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HomeMy WebLinkAbout07-7115 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 7115 Permit Number: 7115 Permit Type: ADDITION/ALTERATION Class of Work: 434-ADD/AL T RESIDENTIAL Proposed Use: SINGLE FAMILY RESIDENTIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 5902 GREENBRIAR CT ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: WEDGEWOOD MANOR Parcel Number: 10-26-21-0120-00000-0581 966.00 10/24/2007 35.00 35.00 10/24/2007 HURRICANE SHUTTER 79x84 Name: NEUBECK, WM, BRENDA, & J.JEAN Address: 5902 GREENBRIAR CT ZEPHYRHILLS, FL. 33542 Phone: bV'~ lol"3D/67 I (slA- REINSPEcnON 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 cordin your notice of commencement." :l CTOR SIGNATURE PERMIT OFFI ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: . \ ("t L--\' \'-, '---(1 Date Received: I .~ ,......".- { Site: " ; t ' --\. ! {. " ll.'l, ," l't- Permit Type: Approved wino comments~ lJ.l.,., --:-'\" ci. \ )l~' .-.f, t,-,,~,-- Approved withe below comments: 0 Denied withe below comments: 0 Contractor and/or Homeowner (Required when comments are present) 813-780-0020 Datj, Received Owner's Name I Owner's Address Fee Simple TiUeholder Name I City of Zephyrhills Permit Application BUilding Department Fax-813-780.()(J21 I N eubect Phone Contact for Permitting D D - I Owner Phone Number I (R /3 ) d ' Owner Phone Number I Owner Phone Number I I q ~Li -7J/tJ/P I ;J;""Jean I ."5QDJ GreeVlbriar Fee Simple Titleholder Address I I 5CfOd- I JOB ADDRESS SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK BUILDING SIZE 1$ 1$ 1$ 1$ D GAS D FINISHED FLOOR ELEVATIONS 1 0 BUILDING D ELECTRICAL 0 PLUMBING D MECHANICAL Green hriar (j , I B D D shu.Hev I PARCELlD#IID--.:2{,; - ),1- 010.0 -- OO()OD -OSg / (OBTAINED FROM PROPERTY TAX NOllCE) 1058/ LOT # ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH REPAIR COMM 0 OTHER I FRAME 0 STEEL 0 OTHER I HEIGHT I r=1- NEW CONSTR o INSTALL D D ihllrr{{tLYlt' I sa FOOTAGE I SFR BLOCK I I I I CJ I DNO VALUATION OF TOTAL CONSTRUCTION o o WRE C PROGRESS ENERGY AMP SERVICE VALUATION OF MECHANICAL INSTALLATION SPECIALTY 0 FLOOD ZONE AREA ROOFING OTHER DYES BUILDER SIGNATURE COMPANY REGISlEREO Y IN FEE CURRENT U'..!!:U license # Y/N FEE CURRENT L:!.!..!:U LIcense # YI N FEE CURRENT U'..!!:U Ltcer\se # Address ELECTRICIAN 1 SIGNATURE . Address I PLUMBER I SIGNA TURE Address \ MECHANICAL I SIGNATURE . COMPANY REGISTERED COMPANY REGISTERED COMPANY REGISTERED L:!.!..!:U YI N I License # I I ~~ 1,~riURE:f L:!.!..!:U ltcense# I C f(.~ OStJ;J.3j FEE CuRRENT Address OTHER SIGNATURE Address RESIDENTIAL COMMERCIAL SIGN PERMIT tJR.. AltaC~) Plot I'>la~ (2~s~1 of BUilding Plans. (1) set of Energy Forms M'irllmum ten (1 O} working days after submittal date, Requrred onsite, Construction Plans, San~tary Facltihes & 1 dumpster Attach (3) sets of Building Plans. (1) set of Energy Forms Minimum ten (10) working days after submtttal date Reqwred onsite, Construction Plans, SanItary Facilities & 1 dumpster AU commercial requirements must meet compliance Attach (2) sets of Engineered Plans --'PROPERTY SURVEY required for all NEW construction Directions: FIll out appllcahon completely Owner & Contractor Sign back of application. notanzed If over $2500, a Notice of Commen cement is required. (A/C upgrades over $5000) Agent (rOr the contractor) or Power of Attorney (for the owner) would be someone with notanzed letter from owner authonzmg same OVER THE COUNTER PERMITTING (Front of AppltcaliOn Only) Reroofs Sewers SeNlce Upgrades Ale Driveways-Not over Counter if on public roadways..needs ROW Fences (Plot/SurveylFoolage) NOTICE OF DEED RESTRICTIONS: The undersigned understands 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. 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. Furthermore, 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 properly licensed and is not entitled to permitting 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 permitting. 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 permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit 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 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 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. Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental 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 "V' unless expressly permitted. 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 permitting 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 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 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 permit issued under the attached permit 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 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 (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. CONTRACTOR ~UblZ~d and sworn to (or affirme tU 07 by ~are'l)sonally, known to ~or has/have p~?duced ~ ~..~ '-'- as Identification ("~ 7) Dr) Notary Public 3/3 Commission No Name of Notary typed. printed or stamned ..i~~~'t~'" l~I"~\ ~. .~j ..l,;,......lJI;".,.. 'I),Rf..ft'i"\ CHERYL M. SNYDER MY COMMISSION # DD 275313 EXPIRES: December 15, 2007 Bonded Thru Picl1ard Insurance Agency Salf's By: ~ Hemando 00521014 - cnrus 99990255147 ' R Pasco 65948 ,,~~. ~lt.'''~ PEClALllir5Inc. ~ Contractor: eA.IAL/~ 7U-32&~r'l~ ~ L-..JGREG HENRY INC' ""1l Ph: 352-592-2008 Fax: 352-592-2009 CRC050239 Toll Free: 888-592-2008 RESTORATION SPECIALISTS STREET JOB LOCATION ARCHITECT JOB PHONE We hereby aubmlt apaclflcatlona and ..tlmatea for: ~ .' th above specifications, for the sum of: q~bJ' tf2) If ~.tomer fA IItIIeIIed wlltt anlna to the b Ino dl!IJWlrtmenl. CUAlnmor noedl!llo..k for r..e Qf lien for mAte'" Md labor before mAking nnN llAyment. If thoy do not alk fOf re!ftlllo d KfIf1, thoy mfIy ond up pllYtnlil twtce. 8J8. 558 LIEN LAW An mate"" '" guN'1Int&l!ld to be 8. apeclfted. All work to be compIeled In II workmanllko mannfll8ccordlng to l!andlWd ~MeHr.ftflL Any IIltMftlkJrw nr rtnvtatlon. ebeNo tlpftclllnd Involving oxtrll co.~ wi! bo ftllftCUted ot'lly upon wrtnnn orrtnrll, .nd wRI become a" IIDIl chM'g8 rMM' And.bow the oseIrMt.. AN agrODmonta contl"Gont t4)OO Ilr1kftS, accidents or dfMytI heymd our control. Owner 10 CM'fy nm. Ioml'do And oIMr nocelMry "'.ur8nCO. Our wMcor. 11Ift fufty cnvomd by Wnrtmuo,"'" Cnrnp"nl".lll'ln 'nllUUlnf:n .&reptmre of Gtontrart - The abova p~ces, specification and conditions ara saflsfaclory end are haraby accepted, You are 8Ulho~zed to do the work as speclfled, psyment wi" be made as outlined above, Date of Acceptance: Signature: SMa By: . 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"'f"l .. , :~:~'~ "\ :::::::::' ::!: 'i:~ n....-......' ,;~~.. ..~-\: II ~. n .." n. ..- ~ ,.~~~. ~ ~ i; ~I" i ~tl - l!11l ~i i- ~ <Ii il:i 'il~ ~i :1 ~~ Ii ,. Uall; III I i D , ~~- s:~~ i~i' s;.: 0:"'" g~~X .w~~; ~~~ :::::::,: :::;; II~~~ ~r , ~u<: ~.., ",-" ..It'. ~ .... gt't~ @~,.; ~ ~ ~ u.:.- r~ ~s~... ~ ".i: ~;- Ja~ :;6 ~~! } b$! 0" I' ~'l;~ :~~~ J - - i1i1~J "ll~~ L 7-- .n_::::::; ~~ ..,.:S '( !~ .;!.. ;}I~ :-s,,"Wr;: i ~-~.. ~u "" . ~~.J a . I'I~W: ~ ~~~ ~~~ i"~ _mr~ iii~ h-~- ....... i<::'" ~ I~~ ~; . .' ~ ..' ~." -?~ ;~~ l ~" .i" ~~ ~ ~ Ill: :-JiP~:: lw~ :,!:iiSt: ;;aVh al;!i~~ ~ ! Oct 18 2007 11:16AM Amer i can Hurr i cane S..Fe~~_~.. 3525922009 p. 1 1t13'.7!D-0020 City of Zephyrli* Permit App~lcatifJn lluildirv Deper\I1'ent FlIlt-Ejl3-780-OOl), _~ ~N'< I(?I~ ~1' P/toJle COIOtaCtfllr PermftfinV 0 0 - [ I- Own.,...... Nu...- ~ 13 ) q ~ if - 7 J 10" OWn., P...... ~ r Own., "bene Number ( \ J Dale~d C iD-I~,OI I ow...~.. ...Ld';- :SeaIl 'v e t,tbecX. Qwn..,.,AdChn f .~~Da Grl!t:t'1Vdaf Cf. Fe. SImple TIlWlO1de, N_ r BUILDING SIZE fir o C1 r-hvrr(cUle I sa fOOTAGE t NEWCONSm 1NSlAU Sl'ft "OCK Gretnbt'iay (J' I ~_W;-J"- J./-O/;;'O -OO~(){)-{).S8/ ~1l__TiTAJlNOllCt:' B. .AODfALT 'OSISN D MOllE 0 flEPAIR D COMM D OT+'lER I D ~IWI1E 0 S'TfiEl 0 OTHER I snu.f(ev LOT. J I J I~I : v1 ,.. SlIIIpIe ............. - I l.5QoJ.. l J08 MJOllDS 5tIIIOIVlSlON DEMOll~ WOM PROPOlSEO DESCRIPTION OF WORK t ),: ;. ...,.~ ". ' ~ . .; , .. _.~-" I I J PROPOSED USE TYPE OF C:ONSTftU(:TION HElGHl'f o BUlLOlI\lG \$ o ElWT"RICH. Is o PLUMBING tl o MECHANICAl \S C]GAS 0 FINISHED FlOOR ELEVATIONSl w.lUAnOlllOF TOTI.I. COt'ISTROCTlON ~-i(...i ,~~, I l lIMP 6ElMCE I 1 CJ SPECUlln' 0 I: l'LOOO Z'OIlE ARE.t. CJ "OGlllESS ENERGV o W.RE c. IlALUATlOH OF ~1'lAN~ INSTALl4TICfl FtOOFJlIIG O'llER CJve~ DtlO . 1.,/:~'~/ -.:7-:,:' .'~: '':':'~: "-~_:r-;7'."1 ,'." BUILO!R r SIGNATURE i I COIIPANV .RBlIS1&lED 'I J HFliiE ~REOIT U!!'LJ lIcense " ~s G:OlIIPANY l f\EGISTEREl1 L.!.!.1LJ FEE cuRRENT. COMPANf ..- I Vi N I lOa CUIIRM1 larin' I ~J~!i~~ UL!LJ tjce......." I (I(~ 0 S(J~a? L:illLJ I J I I I I I I ELECTRICIAN t SIGNA TUite l Addre" r PLUMBER I SIGNA'l\JRE. . AdcIr... ~ MECHANICAL I SIGNATURE L:!.!!Ll License , l COIIf'i\NY _n:_ VI N FEE~EW'/' L!!!:!-J I LlOlInSe . Add..... OTHER SlGNATURE Add"",e /Jl. II ( I' t>ta!(2~7~:Bui~~ (l)':Of~~OI:~:' MW..._ _"l)I~<j"'Y.IIIIer--&IIIle. ~.., ensile, eonelruc:liOn P1_. $elMtKy FaOlilies & 1 ~ _ (3Il_""-.gPans; i'lsetDf~F""",, Mtnim....lIoll <1Dl~ <tap oitle1-.ldale, ~ <lOIiKt, C....- ~....., SaniWy FaOlitiOll & 1 """"""" AlI",,",~~1!lUSl""".~ AlI&h (2) _ 01 Eng.......c PIaM. -__OPE,"" IUAVE'f ~"" l!IIl ~WCOllStfUCliOn, RESIDENTIAL COMUEACIlU. SIGN P~RIIlT Dlreclion5; Fill DLll8W1iclliOn ~ 0_ & eonu_ &igrlbKlt oI.,pIic:aIiaf>, naIII'iII:~ . _$2ll-." N......c-.ol>......_-_..-. (A1C ........-..-1 Agenl (Iar~... c:<>ntradD1'l or "- '" ~y~'he ~ would 0...__ wit/\ _ell_ fmm ow,"'" ....horlling ..- oVEII THE COUNTE1\ PERUI'TJUllG IF11>MI "" ~1Ot1 Only) Rmoob _.'""""...~. /lie FeN:8S{PICl/Sul'll~DOWgI!I Dri_ys.NoI 0VfI( C_ ~ on.llUbIie.'~.."- PDW Oct 18 2007 11:01AM American Hurricane Specia 3525922009 p.3 NonCE OF DEED RESTRICTIONS: The undersigned understands that this pennil may be subject to "deed' restrictions" which may be more restrictive than County regulations. The undersigled assumes resJXlnsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CON'TRACTOR RESPONSIBIUnES: If the owner has hired a con1ractor or contractors 10 undertake work. they may be required to be licensed in accordance with state and local regulations. If the contractor is nollicensed as required by law, both the owner and contractor may be cited lor a misdemeanor violation under state law. lIthe owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact \he Pasco County Building Inspection Division-Licensing Section at 727~847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advisee! to have the contraclDr(s) sign portions of the "contractor Block" of ttois application for whiCh they w~1 be responsible, If you, as the OWller sign as the contraClor, Ihal may be an indication thai he is not property licensed and is not entiUed 10 permining privileges in Pasoo County. TRANSPORTATION IMPACT/UTlUTIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transpor1ation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing bLildings, or expansion of existing bLildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended, The undersigned also understll'lds, thai such fees. as may be due, will be identified at the lime of permitting. It is further understood that Transpor1l11ion Impact Fees and Resource Recollery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certHicate of occupancy or final power release, the fees must be paid prior to permit issuance, Flnhermore. if Pasco County WaterlSewer Impacl lees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordi nances, CONSTRUCTION LIEN LAW (Chapter 713, Florida SUtut.., as amended): If valuation of work is $2,500,00 or more. I certify that I, the applicanl, have been provided with a copy of the .Florida Construction Lien L.<M--Homeowner's Protection Guide. prepared by the Florida Oepartmenl 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 dOClnlent and promise in good faith to deliver illo lhe "owner" prior 10 commencement. CONTRAClOR'SfOWNER'S AFFIDAVIT: I certify that all lhe information in this application is accurate and that aD work will be done in compliance with all applicable laws regulating eonstruction, zoning and land development. Application is hereby made to oblain a permit 10 do work and inslallation as indicated, I certify that no work or inSlallation has commenced prior to issuance 01 a pennil and that all work will be performed to meet standards of all laws regulating construction, Coll1ty and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government lIgencies may appty tD the intended work, and that it is my responsibility to identify whal actions I musllake to be in compliance. Such agenCies include but are not limited 10, Department of Environmental PrOlection-Cypress Bayheads, Wetland Areas and Environmentally Sensilive Lands, WaterNoJastewaler Treatment Southwest Florida Water Management Oistrid-Wells, Cypress Bayheads. Wetland Areas, Altering Watercourses. Army COfllS of Engineers-Seawalls, Docks. Navigable Waterways, Department 01 Health & Rehabilftative ServicesJEnvironmental Health Unit-Wells, Wastewater Treatment, Septic Tanks, US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authortty-Runways, J understand Iha1the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V unless expressly permtted_ If Ihe fill material is 10 be used in Flood Zone "N, il is understood that a drainage plan addressing a "compensating volume" will be submitted al time of permilling which is prepared by a professional engineer licensed by the Slate of Florida. If the fill malerial is to be used in Flood Zone 'W' in connection with a permitled building using slem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is 10 be used in any area, I oertify that use of such fill will not adversely affect adjacent properties, If use of fill is found to adversely affect adjacent properties, Ihe owner may be cited for violating the conditions of Ihe building permit issued umter the attached pennit allplicalion, for lols less than one (1) acre which are elevaled by fill, an engineered drainage plan is required. III am the AGENT FOR THE OWNER, i promise in good faith to inform the owner of the permitting conditions set for1h in this affidavit prior to commencing construction. I understand lhat a separate permil may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or olher installations nol specifically ii'lCluded in the application, A permil issued shall be construed to be a license to proceed with the work and not as authority to vielllle, cancel, alter, or set aside any provisions of the technical codes, nOr sh811 issuance of a permit preventlhe 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 woltt authori:zed by such permit is commenced within six months of penni! issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requesled, 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 ninely (90) c:a'lSeC\Jllve days, lhe job is considered abandoned. CONTRACTOR Sub.crlbed and _Ofn 10 (or atlirmOO) ""lore melhis by Who Is/are personally known to me or ,asihave proo..ced 8S iden1Wication, Notary Public CommllIStO!'1 No a. Inted or Slam Name 01 Notary :yped, printed or stamped Q)~ CHERVLM.$NVOER '*, :wl tIY COUMl. SSION, DO 275313 " :' EXPIRES: Dealmber t5, 2007 J/f.. ecn..dTlvuPi_...........Agonqo Oct 18 2007 11:05AM Am@rican Hurrican@ Sp@cia 3525922009 p. 1 &llllli By. - . HlII1Indo 00521014 . CN 99990255147 ' IRI PaKD&5~8 '(e.. ~,.1) 811DAL1SJ5Jn1:. CRC050239 e}.,IJJ/~ W-3~-3t'~ c; " ,., 11. Ph: 352.592-2008 Fax: 352-592-2009 Toll Free: 888-592-2008 ""I!el CITY.IQn. JCl8 LOCAlJON "RCMmICT .101I PItONI! .. hlI~ ........ apIIcllcaa- llId ........... lor: ~~~~ ~~.jfJ,~~-!!'1f~ ~9b~ . '* abaft speclflcatlGna. for the sum of: 9 LJ/J. tfV " ...-...... 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'').j \' \l . . \~ ' I!J ~I!l ~ ~ ~ GREG HENRY, INC. CR CD5 239 I ~ 8718 CASPER AVENUE (727) 86 .9448. ~ ml HUDSON,FLORIDA 34667 FAX: 86 ,1169 fa) ~ ~ I ~ ~ ~ ~ ******************************************* **** ~ I FM ~ ~ ATTENTION: ~ .~ ~ I ~: I i Mm ~ ~ I ~ PAGES INCLUDING COVER SHEET ( ) 1 ~ ~ . - ~ ~ ~ [E] ~@J 10/17/2007 15:21 FAX 7278831189 FM: 10/17/2007 15:21 FAX 7278631169 SRES HEHRV IHC III 003/007 p',l Oct ~~ 2007 11:12AM American Hurrican~ Specia 3525922009 134&4 ~ St. 8roOJls\flle. PL 346':3 '35~ 592-2008 (3&2) ~-2009 TOil ~rea (861) &9Z-ZDOa .,.,wvv ,amflrieantllmlcanespeclalisl5,c:om American Hurricane Specialists Inc. To: Pllges: L.....'- ~.- ~r'i~ '(~~. d/P.~LI~; Iii I ~ ",( Fax Fax: PIIane: :Date: Re: eel Cl Urgettl 0 For RevIew 0 "lease c..,....nt CJ Please ~ 0 PI fCih , ') D~ Df irphrr~rj(5 br Aled Iv 841 rd~ ~ptJ~ k/h1 frUVI ~ Jact.l e (rl~ ') 7?fD -ODd. I .Co~ '10J ~ 1/ c','} VI. (l4'\J. 5( -{ rti(j- 10/17/:~007 15:21 FAX 7278631168 GREG HEHRY IHC III 002/007 .' ..J:,~ __.... Oct 1~2007 lO:lSAM American Hurricane Specia 3525922009 OC1~15/2CJ7!rUE 10.02 AM ZEPHYRHILLS BUILDING F~X Nc 813-78D-0021 p, 00 1/0 C) _ -r~ . 35a 59 a ~(?)09 . r. ,\!~~"'l.~ f-J / ' ,~~. . c ---~ -(......~:' .r,-;',',' '". , r:,,''''; I ,--" _.n '",(J1:\ ~L . \'~".\ 1'\7<' ' - 'I ~ -"]\ :..-_' ~ ~ ~- -~' r.) , ~-- ,.... _ I fJllF\' City ,of Zepbyrhills :"CO)\,TRA'CT~R:'CERTIFICATE Requirements .in order to. be listed -in our systeD1 we wiU'need 'the bclt)w infomllltiOI1: ~ Stat; Certified Lice11Se, ,OR'. '. . .' ". , '-21 . State llopstered,Liccnse with COUllty Comp~tcncy , ' , a:y- B'usme&s TB."< Reoeipt (formc:dy known as'~'Oe~:pa.tional Lioense' ) <4) Worker's CompCD.Sation ' .' ' 5) Geoe:ralLiabilitY,with the, City of ZepbY:tbille as ee:rtlftcate holde , 6) Fictitious N~e (unless. the business is ,LLC, .DBA.~ lAc) , , ~?:). . Authorization Letter OIl'YOur business stlltiODcry/notarized, listing these wbo are authoriZed to si'gnlpickup pmnits, , ' ~ $30,00 c:hlU'ge (not 3:pplicllble for Stale Ccrtined or R.egi~c:;red' Li If you ar~ ~ State Certified. or State RegistcredJ you will. only need to S"upply.it :;.8, Your documentation con be faxed to 813.-180-0021 but wowC!.D91 become valid. 'the above reqWromCDt$ ar~ m.et, "'Ce:rt:ificate Bolder Wonilaticn City, of Zeph'yr.bills -.Building Dept 5335 81A Street, .Zephyrb1lls. FL 33542 Phone: g13~780.00Z0 ,- " a) 11\ \0 ('\I o 11\ I"C a:I o \0 o ..:a *: a w tn ~ 1-1 j ~~ ~o IJ:I ~ ~~ 01-1 t-HJ1 ~~ <( lilt.l o 1%..... Q2 ~~ o o..>t ..J ~ ~ ~j W,. ~H ~.~ ..< ,24 ~ ,.. ....0 fJ) - tIlH t:lE-4 lIlO o 1lIo~ OE-4 C/J ~~ ~ g. lil Q <..0 ~ M ~ <.D l"- N =II< U c:( . C/J fa.. ~ ~ 0\ CXl ~ ~ 0\ QI , r'l JJ CXl "". 0.0 :.;: mo -- ~ odN Il'I 0 () CE-4Q .. ~ OraJ~.-t tJ~~OI"'l (-4H03C!l ~ ZE-t C:;:l ~O~O< CXl 0 ~ '... c-- om.. 0..:1 '... 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CR C050239 ~ ~ 8718 CASPER AVENUE (727) 862.9448 Iii ~ HUDSON,FLORIDA 34667 FAX: 863.1169 ~ i I I I ~ ************************************************ I I FAX I I TO: karm I ~ ~. ~ A1TENT/ON: _ I FAX: (gLJ)7f;O-OOa/ I ; t I I BE: Perm,l /oy/veuld- . I i DATE: 10 ~7 101. ~ m { . I ~ PAGES INCLUDING COVER SHEET (c!2.7J ) ~ ~ ..;t {1{( ~ ~ ~)~J-t2oa8' il (1M have.. .. ~ ~ &ny ct JUsltlJfs- IIZf1.4J. ~ mJ [!I