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Home My WebLink About08-7403 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 FIRE STANDPIPES PERMIT 7403 Permit Number: 7403 Permit Type: FIRE HOOD SUPPRESSION SYS Class of Work: FIRE-HOOD SUPPRESSION SYS Proposed Use: MOBILE HOME PARK Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 39345 6TH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 12-26-21-002B-00500-0000 2,345.00 1/24/2008 130.00 130.00 1/24/2008 Phone: HOOD SUPPRESSION SYS - CLUBHOUSE/KITCHEN Name: SIXTH AVENUE LLC Address: 39345 6TH AVE ZEPHYRHILLS, FL. 33542 50.00 Aj\J b~ !.AI 1/ ;yt v Chapter 633, Florida Statutes, authorizes the City to charge and user fees to pay for the costs of fire prevention and protection related activities such as inspections, pia review, administrative fees, and other costs related to the aforementioned. Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final inspection shall be charged double permit fee per day of operation or a minimum of $100.00, whichever is greater. All work shall be performed in accordance with City Codes and Ordinances. "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 RECO ING Y NOTICE OF COMMENCEMENT." ~~TOR :IG~ATURE I PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041 813-780-0020 Date Received Owner's Name Owner's Address Fee Simple Titleholder Name bJ-' Oil & , City ofZ~phyrhills Fire Permit IApplication '1)ou~ I Phone Contact for Permit I -, :'0<'6. I ~{l~ LLC i 3i3L;~ GW~ I I I I Owner's Phone Number ,-~ i I Titleholder Phone Number I I Fee Simple Titleholder Address Fax-813-780-0021 -- 117f":2. I J ,,7l.j %).3 II II Job Address Sub Division Clu.b'nol' l)L -\l\-\-chtJ-~V'"'t I Lot# Parcel # 1/..2- ,;;lee -~ 1- oec5,?}. - 00300 - ClOC'C (Utl, A'Nt::U I-KUM t-'KUt-'t::K I Y 'AX NU 11t;t::) 3 9 3Y~ c:e 7t-1 ~ D D D D D D D D D D D o Contractor Signature Address ELECTRICIAN Signature Address I PLUMBER Signature Address I MECHANICALI Signature . Address I OTHER Signature o Fumigation Tent I 0 Hazardous Material (Tier II or RQ Facility) ANNUAL I 0 Hood Installation o LP/Natural Gas-Installation o LP/Natural Gas-ANNUAL Sale o Places of Assembly-ANNUAL o Recreational Bum o Sparklers o Sprinkler System Installations ~ 0 Standpipes (Sprinkler Sys) 110 Torch Roofing 1'0 Waste Tire Storage ANNUAL I I I ;J, '3 y (': 66 I Valuation of Project f\ro C:J."2~ t 0.f2A.. cn~ Hf-e $vr"'(to~~\~ Bio-Hazard Waste Storage -ANNUAL Comm Exhaust Kitchen Hood/Duct Controlled Bum Emergency Generator < 30 kw Emergency Generator> 30 kw Fire Protection Maintenance - ANNUAL Sprinkler D Fire Alarm D Hood Clean/Suppression D Fire Alarm Installation Fire Pumps Fire Works Flammable Application- ANNUAL Fuel Tanks Other: I-::rv,~\\~~ eP Company Registered License # Company Registered License # Company Registered License # Company Registered License # Company Registered I $.) .,,('~~ ~'i ("" t> Y I ~ Fee Current I I Y I N I Fee Current I I Y I N I Fee Current I I . Y I N I Fee Current I I Y I N I Fee Current ~L~-/ 1)ctX' , ( ) f'JOC" - f'-.J 1+ ~-+o ~fM l("'" t=-Ce~ Y IN I I I Y IN I I ~.~. :1 I Y/N 'Y/N Y/N Address License # Directions: I Fill out application completely. 1 Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation ' Allow 10-14 days for review after submittal date. I I NOTICE OF DEED RESTRICTIONS: The undersigned underttands that this permit may be subject"to "deed"restrictions" which may be more restrictive than County regulations. The 4ndersigned assumes responsibiiityior compliance with any applicable deed restrictions. I UNLICENSED CONTRACTORS AND CONTRACTOR RESIPONSIBILlTIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be lic~nsed 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 unc~rtain as to what licensing requirements may apply for the intended work, they a~e advised to conta~t the Pasco County j3uilding Inspecti~n Divi~ion-Licensing Section at 727-847- 8009. Furthermore, If the owner has hired a contractor orl contractors, he IS advised to have the contractor(s) sign portions of .the "contractor Block" of this application for Whichrhey will be responsible. If you, as the owner sign as the contractor, .that may be an indication that he is not properly Ii ensed and is not entitled to permitting privileges in Pasco County. ' CONSTRUCTION LIEN LAW (Chapter 713, Florida Statute!lj, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a cqpy 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 ~he 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 al! applicable taws 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 tb issuance of a permit and that all work will be performed to meet standards of all laws regulating constructi~>n, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other I 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. I If I am the AGENT FOR THE OWNER, I promise in good fait~ to inform the owner of the permitting conditions set forth in this affidavi,t prior to commencing construction. I understand Ithat a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other linstallations not specifically included in the application. A permit issued shall be construed to be a license to proceed y{ith the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issu~nce 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 ~ork 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. I WARNING/TO OWNER: YOUR FAILURE TO RECORD AINOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPEm-v. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO CE OF CO ENCEMENT. FLORIDA JURAT (F.S. 117.~ /l /J . I ! . <. c..i!1 OWNER OR AGENT . '&.L Uj~1.LL~~Il(" CON RACTOR ~ yc / ~ S1:sclibed and swom to (or affirm d) Su s 'bed.~nd sworn to (or affi ) before me this ( I (''71off by '":Do .. l I O~ by ""J::x)US~o...J.:) C~ ~ C.e~ O-~ Who is/are personally kno to me or haslhave produced Who is/are personally known to me or has/have produced - f<- ~uw'2. \-+<-. as identification. -4 l\euQ.. L.4. e.. as identification. I ~ ~~~ C I.. N ommlSSlon o. , ... ~-~~ Notary Public Notary Public Name of Nota. .:'~~~~~ Karen .L. Miller Namelof Notary type · . 0 b 29 2010 ~. expIres eto er , "" _7"",,,,"".,_..,,,,, _1-7010 Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Kerry Barnett Bus (813) 780-0041 Fax (813) 780-0044 January 18, 2008 I have reviewed and approved the plans for a commercial hood suppression system located at 39345 6th Avenue. I have attached the comments for the plan approval. If there are any questions please contact my office at 813-780-0041. 1. Class K extinguisher required on site. 2. System shall be connected to building fIre alarm system. Ifno fire alarm system, a horn/strobe or bell shall be connected to system to notify occupants of system activation. Inspections Required 1. Acceptance test. 11/20/2007 21:19 7278469807 .:c.r-c.,-D...."J1 J..L.L-L-' I un" HARBOR VIEW :,e,.c.- PAGE 02/02 Suncoast Fire Safe~ POST 0tiFIC& BOX 1200 NeoN PGft RIaMf. FlDltde, S4656 E.m;1: 5\!nt[)Mft'!r~fftv:i7'''C!ril(,.I'!.net UC.# e694!i8DOD1:loo=J S2S91100012004 ""P<KtRidMJY (721l~-t'l'14 Tell FrlN 1-800-a270G801 Fax (727) 8012,89$4 TOl StDbAvet.aeMHP -"5'. Aft Zt'*''''_ ~ 33M! Ada: Milc.e ~incoo. PM (813) 782.1.74 Fax# (813) 7B2.3479 R8JIII"IIla" Firn S~io,v ~ ~po)Vet. Chemical Kitchen fire S1JDDt'eSSion..S~ j;nstallation PROPOSAL SPI.CIFlCATlONS ScGpc of Watk: We aft pleased 10 IUb1l'lit this prcp:lSlll m irlstBI1 One (1) Pytc Cbcnl PCL. 300 \Wt <:h~1 r..e suppre$Ilii<m gysrtm to meet U.L 300 compllanee, and protec& die .bDcxI and applilnges listed below at 1b: location l~,~d above. Tbe }.'ire Suppression syscem will be mlltalled iD 8Qcorduce witb NFP A 96, 17 A an4 Stale ud I~ ccxtes. The Fire SIlPJ:"'CS6ion fYs.tem will protect; 1 orie 6t Sissie s..k Hood. 2 one ahaustdueumder IOOeqll perimeter. 3 Two 30" x 'J:J." Gall Ran.- ne ~ to mol. 1. Sufficiet\t agent c:yliJJdl!!ll'S. 2. The ;yliaders will ht equipped with the 8.1'1'l'Ol'ristl) mounting~. 3. NCQOSIl8IY piping, fi:aings. suppom., cxtstiftg ifl(juipment mllY be llSed. 4. Flldory Authorized R.8Ulated a.teeset A~ to ~ the $YstDm cylinders. S. A lIIeaI1S or lI1ROItlltic aQtuatlon us;,ng fusible: link detection. 6. A DH;UIS Of.manual alCtUIdiOD 1. %" MecIw'llcal Cas Shut off valve SUllWQt Fh'e' Safety wiD supply One ~oc:lrlcal...ictu-r.~h to be QOnnecwd by yOLlr etcWic::i8n All work heing done cJurina, norl'Bal blIridcss boura &:d"Mon~~'Frida)' 8:00 A.M.-S:OO P.M. All hood. ~ electric lL1ld aJano work to be dottt by (ItMl'B, ifrequired. Tol8l cooUilr tho file """"""ill oy.- .....,'"::~ ~JlIl 11m 1I1l1...lIaF for~-4!III 1m jnoludod.. bowever IHlnDit will. at CQ!Jt (vritablel. &...:O'O~~~) Camingcncy: lfBoocI dDeI Mt com,,1)' with NFP A96 StaDrll!tds there will be an ~rlAl ~ re-t1lStall pipiDg in NFPA% compliant Hood, . to ~ ~\o.e PAYMENT TERMS~ 50% down (DOJ1oordUadablc). ba.!8ncc d~ upon ClO~ ~~0Wl (net teSt) Villa I M...~ / American &pre!lS I Dis:::ovet ~~ If yotI W01lkllikCl 0$10 proceed with the above olltUned !IIOOpI!b ohvork, pteaR ""~~ and .A.pmcnt end return. We will thIr1 get sl:lIJ'ted oa ttWl dtsign poJ'Eion right away. We .~ia~ the opponunit). to provide)'O\1'1' facility with this proposal and we look ft\I'WBJ'cl to serving yOU Sira:rclyt ~1 3411I,2001 Scott Stroud Please caU with a:ny qucstiC)Qs Of' coa<<:<<n$ Cel1# 727~243.91 92 ~~ AcceptanetlofanoDOti~ tQ proceed with the w()tk described above is lludtOth:ed by:the followin.@ sl~~ ~ ~ . _\\~. >.,.0 L,,",~ . 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Fire Chief Keith Williams ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Bus (813)780-0041 Fax (813)780-0044 FIRE SERVICE USER FEES Occupancy ~: _ Plan No.: - ~ Business Name: -- _ 31/5' t-th/{=- Business Address: ~ h ~~ Business Phone No,: Business Fax No.: Contact: PLAN REVIEW FEES B Site Plan NlC MuIti-FamilylCommen:ial .06 sf (Minimum Charge $25,00 o Plan Revisions DBl SPRINKLER SYSTEMS 8 0 - 25 Heads $50 26 plus Heads $100 STANDPIPE SYSTEM o Per Riser $50 FIRE PUMP D Per Pump FIRE ALARM SYSTEM B 0 - 25 Devices $50 26 plus Devices $100 SUPPRESSION SYSTEMS ~~ : Other ~ KITCHEN EXHAUST o HoodIDucts OTHER B LP Installation per tank Fuel Tank Installation (Per Tank) o Natuml Gas Installation (Per System) o Spray Booth PlANS TOTAL~ Comments: $100 INSPECTION FEES Annual NlC 1 st Re-inspection NlC 2nd Re-inspection $100 3m Re-inspection $250 4th Re-Inspection $500 (Business ctosed until violations corrected) SPRINKLER SYSTEMS ~ Hydro Undergrounds $45 Hydrostatic Test $65 persystem Acceptance Test $45 per system Hydrant Flow $75 Contractor: SC/n~~ .Ii"~ f ~ Billing Address: ?~3 -e"<oL~</ /f/A/ //ud- /(';~y, ~ l.rS72:. Billing Phone No.: Billing Fax No.: Contact: SPrin~~:lt) Standpipes ~ ~ Fire Pump Hoods Fire Alann LP Gas Natural Gas F~ Tanks- per lank Sparklers Fire Works Camp Fire Controlled Bum Hood/Duct Place of Assembly Fire Protection Flammable Application Waste Tire storage Generator < KW Generator >30 KW Bic-Hazard Waste Fumigation Tenting Torch Pot/Applied Haz.. Materials B FALSE ALARM FEE 1st Alarm NlC 2nd Alarm N/C 3m Alarm N/C 4th Alarm $100 5th Alarm $150 6th Alann $200 NON COMPLIANCE $150 $50 $50 $50 $50 $50 $50 $100 $500 $25 $100 $50 $50 $25 $50 $50 $100 150 $100 Annual Annual Annual Annual $50 $50 $100 Annual PERMIT TOTAL~ I /.?O- . I FALSE ALARM TOTAL II FIRE ALARM SYSTEM B System AccepIance $50 Recall Acceptance $50 OTHER ~ Fire WalllSmoke Wall LP Gas Natural Gas $15 per wall $25 per lank $25 per system $50 Tent 10'x1 0' or greater $15 per tent Fire Pump Fire Suppression System AccepIance Exhaust Hood/Duct Re-inspection (other than annual) o Inspection scheduled DBL and cancelled less than 24 hours B Construction Insp, NlC Emergency Vehicle Ao $50 /' INSPECTION TOTAL~ GRAND TOTAL $50 $50 $50 $50 @ Date: $30 DBL $50 J/rfft,B ,{{;,.., ~C{/~4 ^~ ~ Ins~ctor: --:: STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DMSION OF STATE FIRE MARSHAL TALLAHASSEE, FLORIDA FIRE EQUIPMENT DEALER LICENSE ~J~.' .~~ fY \0 '0..,,,- TInS CERTIAES THAT: SUNCOAST ENTERPRISES NN, INC. DBA SUNCOAST FIRE SAFETY 6403 RIVER ROAD NEW PORT RICHEY, FL 34652- QUALIFIER: RICHARD NORWOOD HAS COMPLIED WIlli FLORIDA STATUTES AND HAS QUALIFIED FOR THE TYPE AND CLASS SHOWN HEREON TO SERVICE, RECHARGE, REPAIR, INSTALL, OR INSPECT ALL TYPES OF FIRE EXTINGUISHERS INCLUDING RECHARGING CARBON DIOXIDE UNITS, AND TO CONDUCT HYDROSTATIC TESTS ON ALL TYPES OF FIRE EXTINGUISHERS INCLUDING CARBON DIOXIDE UNITS. EXCLUDES ANY SERVICE, RECHARGE, REP AIR, INSTALLATION OR INSPECTION OF ANY TYPE OF HALON EXTINGUISHER. -r;. ~ Chid Finantial Officer 04 28 2006 07 01 Issue Date Type Class Pasco County 66945900012005 . UcejJSetP"ennitNum1!ef . 6694590001 12 31 2007 Application # Expire Date STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL TALLAHASSEE, FLORIDA FIRE EQUIPMENT DEALER LICENSE 0;;!.~\ ' - . ~ 0'; I C}' ~~ ('y . TIllS CERTIFIES THAT: SUNCOAST ENTERPRISES NN INC 6403 RIVER RD NEW PORT RICHEY, FL 34652- QUALIFIER: ROGER 0 MCKELLEN HAS COMPLIED WITH FLORIDA STATUTES AND HAS QUALIFIED FOR THE TYPE AND CLASS SHOWN HEREON TO SERVICE, REPAIR, INSTALL OR INSPECT ALL TYPES OF PRE-ENGINEERED FIRE EXTINGUISHING SYSTEMS. EXCLUDES ANY SERVICE, RECHARGE, REPAIR, INSTALLATION OR INSPECTION OF ANY TYPE OF HALON EXTINGUISHER. ~~ Chief Financial Officer 01 01 2006 07 04 Issue Date Type Class Pasco County 52691700012004 6694310001 12 31 2007 License/Pennit Number Application # Expire Date '~ ~I '~'i'~ , .. . "CONT,AC.T PERS:ON FOR PjERMIT'APPLICATION .' . DATE:" : I ! /O!Df? ~... LLe.... - -f~ NAME: .' . COMPANY: .' . PHONE: <g4cJ / '71 c; . ' CELLPBONE: '. FAX:.. E-MAIL ADDRESS: . NOTES: " " . . . . TIlE CONTACT PEBSON.'WILL BE CONTACTED FOR ' CORRECTIONS, Em<<>Rs;ADDITIONAL . ' . INFO~TION,;~TC. , I . . FBC 104.1.6 TIME LIMITATIONS. AN APPL~CATION FOR . A PERlVIIT FOR ANY PROPOSED WORK SHALL BE DEEMED TO . , . . . .' HAVE BEEN ABANDONED C?MONTHS AFTER THE DATE OF . . . FILING FOR THE PERMIT, UNLESS BEFORE THEN A PERMIT HAS BEEN ISSUED. . . StAftJ~'S I COMMERICAL PERMIT VERIFICATION FORM BUILDliRICONTRACTOR S(J./0C OA""'::, + . , \. \ ~Jl.- C lct~1 . /0' ^-e CONTROL# J;,,( '\., ~ Checklist Comments Checklist Item Completed I ,Application Package Subcontractors Signatures. Legal Description Verified Flood Zone Reviewed Flood Documents Prepared Site Plan Approved Construction Plan Review Structural Electrical Plumbing Mechanical Fire Marshall . PC/DCIZ-Hills l. Energy Forms Health Dept., Approval Septic Tank Permit on File Utility Company Letter/Receipt , Trans Impact Fee Calculated Address NOC Envelope . Lease Agreement/or warranty deed Sub Contractors/Pasco ID's '. PLANS FEE PAID: ' RECEIPT NUMBER: , . Square Footage: Irrigation/Sprinkler Code: New Old COMMENTS: ' CONCURRENCY FORM STATUS Completed Service Date Retumed Roads Drainage , Water , Sewer 'Solid Waste Parks/Recreation Mass Transit SITE PLAN REVIEW DATA WINDSPEED: FLOOD ZONE: BFE: PANEL#: ZONING DIST: SETBACKS: COMMENTS TO BE PLACED ON SCREEN FLU: PREPARED BY: DATE: I understand that submitting this application does not allow me to operate or engage In any business within the City of Zephyrhills until a Business Tax Receipt is issued. I further understand that &nyone who opens a new business without having obtained a Business Tax Receipt shall be assessed a penalty of 25% of the regular license fee. This shall be in addition to any application delinquent charges. (City of Zephyrhills Ordinance #978-07, 7/09/07). PLEASE TYPE OR PRINT CLEARLY: DATE: ~.lL 10 , ;)(j(Jf 1. ~~EC~~T~~;I~~~;o~DBfl;p;:i~,_ IJtJ ~ 1~?:t..-rf'I~~~1.f 2. ADDRESS OF BUSINESS /J_ _'Vl.:I- t!/t 7f- _ ~__ 3. BUSINESS PHONE 1A7-K1-J,-/7/f CHECK IF APPLICABLE: INC. X: or P.A. 4. OWNERSHIP INFORMATION:NAME ~ R.. tiYuL~ ADDRESS CITY ST ZIP F. E. I. NUMBER.5l, -:Jtf35'lQtp SS# FL D/L# . 5. MAIL RENEWAL NOTICE TO 1,408 ~ I2tJd..d I.1uJ Pt:YtL R.J~ dL ..34&5;)- 6. APPLICANT INFORMATION:NAME ~ VCIl..uJftt)cL TITLE f1vjL1/~ HOME ADDRESS CITY ST ZIP FL D/L# HOME PH: SS# 7. ADDITIONAL REQUIREMENTS (IF APPLICABLE) : STATE LICENSE # MISC. LICENSES 8. CHECK THE FOLLOWING WHICH APPLIES: TRANSFER ADDRESS & FROM WHERE 9. EXPLAIN NATURE/OPERATION OF BUSINESS ~ 'J; ~ ~ ~ (Iud Ch.Mn.-t'{'a C ) NEW BUSINESS TRANSFER OWNERSHIP If Insurance Agent, name types of coverage, (e.i. Auto, Life,etc). 10.IF MERCHANT, GROSS SQUARE FOOTAGE I acknowledge that the issuance of a Business Tax Receipt is contingent upon compliance with all ordinances, regulations, and provisions of the City of Zephyrhills. Should any structure or conditions be found in conflict with building codes and fire safety requirements, that department shall set forth its objections and requirements for corrections. It is ,then my responsibility to correct the deficiency and request a reinspection. The Business Tax Receipt may not be issued until those corrections are made in compliance of all City codes and all applicable fees are paid. I certify that all the information contained herein is true and correct to the best of my knowledge and belief. It is further understood that I must comply with all City of Zephyrhills codes, and failure to correct any conditions in violation is punishable under the code. I understand that if I engage in a business under a Fictitious name, I must comply with the "Fictitious Name Statute," Section 865. Florida Statutes. Signed'~~ Witness: PASCO COUNTY BUSINESS TAX RlSc:glPT 2007-08 ~ PUISU8I1t and ~JoF1orida Statutes and P8$CO County Ordinances. ~ ~ '-'9t ~ cO~'with zoning or other Iaws,_ This receipt must be posted conspicuously in j)Iaee,of busine. ExPires'~3(),. ' ACCOUNT NO: a5~~~a SIC CODE: 7389.31 ~ BUGn-=..svC.. ~"MTe.,..". , --. ~.... ~~T~~'1mS: , Mail ,PIT tlCHY .~." ~. .f,\' ,~.. ~I i ' " i ...~..... ~. .. ..... .""..~ . . ~-~.' <> SUNCOAST eRfERPRISES IN INC PO BOX 1290 lIEN PRT RCKY Fl 3~'56-1290 . ~.... 09'28:107. ~'536'987 DATE. . RECEIPT. ANOONT '~ l. 33.75 ...U.......H...I....tI.nullnl.U.I..Un.I.I..II...d.I.1 , " ,.., " .. ~. -;t ',:.. .. " ,.>', . .. .\;;~>.,-:'~;/<'-..",/ ,": ;" \/ .... / ',_< -..f ,,:-'/;--,- ,NU"~~'." ,BUSINE.SSClA$$:t'PfCATION Olt'OD~716 ;~Z2" COftPRESSElJ'.LlQUIPEO .. GASES, S .. 75.00 . .ISSU'EDATE: OCTOB~R ,oa., 200 E){Pl~AtrON DATE;: . SEPTEMB.ER ' Cit}'()fNew J>qrt Riehey FIRE DE:PARTMENT $U1#~~.AST '. aNT'ERl>~t SES H._ Fire Prevention Division :&,ijf>'3'~IVERRO 'PERMIT " tlI!1fPO!/t'l"~tCllEY ,Ft. a4452 ~___ '. <FiJ:e~~!'ll>' . ... " THIS RECEIPT MUST BE EXHIBITED CONSPICUOUSLY AT YOUR PLACE OF BUSINESS 11CORD~ CERTIFICATE OF LIABILITY INSURANCE OP lOps I DATE (MMfDONYVYj SUNCFIR 01/10/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Greg Roe Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New Port Richey FL 34655 Phone: 727-376-0030 Fax: 727-376-2262 INSURERS AFFORDING COVERAGE NAIC# INSURED I NSURER A Kichi.qan Construction IndulItry 10998 INSURER B MidContinent Inllurance CoIllpOllny 23418 Suncoast Enterprises, NN, Inc, DBA Suncoast Fire Safety INSURER C PO Box 1290 INSURER 0 New Port Richey FL 34656 INSURER E COVERAGES THF POLICIES OF INSURANCE LISTED BELOW HA'rr BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOT'MTHSTANDING ANY REQUIREMENT. TERM OR CONCHlON OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERT AIN, THE INSURANCE AFFORCED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONCHlONS OF SUQ-l POLICIES AGGREGATE LIMITS SHO'NN MAY HAVE BEEN REDUCED BY PAID CLAIMS 'NSR 00' POL.ICY EFFECTIVE POLICY EXPIRATION LTR SRO TYPE OF INSlRANCE POLICY Nl..IMBER DATE (MMIOOIVY) DATE (MMIDOIVY) LIMITS GEt>ERAL LIABILITY EACH OCCURRENCE I 1000000 - DAMAGE TO RENTED B ~ COMMERCIAL GENERAL liABiliTY 04GLOO0673651 05/12/07 05/12/08 PREMISES (Ea occurence) $ 100000 - tJ ClA'MSMAOE 0 OCCUR MED EXP (Anyone person) $ EXCLUDED !-- PERSONAL & ADV INJURY $ 1000000 ~ includes XCU Cove GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 2000000 [POLICY nPRO. nLOC JEcr AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - , ANY ",UTO (EaaCCldent) - ALL OWNED AUTOS BODlY INJURY - $ SCHFDULED AUTOS (Per person) - HIRE.D AUTOS 80DL Y INJURY - l NON-OWNED AUTOS (PeriKcldent) I-- PROPERTY DAMAGE $ (PeracCldenl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY.'UTO OTHER THAN EAACC $ AUTO ONLY AGG $ EXCESSlLIltBRELLA LIABILITY EACH OCCURRENCE $ =:J OCCUR D CLA,MSMADE AGGREGATE I . ~ DEweTlBLE $ RETENTION $ $ WORKERS COMPENSATION AND I T~R~ ~~~~TU~ T -laTH- ER EMPLOYERS' LIABILITY 03/18/07 A WC100-0012132-2007A 03/18/08 E L EACH ACCIDENT l 100000 ANY PROFRI!::lORJPARTNERIEXECUTIVc r:lF~ICERIMEMBER EXCLUCED? E L DSEA5E EA EMPLOYEE $ 100000 Ifyes,descnbeundH SPECIAL PROVISIONS below E L DSEASE POLICY LIMIT $ 500000 OTIER DESCRIPTlON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENlORSEMENT I SPECIAL PROVISIONS WORKERS COMPENSATION APPLIES TO FLORIDA OPERATIONS ONLY. *30 DAYS NOTICE OF CANCELLATION EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION CITYZEP SHOlA.D ANY OF TIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF ZEPHYRHILLS c/o BILL BURGESS, BUILDING OFFICIAL 5335 8TH ST ZEPHYRHILLS FL 33542 DATE THEFa:OF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AN( KIND UPON TIE INSURER, ITS AGENTS OR @ ACORD CORPORATION 1988 ACORD 25 (2001/08) \ r "' () ~. .' ~i~, .' ~ ..s> ~ The Su'}shine State - , , ..\JCENSE N..-eR N630-756-53.345..o . . RlCHMl)RONAIJ) ~ 13544 PLANTATION LAKE CIR HUDSCN. FL 14-,,2A40 , I . IIIR1li IlIl.lE .&EX HGT. REST. EMlOR$E 01-21-13 M WI, EF IS$UED 10.11-02 EllPUIES llUPlICAlE ..... 07-2&04 co, SlIFE DRIIIE' L71lM072ll11ll57 -'''':'''~!''I''''''''~_~'''IO'''~''~rPr-r'' .~.,,,..{lo~~nv~I,,,,,""r.~,,1' ~; i. . SUNCOAST FIRE SAFETY, INC. Personalized Professional Service Caff Us - We Come To You COMPLETE LINE OF FIRE EQUIPMENT & MOBILE RECHARGE SERVICE 6403 River Road Post Office Box 1290 New Port Richey, Florida 34656 Family Owned & Operated Since 1970 License #82327800011997 #06354900011985 24 Hour Telephone (727) 842-1714 Fax (727) 842-6934 1-800-227 -6801 Bill Burgess Building Official 5335 8th Street Zephyrhills, FL 33542 January 7, 2008 Re: Permit Pulling Authorization in Zephyrhills This letter authorizes Doug Cancellara of Priority Permit Services to pull permits for Suncoast Enterprises NN Inc, dba Suncoast Fire Safety for the purposes of Fire Suppression Systems installations by our company. '\ B1d~ Richard R Norwood President I Owner 5,))r5fI.iJ</<>t-SWr/fJ<. r/, ~ fu{ 1M I /)1/ (Jj hto . Cft:/1 /j:j1(l)J()1i1'YJ-rlw(f'ud U:O f rJrb-w fz Signed . / ~ 1/ II AI!~'.II V -- /v'~~ Date -- cJ.../ ~ Qj/' Notarized: ""~~Or""~,, MARY E. JULIAN l..'f ':i. MY COMMISSION /I DD 515771 \i. .: EXPIRES: March 3,2010 ,k Bonded lllru NoIIry PUblIc UtlllOrwrtttNi