERNOR
nl~D' AY .A.~ Rl=nlllRl=n RV I A\A'
KIM BINKLEY-SEYER
SECRET.ARY
MAli.
S.A.Kennedy, Inc.
4255 Trotters Way, Suite 1
Alpharetta, GA 30004-7870
Ph: 770-667-3602
Fax: 770-667-1430
May 19, 2003
City of Zephyr Hills
5335 8th Street
Zephyr Hills, FL 33542
RE: Dollar Tree Store, 7749 Gall Blvd" Zephyr Hills, FL
Ladies and Gentlemen:
I hereby authorize Ramdeo Samaroo to act on my behalf in obtaining a building pennit for the
above project in Zephyr Hills, FL
help and cooperation.
teve A. Kennedy, President
S,A. Kennedy, Inc,
~m"",,~
4,~\u.~~1i
L~~~ ~<i~
tC:Jt. OCT ..
.:a 02 :.
e .
e. -<' 2006 ~:
. u ~.
. <l'; ",. ·
~1-0..?NCO\l~..~~~
~'''' l'.q R'" p\)~\,'.$'
1I111',"U'\\\~
Fed ID#59-3150165
770-667-3602 Ext 224
STA TE OF GEORGIA
5- ICj
,2003
County of
FULTON
Personally appeared Steve A. Kennedy, who, being duly sworn, did say that he is the
President of S,A. Kennedy Inc., a corporation, and that the foregoing instrwnent was signed in
behalf of said corporation; and he acknowledged said instrwnent to be its voluntaly act and deed,
-2~ ~. ~
Pamela M. Meehan NOTARY PUBLIC
My commission expires: 10/02/06
General Contractors and Construction Managers Since 1979
www.sakennedy.com
4255 Trotters Way, Suite 1
Alpharetta, GA 30004-7870
May 8, 2003
City of Zephyr Hills
5335 8th Street
Zephyr Hills, FL 33542
Attn: Kitty
MAli.
S.A.Kennedy, Inc.
Re: Dollar Tree Store 7749 Gall Blvd" Zephyr Hills, FL
Enclosed is $20.00 for registration fee to register in the City of Zephyr Hills,
Please call me with any questions,
T~ you,
t~m~~
Pam Meehan
Project Coordinator
Ext. 235
General Contractors and Construction Managers Since 1979
www.sakennedy.com
Pb: 770-667-3602
Fax: 770-667-1430
S..A. KENNEDY, lNC,
ALPHARETIA. GA 30004-7870
39202
DATE
',. INVOICE NO.
DESCRIPTION
INVOICE Ai'vlOUNT
DEDUCTION
BALA-NCE
-05-03 JD'T19 PEPlvf :?EF1~IIT
20.00
...... '......
.1....., I,)
20.00
CHECK.
DATE . ~ os-en
39202
20.00
.. .Jl)
20.00
PLEASE DETACH THIS PORTION AND RETAIN FOR YOUR RECORDS.
r
S&KennedYttInc.
NationsBan~: of Georgia, N.A.
64-5/610
39202
4255 Trotters Way, Suite 1
Alpharetta, GA 30004-7870
PH: (770) 667-3602
iy: ******************~+************************~Twenty dollars and no cents
DATE
CHECK NO.
AMOUNT
:tvlay 8, 2003
39202 $*********20.00
;.:IT~{ "JF ZEPEYP.HILLS
PAY
TO THE
ORDER
OF
c:NNEDY, PRESIDENT
- -- ----.- ~--_._----_-----"!!
AUTHORIZED SJGi::iflTURE
11.0 3li 20 2111 1:0 b 1.00005 21: 00 I. 0 2 3li liO . 2111
From: Sandy Baltes At: Yates Insurance Agency FaxlD: (404) 633-1312 To: Pam Meehan
Date: 51612003 09:42 AM Page: 2 of 2
. ACORDTU CERTIFICATE OF LIABILITY INSURANCE I DATI! (MM/DD/YYYY)
5/6/2003
PRODUCER .. (404) 633-4321 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Yates Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIRCATE DOES NOT AMEND, EXTEND OR
p, O. Drawer 95806 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Atlanta, GA 30347
INSURERS AFFORDING COVERAGE NAIC#
INSURED S A Kennedy Inc INSURER A: Bituminous Casualty Co
4255 Trotters Way #1 iNSURER B: American International Specialty Lines
Alpharetta, GA 30004 INSURER c:
INSURER D:
INSURER E:
SAKENNE-01
BASA
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 PIiRTAIN. 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.
I~.!l!' ~,~'?:~ POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
~ERAL UABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY CLP3156042B 12/31/2002 12/31/2003 ~REM;S'ES 'fE~~cc~~cei $ 100,OO~
CLAIMS MADE ~ OCCUR MED EX? (Anyone person) $ 10,OO~
I-- PERSONAL & ADV INJURY $ 1,OOO,OOll
I-- GENERAL AGGREGATE $ 2,ooo,oOii
GEI'L AGG~iGAi LIMIT AiPLlEi PER: PRODUCTS. COMP/OP AGG $ 2,OOO,OOC
POLICY X ~~RT LOC
AUTOMOBILE UABILITY COMBINED SINGLE LIMIT 1,OOO,00~
A CAP3163982B 418/2003 12/31/2003 I.Ea accident) $
- ANY AUTO
X ALL OWNED AUTOS BODILY INJURY
(Per person, $
- SCHEDULED AUTOS
X HIRED AUTOS BODILY INJURY
X IP.;w accident) $
- NON-DWNED AUTOS
- PROPERTY DAMAGE $
(Per accldenC)
~AGE UABIUTY AUTO ONL l' . EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
iJESSlUMBRELLA UABlUTY EACH OCCURRENCE $ 5,OOO,Ooe
B X OCCUR C CLAIMS MADE BE2986172 12/31/2002 12/31/2003 AGGREGATE $ 5,OOO,Ooe
Prod/Camp Ops Agg $ 5,00O,Ooe
~ DEDUCT'BLE $
X RETENTION $ 10,000 $
WORKERS COMPENSATION AND X I WC STATU. I OTH.
TORY UMITS ER
A EMPLOYERS' UABILITY WC3156040 12/31/2002 12/31/2003 500,000
E.L. EACH ACCIDENT $
,",NY PROPRIETOR/P ARTNER/EX.ECUT'VE 500,000
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYI:E $
g~~'~L~W~vlk'?~~s below E.L. DISEASE. POLICY LIMIT $ 500,001l
OTHER
DESCRIPTION OF OPERlITIONSI LOCAnONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAl. PROVISIONS
Project: Dollar Tree Store, 7749 Gall Blvd, Zephyrhills, FL 33541
CERTIFICATE HOLDER
CANCELLATION
City. of Zephyrhills
5335 8th Street
Zephyrhills, FL 33541-
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WIL1. ENDEAVOR TO MAIL 3~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHAL1.
IMPOSE NO OBLIGATION OR UABlUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
.-.- - -;:;~,(?.f:;~:""Y;-\1::=~"j~::/~;:i,. .,,,<":-~~~ .
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988