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Home My WebLink About07-6919 CITY OF ZEPHYRHILLS 5335-8th Street (813) 780-0020 ELECTRICAL PERMIT 6919 Permit Number: Permit Type: Class of Work: Proposed Use: Contractor: Square Feet: Est. Value: Improv. Cost: 14,000.00 Date Issued: 8/03/2007 Name: AMERADA HESS CORP Total Fees: 150.00 Address: ONE HESS PLAZA Amount Paid: 150.00 WOODBRIDGE, NJ 07095 Date Paid: 8/03/2007 Phone: 727548-7903 Work Desc: INSTALL TRANSFER SWITCH GEAR FOR GENERATOR 6919 ELECTRICAL MISC ELECTRIC SERVICE/NEW COMMERCIAL A & H ELECTRICAL SERVICES IN Address: 7317 GALL BLVD ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Book: Page: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 34-25-21-0000-00300-0090 Section: ( -- ROUGH ELE TRIC CONSTRUCTION POLE PRE-METER FINAL REINSPECTION 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 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. 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 payin 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 and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. ~~ ~-~ CONTRACTOR C PER~~ PERMJ:T EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER City of Zephyrhills BUILDING PLAN REVIEW COM:MENTS , , Ad.- ~f='tPL+0C.cu 0 g~'3-67 ' , Contractor/Homeowner: Date Received: Site: , (?; \ t- (''-,(''~ ILL /3r ud~ T(-(Jxy).tJ-^-:.. ~..ld-c h b0'l , r-4> ~o::+O(. , Approved withe below comments: 0 Denied withe below comments: D Contractor and/or Homeowner (Required when comments are present) 813-780-0020 City of Zephyrhills Permit Application Building Department Fax,813-780-0021 Date Received H e.~., Owner's Name """.....,,- I 0,., [' Fee Simple Titleholder Name Fee Simple Titleholder Address I \--I~~ JOB ADDRESS 1/3 11 -z.e-~r~~ SUBDIVISION Go...u ~I"a I E3 NEW CONSTR D ADD/AL T D SIGN INSTALL D REPAIR D SFR D COMM D OTHER I D BLOCK D FRAME . D STEEL D OTHER I I j f\. -;.t-w.t 9~o.;l.o{,& w;-l-vL c:; €.~ VY\ ~ -) SQ FOOTAGE I I HEIGHT I I WORK PROPOSED D DEMOLISH PROPOSED USE TYPE OF CONSTRUCTION I I ,~~fet2- , ., \\C-.H- DESCRIPTION OF WORK BUILDING SIZE o 1$ I 000 "'''''CAe :: 14,000 .1-Jco ,'a1R~" PLUMBING, ~ D MECHANICAL 1$ I o GAS 0 ROOFING D FINISHED FLOOR ELEVATIONS I I BUILDING VALUATION OF TOTAL CONSTRUCTION D PROGRESS ENERGY D W.R.E,C, VALUATION OF MECHANICAL INSTALLATION SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO BUILDER SIGNATURE Address ./ ELECTRICIAN SIGNATURE Address PLUMBER SIGNATURE Address MECHANICAL SIGNATURE Address OTHER SIGNATURE Address RESIDENTIAL COMMERCIAL SIGN PERMIT U::..!..!U FEE CURRENT l...Y..!!!..J License # COMPANY REGISTERED U::..!..!U FEE CURRENT l...Y..!!!..J License # COMPANY REGISTERED U::..!..!U FEE CURRENT l...Y..!!!..J License # Attach (2) Plot Plans; (2) 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 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, Attach (2) sets of Engineered Plans. -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. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attomey (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 AlC Fences (PloVSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW A. NOTICE OF DEED RESTRICTIONS The undersigned understand 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, B, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, he may be required to be licensed in accordance with State and local regulations. it 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 is uncertain which licensing requirements may apply for the Intended work, he is advised to contact the Pasco County Building Inspections Division, Licensing Section, at (727) 847,8009, Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractors sign portions of the "Contractor Block" of this application for which he will be responsible, If you as the owner sign 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 indication that he is not prope~y licensed and is not entitled to permitting privileges in Pasco County, C, IMPACT FEESIUTILlTIES IMPACT AND RESOURCE RECOVERY FEES The undersigned understands that Impact Fees and Resource Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings. The undersigned also understands that such fees as may be due will be identified at the time of permitting, It is further understood that 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. it must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. D, 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, has 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. E. CONTRACTOR'SIOWNER'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 commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County 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 which actions I must take to be in compliance, Such agencies include, but are not limited to: Department of Environmental Protection: Cypress bayheads, wetland areas, environmentally sensitive lands, and water/wastewater treatment. Southwest Florida Water Management District: Wells, cypress bayheads, wetland areas, and altering watercourses, Army Corps of Engineers: Sea walls, docks, and navigable waterways, Florida Department of Children and Family Services, Environmental Health Unit: Wells, wastewater treatment, and septic tanks, U,S, 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 "V' unless expressly permitted, ~u~~7t1~~~r\~~ lfm~e o~~~~~~ti~~~i~~~~ ~~~~~~~ g~~e~~~~~~s\~~~lae~~~~~~~ll~~~e~dg~1~~ins'la~e"gY~~~i~~ating volume" will be If 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 adl"cent pr~erties, If use of fill is found ~~t~gh~~s~~~rrea~p~;'~j,\'tT~~t Wgtl~~l~s~ht~aOnw~.\'~ ~)~~~ ~1,1ghf~~:i~I~~~t~dh~y ~~C~~"enn'g~e~~~~~ai'~~g~ep~~l i;~~~~ir~~der the 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 be 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 months after the time the work has commenced, An extension in writing, may be requested 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 PAYING T E FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER 0 N AT NEY BEFO YOUR NOTICE OF COMMENCEMENT, ~ / SIGNATURE:--f). .. :t':h,a../2..- SIGNATURE: % ~ : ~W~ENT C STATE OF FLORIDA COUNTY PASCO STATE OF FLORIDA COUNTY PASCO identification) as identification, (type of The foregoing instrument was acknowledged before me this _ 200 by (name of person acknowledging), who is personally known to me or who has produced (type of NOTARY ~ - dv/pc93043032 Rev, 3/1/05 "'0(');0 ~-m z~< cnom m"TJ:E ~NO s:~~ -Im Z-< ~~, ~, 1 F=\rJ en' o (/) f--/ -j rrl J> Z t::l rrl X f--/ (/) ~-j d f--/ 2~ n D Z t::l f--/ -j f--/ D Z (/) SHEET 1 OF 2 DATE: ~-1-2007 .......'ll .."'''' ....:J>C :I:~'ll n..,~ ~"'''' i"'l:I "'..,a- ~~g ..,....:J> Q~ ..., on;g~ ....., g tTl r..... .....:::: <........, Orn;>><: "TjZ~O N~Z~ ~-Ocn ~~(J~ .....::::~O~ :;;drt:lr ~ tTlr -tTlcn(J r r- 0 ~~~~ 0>---30--0 :;;d~~t< t:l(Jt:l~ Z(J~;:S --0 tJj >---3 Zdc:::J:: (JtTl~?:; ~ ~ s:' t"''' );-:1 ....;j '- C;S MANUAL SWITCH GEAR HESS STORE # 09535 7317 GAI1 BlW. ZEPH'l'RHIUS, flORIDA. JJ5.41 D-I.!AR GENERAL CONTRACTING AND DEVELOPI.!ENT, INC. 14117 lMRllN LUlHER IOHG .II, A'r{NlJE SOUlH llEARWAlER. FUlRIlA 33756 PHONE (727) 461 - 4760 SCALE : NONE -j<~ ~~c: St~ MA .. :I:g~ 0(1'"0>- ClJl:O Plo >-'; 0 :::0 r< ~Jl:0 '-oJ t::l tri t..... '" c .-< :< +Z O.~ :>> ~ t:l -c: 'TjZt==10 1- ,-j N~Z~ 0 ~>-aen Cl '" ::r::~0::r:: PI t:l )( --<>-0>- lA ;;lJI:l""ili - sg r t::n-< .... mr ~ ~~~~< t==1 PJ _en 0 _t:l... - rm'TjO 0 "" 0 0 - enOr~ !i PI PI 0 "'" 0>--30 p c'" ~ ~~~Q OPl "'~~ < ~~ S",;;l o t::l ' ~ -j t:l zo>-~ r n '" :I: >-00;1>--3 ) -jZ L- "t:lj...nili zt:::Jc::::::r:: Cl nClO Q~t==1>- N !~~ ~5,l!i< L~, g b ~ ~~og~N ~ ~~!j! "'l!~jIi-j~ (/)~) ~!il =t:lJl:S" I'l r liii:l+:;!~ ~/O l1> jtj~ SERVICE F'ROH .. 0 0 0 -j- d PO'w'ER COHPANY . ~ PI'" "'= ~O ~ ~ 1 f---l J> i:lSili CI ",:;!< ~il'i /0 S...ru r< -j,(J1 ~- n... . -j~ J> :I:g~ "'x !:ljlin c- ::s: ~~ ~Jl:8 :I: +z t:l -c: ,- ,.... 0 \10;0 Cl ~-m '" t:l z:<S ClJom m-n~ ~FrI~ S:'l1-., -.:r:m 2-< m;o ~.~ r-\...v ~3 SHEET 2 OF 2 MANUAL S\\lTCH GEAR HESS STORE # 09535 o-UAR GENERAl CONTRACTING AND OE\oUOPUENT, INC. 7317 GAU. BlW. 1-41i7 IlARlIN WllER lONG .II. A'vt:NUE SOU1H ZEPH'r1lHlU.S, flORIDA. 33541 aLARWA lER. FlORlDA 3J7:l6 OA'TE: 5-'-2007 SCALE : NONE PHONE (727) 461 - 4760 I :J n ~~~ I ! 0> o. J , DO o o ,. I o n -- ~ 5" I' ~ L ,. '" n ~~"'/ n \ j; g {IJ n 1_ 1 o '" o -.J "[ ~i\'O" ~,\ '0<'> OS'Oa\ ; IrL0 ~JHHd ~ . J'-r Ie! f. .,-..., rn ~ ?~: .ti~~!~ ~ r 1! ~ : : . . . . ~ () ~ --:p. lo:d~.l~ Z . H~ ~i C! 'ft ' , '~ ~ H ~ 0 w~ , 0' il,8 !: III , ;.8 I'; ~ : i ~~ i,! . "1. l'i Z ' '" 'n i ;, ~~! l ~~~ I~~!::, ";;;~:; !~~r m CD n - ::::!. n ll) :;; rll r;: r >-- I-~. ------- ~"'----- -------- 19J ~ I ~ l' I I ~ I I ~-~---I . F~T.N :,HJII :::;'-'10':'1i:11011 ;09: :,: ~ I il""J~8 'I~ C 2'/C'~'C:, HJ ,:C~I~ ('I 42:L~ ~6,r,l" 1 :~lX 4;~:) 4/[\02\~J~ April 18, 2007 Mr, William Rosselle Vice President, COO Power Integrity Corporation 1834 Pembroke Rd, Greensboro, NC 27429 Dear Bill Per your request for clarification of the Quick Connect Double Throw (QCDT), I submit the following: · The OCDT is built under Eaton's UL File for Safety Switches, The UL File number is 5239 Vol 6, Section 19, · The Switches that we are sending to Hess are fused on the utility side, and non- fused on the generator side, The fused switches are furnished with Class T fuses and are suitable for 1 OOK AIC from the utility, Per UL standard 98, the non-fused (generator) switch is rated at 1 OK Ale unless it is protected by a class Tor J fuse upstream Based onthe generator size, the 800A generator switch will never see a fault current close to the 1 OK rating, I sincerely hope that this answers any questions that the local inspector may have, If not, please have them call me at 423-478-0211, Regards, ~~ Brendan Foley Product Manager Cc: Kenny Olivey, Gary Law, Randy Gazdeckl C\Documents and Setlings\Andy\Local SettIngs\Temporary Internet Flies\OLK11\UL File doc Llcense# EC0002891 · Fax: (813) 971-8819 2006-2007 HILLSBOROUGH COUNTY OCCUPATIONAL LICENSE TAX RECEIPT o 0 0 " 30 BUSINESS LOCATION ,..,21l0 6 - 2007 TAMPA 33613 BUSINESS TYPE CONTRACTOR - MASTER ELECTRICIAN EXPIRES 9-30-2007 FOLlONO. R~NEWAL, 1:?5?0000 H. WASTE TAX stlRCHARGE OCC. CODE 090.008 54.00 HIMES CHARLES A A & HELECTRICAL 'SERVICES POBOX 82981 TAMPA FL 33682-2981 LICENSE DOUG BELDEN, TAX COLLECTOR 813-635-6200 THIS BECOMES A TAX RECEIPT WHEN VAUDATED. (SEE REVERSE,8IDE) PAID - 11456 - 85 08/1612Q06 *** 54.00 .81ERUY UCl!N8l!D TO INOAOII.. ~88. PROI'l!SlIION. OR oc:euoATlOIf 8PECI'IED HEReON, Certi~icate o~ Competency CERT ELECTRICAL CONTRACTOR Hillsborough County, ~lorida NO PERMIT UNTIL STATE REGISTERED,IP APPLICABLE EC0002891 09/~0/2008 Certifioate No. Expiration Date Issue, To: HIMES CHARLES A Dba: A & H ELECTRICAL SERVCS INC Workers'Comp. 01/01/2007 t Or ~....", . "'- .". ....'~..- '.~~ ~';'a ....~ .!~.._ ~-. ~... _....~.,. ."'l... .'\ ... . '~.-' :;:;::..: ~_.~ . 'N ',:_;~'~,.' . 4..&?~ ;:3/' A & H Llcen.e# EC0002891 CLECTR':~RVICES' 'HC e: P.O. Box 82981 · Tampa, Florida 33682-2981 . Phone: (813) 972-3880 . Fax: (813) 971-8819 RESIDENTIAL · COMMERCIAL · LICENSED. BONDED August 3, 2007 City of Zephyrhills - Building Department 5335 8th Street Zephyrhills, FL 33542 RE: Letter of Authorization Contractor Affidavit To Whom It May Concern: Effective immediately, the following individuals are authorized to process permits: Charles A. Himes - Florida DL# H520-l4l-60-060-0 Bradley Pendergrass - Florida DL# P436-072-58-448-0 Brian Phelps - Florida DL# P412-073-57-288-0 Steve Tupper - Florida DL# T160-799-67 -162-0 This authorization shall remain in effect until notified otherwise in writing. Sin~~ Charles A. Himes President EC000289l STATE OF FLORIDA HILLSBOROUGH COUNTY 3.........ct The foregoing instrument before me this -, day of t1'-\.~"'-$o'" , 2061 who is personally known to me, and who executed the foregoing instrument and acknowledged to and before me that he / she executed said instrument for the purpose therein expressed. '1 "",,-a Witness my hand and official seal, this "/ - , day of ~~O 07 ~~, "fii.~.'~"",,, DENISE A. EVENSON t.1'J;.IIift[:: MY COMMISSION # DO 520261 ~.~~ EXPIRES: March 27, 2010 "4i:l!r:t~~" Bonded Thru Notary POOIic Underwriters A&H ELECTRICAL SERVICES, INC . P.O. Box 82981 · Tampa, Florida 33682-2981 . Phone: (813) 972-3880 . RESIDENTIAL · COMMERCIAL. LICENSED. BONDED . Llcense# EC0002891 Fax: (813) 971-8819 Charles A. Himes FEIN # 59-2940606 ~M CERTIFICATE OF LIABILITY INSURANCE I DATE IMMIDDIYYYYI 08/03/2007 PRODUCER (407) 788-3000 FAX (407)788-7933 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 4915 W. Cypress St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Tampa, Fl 33607 INSURERS AFFORDING COVERAGE NAIC# INSURED A & H Electrical Services, Inc. INSURER A: Old Dominion Ins. Co. 40231 P.O. Box 82981 INSURER B: Auto-Owners Insurance Co. 18988 Tampa, FL 33682-2981 INSURER C: AmCOMP, Inc. INSURER 0: INSURER E: 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 I4DD'l TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY MPG71368 06/01/2007 06/01/2008 EACH OCCURRENCE $ 1,000.00~ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100.000 ~ :J ClAIMS MADE [K) OCCUR MED EXP (Any one pBrson) $ 10,000 A X PERSONAL & ADV INJURY $ 1 000. 00(: I-- 2,OOO.00~ GENERAL AGGREGATE $ I-- 2.000.00~ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMNOPAGG $ n ,nPRO. n POLICY JECT lOC AUTOMOBILE LIABiliTY 9542523102 03/15/2007 03/15/2008 COMBINED SINGLE LIMIT I-- $ X ANY AUTO lEa accidBnl) 1. 000. OO~ I-- - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Pef person) B - HIRED AUTOS BODILY INJURY - $ NON-OWNED AUTOS (Por eccidBnt) - '-- PROPERTY DAMAGE $ (Pet accident) ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ :=JESSIUMBRELlA LIABILITY 95 425231 03 03/15/2007 03/15/2008 EACH OCCURRENCE $ 2 ,000 0()1I OCCUR 0 CLAIMS MAOE AGGREGATE $ 2,OOO,00~ B $ ~ DEDUCTIBLE $ X RETENTION $ 10, OO~ $ WORKERS COMPENSATION AND WCV7070721 01/01/2007 01/01/2008 X I T"X~~T~I.l.;!;, I IOJ~ EMPLOYERS' LIABILITY 500.00{l C ANY PROPRIETORIPARTNERlEXECUTIVE E,L EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? E,l, DISEASE. EA EMPLOYEE $ 500.00~ ~reMt'~'Ov~s~8NS below E,L DISEASE. POLICY LIMIT $ 500.00(] OTHER DESCRIPT~N 0; OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS e: C ar es A. Himes - Qualified License Holder #ECOO02891 ity of Zephyrhills is additional insured with respects to general liability per form# 64-5481. City of Zephyrhills Building Department 5335 8th St. Zephyrhills. FL 33542 SHOULD ANY OF THE ABOVE DESCRIBED POLICiES BE CANCELLEO BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTAnVE ~C 0 ../ -""'-/ Don Le r r ACORD 25 (2001/08) FAX: (813)780-0021 @ACORD CORPORATION 1988