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HomeMy WebLinkAbout08-8664 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8664 BUILDING PERMIT Permit Number: 8664 Address: 6201 ROYAL ST Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: OAKSIDE MHP Est. Value: Parcel Number: 02-26-21-0020-00300-0010 Improv. Cost: 3,777.00 s s Date Issued: 12/22/2008 Name: ZACK WILLIAM E TRUST Total Fees: 75.00 Address: 10063 OAKS LN Amount Paid: 75.00 SEMINOLE FL 33772 Date Paid: 12/22/2008 Phone: Work Desc: REROOF METAL 111111 J !JUI11IP1 COMFORT COVER SYSTEMS INC REROOF RESIDENTIAL 75.00 &ov DRY IN ROOF INSP TAPE JOINTS ROOF INSP FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection trips are necessary due to any one 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 improve to your property. If you intend to obtain financing,consult with your lender or an attorney before o mg ur otce of co me ment." CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER V 1 J-,V Vvv- --- Building Department (� Date Received 1 '0 Phone Contact for Permitting 7 ) I IllIllIllIll Owner's Name 1 v+h I Y r Owner Phone Number 1/3'-7 la Owner's Address S , Owner Phone Number Fee Simple Titleholder Name .W (J Fvh zc c k / t vs f Owner Phone Number Fee Simple Titleholder Address PU U 6 3 Oa S Ln• Ste,_�Q I>° `3 a 7 JOB ADDRESS �o a O1 O G. LOT# SUBDIVISION 5 0O, S i CJ I PARCEL ID# CZ `'a(- O 003a0 -Uo i (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD/ALT SIGN MOVE Q DEMOLISH e INSTALL e REPAIR PROPOSED USE Q SFR Q COMM Q OTHER TYPE OF CONSTRUCTION Q -BLOCK [� FRAME Q STEEL Q OTHER�- DESCRIPTION OF WORK e L ro�-t BUILDING SIZE / SQ FOOTAGE I 73s HEIGHT Uh s` EEl BUILDING $ 3777'o 0 ] VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $. AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. Q PLUMBING $ I 0 0 MECHANICAL VALUATION OF MECHANICAL INSTALLATION $ 0 GAS Q ROOFING El SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO BUILDER COMPANY r S s wS ✓ C SIGNATURE I, REGISTERED I Y/ N I FEE CURRENT I Y/ F1 i Address I ( 7Sb License# CCC Q,s 7p_ / ELECTRICIAN COMPANY SIGNATURE REGISTERED I_Y/ NI FEE CURRENT Y/N License# Address PLUMBER 1 COMPANY SIGNATURE REGISTERED �I �FEET Y/N Address License# P MECHANICAL COMPANY SIGNATURE REGISTERED Y/ NI FEE CURRENT Y/N License# Address OTHER COMPANY SIGNATURE REGISTERED Y/Y/ NI FEE CURRENT Y/N License# Address RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&I dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL. Attach(3)sets of Building Plans;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT 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. (A/C upgrades over$5000) ** Agent(for the contractor)or Power of Attorney(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 A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW 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 IMPACTIUTILITIES 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'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 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, Water/Wastewater 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 I commenced within six ruction or violations of any codes. Every nths permit permit issuance, or ud shall become invalid if work authorized by unless the work authorized by such perm the permit is suspended or abandoned fora period of six(6) months after the time the work is commenced. An extension may be requested, in writing, from the Building aseOiriod not to exceed nety job is0consda de ed bandoned and will strate justifiable cause for the extension. If work ceases for ninety(90)consecutive days, th WARNING TO OWNER: YOUR FAILURE TO RECORD A N TiF YOU INTOEND TO OBTAIN F NANCING CONSULT PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER WffH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT'(F.S. 117.03) CONTRACTOR OWNER OR AGENT Subscribed and swum to r affirmed)be re me this Subscribed and sworn to(or affirmed)before me this _by —bY Who is/are personally known to me or has/have produced Who Ware personally known to me or has/have produced as identification. as identification. Notary Public Notary.Public Comm/ slop No. Commission No. Name of Notary typed,printed or stamped Name Notary dr a, y Pubiic S z:of ,n J tinier M Meade M -mmissian DD483567 Exi reS /1/04/2005 Comfort Cover Systems,Inc. 711 Turner St. Clearwater,FL 33756 727-298-0955/FAX 727-298-0111 Contractor's Letter of Authorization I hereby Authorize the below named individual(s)to act as my agent to obtain all necessary permits. This person(s)is also empowered to obtain,complete and sign all forms, applications, registrations and documentation with this limited power of attorney on behalf of me that may be required to accomplish the issuance of any permits that may be required in any jurisdiction in the State of Florida. Authorized person: Daniel A. Wilder Authorized person: Robert Mays FL D.L.#: W436-161-53-218-0 FL D.L.#: M200-778-67-137-0 iAut riz d pe n' signature: Authorized person's signature: Authorized person: Christopher L. Eldridge FL D.L.#: E436-112-73-219-0 Authorized person's signature: Please remove any other names from your list of authorized agents. I am authorizing the above person(s)to act on my behalf in securing permits between January 01, 2008 to January 01,2009. Thank you: Rebecca . Mays State License#CCC057091 STATE OF FLORIDA, COUNTY OF PINELLAS THE FO• OING INSTR �jrNTWASCKNOWKEDGED BEFORE ME THISI .a 3U BYTHEABOVE NIG JQUØWHO IS PERSONALLYKNOWN TO BE OR O S PRODUCED IDENTIFICATION AND WHO(DI,Q (DID NOV TAKE AN OATH. ,xr o Notary Public State of Florida _° Anne M Meade h My Commission DD483567 Slgna of '�or F�° Expires 1110412009 41 CITY OF CLEAR WATER DEVELOPMENT AND NE1GHBORF1QOD:SERVICES t► w` MU--NICIPAL SERVICES BUILDING, 100 S MYRTLE AVENUE RM 10 .$Y POSt OFFICE:BQX=474 ,GLEARWQTER, FLORIDA 33758=4748• Telephone (727.)5G2-4567 Fax;(727)"562-4576 Development Services 2008 21}09 QCL 341 71 LOCAL"'BUSINESS-`TAX RECEIPT THIS RECEIPT MUST BE PUSTED;:.CONSPICUOUSLY IN PLACE OF'BUSINESS Owner Name&•Maibna-Address Business Name&AddYess. REBECCA MAYS' COMFORT COVER SYSTEMS"INC COMFO RT COVER SYSTEMS INC 711 TURNER ST 711 TURNER ST - CLEARINATER CLEARWATER, FL 33756-5631 (727)298-0955 Category C3uant1t 038540;' :. CONTRACTOR: ROOFING 1:CCC057091` TAX YEAR P, IOD BECaINNJNG::: , . PERIOD ENDING PRINT DATE 2008-2009 0ctober.1 •2048 Se tember 30 2009 September 04 2006 FEE TYPE FEES. BUSINESS.TAX „RENEWAL S09$0 OALLzFEES- =6920 THE ISSUANCE OF A;:BUSINESS TAX RECEIPT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY ZONING::LAWS OF THE Crry OF CLEARWATER NOR DOES IT EXEMPT THE;HOLDER':FROM ANY OTHER LICENSE,-PERMIT OR IMPOSED TRAFFIC IMPACT FEE§; ANY CHANGE IN'LOCA'rION,BUSINESS NAME,OR.OWNERSHIP MUST BE APPROVED BY THE, PLANNING AND DEVELOPMENT SERVICES DEPARTMENT. NON REFUNDABLE .:;;: ,•--..... ,.. DELOPMENTSERVI VE CES DIRECTOR bCLB.IdIPMi 20D041 �_. . STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET 'ate `• TALLAHASSEE FL 32399-0783 MAYS, REBECCA J COMFORT COVER SYSTEMS INC 711 TURNER ST CLEARWATER FL 33756 S +7T.ue.t ' „ .,°.-.O 'era+ t tti�hJ Congratulations! With this license you become one of the nearly one million �,. �► Floridians licensed by the Department of Business and Professional Regulation. � ;3 { - Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services,please log onto www.myfloridalicense.com. _] There you can find more information about our divisions and the regulations that M4Limpact you,subscribe to department newsletters and learn more about the ! s Department's initiatives. 'Our mission at the Department is: License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. r r ₹ p (3 ;w' Thank you for doing business in Florida,and congratulations on your new license! " � t DETACH HERE ._.............. .... . ..._ . .._ _.. ..._ :ioi: ii'3: ♦J v. �s�� 33 ..�� i•aT, p,,}^��R�.t� klr�'-.i�` . ._`r. r.. � 7. ) ' f � ' ` �� ��� 1! ++S�3 �� A�y"�,, s ) a L .: ]' ✓" �*li,'^ �"I ti .f.,K ;� '-0'i '.$. * k _ ' kk Y ' :GS; _nT: ./ �+M/ ^.... .YI •' Y% �!' Y"r/ \7 \ ' \% (s) ' l J'` m.[�1'a.�'F yki.4 f. {I rI r ,r� )Y '.- , ,�� . . ,; 'C�� '� '�' U ;- t.�� ��.s . '�x r�'" y�f ^,.�1. :Gl' _?S` :��+? } i alt. �v3: ACORDTM CERTIFICATE OF LIABILITY INSURANCET-67T7- DATE021151200$ PRODUCER USI NORTHEAST THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 555 PLEASANTVILLE RD.STE. 201 N. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR BRIARCLIFF MANOR, NY 10510 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED 2527 INSURER A: TWIN CITY FIRE INSURANCE COMPAN STRATEGIC OUTSOURCING, INC. INSURER B: PO BOX 241448 INSURER C: CHARLOTTE, NC 28224 INSURER D. I 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. p INSR AND' TYPE OF INSURANCE POLICY NUMBER DP ATEYMM/DD/YYE PDATE MM/PDD/YY" LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMA E TO RENTED $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea Accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION .$ $ WORKERS COMPENSATION AND X WC STAT - TH- A EMPLOYERS'LIABILITY 16WBRJ79226 03/01/2008 03/01/2009 E.L.EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS LIMITED TO EMPLOYEES LEASED TO COMFORT COVER SYSTEMS INC. BY STRATEGIC OUTSOURCING, INC. REBECCA MAYS, LICENSE#CCC057091 FAX:727-298-0111 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF ZEPHYRHILLS DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 5335 8TH STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL ZEPHYRHILLS, FL 33540 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATITIVES. AUTHORIZED,RE�NTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 I CORD,. CERTIFICATE OF LIABILITY INSURANCE DATEIMMlDDlYYYY) l0 27 08 UCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION E. Wilson Ins . , Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR O. Box 1429 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 475 Belcher Rd. S . gar O FL 33779 INSURERS AFFORDING COVERAGE NAIC# tED INSURER A: Auto-Owners Ins . Co. .EBECCA J MAYS & COMFORT COVER INSURER B: YSTEMS, INC. INSURER C: 11 TURNER ST INSURER D: 'LEARWATER FL 33756 INSURER E: 'ERAGES E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ¼Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH LICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DD LL,, POLICY EFFECTIVE POLICY EXPIRATION NSRDI TYPE OF INSURANCE POLICY NUMBER DATE MM DD/YV DATE IMM/DD/YYI LIMITS GENERAL LIABILITY 20407421 11/08/08 11/08/09 EACH OCCURRENCE $ 500, 00( I DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES IEa occurence) $ 50 00 CLAIMS MADE C OCCUR MED EXP(Any one person) S 5 00 PERSONAL&ADV INJURY $ 500, 00 GENERAL AGGREGATE $ 50 0 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 500 00 fl POLICY flT PRO n LOC JEC AUTOMOBILE LIABILITY 95432341-00 11/08/08 11/08/09 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 100 00 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per.person) HIRED AUTOS - _ BODILY INJURY $ X NON-OWNED AUTOS (Per accident) --"� -- PROPERTY DAMAGE $ (Per accident) GARAGE UABWTY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR i CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I WC STATU- 0TH- EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E-L.DISEASE-POLICY LIMIT $ OTHER ..-- .. .-- . ,. .., ...........--.. .,.-.. - 41PTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS TIFICATL'31l LDER =• "' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED.POLICIES 8E..CP,NcEI1ED. EFORE.THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 0 DAYS WRITTEN ITY OF ZEPHYRHILLS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO ISO SHALL 33-5 8TH ST IMPOSE NO OBLIGATION OR UABWTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR EPHYRHILLS, FL. 33540 REPRESENTATIVES. ,,,.. AUTHORIZED REPRESENTATIVE O. E. Wilson Ins . , Inc . �RD 25(2001/08) ®ACORD CORPORATION 1988 1111111 11111 11111 11111 11111 D I I 1111111110 011101111111 I I I I 2008178748 Rept: 1217810 Ree: 10.00 DS: 0.00 - IT: 0.00 12/17/08 Dpty Clerk NOTICE OF COMMENCEMENT J D PITTMAN PASCO COUNTY CLERK 12/17/08 1>t:02am 1 of 1 OR BK 7985 PG 56 Permit No.# �l O Tax Folio/Parcel ID:O2 2(0.2i-.2i- 02(.) 0J O State: R_ County: rO C.O The undersigned hereby gives notice that improvement will be made to certain real property. In accordance with Chapter 713, Florida Statutes,the-following information is provided in the Notice of Commencement: 1. Description of property(legal description.,lot,.block and street address if available): 02.2(0-2I cO2O"Oo3OO,OQ) C 1o2bl Rot�a.t St-, Zeph9rV 1 -53542. / z�kys aa. c' e- w t 2. General description of improvement: 3a. Owner name/address: c i r\ He Y re LP2f 1 1 S \ s r-t... 33 S4 2. 3b. Interest in property: btfJ1'1Q_1r r-- 3c. Name and address of fee simple title holder(if other than owner): `TT'� "�� 1` tec�� O Q fo 3 (Sj �L`r- Se+w�',y�d L\ a-.. �33'? - 4. Contractor—Qualifier Name and Address: l I!�YYI (-� l_ r l Inc . - III -nji n r S--, elect uO-t-EX FL 331 5. Surety—Name and Address:. NA.., AmolJiat of bond: $ 6. Lender—Name and Address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a) 7, Florida Statutes: NA 8. In addition to him/herself, Owner d'esigriat'es'the•following person(s)to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes(Provide Name/Mailing Address]:' 9. NoC expiration date(one full year from the date of recording unless different date is specified): l' - WARNING TO OWNER:ANY PAYMENTS'MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature of Owner(or Owner's Authorized Officer/ Date Director/Partner/Manager) STATE OF FLIDA County of ASCb The foregoing instrument was acknowledged before me this ( (day of rXQ • , 20Q by Et Vin L. -4e Y.r _ (print name of person)as bwY\ r (type of authority,e.g. officer,trustee,attorney:in fact)for (name of party on behalf of whom instrument was executed). Notary Putft State of Florida Not tc GOOMOY H wrlpht My COmmisaion DD733683 orr� Expires 1I/OWO11 Personally Known -OR- Produced Identification 2jA. -L. Verification pursuant to Section..92.,525, Florida Statutes: Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. Signature of Natural Person Signing Above -t I TLU'Yttr 7 t . i->�r -e r P Si.TF4TE OF FLORIDA COUNTY OF pASCO TH11'IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COpY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OF CE.,WITNESS MY HA D ANO OFFICIAL SEAL THIS `Y.'j JEDPI- 7 ---�2 �D DAY OF MAN.CLERK O CIRCUIT QY Cu"URT _. _.. JEPUTY CLERK Pasco County Parcel: 02-26-21-0020-00300-0010 001 Page 1 of 2 Search Again Snow Map Generalized Buildinq Schematic Estimate Taxes Frequently Asked Question, Other Parcel Cards: 1 1213141S161718 1 3 1 4 1 5 1 6 1 7 1 8 Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: Weekly Archive - Saturday, December 13, 2008 Parcel ID IJ 02-26-21-0020-00300-0010 (Card: 001 of 008) Classification II 28 - Rental MH/RV Park Mailing Address Property Value ZACK WILLIAM E TRUST& Ag Land $0 ZACK MILDRED S TRUST Land $3,006,311 ZACK WILLIAM E &M S TTEES 10063 OAKS LN Building $148,073 SEMINOLE, FL 337722006 Extra Features $14,459 Physical Address - See All 213 addresses (First Shown) Market Value $3,168,843 6038 14TH ST Assessed (Save Our Homes) $0 ZEPHYRHILLS, FL 33542 Legal Description (First 4 Lines) Taxable Value $3,168,843 SUB W1/2 OF SE1/4 B 2 P 6 LOTS 1458BLK3 &LOTS12345 6 BLK 4 &LOT 1 BLK 5 EXC PCL 20 FT BY 20 FT WHERE LIFT Land Detail (Card: 001 of 008) Line Use IlDescriptionli Zoning I Units Type Price IlConditionhi Value* 1 II 0210 TRLR PARK 00M2 I 239.00 UT 1I$13,614.00hI 0.92 $2,993,446 2 f 0100 SFR 00M2 I 0.11 AC II$22,350.0011 1.00 J $2,459 0 0220 II RV PARK 00M2 I 2.00 UT $5,203.00 fi 1.00 I $10,406 Additional Land Information Acres [HiD�11E] Code EResidential Code RMHPCL2 Commercial Code RMHPCL2 Building Information - Use 12 - Stores/ Office SFR (Card: 001 of 008) Year Built 1957 Stories 1.0 Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None Roof Structure Flat Roof Cover Built-Up Tar and Gravel Interior Wall 1 Plastered Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 None Fuel Electric Heat Forced Air- Ducted A/C Central Baths 1.0 Line Description Sq. Feet Repi. Cost New 1 BAS 832 $47,840 2 UST 55 $1,265 3 FCP 209 $2,990 4 FEP 132 $5,290 Extra Features (Card: 001 of 008) Line Description Year Units Value 1 DWSWC 1975 44 $17 2 UDG 1985 480 $943 3 CANOPY 1989 960 $2,402 4 CLFENCE 1975 11,400 $4,019 5 SHUFFLE 1975 3,333 $1,250 http://apprai ser.pascogov.com/search/parcel.aspx?sec=02&twn=26&rng=21&sbb=0020&...... 12/16/2008 Pasco County Parcel: 02-26-21-0020-00300-0010 001 Page 2 of 2 6 II UDU-M II 1984 II 1 $448 7 CANOPY IL 1993 1,200 $3,255 Sales History Previous Owner ZACK WILLIAM E& Year Month Book/Page Type Amount 2002 IL 02 4984/ 1216 WD I $0 2002 Ii 02 4984/ 1213 WD $0 1991 I- 01 1981/ 0205 QC $0 Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Questions Other Parcel Cards: 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 Other Agency Data: Tax Collector School Board Supervisor of Elections http://appraiser.pascogov.com/search/parcel.aspx?sec=02&twn=26&rng=21&sbb=0020&... 12/16/2008 = _ BCIS Home I Log In I Hot Topics I Submit Surcharge I Stats&Facts Publications I FBC Staff BCIS Site Map I Links I Search Product Approval USER: Public User Product Approval Menu > Product or Application Search >Application List> Application Detail FL # FL1875-R2 Application Type Revision Code Version 2004 Application Status Approved Comments ®. Archived Product Manufacturer Cooley Incorporated Address/Phone/Email 50 Esten Avenue Pawtucket, RI 02860 (401) 724-9000 ext 6374 mehtan@cooleygroup.com Authorized Signature Naresh Mehta mehtan@cooleygroup.com Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Single Ply Roof Systems Compliance Method Certification Mark or Listing Certification Agency Miami-Dade BCCO - CER Referenced Standard and Year (of Standard Year Standard) ASTM D4434 1987 Equivalence of Product Standards Certified By http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgtY2IEH2a%2fOjnp8yDz%2fb... 5/22/2007 Product Approval Method Method 1 Option A Date Submitted 03/28/2006 Date Validated 03/28/2006 Date Pending FBC Approval 03/15/2006 Date Approved 03/28/2006 Summary of Products FL# lModel, Number or Name Description 1875.1 C3 Single Ply Roofing PVC 40 to 100 mil with Antiwick Fabric between Membrane two layers. Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL1875 R2 C CAC_C3over.Cementitous_Wood Approved for use outside HVHZ: Yes Fiber Decks.pdf Impact Resistant: Yes FL1875 R2 C CAC C3__over Concrete Decks.pdf Design Pressure: +90 /-90 FL1875 R2 C CAC C_.3 over Gypsum Decks.pdf Other: FL1875 R2 C CAC_C3_over Recover Decks.pdf FL1875 R2 C CAC C3_over Steel Deck.pdf FL187.5 R2 C CAC C_3.over Wood Dec_k_s.pdf Installation Instructions FL1875 R2 II C3 over Cementitous Wood Fiber Decks,,pdf FL1875 R2 II C3_over_Concrete Decks.pdf FL1875 R2 II C3 _ov_er Gypsum__Decks,pdf FL1875_R2 II_C3 over Recover Decks.pdf FL1875 R2 II C3 over Steel Deck.pdf FL1875 R2 II C3 over Wood Decksdf Verified By: Miami-Dade BCCO - CER Back Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee,Florida 32399-2100 (850)487-1824,Suncom 277-1824, Fax(850)414-8436 ©2000-2005 The State of Florida.All rights reserved.Coovrioht and Disclaimer Product Approval Accepts: ' W WElfp fitsMNO ve�rrr• httfr.//www.flori&building.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgtY2IEH2a%2f Ojnp8yDz%2fb... 5/22/2007 -00,3 0 - 0010 C' 'z -JXr1/s Contract (727)298-0955 711 Turner St. (800)226-0955 Fax:(727)298-0111 COMFORT COVERSy5TEM5 Clearwater,FL 33756 FL Lic.#CCC057091 PROPOSAL SUBMITTED TO ONE t Z O CONTRACT DATE STREET MHP NAME C CITY,STATE,ZIP /, /4 MHP ADDRESS IG1 REPRESENTATIVE: rt' T APPROX.JOB START DATE We hereby submit the following specificatio and estimates: Ye : /9 .-� Make: Model: ,� I 1. INSTALL COMFORT COVER SY TEMS PATENTED ROOFING SYSTEM FOR THE FOLLOWING AREA:_, g, 2. SYSTEM TO BE INSTALLED: WHITE GRN. GREY BEIGE 3. INCLUDE DOUBLE-FOIL-FACED INSULATION AS INDICATED: -' 2"nom. 3l4"nom. NONE 4. INCLUDE NEW SPUN ALUMINUM VENTS, EXCLUDING FURNACE VENT; (ELIMINATE DEAD AIR SPACE VENTS) 5. INCLUDE ALL REQUIRED PERMITS. 6. CLEAN UP AND REMOVE ALL JOB-RELATED DEBRIS FROM JOBSITE. 7. #_J9k' SKYLITES TO BE INSTALLED. NO INSIDE FINISH INCLUDED. 8. PROVIDE TRANSFERABLE LIFETIME CONTRACTOR'S WARRANTY COVERING LABOR AND MANUFACTURER'S BACKED LIFETIME WARRANTY COVERING MATERIALS. SPECIAL INSTRUCTIONS & EXTRA WORK(USE ADDITIONAL PAPER IF NECESSARY) NOTE:RETAIL SALES TAX MUST BE CHARGED UNLESS THE CUSTOMER SIGNS THE FOLLOWING: I certify that I own the land on which the structure I am improving is permanently affixed. Futhermore, I have filed a declaration with the Property Appraiser requesting the structure assessed as realty and it bears an"RP"decal. SIGNATURE: CASH PRICE AND PAYMENT SCHEDULE: (Reference to a phase of construction means all work, materials and equip- ment necessary to complete that phase). Buyer agrees to pay Seller the Cash Price at Seller's office in accordance with the following payment schedule: I have the authority to order the above work and do so order as outlined herein, Price $s��'?'7' el it is agreed that the seller will retain title to any equipment or material furnished 1. until final&complete payment is made. An express mechanic lien is hereby 2. Tax $ i 69- 3 9. acknowledged for security of this debt and the total amount will be paid within 3. Down Payment $ 'r terms shown. 4. Balance $ i//" I,(we)herewith expressly agree to pay not as a penalty but as liquidated damages,25%of the principal amount of this contract to Comfort ON COMPLETION OF ALL WORK CoverSystems in the event of a breach of this agreement by I(we)for any reason whatever. Terms: O Cash O Credit(Subject to the approval of the Credit Sales Department.) Authorized Signature NOTICE TO OWNER DAll material is gu eed to be as specified.All work to be completed in a workmanlike blank,not sign this home uread improvement i.You arecontract d to manner according to standard practices.Any alteration or deviation from above specifica- of or before you it.You igntled i tions involving extra costs will be executed only upon written orders and will become an tcopy this t yourco legal act rights.a the time you sign.Keep it extra charge over and above the estimate.All agreements contingent upon strikes, on protect Buyer's right to cancel accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary reverse side. insurance.Our workers are fully covered by Workers Compensation Insurance. Acceptance of Contract—The above prices,specifi Signature cations and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Signature Payment will be made as outline above. ro City of BUILDING pL�ZePhYI'Iulls REV Contractor W COA&MNTS /Homeowner: cZii Date Received: l T / � �' �►'1 Site: ` Z 2.j/ Permit Type: Approved w/no"comm eats: Approved w/the below co mments: ❑ Denied W/the below co dents: ❑ nment sheet shall be kept with the permit and/or plans. wi s ExatniIIer Date Contractor and/or Homeowner (Required when comments are present)