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HomeMy WebLinkAbout08-7369 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 7369 Permit Number: 7369 Permit Type: COMMERCIAL Class of Work: ADD/AL T COMMERCIAL Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: 30,000.00 Date Issued: 5/06/2008 Name: FLORIDA TRADITION HOLDINGS INC Total Fees: 401.00 Address: 37741 EILAND BLVD Amount Paid: 401.00 ZEPHYRHILLS, FL. 33542 Date Paid: 5/06/2008 Phone: 813714-6596 Work Desc: REMODEL INTERIOR FOR MODULAR BANK FLOOR PLAN -FLORIDA BANK Address: 37741 E ND LVD ZEPHYRHILLS, FL. Township: Range: Book: Lot{s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 03-26-21-0010-06300-0000 RJ BALAITY ELECTRIC INC ~{u8 s~~ , ~~~~v/ ~~'s\>atolv FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. 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. n IS. PERMIT OFFI I I 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR SPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 7369 Permit Number: 7369 Permit Type: COMMERCIAL Class of Work: ADD/AL T COMMERCIAL Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: 30,000.00 Date Issued: Name: FLORIDA TRADITION HOLDINGS INC Total Fees: 401.00 Address: 37741 EILAND BLVD Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: Phone: 813714-6596 Work Desc: REMODEL INTERIOR FOR MODULAR BANK FLOOR PLAN -FLORIDA BANK Address: 37741 EILAND BLVD ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 03-26-21-0010-06300-0000 BALAITY ELECTRIC INC F I FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. 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 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." CONTRACTOR SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED PROTECT CARD FROM WEATHER 05/05/2008 16:23 9414455976 ",..,. .J. LIJVV Il. .", "I RJMAH'AFFEY CONSTRUCT PAGE 02 no. YU jtj "r...j .-- ~-.-- .. N6tr11l OJr.coMMENprMIlNT" . _ ~ _ ZEPHYRHILLS COLONY COMPANY LANDS PB 2 PG 6 THAT 'PART OF . r, TRACT 63 LYING WEST OF SEABOARD RAILROAD R/W LESS 'PCODitNa. t 3 t"q ~ THAT POR THEREOF LYING WITHIN PCL 165 iEPHYRHILLS BYPASS . WEST . ..OR 7619 PG 423 ~I~No.Ql-~'--~.J'~b&lo.~D~O:"OO':'~' . "., ~ UNImRSIGNP:D Mfeby,giwCiDbiDI ~ that die ~DwDat w?Jl be ~to ~ fteI )li~, _ ia _........ with SactiCID'13.0 of't1EPIoriIhs.~~~~ .bI~'iI~ ill. _1"I()1J\a,.Ofco~. . l.~~",\~)~ ~ ~.\ ~.tl. . 11111111111111I111I1111111111111111111I111111111111111111111 2.~~~.... ~.- ._2.00~07013!_ qH _.___. ~~..d'\'OdJ.:'.4': . . .' 3..0WJic:r~~~'~;~h ^~.....,~~ ~it\ll\~v\~.5. II\i!.' ~h3~ t !!1,",~+ N ",~\i~ ~S tlU1 , ~)N""ullhddl'ellllOfklliapletidchoJder=(trofhcr"~ ~ ::::=::::::.. R~~~f:E!~=~~"tA.P,~:r . ':itjpb~<Acr;'~ ~~~. ~~"~~~~ . . b)~N~.:. 'f.tO. > -," '3t!!JL7 9 .' "BNCl.(OJlt.) qJf! l:/~'5 is''' ~ ..J . t s~ l:D:fOfll>>4:ilm. . . . .' . .. . . .' a)N"_~:" tJ I A". . . .. Rcpl: 1179643 Rae: 10.00 . . .'b).AJDoumof'BCIIId: ". "" DS: 0.00 IT: 0.00 c:)T~No.: . . 'PaNo.(OPt. .,._ 05/09/08 Dpty Clerk 6~' , ->'Name IIIIlIld4rOlr. <. f>.//^ : . . '. . . . PDaaeNo. 7. Id.dty' of ptnQD widIia the SI3te ofFlIIrida ~ by lJWD,lR' apall ~ aiQ:es QI' 1:6er"'~ may be S8ffIId: '. . 1l)l&m.,2!D41dcm!: lJ7A' .' '. ..."... .'. '. .' . b) 1'a\e.PhODc ND~ '. '.' : . F~ 'No. (Opt.) . 8.'111 e:ddif:ianto ~ DWam'~1bD ~~ U) ~e a~ ~1bo ~'s'NotitC as primdal iIi Scc:tiDIl 7J3.l;l(1)(b), ~9Ia1mcs; J (lA' .' ," . . .' . : . . I)NmDcmd.a&fioea~ . . bl _ . . . .' .., . 'b) ~ No.: .'. ~. . '.' .I!~'*,,<()pt.). ..... . 9~iratiOll d8I8 otNo,U= of~~ (Ole ~OJJ.cJate" oae-';year ~ the aaae ottee:ardJDg.~.. cIIftIItc:IK ..1& speaifte4): , . ".' .' . o CSI"-o ::v~ : OIl ~"V ~ ......- . CSI-l.... '~Clll:3 OO...:D N.,Z W.. 'W~;8 I l~ o. I "V "'0 . . ..a 0 . ' . . . . ." c::: W All!UNG TO OWNDt ANY'Pk~ MAJ):lBY TBJ:'OWNDlAJTJtll 'l'BB EXPlRATJi:Mtf DFTIIE lVI1"CB(m ~ ~ COMMEKCEMJ:NT :ARE amsJDUD lMPItorm PA'DfIN'l'S tJMDBIl OIAPTD 713..PAllT X, SEC"nOl't 113.13,., ~ ~ FLOIUDA STA TtT1'I:5, Al'G) CA1'f BlCSlJLT 1N YOOB. PA~ TW.JCE.FOll IMPROVEMENTS TO yotJR.PROJ'B1tTY. i :t 0 A NonCE OJ COMa.IEJ!fCEMRNT MIJS:l' BIt bCOIIDD ANDPOSTJm (JIll ~)OJI Sl'1"B HPORJ, ~ PIR.sT . ~...r;; . ~ON: ;or YOU.JIll"mQ)'TO OBl'AIN l'INANaNG, CQNSULT YOJIR u:ND1Il Ok AN A~RNIY BDOU ~ ~C2NG WOR:XORDC~G YOTJR",Ol1cr.OP~MMBNi . . \ $'rAnOP.;.}(tPJ' 4..$. ." . .MY PUBlIC - of IaDias . . . SARA ER1c:"80". '. .' '. ,,:.'. . '0 . .' MyAppt '.' . .' . . f~~~~}:ft.~.~~Aif (tmjf~.::r~t"':1!.... .m~)-.~(J-_~~aa.~.Df.~"~~' PenaaaDy1iio.~~~it~~~IMt~ . N,.,,~ ~ ~ . ~ ~af~~cm~ . .~.~) 5i~~.'Ci6~f1 ".' . ...,. .," - '" ." V.id60d0n pursURt to Ser;tlCm"~:z.s.tS. FloridA st.mte..,Un4rr~ of~. I ~.fhIIt t havDnBi thDfcIrIIP~.m that ..tbef.lctlllllDdtDIUretmetotlletleltofmybow1cdeea4beJW. . s:rATEQFFLOAIOA' . . . . COUNTY OF PASCO . .' '~~~~.~!.,Jr~UEJE T9 eCR'ft,." ThAI IN!: fOREGOING IS A -. '. . ' . CORRECT COPY OFTHE DOC'liMENT ON FILE . ,. .' . 08 OF PU8UC RECoftD IN THIS OFFICe. 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Zepl1yrhills, FL 33542 Bus (813)780-0041 .=ax ;~8: 3)780-0044 Fire Chief Keith \Nilliams FIRE SERVICE USER FEES Occupancy No.: Plan No.: Business Name: Business Address: Business Phone No.: Business Fax No.: Contact: (JF)fi.~ . p;, if1f/J~f~ PLAN REVIEW FEES INSPECTION FEES B Site Plan N/C Annual N/C Multi-Family/Commercial .06 sf 1st Re-inspection N/C ~ IMI,On,m Chaoge $25.00 2nd Re-inspection $100 (9) Plan Revisions DBL 3rd Re-inspection $250 4th Re-Inspection $500 SPRINKLER SYSTEMS (Business closed until B 0-25 Heads $50 violations corrected) 26 plus Heads $100 SPRINKLER SYSTEMS STANDPIPE SYSTEM ~ Hydm U"""",,,,,,od> $45 D Per Riser $50 Hydrostatic Test $65 per symem FIRE PUMP Acceptance Test $45 per system D Per Pump $100 Hydrant Flow $75 FIRE ALARM SYSTEM B 0 - 25 Devices $50 FIRE ALARM SYSTEM 26 plus Devices $100 B System Acceptance $50 SUPPRESSION SYSTEMS Recall Acceptance $50 ~we $50 OTHER Dry $50 ~ Rm w..._ WoI $15 per wall CO2 $50 LP Gas $25 per tank Other $50 Natural Gas $25 per system KITCHEN EXHAUST D Hood/Ducts $50 ~ T"" 'D'><1U M ,..... $15 per tent OTHER Fire Pump $45 B LP Installation per tank $50 Fire Suppression $30 Fuel Tank Installation $50 System Acceptance (Per Tank) $50 B Exhaust Hood/Duct $30 D Natural Gas Installation $50 Re-inspection DBL (Per System) (other than annual) D Spray Booth $50 o Inspection scheduled DBL and cancelled less than 24 hours ~ Coosbuotiool... N/C Emergency Vehicle Ao $50 PLANS TOTAL INSPECTION TOTALc=J GRAND TOTAL Comments: Contractor: Billing Address: Billing Phone No.: Billing Fax No.: Contact: PERMIT FEe $50 $50 $50 $50 $50 $50 $50 $50 $100 $500 $25 $100 $50 $50 $25 $50 $50 $100 150 Sprinkler Standpipes Fire Pump Hoods Fire Alarm LP Gas Natural Gas FLJel Tanks- perlank Sparklers Fire Works Camp Fire Controlled Bum Hood/Duct Place of Assembly Fire Protection Aammable Application Waste Tire Storage Generator.< J<JN Generator >30 J<JN Bio-Hazard Waste Fumigation Tenting Torch PoUApplied Haz. Materials B $100 Annual $50 $50 $100 Annual PERMIT TOTALr=J J1h~1 I FALSE ALARM FEE 1 st Alarm NlC 2nd Alarm N/C 3rd Alarm N/C 4th Alarm $100 5th Alarm $150 6th Alarm $200 NON COMPLIANCE $150 Annual Annual Annual FALSE ALARM TOTAL I Date: I~~ ~,d1i Insij~ctor: Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Kerry Barnett Bus (813) 780-0041 Fax (813) 780-0044 October 15,2007 November 15, 2007 (revision) I have reviewed and approved the plans for the installation of a modular building located at 37741 Eiland Blvd. I have attached the comments for the plan approval. If there are any questions please contact my office at 813-780-0041. 1. Install additional emergency light in break: room. 2. Certified fire extinguisher shall be located inside in accordance with NFPA 10. 3. Install hard wire smoke detectors with battery back up outside bathrooms in hall, in break: room and in office where phone board is located. 4. If a fire alarm system is to be installed, plans and permit required. 5. Fire hydrant required to be installed (per site plan meeting) prior to receiving building final. Contractor responsible to paint hydrant to color determined by water flow. (WAIVED - HYDRANT SHALL BE INSTALLED PRIOR TO ANY CONSTRUCTION OF NEW BUILDING PER LAST SITE PLAN MEETING) Inspections Required 1. Building Final. NORTH AMERICAN BUILDINGS, INC. City of Zephyrhills Florida Equity 0888 ZephFl 456l 7994 152 5/5/2008 401.00 401.00 Page 1 of 1 Jacqueline Bages From: Billy Poe Sent: Tuesday, January 08, 2008 2:43 PM To: Jacqueline Boges Subject: RE: Hey check this out! It has not been released. We are still working on the Basin of Special Concern issues/ Billy From: Jacqueline Boges Sent: Tuesday, January 08,200811:34 AM To: Billy Poe Subject: Hey check this out! Mr. Billy Could I get an update from you about the Ryman project on the Bank that will be going up at 37741 Eiland Blvd ? Have this project been release from your department to be permitted? Let me know, thanks Jackie 1/812008 P.01/01 TRANSACTION REPORT NOV/16/2007/FRI 11:21 AM RECEIVER 813168219597 TYPE/NOTE OK SG3 Roger attached with this cover sheet our permit application to be. su~mitted by the contractor. The application is self explanatory. I also phoned you back and le~ a message : that I can not receive th.e' fees for this project until every thing ~s a go for permitting. So as I . : much as I would love to take the money I can not at this time '. Please fax. back the permit to I . . . .' . : my attention so that I could pla~e With review. plan. The original appliCation will still haye , . .' , ': to be submitted once every thirig is a. go. o .' , Will let U know as soon as 1 know w;hen every thing has been taking care of. . .. . Any.addition questions do not hesitate to contact; My .ext. # 354~ " '~~~~f'II'-'" . "'<:t"". "*.~. . .Ci1yof..Zep~yrhill~: . ~~~~, 'l:\;. '\'( Phone: (813)-780-0020 .th FAx: (813)-780.0021 ,~~,,, Building Dept. ~'; . ..' .,' . i~\ .' . . ~ . . ~~., ----------~-------------------------------------~----------~~----~ : TO: ROGERWYCOFF . PROM: JACKIE :' I I : FAX#: 316-821-9597 .FAX#:.813-780-0021 , : I I : DATE:11~16-07#OFPAGES: 2 : I I I I I I I I I I I ,. I I 1 I' 1 1 1 I J .1 , MESSAGE: Jackie I . . , I' '1 1 I 1 1 . .: .. . .1 , .. '1. . L~_________~__~_~~_~__~_~~~_~~______~__~~___~~~~--~--~---~~_:_---j' I ! Ii j I~i ~I I I I I i !~i I~! I I i I i I I I~! i~II, I I I, II; i j i I : , I I~ , I, Ii" I ' I I I!, I I I I I iz.I!.'3! Jill I i i I j Ii! i : ! I I' I II!' i! I' I I i~ISi~Ift!1 ! I,' I!,' I,' i i ) I I Iii I I I!l.. 11:z I...J o! I I! I i .1 I I I ' . I ,! I. i I I I':: I . I II.) l.lJ 1'1. Z II! ! i I: ; :,! I ii' I ;j~l~ I~I~' i Ii! i I I, i! Iii . , (-,/' 0 i r.:: 1= ,I I ;! I,.': I I' ! 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I/) 1tI I/) I/) Q) ~ OIL. 1tI ltI a.E Q) rx. ~ z W :E ~ ~ 0::: - o <( u.. ::E U1 L1 ~ IX u... 0 I- ~ - ~ :E <( 0:: U w w a. V) a <( IX w <( ...J s: 0.. c:: o \.L. W (J) <( W ...J 0.. .. t2 z - ~ W J: ~ o ~ ~ z e:( - w 0 u tti z z ~ ~ ~ 0 (/) >- Z LL ..... - (/) ~ 2 <( J: I- L6S61Z;891E E o CJ . U c: .- fI) .c ca c: ... G.J OJ () '- ..J - <( :Ii I W LL LL o U ~ ~ W C) o a:: L- a> IC C It'S :E 1j Q) o L- a.. 1Z;:813 81313Z;/1Z;/E13 04/07/2008 07:36 9414455976 RJMAHAFFEY CONSTRUCT PAGE 06 .: '- -''': .:t!f~ '!!:!~::~~:~;.:J~~~: ... ... ~ !.~'...tfc S . .. . ,~:; I, '.:' .;,:,' . ,'::; II :. :-. . - ~lZZGtl;l6l 'tJ'.l XtI.;/ 8n.o::~iLI.BR H3>Dt IW :>l~ A.L.I I:rtIEl ~ ld WcM!l;c;t ~ tI0 ""'dtJ 04/07/20~8 07:36 9414455976 RJMAHAFFEV CONSTRUCT PAGE 04 ~~' ." . - n -13-2007 ALeX SIN!'. ST... 1'& OF FLORIDA QlJl:PfUWiCW,. 0FFlC&l DEPAfn'MBtT OF F'~ClAL SERVICES DIVISlaN OF WOfICBQT COMPSrtSATIOH .. .. eBITIflCATE OF ELI!CTI" TO . Qu.1' FROM PLORIDA WDIIlEllS' ~TI8N LAW .. .. CONSTftUCTION INDUSTRY eXl!MPTlON l1'lit: certifies that the individual listed llelDW ... t'ect.d to be exempt from. Florida Workers' ColIIP'fIIICion law_ EFFECTIVE DAl'E! t2112/2CI07 PERSON: BAl.A1TY ~I~ 6506892tO BUSINESS NAME AND ADDAESS: ~ZTY IL~IC INC .75~ SWEEBEADCN C!RCLE SMASOTA 'L Mn8 ~IRATION DATE: 121ft!.. STEVE J SCOPES OF BUSINESS DR TRADE: 1- CIIlTlFlED filDmW. CDIlI1'IW:TUR lIlII'OKTAIlT: ~.n"" It n."",. 440 ' Dlill~, ...... .. elH- ., . C...,.,.... .... wltcb 0""'. 1_ ... ....... IV IIIllIt . anifl'.. .. ..~ ..., lIIIt s_.. _~ .., ....... _i'. or c..,........ ...4., .,. ~" ..._ . ~ ~IZI. ..1., Clnllklln .. eIl!ClIII Ie .. ......... W" ..., .iIli, .. ...... f4 .. ...i.... ... .... UMod tlI .. "'CI ., ..._ . k ._,1. .,__ .. CIIIICer ....."">>. '.1., .... .. _ " ie e...,. .., COIIlllUIM 01 ""Ii.. .. Ie ..... ..., .. _j_ I. ..v....... iI. II 'IIY tiIIie ..,,., llIt In., ., .... 'l4tice ., .1 ~ .. .. .certlflclte, .. ._ _, . ... Illite .. -.. ,. ,_ ... ... ._1,.._ .. .is ....... I.. I_ooc:e 01 . ......,.... 'no" ...,__ ...., .__ . .,nn,... iN -r _ .... hll_ 01 ,.. _ _ 011 "" cNUf'ctlt " "" 1Ite t~.'",_ .. llIia _. DUE5TJONs1 tl501 413-1&09 DWC-2U ~ICATE OF ELECTION TO R V<9FT IfEVISm 09-08 td WdL0 :~1 aooz; 1:'0 ...ldt:t LO'lCZtSlV6l 'CJ-l xtI.:l N3X>1IW J 1&:>313 AJ. ltntta : ~ 04t07/20~8 07:36 9414455976 RJMAHAFFEY CONSTRUCT Date, 4/4/~UUB ~~, ~,~7 ~n TOt ~ R&D4ttey ~.~rua;.QQ, ~~~~ "~~~10 PAGE 05 ~-V"" .. PIUlDUCIR (941)366-7070 .FAX (941)953-4901 PunllOrt a Nartin Insur..ce Agen(;)', lLC 2301 R1ngl1ng Boulevard Sarasota. FL 34237 Ashley Cote INIUIlED 8a 1 a1 ty El ect r1 c , Inc. 4753 s.eetmeadaw Circle sarasota, Flor1da34231 ACOBQ CERTIFICATE OF LIABILITY INSURANCE I :'i= THIS CERTlACATE IS ISSUED AS A MATTER OF "FORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTFICATE HOLDER. T" CERTIFICATE DOES NOT AMEND. ElTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. INIURERSAFFORDlNG ~E I~A; Old OaIlinian Ins. Co. INSlflER B: INSlIlER c: INSt~D: INSlID!R E: NAIC# 402U 'THE POLICIES OF lNSIJAANCI: LISTeD lleLOW""VE BEEN IssueD TO 1M! INSURED ~ED ABOVE FOR 'THE POLlCV PERIOD INDICATED. NO'IWmlSTANDINQ IW'( REQUIREMENT, TERM Oft 00NDrTl0N OF f/H'( CONTRACT OR (1)tER DOCUMENT wmt RESPECT TO WHlCH'THlS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN. 1llE INSURANCE AFFORDED BYlHE POLICIES DESCRIBED HERE" IS SUBJECT TO ALL 1lE TEIUIS, EXCWSIONS AND CONDITIONS OF SUCH POLICIES. AOOREGATE UMITS SHOVt'N MAY H.t.VE 8EEN REDUCED 8Y PAID ClAIMS. = lYPEOFINlMW4CE I'OUCTNUlIIIER ~ I'OUCV~ LIIIl'S ~LIMLITY MPG76144 01/26/2008 01/26/2009 E,ACH()C(;URREN:E $ ~ ~IAL GEl'ElW. LIPelI.lT1 ~ 0 RENIED f I--~ ClAlOll6MAOE [[] ~ t.EDEXPI"InJ_......on) $ I-- ~- 1lN)1I IN.UlV S I-- Gl:NEIW. AOOlEGA'TE S GEN'I. AG<R:GA'TE lllillT APPLIES PER: PRODUCTS - CXM'fOP "'* $ h POliCY n ~ n LaC AUTOMOIlIl& LIMlUTY I-- I-- /1M fl/JrO ALL CIN/6J I\IJl"OS I-- I-- SOEOU.eO lllftOS i"'- HiReD AIJT"OS i-- NON-OYVIED Al1r05 A 1000 100. S 1,000 2000 2000 COMBINEO SINSU! LIMIT lEe eoadcrtI} $ 9OO1L Y INJlRY (Pet person) BODILY IN.A.RY (PerICClClll!1l) $ =~~ S R=~ tJlEX~ ~ LAL1AIIUlV OC~ 0 ClAItolSIoWlE . h OECUCTlBLE H RET'ENTJON $ __AM) Ellll'LoYERS' IJNalTY _ ~1E1al.4'~cvnVE OFFlc:EAIMEMllER EXCLuoeD? ~e~=II~below aTHER I'IJTO ONLY - EAACCJCeNT S EA,o"cc ~ 0llER'1lWI I'lJTO ON.. v: AGG $ I:J\CH ocaJlIlENCE $ AGGIlfGATE , S $ $ I we STA1U- I I OJ::- E.L:eAOi ACCIOENT S E.L. DISEASE - EA eMPLOYEE , E.L DIlieAH - POLICY LIMIT , bE8ClIlll'1XlN OF OI'I!RATlONIII LOCA1lONS J\Il!HlCU!IJ lEXaJJIIONI AIlOID BY BlIIClftt8llliNl' ,-.1'R(MlIlC)NI SHOULD NI'I OF'ntl!1lIIOVI! ~ ~ lIE CMCBJ.EI) II90flEM EXI'IWlON DA1E lHEIlliDf, 'Tlfti.... MUIlIR WLL EMlEAYOR TO .... -.UL. DAYlI WNT1BIIIO'I1Ce TO 1NI! CI!R'IlFIC<<l1! HOLDeR NIIEl TO lHI! LEfT. BUr 'M.~TD....IUCH H011CI! -.L. WCII! NO ClIlLJGAllON OltUo\8lLl1Y OF NNlCNIlI'OIlHI!.........1IS AGBCY8 ClRREPJlIiIENI"Jl11\/es. AUntlIRIZID....--<I"AlM <l~l.;d-.. Wells Pumeort ATTI T ~ RJ Mahaffey Construction, LLC 1109 Dona Way Nakanrls, FL 34275 ACORD 25 (2001108) FAX: 445-5976 _CORD CORPORATION 1.. 04/18/2a08 08:16 .9414455976 RJMAHAFFEY CDNSTRUCT PAGE 02 2007-08 . SARASOTA COUNTY LOCAL BUSINESS TAX 1tECE1PT ACCOUNT NO, THIS TAX DOiS I'Ktr AIII>'1J)lE QU/U.I-n"~" WOJIIK OJII COI'I"'''''''' nlll.'J' ~lIt,^..l'OIt1f ow ~00IIl0'7'1" l.clNIN(i -.QV.lltlltllUlft1'S HA.VE BDl'C MF.T. IT J' TJlE OWlfEP!S R1tSfOI'CSJJULrn TO ~\lll.r. C:UlWrJ,.l,,"U"'- ~ ROOWI aeooe ~ 2 8IJSlNESS lYPE ..~ ELEClRlCAL ~-RECJ{l. IlUCI..SIlS AODAI!SS 4763 SWet:TM&ADOW OR SARA50TA FL M238-C)OllO p~142.QC)01~1 HSP DOf2AI200711.81 IW.AITY Il.ECfRIC INC -4753 ew&TMIADOW CIRa.E 8AAASCff'A. JOl. 3423a-OOOO ACT\\/! itA"""",, ,..~D-OO,.Te9. TAX COllECTOR td '-'--"'~~ .~~ N '" roN..~CU()1JJ rJACE 101 S. WASHINGTON BlVD.. SAAA8OfA, I"L~- O'VCK.. sa ~ 91: -tdtI (Ml) 881.&300 . . O:plZ26t~1 : 'ON ><1::1.:1 - .. ..~. ........ lnfnm.A11I'BlOtaTalCOlectOr.COJn N;Df)fIN/ :>[~ A.lIl:rMI : ~.:l 15:50 APR 10, 2008 FR: WENDI MCILVAIN *2150 PAGE: 1/2 Employee Leasing Solutions, Inc. 1401 Manatee Ave W. Bradenton, FL 34205 I I I I I To: Company: Fax Number : Phone Number : 1(813)7800021 From: Wendi McIlvain Fax Number : Phone Number 757-1333 941-746-6567 Time Sent : Pages : Description : Thursday, Apr 10, 2008 04:49PM 2 Attn: Jackie ACORD.. CERTIFICATE OF LIABILITY INSURANCE 1'=:;m ml6 CERTlFlCA'l'I! IS l8SUED A& A MAnER oP 1NftORIIA1ION ONLY AND CONFERS NO fIjIGtfTS UPON mE CERTlFlCAl'E HOLDER. THI$ C::ER11FICA'R DOES NOT AIIEND EXTEND OR A II ".-/ IllIClIlIlCllR Affiliated Agency Ops 16 South River SIt"t Wilkes-Barre, PA 18702 _flED Employee Leasing Solutions. Inc. DING COVERAcI}! HAle tI 1401 Manatee Ave W. Suite 600 Bradento FL 34205 IN INSURER c: INSURER 0: THE P(lLICIIiS OF INSURANCE US18l BeLOW HAW BEE/( ISSUED TO nte INSUReD NAYl!O AlI0VE FOA nE P9LICY PlAID!) INOlCA'Ta:l. NOlWrrHSTANOlNG ANY AIOQUlAlONliNl', ...~ OR COMlI'l'ION Of N<< CON'rAAI:T OR oTl$ OOOuMENt Wlll1 RESPECT TO WHICH THIS CERTlFICATEMAV &E IHUED OR MAY PERTAIN. THE IIlSURANCE """ORDED BY nte POUCIES IlESCRIllED Hl:AEIN IS SUBJECT TO AU. THE TEAMS. EXCllJ$IONS ~o CQNOITlONS OF SUOi POLICIES. AGGREGATE UMITS SJ-IOWN MAY HAW MEN REDUCED BY PAID ClANS. I ~ l:J;I jJ!e~1JY ~~UA8lUTY ~:J <UII08_ DOCCWl ~ lIII p~~~~ . ...-.. IiIIQI OCCURIlI!NCl! ~ AGGMI!GA,.!!, ur:o. N'PUIili ~ I I-.~ I IJliE' I I QC u-.rr "-- ANY AUTO f- I\l.l.QWPlI!Il"ur06 "-- ~SD..ufOll "-- HIMIiIl AIIr05 I-- ~EDAlJros ...._~. &~I- o__re . -~-~. . ~liINIiU. UMII" S lEe-I fIOOIl.V....IuR'( . 1Pw_1 lID011.YIN.NR'( $ [Par~ ._"-~ .-.--- -- .- - ~=.o-G&"---..- .-...----...' ~..... ~AGlI_n H ANY AUTO AIlTOON.....EIo.ACCIIIENT I EAACC I orHEll TIWI IWYO CN.'t: ocr. ElICElI~UAMJTY o OCQJR 0 Q.AlMS lWlE. RDt;OU,~rllil.j RETENTION i __AllDlt_ iWl.OYEh' UMIIlT\" A ,,",,~AimlERIPiI:UTI\IE DFFlce_.ElCI:l._ ,,\ !!~!11.4!""" ..... I!ACHOCQJllRl!NCE AGGREGo\TE EMWC802839 1 0/10/2007 01/01/2008 Xl Y=~ I 19!r" lOA.. illiCIt I\CClOliHt $ ''-.IlllI EA.. llt&EASE. Ell EIoFLDVEI! $ j GOD- i!.L llI&EA&E. PClLlC... UMll" $ 1.0000GllO OnteR Client ID: .2108130 ___..._.....-... H.__.._........ . _---..__ ~ ~gN 01' ~T1gNli I LO<:ATION& IviAlcI:QJ EXCLUlIlONl AOOED 8'1' ENDOIUi8IENT I &PECUl&. PROVISIONs ~UARD Insurance Company . ( CCl\/EAAGEi APPLJ&a ONL'I' TO THOSE EIII'LOvas LEAlEIH'Q.1IUT NOT SUBCONllUCTORS Of: . R J Mahaffey Construction LLC.".,., carries an A.M. Best Qualifiers Name: Ed Hardellty/RJ Mahaffey;' Rating of A- (Exce'I~) ~~ ' Flft_cIal~'" .-- ...-" and a tlnanclal sb ~ Ap ~n!l_~P'~llt!!!9.~nt:.~to-_... - Category ofYlI' -::i~~ CERnRCATE HOLDER AUn: Roger North American BUildings, Inc. 9139 e. 37th St. N. Wltchita, KS 67226 CANCELLATION lIHOULD IoKr onllE MCl\Ili OUCRtSEO POLIc:les IE CAHeaLED IEFOIlETHE EllI'IRATION DAlIiTlElEOF, THE IIIIIN8 lNlUllEIt WlLl.ENDEAVOIlTOIMIL A- OAYSWIIITTEN NOTICE TO.Tt1E CElmflCATE HOLDER NMIEO TO THE LEfI', IUT fAIWRE TO oo.~ IHALI- l".ooaa IlO OIILIGATlOlll OR IJA8II.Il'Y Of Nf'f lQIItD llPOft TIle IIllIUilElt, ITI AClE/ml DR IUiI'IlI!_A'IlVeS. AUTt10RIDD REI'RESENT" ~ ACORD CORPORATION 1988 ........,.. ACORD 25 (2001/08) P13 39t1d S90iH Nt1OI~3Wt1 Hl~ON L6S6'tZ89"[E "[Z:813 81313Z/"[Z/E13 To: N~rth A~erican Building Inc From: Vicki Schooley 217/20083:33:52 PM (Page 2 of 3) ~.c.ORDPM INSUItt;D R J MlIhlltfcy COl\stlUL:tiUlI 1109 Dona Way Nokomis, FL 34275 DATe I_DD/nvy) 217/200R 'rt11S CERTIFICATE IS ISSUED AS A MATTEA OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATe DOES NOT AMEND, EX'reND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. CERTIFICATE OF LIABILITY INSURANCE PRODuCliK Diclc, Johnson & Jet'fua'Scnl, irK::. - CORI~ 1429 60th A\lel1LlI~ W Suite 200 Bradollt'lIl, FJol'idil 34207 INSURERS AFFORDING COVERAGE IN$\JtlEFl A: Amcri~ll ~fclY lllwrmily !N.SI~ RER 8: INSURER C: ~IN$lJl'IF:R D: INSURER E: NAIC_ 25433 COVERAGES "1"111:. ~I.ICIES OF INSURANCE. LIS I ~o lil:;L.OW I.IAVE BEEN ISSUED '1'0 'H~ IN$llRED NAMED ABOVE ~OM , HE POLICY PERIOD INDICA-rt:U. NQ1Wrn ISTANDING ANY REQUIREMENT, 'rr:RM OR CONDITION OF AN'\' CON"~ACT OR OTHER DOCUME'IIT w"f~1 RESPECT TO WHICH THIS CclHIFICATE MAY BE 'ISSUED OR MAY PERTAIIIt, '1' H~ INSURANCE AFFORDED BY THE ~ICI[S DI;;SCR'BED HERI3N IS SUtsJLC 110 AL.L THE TERMS. EXc..USIONS AND CONDITIONS OF SUCH POLICIES. AGGr..EGATE LIMITS SHOWN MAV HAVE BEf.N REDUCED BY PAID CLAIMS. l~ ~~ TVP&O~ IN~~~~- POUC'I' NUM~R-" "~c'Y "......,CTlVlO ~ENERALWWIUI'l' I S6A 111J3063-oo 112R1200fl '"",/- COMMERCIAl, c;F.,..,eRAL LIAliILrrv '. :=J CLAIMS "'''DE 0 OCCUR p~~~.re~~" 1/211/2009 UMlTS PHOQUCTS-COMP~rAGG $ $ 1.000,000 . . ~ ---.-. --~~--i OO~ $ 5,000 $ 1.000,000 _". . $ ... 2,000,000 _. _ 2!~O~,OOO . - -.. ."..- ~'LAGGR~~..!f LIMI~ oIU'~ 1'1:11: I POLICY I I ~~81 I I LaC AUTOMOIJII.E UAlJlury ==1 ANy AUTO ..._' ALLOWNEPAVTO.s _ SCHElJuU;:UAUIOS HIRI'nAVrOS EACH OCCUI~R15NQ; lJAWc;i! 'i'i:1 RIiNT!;D . .. . P~FMI8ES lE.occ.....,cel ~!! ~XP (Ally one porsan) ~!;<!lONAI.'.4\l1V INJUny GF.NFAAI. AGGAEGA',,, ^ I - ,..,ONoQVVNECI AUTOS COM81NED SINGLI: LMIT $ I En t1Gcidonll - .. .. -... BODILVINJUHY $ (PlN' IN'lIUI1) .....~_.. 80DllY INJUIW $ (pa.. Ut!~':knll) r-ROI'EH 1''1' DAMAGe $ IPOl' ~cQd..nI) "~~ic;E UAIIIUTY I ANY.lITO AUTOONLY.EAACCIOliNr s "..--.. - ... . .... OIHtRIHAN ~.ACC $ AUTO aNI. y, AGG 5 EJl.CE BSIUMBREUA L1AilLHY :=J OCCUR 0 CUll"le MADE EACH OCCURRIiNCE _._.~ AGGRl!!GATll $ S $ ROEDUc:TlIlI I' RE)'''N'(,ON :$ WORI(ERS COIiIPENSA'rlO.._o EMPI.OYERliI'l.IA8IUTY /lNY PIlOPRIETORJPARl'NEI:QlOOiCU'i'IVti O"~'Ct;l\Ifoo1EMBER EXCUJOED? ~~CI~~~~~~~~ Nil bolDw OTHER I~~~I~~~I IO~~- ..._ E.L. EACH ACCIDEN:f_.~.____._ S:L'!!I~E.~S.~.~E.~.EMPLOYEE s .._ E.L.DISEASIi .POLICVLIMrf S DI!SCK.TION OFOPEAATIONS' I.OCATIONS I \/EKICU:S I C:XCLUSIONS ADDUl BY ENDORSEMENT I &PECIALPROYIliIIONS R.,,~idO::llliill (j~neral ConlCllClor CERTIFICATE HOLDER CANCELLATION Hulder'~ Nilture of Inl~rc5t : Ccniliclte HDlder SHOULO ANY Of' rHI ABove UESCHIlIaIt>OllCIIO. lllO CANCIiL.U:1:J 1I....0Rl; .... ~MA lION North Amorican Buildill& Inc DAn; Y"Ii.n!op, THti JSsu...G INIiUIlIER WILL ENDEAYO'" TO MAIL .. 10.. DAYS WI'lITf"N Roger Wycoff NOllCE 1 D TIlE CERTIFICATE HOLDER NAMED TO THf U::"'f. auT I'AILUIUi'1 0 DO SO SHAlL 9139 E 37th St N IMPOS6 NO OlluGAllON 011 lJAB,LJTY OF AHY KINO UPON THE II'ISUAe.... ITS AGeNl'S OK Wi\;hitOl. KoS (,7221'1 ",""MllSllN'i'ATlViiS. ~"f.m_D~R~~~ v' ACORD 25 (2001108) @ACDRO CORPORATION 1988 913 39\1d S9aie N\18I~3W\1 HL~ON L6961Z;S91E 1Z;:Sla SlalaZ;/IZ;/Ela 04/07/2008 07:36 9414455976 RJMAHAFFEY CONSTRUCT PAGE 02 , ~..~~"''-'\~ ~ '> - -- "lb(,-.c ~-.-.:.-" ~ I ~ n ~-=:"'-_. ~1~::..< ~ .!1d: I ,. lil.... .....~ _-,;If' ~~ J r ~ jij. J;;" ~. I:-~I :b.-I..... '~i~....~ "~_~..n".'n"TLC" :-. ;:I:~' '~4~~~~~~~;~1,~ .:~ ...'. 11~!~W~ :~oafsif'34~' ..~U~%~.....~(~:i4$j~ Alwa.,ys check out your Contractor' Use the link below.and use the Contractor Number CGC047540 hnPs:llwww.my(loridalicense.com/wll1.~~?mod e= 28lsearch = LicNbrItSID=8lbrd =8ttyR= Certified General Contractor MAHAFFEY. ROBERT JOHN CGC047540 Current, Active Primary Cert General 08/31/2008 No License Location Address*: Main Address"': Mailing Address"': BRADENTON.FL34203 BRADENTON, FL 34203 BRADENTON, fl 34203 :".;: _:":_' IJt ~ ., ^,~l'... ' ,- 04/07/2008 07:36 9414455976 RJMAHAFFEY CONSTRUCT PAGE 03 2007-08 SARASO'1~COUNTY WCAL BUSINESS TAX RECEIPT ACCOUNT NO. MAOHINES TIIlS"TM DOM "Of ASSUItE QUALITY 0,.....080.. C()tllfDlM TllAT gOOLA.TOIlY O. 990010089219 ZONING IlEQUIIlEMENTS HAVE tEEN MltT. IT IS TBB OWNP'S JliSPONSIBILlTr TO ElIISURE COMPLIANcy!" ROOMS SeRs EMPLOVEES .1 BUSINESSlYPE .' 230049 GENERAL .CONTRACTOR - CERT (L) EnJSlNESS ADDRESS 1109 DONAWAY NOKOMIS FL 34275 '. .. ... .PAI~~OOO'~-T04'02n3i2ooa-14;16 .' . '. '.. R J-IWfAFFEY CONSTRiJCTloN..... . . 111J9 'DONA WAY NOKOMIS R.. 3oQ75 .-,.... ......... 4;C~"":_~:"'.".'''.'.':.'' :':~........;..' ~-- NlIIYC. . ',' '.. .'....h ." . . . . . . .:8ARBAAiFbRO-Co#~;TAX.COL.LECfOR. . . u',_. ,.' ';'01 S<~ASHJ~ON(~~~=~~. FUI'~~~6-6993 .. '" ::~~.S~TaxCoIlector-oom ~ 1~~~~~!aicCo1teC(6i';col . MUST'BE niSPLAYED 1N A cONsPicuous PLACE VALID UNTD:.I0111O& . ,. ..- ~ :'. ~ ... 04/07/2008 07:36 9414455976 RJMAHAFFEV CONSTRUCT PAGE 01 ~'I".'''''''~.V.''l.~''''_I''.rr''~~..I'!..I~_':'' 1 u~" ...*' 3<'1/liio . . I ~ . g.--.... .:c...,..."", t I..~.. ._".1 ~. ......... I -, ill ~i:I""'. ~:.'.';L~ .:~~.J.-,~i(i. .:...,y,.~,;. .~ ~ ~v.wl4Uile . uVlml:LU;"1dHJ:',:hI~. ~~~:r;:~:l~~~ 'C"~'" "$4' i1.S4J' 0' ~ . . . '. . . " ." , :. ..,' ':'" ....' '. .::." .:. Fax Transmittal To: ~~ ~ 0 'Jt.JlJ...z Fr: J:,{ /'4---- if Re: ~~ Date: t{,~ 7- e8- << Number of pages including cover sheet:" ~ I. .~c. _~~~UJ ~.~4";J<< __~~-' 3. /3At.A fTY E 4& cTA./e; W/c:: ~~j ~~I ~'.~ / Please 5J~1 with any questions or receiving problems. t;.l ~ . f~/- 73"7- 3~<{q 16:50 APR 10, 2008 FR: WENDI MCILVAIN *2160 PAGE: 2/2 .ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MINDDJYVYY) 04/10/2008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Affiliated Agency Ops ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16 South River Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilkes-Barre, PA 18702 Tel: (800) 673-2465 Fax: (570) 825-0611 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: EaslGUARD Insurance Companv 14702 Employee Leasing Solutions, Inc. INSURER B Phone: (941) 746-6567 INSURER c: 1401 Manatee Ave W. Suite 600 INSURER D: Bradenton, FL 34205 '1 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY 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 "DO' P~~~~=~ ~':i:Y,=~~ LTR INSR; TYPE OF INSURANCE POLICY NUMBER LIMITS ~ERAl LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED - 5MERCIAL GENERAL LIABIliTY $ - CLAIMS MADE 0 OCCUR MED EXP {f,~, one -son' $ PERSONAL & ADV INJURY Is GENERAL AGGREGATE $ ~L AGGREM LIMIT APn PER: I~ PRO. POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE lIMrr - (Ea accident) $ I-- MolY AUTO I-- ALL OWNED AUTOS ll9.DIL Y INJURY er person) $ I-- SCHEDULED AUTOS I-- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I-- I-- PROPERTY DAMAGE $ (Per accident) GARAGE lIABLITY AUTO ONLY - EA ACCIOENT $ R MolY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ ~EISSIUMBRELLUILlTY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ =l ~EDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND X I WCSTATU,: W~i EMPLOYERS' LIABILITY TORY lIMrrS ER A AIofY PROPRIETORlPARTNERlEXECUTIVE E.L EACH ACCIDENT $ 1,000,000 OFFICERlMEMBER EXCLUDED? EMWC904495 01/01/2008 01/01/2009 E.L DISEASE. EA EMPlOYEE $ 1.000,000 ~fE'b~~o~~~s below E.L DISEASE, POLICY lIMrr $ 1,000,000 OTHER Client 10: #2109130 .. Valid in the State of Florida .. DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT (SPECIAL PROVISIONS EastGUARD Insurance Company COVERAGE APPliES ONLY TO THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF: R J Mahaffey Construction LLC carries an A.M. Best Qualifiers Name: Ed Hardesty/RJ Mahaffey Rating of A- (Excellent) and a financial size Fln.nDi.. St......gth Aprox active employee count: 10 Category of VIII ~ A- 'Eiiaituent CERTIFICATE HOLDER CANCELLATION City Of Zephyrhills 5335 8th Street SHOUlD ANY OF THE ABOVE DESCRIBED POUCES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WLL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTFICATE HOLDER NAMED TOTHE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR lIABLITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhills, FL 33540 AUTHORIZED REPRESENTA @ ACORD CORPORATION 1988 ACORD 25 (2001/08) : i, ,: I') ;" I:,: /:-p' "J c.: r:.' 'I t. :I. 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