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Home My WebLink About04-2714 I , . CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL 2714 Permit Number: 2714 Issued: 2/04/20041' Permit Type: ALUMINUM Class of Work: SCREEN ENCLOSURE ' Proposed Use: SINGLE FAMILY RESIDENTIAL Sq. Feet: Est. Value: Cost: 9,500.00 Total Fees: Amount Paid: 120.00 Date Paid: Address: 7246 HIGHLAND LP ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Section: Book: Page: Subdivision: OAK RUN Parcel Number: 34-25-21-0100-00000-0070 Name: LUMINUM EXCHANGE,INC. Addr: 9508 DR.MLK BLVD. TAMPA,FL. 33610 Phone: S13)621-9208 Lic: Wor Desc: SCREEN POOL ENCLOSURE LAURA & RICHARD NEWSOME 7246 HIGHLAND LP ZEPHYRHILLS, FL. 33542 Phone: I REINSPICTlON FEES: When extra inspection trips are necessary due to anyone of the following reaSons, a charge Qf 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. II _ __~m t NO OCCUPANCY BEFORE C.O. ~- - 'TRACTORS~ PERMITOFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CA~D FROM WEATHER CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 813-780-0020 FAX:813-780-0021 DATE RECE IVED ( f~/nr PHONE CONTACT FOR PERMITTING PARCEL ID # /U €t>>.s Oj4/) ~ 73.- Lib f/;~ h 4v./ L-CJo ~ 7 '3 ~-;{ ~--~ 1- 0/00 -()CJOt)C)- 0070 PHONE (0.2 / -j ~-() ZJ OWNER'S NAME JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION 00- Ir /dun, (OBTAIN FROM PROPERTY TAX-NOTICE) WORK I?ROPSED: DNEW CONSTRUCTION o ADDITION DALTEPATION o REPAIR o INSTAI,L DSIGN o MOVE 0 DEMOl,ISH PROPOSED USE: DSGL FAMILY DWELLING DMULTI - FAMIL Y 0# OF UNITS o MOB ILE HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER DESCRIPTION OF WORK CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL ?oo L ~0ct. oga~ r-'--P, BUILDtNG SIZE SQUARE FOOTAGE HEIGHT ~/ o BUILDING $ VALUATION OF T ENERGY FORNS. RESIDtNTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING COMMtRCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY F9RMS. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. . PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. -'~ PERMITS REQUESTED rG ) yJ// \, . -_/ ...._.~--_.....,.....-_...-'--~ o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C, o GAS o ROOFING o SPECIALTY o fo if I~ ~:;bJd! VALUATION OF MECHANCIAL INSTALLATION?, ~ (~h ) r 0 () o OTHER egO) 0;)1 ~ 5:> o FRAME 0 STEEL 0 OTHER o PLUMBING o MECHANICAL $ TYPE OF CONSTRUCTION: 0 BLOCK FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO BUILDER COMPANY SIGNATURE STATE CERT OR REGIST # *******************************************************~,********** ELECTRICIAN COMPANY SIGN~TURE STATE CERT OR REGIST # MEC~ICAL COMPANY *** ficCA.a~~ ff..0' CC:__ DJ-~ (,.2/ *******************************************************,,********** PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST # ************************************************************ STATE CERT OR REG~ ****************************'*********************~~ ::::tRE ~ - ::::~~ERT OR REGIS'[ SIGNATURE A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to ~deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. B. 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, 813-780-0020. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the ~Contractor Sections" of this application for which they will be responsible. If you, as the owner signs as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indica~ion 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 LAW (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 Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the ~owner", I 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 cormnencement. 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 permit to do work and installation as indicated. I certify that no work or installation has cormnenced 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 also certify that I understand that the regulations of other governmental 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 Regulation-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 *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "A" or ~A,etc.", it is understood that a drainage plan addressing a "compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit 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 issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is conunenced 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 is cormnenced. One 90 day extension of time may be allowed for the permit with fee charge of $15.00. The extension shall 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. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _ day of by acknowledged , 20_ STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _day of by acknowledged 20 (name of person acknowledged) Dwho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or Dwho has produced (type and whoD did Ddid not of identification) take an oath. Dwho has produced (type of identification) and who Ddid O:iid not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped -:---~ y~' , ./' NOTICE OF COLYllvlENCEI\1ENrr . 111111I11111 "11I 1111'11111 11"'1111111111111'111111 "111'11 2003233510 Permit No. Parcel 1.0. No. /04 -,Q0 -/1/' DiQO-OO()(,[) - CX) '70 Rcpt: 741209 DS: 0. 00 12/17/03 Rec: 6.00 IT: 0.00 Dpty Clerk S tare of Fl oJ.i4 a County of' Pu6CO JED PITTMRN, PASCO COUNTY CLERK 12/17/0301:56pm 1 of 1 OR BK 5662 PG 26 THE UNDERSIGNED hereby give llutice lllllt rhe improvcment will be made to certain real properly in accordance with Chapter 713, Florida Statues, the following information is proviueu ill this Jlotice 01" cornmencement. -L' A.Contractor (name and L1CJdress) ?J/cC,i..//l< ~ Ad j!.L--'c.K5 f/ j LL[;:::2. :y {?(; (.;' I 5.Surety u)Name and address b )Amount of bond 6.Lender (name and address) /19 if: //J.?-1:::...jk.~ BL lId), 7 .Person wi~hin State of Florida designated by owner upon wl10 notices or other documents may be served as provided by Section 713. 13(1)(u)(7), morida Statues. Name and address 8.ln addition to him or herself, owner dcsignates of to received a copy of the Lienor's Notice a~ provided in Section 713 .13 (1 )(b), Florida Statues. 9.Expiration date of notice of commenccment (the expiration date is one year from the date of recording unless a different datc is specilied). iJLll'~6C! -1'13 --~,"'7.J"J -co') ,:;: . , . ./ / STATE OF Fl:;~p~<,_, . X-/c-J;;.L.;C /'t:1J.:<:~--)c.:->.J~:';'" _ '/I_Y: COUNTY OF"~~,f / Signuture o[owner .,.-J=he [ollo;.;,i l~)n?f-..n ,lIment wns nck:19wledged before lIle this :~,~dny nf (V :1'.: ^1\}-yJ~200 5)by_ -i(Vi (V -W},tk);tTt6'>1ho i" pl>t~onf;lUy k~ or whll produced LLG .-') as idenlit1cation. . -f l' 'l~lC' ", ') Inc. ~~ -:> \J'\ ~ \rJ 7"'1 , <:P_ z.,. ~ -a. ::z-B ,.., ~ ... ." ~ ~ ;;z,.. 2.-3 Z><]. ~- IJ\ ::: 'bo ~~ .~ -t.~j .. ~~ VI ... -1 00 -c:: -. - 1- ..J - ~ ~ N ... ... '2,,~ '", ~~~ ,,,---.. ..~ . . . \ : '", '. " ,,', . ... ".~ '"'''' "" '" ~ ~ ' - '"' - - ....-- '~- -" ... w- -C. ~ ~ ~~~ lJ 1::::- - ~ ~ l'\ ~ ~ ~, ~ ~ ~ ~ ~ -t "-. . .",: ... " ~ ~ o t SINCE 1960 KEN ZECHIEL, PA Consulting Engineers February 24,2003 TO: BUILDING OFFICIALS OR PLANS EXAMINERS (ANY FLORIDA COUNTY, CITY OR MUNICIPALITY) Ref: MASTER SET ALUMINUM CONSTRUCTION STANDARDS 2002-2003 REGISTRATION SERIES: 3389-009-205 To whom it may concern: This is to notify you that STEPHENS AND WOOD, INC. is registered to utilize our 2002-2003 ALUMINUM CONSTRUCTION STANDARDS for a period of two years expiring FEBRUARY 28,2005. The signed and sealed cover sheet (page 1 of 36) and ten addendum sheets is considered inclusive certifcation of the set. lhese standards are applicable to the State of Florida only and are for a maximum wind speed zone of 130 mph. Site specific engineering must be obtained for any job that is an area that is designated above 130 mph and/or Exposure D or commercial construction. We will notify you of any changes, additions, addendums , omissions or errors. Kenneth C. Zechiel, P.E. 09931 .,...., , \ '":(r 1 4316 New Riverhills Parkway, Suite 11 Valrico, FI. 33594 (813) 689-2775 (813) 677-7882 Fax: (813) 677.7119 E-mail: aluminum@engineer.com ( . AL~) -'.j 'v~ r2xc )~ G-1i. 7 L Y ~ (..(/ Cr- ,~lt1-N 'D ~~-p. '~L ~LL 6')\J (L[l.- -,- "- ::'\...--- --' --- ?~~(=== .,.'~ =Ulc:" . 'O.l-= '; llae:- :7,':;:J I ::ru=UI:L OJ I c.) U 0 _.:> < /'1 r"\ .00 ':':'l.l!lLL.l::l!!: L.-LJ .................-.-- _................~.....- -~..:nn:::; Ul~~ '..Jic..::~~ .:-':'uua: ~:':::lJU1~-:: -..;nnt::::::J.;.:l ~ IDDat.-: p.LAr OF SURVEY SEC. 34, TWP. 25 .S., RNG. 21 J PASCO COUNTY, FLORIJJ N ()fJ~ ~V oil. ~~, ..lV~~ I'ND 'r~K ~\c,l-.t~V 't"nu \ \~ \~ , \ LlCI"'. flU .... PJUU.lS.SYO#.4L LilNP s-ua"rI'II" ID .. '0lllfI SOt .. SIr IIltl." RM nR .- I'fJUMJ JIIDN AU (,) - PLlr (X) - 6~ I;,:- JrIt:8:t' or Jf"AT -~I .. I:8NOII:rI .uti" I ..". ,- ., .< J.or 4 ~..~ tJo~ ""~ f' ,II/wE! 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(J'Ur,).4.UNtI nrr rISW.lUY ~ IV ur r: 4 r6.l$ SUJlI'Jin'U J$ HfJr JU'~ FtM &I8IKINr.S: ~-r.s: QR IKCV6I&INl'IS' tV JU't:'I'JiU) NOr S811,a .JU:JlItlN rJr.Ir JUI'I NI1:t'.1111N ~RHJSIIIP TII :t'JiUS' t>>"JIYCI tJF rHAr.HZ .&JS' Nt1 A;W'~&I F.lU'JlItU: So nus SVJl1'JfT IS SOJIJ.I'Cr ro 4IV1' ,.,t:r.S' rial" .JU.r .//1 .lIJ'SatU:U //.r ~ .PUU .4#1 At:CUJUrl rnu SZUICJT. 1lllS COI1NS: 1HA1"" ....\C II"'~T.. f6 - _~ IIDCIIlED ,/D,.. _~_ "IO, P1111rl1rn: !HAT If IS: _ ealIIiCI 10 1IC .". ar ~ ....._... ..." - IlIIOIUIIGt HIIJ All(, lItAT 1ItIS l'IJIT IS A 1IlUl IlD'Il....T~1IOI ~ _ lItE SlJIIlI('t AMIl 'DlIt flI.AT COolfCIIlMt '0 TI1I: 'll:ChICAI. $",__ SltT R*1II llY M I\OIIIlA &o..r.G 1.,- ~1Ill .. __ 61C\7-G f1.A. ~ 11\; ~ ~'Wr m sn:_ 4~on RA. srAl"'.otI. 4-~4~~~._~. ~Tn ,"'" -eftS old .IH #/AJ RrnSlDNS: i BIU R. BROTH AI"~ (HI ~A' lJ-17-D:1 .uJDRA I!IlJnR IUrI f>>' SUIl'I':'", d- ..ISSOC/ArK~ INC. t:ZJ.lrAI7:- RI'.fUN &rJNSTRl/l:7T(J./I .u.YSI "I'. U.I- J1J1 NU.V11I.a.. 4':1IJ~ ZA:P1.Y.IUI.f.US. .PUJIOM .<<II.'fJIt -.....- .. aua... RAg:Ol ~o ~ 1 If :1 I I AUTHORIZED AGENT AFFIDAVIT I ,4If" O/Vr> hereby grant authorization to /);~,&! t ;{;~T/J r., ~ (Contractor) (Authorizect1Agent) to act in my behalf with the Hernando County Development Department while conducting activities related to obtaining permits. These activities specifically include signing all documents requiring signature of "contractor". j'. / .. ~'{Jf( J:~" ;/1" (Authorized . gent) therefore the signature of said agent is binding and causes me to assume all responsibilities connected to or associated with the signature as they may relate to my contracting business. v / /.J Stele f.;;<7/V.'e/7 (Contractor) and agree to hold the Hernando County Development Department harmless from, any and all responsibility, claims or other actions arising from or related to the Department's acceptance of the above agent's signature for permit-related activities. I further understand that it is my sole responsibility to grant and terminate any such authorization and 70': nsure ~ Departr1)ent receives timely notice of any such grant or termination. /, //1 /l / / >?: /f!'t :z" / /~t/ 4t . 'VL -.. 81 n ture of Contractor i __ Signature of ,t\gent ~ is to be considered an agent of my business and relieve the Hernando County Development of, .:::;(' r: (~;~ UN> 7 / State Certification or Registration Number County Certification Number (if applicable) -PLEASE NOTE: BOTH SIGNATURES MUST BE NOTARIZEO- Notary for Contractor's Signature: Notary for Agent's Signature: .---; J State ofL L-1..-f County Ofi~ , ~'-; r/'" ..>~ L~:i.,. (_~ /--:' - The foregoing was acknowledged before Te this -7'" ,. day of ~/,,/.1 /L<'-I . ,;.;. C~ . by -~, /' /. '" ,>':1 /; . who is personally known ~or whq-produced as id9ntlfiiGt~?-'~ ,0~ r/ l~ ~ ( [t,. I.,':,"'" _ , /_'-:-"?',...(:-.~,_, __ --i--'C.f.... U-,tui~,-I ,-. ~l;T NotarY Public Signature . / ,/ l/ - , . . Slate ofee H County of ,c'--f- 'ii!:!.. y/""(/j.(.r:' I .- The foreg.~"E"wa~ acknowledg~ bef~r~me this J I dal( of ... 11../ i / . -I r (/ :5. by /., 1'(/ YC-j' - /! who is personally known to me. or wtm-pt:Oau~, J - ~ as Ident~Caoon. / - '~..I../'~-,/ .1.. /, v.(_. tl,....~... / ...: :.-./. 1,../:,. J .~ - . C r U:'j/~-L..'; (~'.....:;.-:pt~ Not;;ny Public Signature ij' " '.~ ...~;':lpp~... Shaunessy Owens "011"", '~~..... '. . -;;;'''''ep'' Prirr.t\:1 :~~ ~~~ ~f 1oIHW::l;>flO cll~l~t~ Prinf:~~. :~~.bi=.o ~lIIte."'~s . ~~'. :,,~ rebniary 23;2lit6 = : ; = IVrn:.0J\4_aN'# ODe71 ;: '-.::to';",*,"" clONOEDTHRUTROYFAlNINSURANCE.;NC '~;~"",,""~';- i=@bruary23285}G6.XPIRES '..""., . . . . ,.of..f,;'t. 89NDEDtH ,U . The original of this affidaVit snould be kept In the possession of the above deslgnate~~liW!~Agent". This affidavit need only be produced to Hernando County when signing documents in the presence of a permit ;'epresentative. When you sign a permit application be prepared to produce this affidavit. it will be copied and placed in' the appropriate permit application.' Revised 11/08/99 contauth.sop AUTHORIZED AGENT AFFIDAVIT l II I hfevl." C~{Ur:l hereby grant authorization to J.Li,/;;/v(' t1l?;C,Ty1C,-" (Contractor) I (Authorizect-lAgent) to act in my behalf with the Hernando County Development Department while conducting activities related to obtaining permits. These activities speCifically include signing all dccL4ments requiring signature of "contractor". '. ;)&1 j {i" i'."- is to be considered an agent of my business and (Authorized . gent) therefore the signature of said agent is binding and causes me to assume all responsibilities connected to or associated with the signature as they may relate to my contracting business. 51e'J/r!- C:;'fl;>f;r] relieve the Hernando County Development of, (Contractor) and agree to hold the Hernando County Development Department harmless from, any and all responsibility, claims or other actions arising from or related to the Department's acceptance of the above agent's signature for permit-related activities. I further understand that it is my sole responsibility to grant and terminate any such authorization and. tPJ8. risure t~ Department receives timely notice of any such grant or termination. /1'1/ A ;:;;~, /1' ,/ // -~ .// r //~~It!,//'/t//Z~/C/L ~ Sign ture of Contractor / /_ v Signature of .!\.,ge:1t ..~;: '~- ;.... .~e (' r:7 ~ &"C' 7 / State Certification or Registration Number County CertifiC:3tion Number (if applicable) ....PLE:ASE NOTE: BOTH SIGNATURES MUST BE NOTARIZED** Notary for Contractor's Signature: Notary for Agent's Signature: ---7 _'! State of .."'- L /1 .''; County of /~-." '. i~~"/~'i" ~~,..,~."""."/'~ Slate of C~ r County of ,--... ,r,:"(. ,:.." f;[-/ _,~,- .' j The foregoing was acknowledged qefor~ rpe this ,~ ,; day of-">'/f /;;: '- , ,J\ I. L .5 ,by ;:-J-; , " -- '-: ,-,,9 /1 . who is personally known ~.or wh9.-produced as :d'ef1tifi~h9f / .-b(~U.2c c ,~U; :)0 L / (S'7~ UJ:.~l;r NotarY Public Signature ' wh1J'Q(6<1.~' Identilieati(n ..dr-,j' ((I/{i~;;'. I ...' - '- " - Not<;riy Public Signature' . ,/ - ../", ../ ~. ~.,_ '_:; <N:--Y- '/ .-:.~:t~::'~)' Shaunesc:v Owens ,..Ill'", , "....r~, -, .' OJ\"( Ps'" pri~f-r~:f~ ~~~111 flf lolUW::Ii'fII\ :)(PIRE~ Prinf:~~:~ ~,,~WleI3It~s . ~~.~:.;: 'teDiilary 23;2lb'6 c~: .. ~ - -~# "OD07!5;o 'XPlRES "'~-%';'.A.*,~ JONOEDTHRUTROYFA:NINSURANCE.;NC "~"''''~o/ February 23 2806 - . The ~'~;~inal of this affidavit should be kept in the possession of the ~b~~e de~?g~~rJ~Tt<Jl:UW;~~ ~ent". This 3~-fidavit need only be produced to Hernando County when signing documents in the presence of a permit representative. When you sign a permit application be prepared to produce this affidavit, it will be copied and placed in the appropriate permit application_* Revised 11/08/99 contauth.sop -....: 9508 East M L King Jr. Blvd. Tempa, Flori. 33610 (8'l3) 821-2200 Fax (813) 821...i'i-i:"c AtTTHORIZA nON LETTER r, Steve GremJ. '~('mract.or license !1ilrnber SC:COS6671, hereby authorize the following .r~, act as my agerl1 in obtaining permit:s: TI~~'r J~u"'J.O:D AI. KING ~ . @,/;~l&~_ ~.,~ ( HAROLD W.AG};fEP. ' DAN HAJ.L!')P~AJ\j -----.........-.....-.. '_' ._ _"-Il!l."'_.":"_.,:,__~_.~_..........,"_"__,._,_.",..,, BRrAN tyeE This autn0.d~~atk1i :~ tc f,;mallidl ,~~t ir~Jefuritely. unless canceied by me in "Titir~g. .---~;("~~. ~ / ~--~~;~~, l A Steve~.~_ '.~4 "-,.~_.,__.__,-~.- Sworn '" - 51Ibscribcd to o.m", me this gT6- day of k 2003 by !-:~ w._.~. tePhe.IJ.S., wOO. '.. is~.~ .....knc,"TI to me or. has produce ._/ PI( as \ ldt:utifi~:p ;;nQ:Wli~ did d no' ~e ~ oath. '-- . . Ii 7 , . ( A' ~. . \ !...~ /. ....---.. .,.1 ." l~: :. ..! il'n1..J.~/ . . Ie'. Crt..-' !d()f.,t/ L.'- ~J' -" -~~M' () I .. . . ! ! /' My commission expires: G! 5 / ~<<.) 1 t " Wl.~7J:."I' Mitilelie Gonza~t ;,.,>>. :.~ MY COMMlSllKm (f. D02ro.~80 ~j>;~ ~\ : : June 5, ZOO7 ~'}'.~\. ~'i1IIU"!'lID't'e~ 1~'A""':i,. 110M: AUTHORIZED AGENT AFFIDA VJT II 1. I 4/,'(1 (Jrler-J hereby grant authorization to II:"./' u tv:;q "'r. - (Contractor) . (~~~hOri;~;~9~~t) to act in my behalf with the Hernando County Development Department while conducting activities related to obtaining permits. These activities specifically include signing all documents requiring signature of "contractor". ~i;;o~~i;~~ is to be considered an agent of my business and therefore the signature of said agent is binding and causes me to assume all responsibilities connected to or associated with the signature as they may relate to my contracting business. ,// It /) ~ ~I./~ L-n/72~e,r} .-' (Contractor) and agree to hold the Hernando County Development Department harmless from, any and all responsibility, claims or other actions arising from or related to the Department's acceptance of the above agent's signature for permit-related activities. I further understand that it is my sole responsibility to gr~nt and terminate any such a~th~rization and... ti9' nsur~.th ..... Department receives timely notice of any such grant or termination. . " / .r I...' ;" in / /' // / / " /'/;!' ~/,-' ,I.~ /l ., / / _" ,,"} ~ ,~ /2 f //tt/IJ'<r/ /~ /Lv:.~/L~ -' ture of Contractor I)' Sigr.at.J're of Agent /~/ relieve the Hernando County Development of, i Sign ~ L..{J/:r~ .r-.:.-,,/, 7./ , / , ,'''''' V l./ State Certification or Registration Number ------- County Certification Number (if applicable) "'PLE:ASE NOTE: BOTH SIGNATURES MUST BE NOTARIZED** Notary for Contractor's Signature: Notary for Agent's Signature: C7 ..-) State of ; '--' I / ;, County of i'-r' . , ' .-: ~:~ /7,c-'// !:~\., .'''~''''r'/-- ---, "': Slate of .L- L ,- County of i 1';'-",' '.I' ,/,:/... 1,1 ~ f.,.( :.oj' .> / -' - The foregoing_was acknowledges! befor~me this;;r' daX of '--If tf,ci . , ,-' / () :5, by i'-' i 4:'., .~,-' ,1 who is personally known to me. or who-!;l(oau~, .' ~as tdentT6a,~n, ./ _ .! :L; /'( , i :I/L.~ __/'-;; .~, l....:/....t /~ L~' ::~/;..-~..-- ~., .~. '-.- ;.- /'" Not;;rry Public Signature The fore.going w,as,acknowledgedbefO(e,pe this ,~' day of _ir~/,' / L ,'_1. ,?<.' C -' ,by S:v / (. ,. - ,...,9 /-"' . who is personally known ~or whq..produced ,- as :d'ent!f!~.."t!!.r..y( .. . . . ....--/ \pr~;/_., .. .. .. -, .~. -l.-~</ - ,. /. .'-; ~_ ~ -------+--'.C U_L L L .~. Cd- _/C' :.. I -' " /, '-""- i.J, ;.7 NotarY Public Signature ! 'J 1,111'1, ....h "wen" .......~~~!'sf'~~~... :;; aunessy '.-J ~,: . ,-"'rr.yIW~/, pri~t1~ltt 's'tMrli9~ ~f ~~i'f "J'J'IRE:; prin!'':;~:l. :~ ~J~{JJ~W\III$W~S , ~~"~'~~ r-ebruary i3;29l1'6 '3:. :_= M.fi5lBN'# DD071StiI SXPlRES '.1.iip,...;;.,l{;,.,.- oONOED THRU TROY FAlN INSURANCE, IN(, '..;,......~}: r-ebruary 23 2806 . The',~f~;~inal of this affidavit should be kept in the possession of th~ ~b~~e de~ig';i~W~T~UW:lI'j~lI'fgent". This 2;fidavit need only be produced to Hernando County when signing documents in the presence of a permit representative, When you sign a permit application be prepared to produce this affidavit, it will be copied and placed in the appropriate permit application: Revised 11108/99 comauth.soP