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Home My WebLink About06-6316 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 6316 4,000.00 75.00 Address: 38039 7TH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-12900-0015 Name: COLL YMORE LAKEYSHA & JAMES KIM Address: 38039 7TH AVE ZEPHYRHILLS, FL. 33542 Permit Num er: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 6316 SLAB PERMIT SLAB SINGLE FAMILY RESIDENTIAL Phone: 12x12 & FOOTING FOR FUTURE SUN ROOM 5-d-d-Oi- Clt~ c ~.dl f p~~6c.-"- vJl Ol:d"'C\9-"--, w " ,\ , C:~ )LQ o...~ . J ph CCL-\--tcFn - ~iLUJLL Q(j)mr~-hfl... C o-wdJ ~ -S~b~ (w\~4~ ~oc.. S, ~ &rn-,mo_~ _ Houd <2..\.p-0Cc-\-t 0V) P'I\ o-r +0 -.:rnsp SLAB FINAL REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections 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. 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 permits required from other governmental entities such as water management, state agencies or federal agencies. 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. " NO OCCUPANCY BEFORE C.O. ~~ CONTRACTOR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED - PROTECT CARD FROM WEATHER City of Zephyrhills BUILDING PLAN REVIEW COMMENTS 35'd 5@ \ DS'ieo Hw- 0<1.554>H Site: eLf t1 t1 i'J AfllY\ ~<fru I!. 'It'llY) /2 -1<1- lJ~ 38038 7~ 4v6 r-e.-~ s/i{,b Denied withe below comments: 0 Contractor/Homeowner: Date Received: Permit Type: Approved wino comments: 0 Approved withe below comments: ft\ \A I' o ~'J!IL-r=r l't> l t.( fL0~V UN li n ~ ~b- ~ ttS ~ l>Sr=--. $LbNW ~h~1)2- S-~l ~~ D\-\15Y\-tIITW . JtL\"'1L ~ ~~vrrL DP 5~3 J~~~c-1\~t\i, '~1J ~0 i rtt=-> 51ZAli.9 ~j/ p:u2.",~ r; ~rl ~ P ulli>u.Jl:s dm<.;~ This comment sheet shall be kept with the permit and/or plans. fJ}/f/cL ding Official Date Contractor and/or Homeowner (Required when comments are present) 813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Dme Received Owner's Add...... Fee Simple TIUeholder Name I Owner Phone Number Owner Phone Number I Owner Phone Number I I - .$'17. 7J1~. 1/J/7~ Owner's Name 7" f1Vf.- I I I I +~ ~ JOB ADDRESS ZC,~y"'h;'J~ I PARCEL lOti 1 //- at. ~ .1.1- O~I b - /2.ctO() - tJOI S (OBTAINED FROM PROPERTY TAX NOnCE) CJ.. NEW CONSTR D ADD/All 0 SIGN 0 MOVE D ~ INSTALL D REPAIR PROPOSED USE 0 SFR D COMM D OTHER TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL 0 OTHER I I DESCRIPTION OF WORK PlJSfAL.L..A-1io'.1l o-f- C!oNti2l!~ ~; I=001ti1Jt..J for +tifWL-e. S'4~r/ZoOM 12.' x. 12.1 I SQ FOOTAGE II'ILl a I HElGHrt- I Fee Simple T1Ueholder Address 1 13-rfJ3ff I LOTti SUBDMSION WORK PROPOSED DEMOLISH BUILDING SIZE D BUILDING ELECTRICAL IS ~&lOO.c90 IS 1$ 1$ rdJ!!}- ROOFING VALUATION OF TOTAL CONSTRUCTION BUILDER SIGNATURE Address ELECTRICIAN iliA- SIGNATURE Address PLUMBER Nit- SIGNATURE Address MECHANICAL Nil-- SIGNATURE Addrus I I I I rd1t- I AMP SERVICE D PROGRESS ENERGY rti1r /i51 tilt- NIb GAS FINISHED FLOOR ELEVATIONS I SPECIALTY 0 FLOOD ZONE AREA OTHER DYES ~ PLUMBING MECHANICAL VALUATION OF MECHANICAL INSTALLATION I ~'U/IU'jJ' h.~ Q.oN,.Trw,a.r;,J ~ FEE CURRENT ~ License # It! 6e.. O.y" t..33 COMPANY REGISTERED ~ FEE CURRENT ~ license tI COMPANY REGISTERED ~ FEE CURRENT ~ license tI COMPANY REGISTERED ~ FEE CURRENT ~ license # COMPANY REGISTERED ~ FEE CURRENT ~ license # OTHER SIGNATURE Address RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal dete, Required on site, Construction Plans, Sanitary Fadlities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms, Minimum ten (10) worl<ing days after submittal date. Required onsite, Construction Plans, Sanitary Fadlities & 1 dumpster All commercial requirements must meet compliance. Attach (2) sets of Engineered Plans, -"PROPERTY SURVEY required for all NEW constI\Jctlon, COMMERCIAL SIGN PERMIT Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If oyer S25oo, a NoUce of Commencement Is required. (AlC upgrades over S5000) Agent (for the contractor) or Power of Attomey (for tha owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMlmNG (Front of Application Only) Reroofs Sewers Service Upgredes AlC Fences (PloUSurveylFootage) Drlveways-Nol over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this pennit may be subject to "deed" restrictions" which may be more restrictive than County regulations, The undersigned assumes responsibility for compliance with any applicable deed restrictions, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations, If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law, If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847- 8009, Furthennore, 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 property licensed and is not entitled to pennitting 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 be identified at the time of pennitting, 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 pennit issuance, Furthennore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to pennit issuance in accordance with applicable Pasco County ordinances, CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs, If the applicant is someone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the infonnation 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 pennit to do work and installation as indicated, I certify that no work or installation has commenced prior to issuance of a pennit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction, I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance, Such agencies include but are not limited to: Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterlWastewater Treatment. Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Anny Corps of Engineers-Seawalls, Docks, Navigable WatelWays. Department of Health & Rehabilitative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment, Septic Tanks, US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways, I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "Y" unless expressly pennitted. 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 pennitting 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 pennitted 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 pennit issued under the attached pennit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required, If I am the AGENT FOR THE OWNER, I promise in good faith to infonn the owner of the pennitting conditions set forth in this affidavit prior to commencing construction, I understand that a separate pennit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application, A pennit 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 pennit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes, Every pennit issued shall become invalid unless the work authorized by such pennit is commenced within six months of pennit issuance, or if work authorized by the pennit 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 OMMENCEMENT, FLORIDA JURAT (F.S. 117,03) OWNER OR AGEN~12J:JLl ~ Srbscribed and 'SW to (or affirm J ,lI-'clq by t1 Who i are personally k me r haslheve produced CJ. s identification, ~. >,t:.~' tL .tI~~ , mlssi~ o. . .........,.. JA OUELlNE A VA JEZ tj.),. .. "" ' " I :f-\ Notary Public. S1IIte o' FIOIIlII . .;.ty Commission Expires J ul 21. 2ID1O l~ .r.,fli Commission tI 00549872 ...... Bonded National Not,,-! ~ Plot Plan NAME: Mr. Kim C James & Ms Lakeysha Collymore ADDRESS: 38038 7th Avenue Zephyrhills, Florida 33542 PHONE #: 1-347-742-4472 CONTRACTOR: Cunningham Construction ADDRESS: 12152 Fort King Road Dade City, Florida 33525 PHONE #: 1-352-521-0955, Fax 1-352-521-0596 I-~~~-w-- '" o '" .0 a:; (f) o z "".". --------11'-0" ---- 14'-0" l NOTE! the old 14' x 20' carport was removed Existing Home NC- Setbacks 1'Z-o" " .. Existing Porch ~ '" .0 a:; (f) o z Proposed New 12' x 12' Family Sun Room ~-I " ~ " l:l Setback Changed to 2' less (Carport Removal) Cunningham Construction '12152 Fort King Road Dad City, Florida 33525 Phone # 521-0955 Floor Plan With Footer Details BillLDING SHALL COMP6i wITH ALL APPLICABLE CITY ZEPHYRHILLS GRDIN I\NCB 12'-0" - LlJ ~ o I <.9 z - I- C/) - >< W FINISH FLOOR ELEV A TION SHALL COMPLY WITH ENGINEERED DESIGN AND/OR CITY OF ZEPHYRHILLS ORDINANCE 12' x 12' Concrete Slab with Monolithic Footing -( 121L'W'fl}i.- ~\4..'\~-r ~\Jl- ~\)D ~"AT(~ C-f....L.\)f\~. ~\~ BFB- 351 A b -' N ...- , COMPLY WITH BUILDfNG ~~t~ BUILDING, ALL APPLlCMBING AND ____ELECTRICAL, PLU ~_~ MECHANICAL---coD ' REV~'7W DATE: i~1 \ Lf (~.L ClT1 nF ZEPHYRHIL~ II'~,L . ," /1,.0"'" <WFICIAL IWUt'l Monolithic Concrete Footing(3000 Ibs. Mix) 6 mil plastic installed 6"+ slab above existing ground level \;\Xx/I ground level JXfx'/\ I HEARBY CERTIFY TIIAT I HAVE REVIEWED THIS PLAN AND FOUND IT TO BE IN COMPLIANCE WITH THE 2004 FLORIDA BUll..DING CODES, THIS PLAN MEETS THE REQUIREMENTS FOR 110 MPH, WIND ZONE (3 SEC. GUST) SIGN; fI~~ - J.A.W. DAVIS # 6603 P.O. BOX 720 WEBSTER. FLORIDA 33507 #6603 DATE Cunningham Construction 12152 Fort King Road Dad City, Florida 33525 Phone # 521-0955 Floor Plan With Footer Details m._ 12'-0" ----- UJ ~ o I <.9 z - I- CJ) - >< UJ FINISH FLOOR ELEVATION SHALL COMPLY WITH ENGINEERED DESIGN AND/OR CITY OF ZEPHYRHILLS ORDINANCE. 12' x 12' Concrete Slab with Monolithic Footing ~\15~ '-~l~' ~Vtt~h ~ ,Ii. b -' N ~ , ~,,"j) ~f'ffl=0/ (~1i4"A'J2- f2 a r. ~ o'l.~ r~ ~ 05' . BUILDING SHALL COMPLY WITH ALL APPLICABLE BUILDING, ELECTRICAL, PLUMBING AND' ..-MECHANICALCODPS, -- BUILDING SHALL COMPLY WITH PPUCABLE CITY OF , . . C t ~i~:YRHILLSORDlNANCE. Monolithic oncre e Footing(3000 Ibs. Mix) 6"+ slab above existing ~ " J 6 mil plastic installed ~ -..c> -' '~'. ~ _' -~~. ",," ground level ., l(;::: _... over pretreated SOl, ,', '_ - ~ 4 . _ ~., '\ ^&" /' / , ,', '\ \ I 6" x 6" weld wire mesh lapped and tie);,' \ \'.' <l _ . groun level EXistin~ le~n FII(". - -~, .... ~'Y,\\;\/\'\ /'J' ~\ ,.' , , .X XX'V\,A \ "o' / ;: ',' / /I 2 # 5 rods lapped & tide as per . :\1b--4~ ~ 2006 Florida Building Code / x?y K~VIEW, DA, T, ,E, ',I f"J2 J It.!' ' , / cln OF ZF.PHV~. /J , BUILDING OFFICIAL ((( [J '5<-- I HEARBY CERTIFY THAT I HAVE REVIEWED TillS PLAN AND FOUND IT-TO BE IN COMPLIANCE WITH TIlE 2004 FLORIDA B~DING CODES, TIllS PLAN MEETS THE REQUIREMENTS FOR 110 MPH, WIND ZONE (3 SEC. GUST) SIGN; 1J~~- J.A.W. DAVIS # 6603 P ,0. BOX 720 WEBSTER. FLORIDA 33507 #6603 DATE Parcel Information for: 11-26-21-0010-12900-0015 Card: 001 Page 1 of2 Search AQain Show Map Generalized Building Schematic Estimate Taxes See Tax Collector Information - CurrenUDelinquent Taxes The online search system is currently unavailable. Information displayed below is from a weekly archive. SOH and Taxable amounts may not reflect current values. ParcellD 11-26-21-0010-12900-0015 (Card: 001 of 001) Classification 01 - Single Family Mailing Address Assessment (totals) COLL YMORE LAKEYSHA & Ag Land $0 JAMES KIM C Land $13,650 19046 BRUCE B DOWNS BLVD #140 Building $17,147 TAMPA, FL 336472434 Extra Features $69 Physical Address 38038 7TH AVE Total Assessment $30,866 ZEPHYRHILLS33542 Save Our Homes $0 Legal DescriDtion (First 4 Lines) CITY OF ZEPHYRHILLS PB 1 PG Taxable Value $30,866 54 PORTION LOTS 1 2 & 3 BLOCK 129 DESC AS BEG AT THE NWL Y COR LOT 1 TH EL Y ALG NL Y BDY Land Detail (Card: 001 of 001 ) Line Use Description fining Unlls~ Type I Price I Cond Value 1 0100 : SFR OR3 4,200.0 SF I 3.25 I 1 $13,650 Additional Land Information I Acres I 0.1 Tax Area II 30Z'Hl/" Fema Code II AE I Res Code LHLP2 Building Information - Year Built 1922 USE 01 - Single Family Residential (Card: 001 of 001) Ext Wall 1 Asbestos Shingle Ext Wall 2 None Roof Str Gable or Hip Roof Cov Asphalt or Composition Shingle Int Wall 1 Wall Board or Wood Wall Int Wall 2 None Flooring 1 Pine or Soft Wood Flooring 2 None Fuel Gas Heat Forced Air - Not Ducted AC Window Unit Baths 1.00 Line Description I Sq. Feet I Repl. Cost New 1 FST I 66 I $1,802 2 BAS 472 $25,771 3 FOA 120 $1,310 4 I UOA I 280 $2,293 I Extra Features (Card: 001 of 001) I Line II Description II Year II Units II Value I I 1 II UDU-M II 1985 II 1 II $69 I Sales History Previous Owner EISENBERG ANGEL I Year I Month Book I Page I Type II Amount I I 2006 /I 03 I 6915 / 0549 ][]f I $59,000 I I 2006 II 03 I 6885 / 0428 I $19,100 I / http://appraiser.pascogov.comlsearch/offline.asp?Sec= 11 &Twn=26&Rng=21 &Sbb=OOl 0... 12/14/2006 Parcel Information for: 11-26-21-0010-12900-0015 Card: 001 Page 2 of2 2001 04 4589 / 1562 WD $22,000 Search AQain Show Map Generalized BuildinQ Schematic Estimate Taxes See Tax Collector Information - Current/Delinquent Taxes http://appraiser.pascogov . comlsearch/offline.asp?Sec= 11 &Twn=26&Rng=21 &Sbb=OO 10,.. 12/14/2006 12/14/2006 09:34 3525210596 CUNNINGHAM'S PAGE Ell ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID scsj DAn: 1~0NYYY} CTJNNJ: 5 09/25/06 PRODUC~ THIS CERTIFIC.TE IS ISSUED AS A MATTER OF INFORPAATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ~acock XDsuranee - IKiJceliUld HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR "- O. Box 328 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LaJce1and F.L 33802 Phone: 863-683-2228 Fax: 863-683-3309 INSURERS AFFORDING COVERAGE NAIe # INSURED INSURER A: MI:eIop hefund 1M""'....,. CD INSURER 9 CunniDgham construction , INS~E~ c: Gr~ unniaqbam 1215 'oz:t ItiDi i INSUIlEll D .-- DaCle C.ty !"L 3 525 I'NSuI\E~ E: COVERAGES THE POLICIES 01' INSiJlANCE L'STED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED )\SOVE FOI'l THE POliCY P~IOO IlIDICATEO. N01WrlH$TANDING ANY REOUIREloENT, TERM 0I'l CONDITION OF AAY C~CT OR <mER DOCUMENT WIlH RESPECT TO WHICt1 THIS ce~IFICATE MAY ElE ISSlEO OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED foEREIN IS SLlBJECT TO,o,Ll THE TERM$. E.>ICLVSIONS AND COI>OITIONS OF SUCH POLICIES. AOOREGATE LIMITS SHOWN MAY HAve eeEN REOUceO BY F>AiD CLAIMS. rjR INSIil TVl'i 'OF INSURANCE! ) POLICY NUMBER DATE IMWOOtW)~ OA~ IMMloDM'I LNTS CiENEAAL. L.lA8I1.1TY EAC'"' OCCVR~eNce J I-- ;;ses IE. oe~enc.) 3MtoERCIAl GE~Al LII\BIL'Ty S I-- ClAIMS W'DE 0 OCCUFI I\IIED EXP (My 0Ilt person) S I-- PERSONA.L 4 PDV INJURY $ - GeNEIW. A(;~eGATe $ ~N\ .-.GGIlEGATE LIMIT JlPPLIES PER: PROOUCTS. COMPIOP AGG $ ~ POLICY n ~ n LOC AUTOMOBILE UAkrry COMBINED SINGLE LIMIT '- $ ANY AUTO (Ee eccidtlll) I-- I\L.L OWNED ,o,urOS BODILY IN.JuRY - $ SC>EDlA.EO ,o,urOS (Per Pinon) - HIRED ,o,urOS BODILY INJuRY - $ NON-OWNEO AUTOS (F>er~CIet'I.I - .~ ,.' PROPERTY DAMAGE $ (POl' BO(:odml) GAAAGE LlASllnv AUTO ONL Y . EA ACCIDEII/T' $ R my AlITO OTJ.<ER 1liAN EAACC $ ,o,urO ONl. Y AGG $ ElCCeSSlUMBRElLA LIA8Il/JV EACH OCCURRENCE S :JOCCLR o CL,O.Il.lS M.o.DE AGGREGATE S $ ~ DEDUCTlel.E $ RETENTION $ '-'- $ WORKERS COMPENSATION AND X ITOOy'L:M:-rs I r~ EIiIPI.OYERS' UI\8ILnY A llI'Iy P~IETORIPARTNERlEXECVTWe WCV'7053171 06/26/06 06/26/07 E.L. EACH ACCIDENT $ 100000 OFFICERNCMElER EXCLUOEO'> E.L. DISEASE. fA EMPLOYEE; S 100000 It yes. Gt9crlbt under sPECIAl. PROVISIONS bOlOw E.L DISEASE. POLICY LIMIT S 500000 OTHER DESCRIPTION Of oPEAAllONS / LOCAl1ONll / VI9IICU8 , EXCl.USIO~ ADOEO BY ENOORSEMliNT , SPECIAl. PROVISIONS ceRT'F~TE HOLDER ./ C.i t.y ~ Dade City B~dq CODst.ruet1oD Dept PO Box 1355 Dade City r.L 35525 CANCELLATION CJ:OJ"DAl) SHOUlD A.I<< Of' n4I! ABOIfE DE8CRIllEO ,.OLlClES lIE CANCELLED BEI'~E 'n1E EllI'lRAllON DATE TWEREOF. THE ISSUING IN8UIU!R. WILL ENDEAVOR TO MAIL ~ DAYS WRITreN NOTICE TO TWE CElmFlCATI! HOLDER NAMED TO 'YHE l.EFT, BUT fAILURE TO DO SO ~LL IMPOSE NO OBLlGA,TloN OR LIA8ILnY OF AI>N KIND UPON THE INSURER, ITS AGENT'S 01\ R&PR.ESEIO'ATM;$. " ENfA'mIE ACORD 2512001108) lD ACORD CORPORATION 1988 12/14/2006 09:34 3525210596 :?~~\;.,:.;:<tl:'Jt'._.... ~.: ,r '., " ,""~'. ".' ,:. l......o:;.=:.:.:~~.::.::'::~.:.~.. ~. ":,:'Hr o . C....f)():.. I'. ta:I Cl Z ~ .0\ ~~SS' .~ [G ~ t.3 . tIJ r.nZZ . ....lD If) IV IIJHH. 11 I"f .Q,m . . n ~~ 'H'PJ Cl IV' H"4QQ 'r't'r't'tJ'HO. ~~E~." g';~g ~ , . .... . '..:.:J. 'O.at'!i!: 0 ",n .' .... Qd"l.Cl V1, t-iOQ , . III 0 I-l)' 0 :C:~~ -"..~.rt <.'{f.l 0.. CD':. 'Q fI) . '.. CD .t-'~:' O. J-l'. tl toi ;... Ill.a ~ J-I': tIJ' .:~, ~~ ~.~;::::::. :~ g.!~: : . .~.~.:; ,,'r'.. . ~~.. G) III ~ ~..,,; _ ,.,:..,..,;"tllI~: :,'::;' t.:. . . " - 0'" ."w 0';;.........0. /;,l' ... \. ' . .;!~> ',.t!<<, ~~'. J-l ~~.hQ iXl' H'. O'~ i _,:/":':';~~ 'if,' '?~. g,L' i<< ,.I;;;'I:::~., )' .rn ..lr,--'d,'J " .~ '.' "-.~ . 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