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Home My WebLink About08-8173 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8173 - BUILDING PERMIT r � o Permit Number: 8173 ` Address: 37930 MEDICAL ARTS CT Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD/ALT COMMERCIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 34-25-21-0080-00000-0010 Improv. Cost: 420,000.00 _ Date Issued: 12/,D8/2008 Name: DAIRY QUEEN Total Fees: ç2,691.54 Address: 37930 MEDICAL ARTS CT Amount Paid: 1:€4 ZEPHYRHILLS, FL. 33542 Date Paid: 12/08/2008 Phone: (813)780-2826 Work Desc: REMODEL II -DAIRY QUEEN ELFRINK CUSTOM CONSTRUCTION INC BUILDING FEE 1,894.50 ELECTRICAL FEE 360.00 DRURY HEATING&AIR CONDITIONING PLUMBING FEE 127.50 MECHANICAL FEE 120.00 PARTIN PLUMBING SERVICES INC FIRE PLAN REVIEW FEES 159.54 FIRE INSPECTION FEES 30.00 AMPERE ELECTRICAL CONTRACTORS IN AFFORDABLE ROOFING SYSTEMS INC cP/ j En FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING 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 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 ents to your property. If you intend to obtain financing,consult with your lender or an attorney befo rding your notice of mencement." O S PERMIT OFFI R PERM EXPIR SIN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Print Date: 3/12/2009 P t ,@r.a,.n,. .,.,e,.0 Q.,fi'•� >.,.,�.�E..f ',.� tip ,'-`, h' " a pn,,' Zephyrhills Fire Rescue InspectionDate: 3/12/2009 3:30:00PM 6907 Dairy Rd ; InspectorName: Kerry Barnett Zephyrhills, 33542 nspectionNumber: 1-113-09-0540 Phone:813-780-0041 Fax:813-780-0044 InspectionCause: Periodic Inspected Party OccupancyType: Assembly DAIRY QUEEN PropertyUseType: Restaurant (000184) ViolationCounts: 0 37930 MEDICAL ARTS CT Hrs: 0.30 ZEPHYRHILLS, FL 33542 Phone:813-780-2826 Comments: BUILDING REMODEL FINAL:ALL LIFE SAFETY LIGHTING INSTALLED, SMOKES AND DUCT DETECTORS INSTALLED, FIRE EXTINGUISHERS INSTALLED, HOOD CLEANED, SUPPRESION PREVIOUSLY INSPECTED AND APPROVED, FIRE WALLS PREVIOUSLY INSPECTED AND APPROVED, EGRESS ACCEPTABLE. ANNUAL ASSEMBLY PERMIT REQUIRED, BELL REQUIRED FOR HOOD SUPPRESSION ACTIVATION AND SIGN FOR PULL STATION.CONDITIONALLY APPROVED WILL REINSPECT IN 30 DAYS. ITEMS SHALL BE COMPLETED OR BUSINESS WILL BE CLOSED. Re-Inspection to be performed on or before: April 12,2009 12:00 am Sign Here Page 1 of 1 City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: r CCSf0 CO !çuj'i7vi Date Received: 77-a.`.Q Site: y7O l''!P L /3S C Permit Type e: JV) €f(11 1t- MEO Approved wino comments:❑ Approved w/the below comments: Denied w/the below comments: ❑ f,P . rrL U 6i , i ThcA 9V44 4 / M &f SILt! 4 mJ This comment sheet shall be kept with the permit and/or p Kalvin Swi —plans Examiner Date ontrac and/or meows (Req ed wh comments are present) 1111111 IIIII IIIII illll 11111 11111 11111 11111 11111 11111 1111 llli NOTICE OF,CO NCEMENT 2008174228 Rcpt: 1216297 Rec: 10.00 DS: 0.00 IT: 0.00 Permit No. 12/08/08 _ Dpty Clerk JED PITTMAN PASCO COUNTY CLERK Property Identification No. 12/08/08 1 f:11am 1 of 1 • OR BK 7978 Pra 1959 •THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property,and in accordance with Section 713.13 of the Florida S tugs,the$ollowin info ation is provided. this NONCE OF OMMENC � / la�.a�v�a✓ ) �c7.'CR� h5 Ce"7te�� Gcv,��l'.:7 f.�•-t - ft1A° of ,4*- a� 1.Description of property(le al descr lion:) Rio "' P� �'S�� t9. �'&' �';+bl« mow_ cam- q < C a)Street Address: Q •G y '' e'zec�r 2.General description of improvements R 3 f ft wner Information a)Name and address:_ft%1'rPi! [ /1 p eif n2 �n b)Name and address of fee simple titleholder(if other than owner) e__ __ • c).Interest in property •4.Contractor Information a)Name and address: ` ��- Fax b)Telephone . (Opt.) —/q D/ /7S-( 5.Surety Information a)Name and address: b)Amount of Bond: c)Telephone No.: Fax No:(Opt.) 6.Lender • a)Name and address:sy1lJw DO iiL W O' Stc'iT oR 05 Phone No. 7.Identity of person within the state of Florida.designated by owner upon whom notices or other documents may be served: • a)Name and address: • b)Telephone No.: Fax No.(Opt.) 8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes: a)Name and address: •b)Telephone No.: Fax No,(Opt.) - 9 Expiration date of Notice of Commencement(the expiration.date is one year from the date of recording unless a different date is specified): 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLO "":d14 Pat Johnson CO d.�CCommission#DD607504 Expires October 22,2010 • �, ,i, r3o•E Troy a" +iininc•, r sod:W_70 o • rgnatLre of er or Owner's Authorized Officer/Director/PartnedMenager• • ñiIc. 1KrQps s �� • Print Name . • The foregoing instrument was acknowledged before me this $ day of D6cC,.g . 20 OS ,by MICHA£t.. K AGssxt as • (type of thority, in fact)for au ,e.g.officer,trustee,attorney • (name of party on behalf of whom instrument was executed). Personally Known OR Produced Identification Notary Signature .Poiivi,.a,,. Type of Identification Produced 1(6439=SSS-64- '38o Name(print) PAT d otf n1SbN • 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. FORMS/NOC,rvsd2007 Signature of Natural Person Signing Above STATE OF FLORIDA COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FO GSA TRUE AND B ICRECT RECORDCOPY INOF THE DOC ON FILE THIS OFFIC IT ESS MY H N AND OFFI IAL S AL THIS OF e 2 JED N,CLE CIRCU T COURT BY k- RK FROM :ECC FAX NO. :4073651901 Jul. 28 2008 10:52AM P1 813-780-0020 City of Zephyrhills Permit Application // C� ra"-a"IVU_uuz1 ( '73 Building Dt> 7 3 ( - (P ! d ( L Oata Received J— Phone CoMac1 for Permlttln Owner'eName Air MaintenArIcw dba Dairy queen J Owner Photo Number 813-780-2826 Owners Address 3 9930 Medical Arts Ct.Zephyrll ,FX WnerPhone Number L. Fee Simple Titleholder HamelOwner Phone Number Fee Simple Titleholder Address JOB ADDRESS 37930 Medical Arts Ct. Zephyrhills, FL � LOT0 L ______ SUBDIVISION � PARCEL 100 • (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADO/ALT Q SIGN Q MOVE Q DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM Q OTHER E T111 TYPE OF CONSTRUCTION 1..._.1 BLOCK Q FRAME Q STEEL Q OTHER DESCRIPTION OF WORK I Remodel Type II BUILDING SIZE I SQ FOOTAGE I 2659 HEIGHT 21 Q . BUILDING $ 361 ,000 VALUATION OF TOTAL CONSTRUCTION Q ELECTRICAL $ AMP SERVICE Q 1!J PROGRESS ENERGY W.R.E.C. 42,000 Q PLUMBING $ 11 ,000 Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 6,000' Q GAS Q ROOFING Q SPECIALTY OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA EYES ©NO Existin sUN.OGN V COMPANY lfrink Custom Construction, Tnc1 SIGNATURE REGISTERED Y/ N I Far CURRENT LYIN Addrose 726 Qn , ow Av(,2'Ovie(o FL 32mb111 License* CBC0 3 3 2 4 6 C BIGM11TURP V T / REGISTERED 'FEE CURRENT [ Y/N N 4 Address License II PLUs1rER .G'� P ' COMPANY I . SIGNATURE ¼.-)e `C 1 RiotsTaRso j YIN I FEE CURRENT I f/N I ILicense S ECFIANC4 ' O \ ' SKilNATIIRE i s IxEcisrFb I Y/N I FEE CANT I YIN Address J License S I R r�- +{/. COMPANY G LURE ) `, `,fl9M/ "EmISTa o lY/it I FEE C RRENT I Y/N Address Uconse# _______________________ RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bulidklg Plans:(1)set o1 Energy Forms;R-O-W Permit for new construction, Minimum ten(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans W/Silt Fence Installed, Sanitary Facilities 5 1 dumpster;Site Work Permit for subdlvIskmsAarge projects COMMERCIAL . Attach(3)complete sods of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal dale. Required unslte,Construction Plans,Stormweter Plans WI Silt Fence Installed, Sanitary Facilities B I dumpeter.Site Work Permit for all new projects.AN 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 ti Contractor sign back of appilcatIon,notarized It over!1(:500,a Notice of Commencement Is required. (A/C upgrades over$5000) Agent(for the cgntractor)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(Plnl/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW Page 1 of 1 Jacqueline Boges From: lfayer@elfrinkcustom.com Sent: Thursday, December 04, 2008 1:54 PM To: Jacqueline Boges Subject: Dairy Queen Zephyrhills Attachments: A101 -Dairy Queen.doc Jackie, We are the G.C. for the Dairy Queen in Zephyrhills. When we spoke today, you had received our State License and our Tax Receipt and still required our subcontractor's list and our contract, in order to pick-up the permit. Here's a list of our subs and the contract is attached. Please call me as soon as the permit is ready for pick-up. phone fax ct4 kffordable Roofing 813-986-6683 813-986-6779 — €-"e"1 fury HVAC 407-365-6164 407-365-3127 - Par-tin Plumbing 407-578-9553 407-578-9396 - mpere Electric 727-432-5890 727-328-2099 Thank you. Lynn Fayer Elfrink Custom Construction, Inc. 407-365-8538 12/4/2008 ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams ' Bus (813)780-0041 Fax (813)780-0044 FIRE SERVICE USER FEES Occupancy No.: Plan No.' Contractor: 1- %vim Business Name: w t Billing Address: — Business Address: 43ct ( pYtLk j-L32"Z(o Business Phone No.: ' Billing Phone No.: 1c'7- -- Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE Site Plan N/C Annual N/C Sprinkler $50 1st Alarm N/C Mufti-Family/commercial sf_ 1st Re-inspection N/C Standpipes $50 2nd Alarm N/C (Minimum Charge$25.00 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C 0 Plan Revisions DBL 3rd Re-inspection $250 Hoods $50 4th Alarm $100 4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Alarm $200 8 0-25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- per tank $50 STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100 Per Riser $50 Hydrostatic Test $65 per system Fire Works $500 FIRE PUMP Acceptance Test $45 persystem Camp Fire $25 fl Per Pump $100 Hydrant Flow $75 Controlled Bum $100 FIRE ALARM SYSTEM Hood/Duct $50 0-25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $50 Annual 26 plus Devices $100 System Acceptance $50 Fire Protection $25 SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $50 Annual Wet $50 OTHER ]✓-Z- Waste Tire Storage $50 Annual Dry $50 Fire Wall/Smoke Wall $15' r perwall Generator<KW $100 CO2 $50 LP Gas $25 pertank Generator>30 KW 150 Other $50 Natural Gas $25 per system Bio-Hazard Waste $100 Annual KITCHEN EXHAUST Fumigation Tenting $50 Hood/Ducts $50 Tent 10x10 or greater $15 Per tent Torch Pot/Applied $50 OTHER Fire Pump $45 Haz.Materials $100 Annual 8 LP Installation per tank $50 Fire Suppression $30 Fuel Tank Installation $50 System Acceptance (Per Tank) $50 Exhaust Hood/Duct $30 flNatural Gas Installation $50 Re-inspection DBL (Per System) (other than annual) fl Spray Booth $50 Inspection scheduled DBL and cancelled less than 24 hours Construction Insp. N/C Emergency Vehicle At $50 FALSE ALARM PLANS TOT INSPECTION TOTAL PERMIT TOTAL= L TOTA GRAND TOTAL Comments: Date:___ _ lnsgRctor: ?_'(../ i(tJf -.-- Zephyrhills Fire Rescue 6907 Dairy Road,Zephyrhills,FL 33542 Fire Marshal Bus(813)780-0041 Kerry Barnett Fax(813)780-0044 Plan Review#: 08-089 Project: Dairy Queen August 5,2008 Plan Review Comments I have reviewed and approved the plan for an interior remodel located at 37930 Medical Arts Ct. My comments have been placed below. Please contact me if you have any questions with regards to my comments. 1. Panic hardware required on all secondary exits. 2. Privacy gate can not be locked during hours of operation.This serves as an emergency egress through the rear of the kitchen. A locking device shall be installed on the gate that allows egress, should the gate be locked, during emergency situations. 3. Address front of building,6"minimum. 4. No storage is allowed in within 36"of electric panels. 5. Knox box required due to the suppression system. Application can be obtained from Zephyrhills Fire Rescue,6907 Dairy Rd,Zephyrhills. It shall be mounted at the front door area at a height of 6'. 6. Trash compartment shall be concrete walls with non-.combustible gates/doors. 7. Plans and permit required from contractor to install suppression system for greaselexhaust hood. All calcs, details,specs,cut sheets, etc. required with plan submittal. 8, Plans and permit required from contractor install/redo gas lines. 9. Permit required for any tar kettle or torch system being used to lay the roof. 10. Duct detectors are required on all units with 2000 CFM's or greater. Detectors shall be resettable. Key switch is allowed. 11. Install carbon monoxide detector due to gas appliances. 2 Inspections Required: 1. Firewall/ceiling(screw—per layer and overall final) 2. Inspections related to separate permits(gas,hood suppression,roofing) 3. Assembly 4. Building Final KE BARNETT,FIRE MARSHAL xc _ AIA Document A101 - 1997 Standard Form of Agreement Between Owner and Contractor where the basis of payment is a STIPULATED SUM ADDITIONS AND DELETIONS: The author of this document has added information needed for its completion. >..The author may also have :'. rdvised the._,text of the original PTA Standard form. An Additions end Deletions Report that notes added it formation as well as revisions to the standard form're7tris I'db'I ''Frm thg authgrand,.�sJ0L kt $...: reviewed. This document has ippot ant legal consequgnces. Consult with an'°"` attorney is,,, ouaged with «^respe t--'to itsico pletion on1gdificatiors. 'ATA.. ocumeht_ 01-1997, Generar Cozlditions,=of the Contract for Cengtruct on is adopted in thisdecumert by reference. Do not use; with..:other general donditions unless this doc 11h d't";is modified This document"h a'been approved and epddorsed by The Associated General Contractors of America. ELECTRONIC COPYING of any portion of this AIA® Document to another electronic file is prohibited and constitutes a violation of copyright laws as set forth in the footer of this document. AIA Document A101f1-1997. Copyright 0 1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991 and 1997 by The American Institute of Architects. All rights reserved. WARNING: This Ale Document is protected by U.B. Copyright Iaw and International Treaties. Unauthorized reproduction or distribution of this AIA° Doomasnt, or any portion of it, may result in severe uvii and criminal penalt.o. and will be prosecuted to the eaafmmffi extent possible under the law. This draft was produced by AIA software at 16:08:07 on 08/14/2008 under Order No.1000321196-1 which expires on 9/13/2008, and is not for resale. User Notes: (3303019566) { AIA Document A1011" - 1997 Standard Form of Agreement Between Owner and Contractor where the basis of payment is a STIPULATED SUM AGREEMENT made as of the;,,, day of in the year of •' (In words,indicate day,month and year) ,'.ADDITIONS AND DELETIONS: Thy author of this document BETWEEN the Owner: han added information (Name,address and other information) "needed for its completion. The author may also have remised th xt of the ra-�. original AIeA standard form. '�'- '° An`Additions and Deletions 'y;:_, Report that nptes added s information as we 11 as revisions to the standard ....��'•..�a` °;%..' s�.s, �c. °,......�.. ..; x."a�Aa n. ".. 3 fornr"Text"pis a'va• k7Yw"fresn the author and should be and the Contractor: reviewed. (Name,address and other information) This document has igp�rtant legal consequenees. atto>"mrr"vy is eneouragedF with •�� ."•respectoits:completion ,, ora�,odificatiori. j A2A-pocumefft-A201 1997, ,d �. .,b_- r ". - Genera Y""Co dltions_of the Contract for`@wlStruct ion.,; is adopted in this cteecumer$t The Project is: by reference. Do not use (Name and location) wither general conditions"unless this .us ��. ;"doc==e'n't•,,, s f6od�fied ahproved and endorsed by •'• •'�•�.�'- ^`>°- ,t s.�� - The Associated General Cgntractors of. America. The Architect is: (Name,address and other information) The Owner and Contractor agree as follows. ELECTRONIC COPYING of any portion of this AIA® Document to another electronic file is prohibited and constitutes a violation of copyright laws as set forth in the footer of this document. AIA Dme,meet A101 -1997. Copyright O 1915, 1916, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991 and 1997 by The American Institute of Architects. All rights reserved. MOANING: This Ale° Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ate Document, Or any portion of it, may result in civil and criminal penalties, and will be prosecuted to the maalnteu extent possible under the law. This draft was produced by AIA software at 16:08:07 on 08/19/2006 under Order No.1000321196_1 which expires on 9/13/2008, and is not for resale. User Notes: 133030195661 ARTICLE 1 THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,Conditions of the Contract(General,Supplementary and other Conditions),Drawings,Specifications,Addenda issued prior to execution of this Agreement,other documents listed in this Agreement and Modifications issued after execution of this Agreement;these form the Contract,and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations,representations or agreements,either written or oral.An enumeration of the Contract Documents,other than Modifications,appears in Article 8. ARTICLE 2 THE WORK OF THIS CONTRACT The Contractor shall fully execute the Work described in the Contract Documents,except to the'exienf specifically`""`"'"" indicated in the Contract Documents to be the responsibility of others. ARTICLE 3 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION §3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. (Insert the date of commencement if it differs from the date of this Agreement or,if applicdble state that:the date will be fixed in a notice to proceed.) If,prior to the commencement of the Work,the Owner requires time to file mortgages,mechanic's s liens and other security interests,the Owner's time requirement shall be as follows: §3.2 The Contract Time shall be measured from the date of commencement. §3.3 The Contractor shall achieve Substantial Completion of the entire Work not later than S days from the date of commencement,or as follows: (Insert number of calendar days.Alternatively,a calendar date may be used when coordinated with the date of commencement. Unless stated elsewhere in the Contract Documents,insert any requirements for earlier-Substantial -_ Completion of certain portions of the Work.) Portion of Work Substantial Completion Date subject to adjustments of this Contract Time as provided in the Contract Documents. (Insert provisions,if any,for liquidated damages relating to failure to complete on time or for bonus payments for early completion of the Wor ARTICLE ONTRACT SUM §4.1 Th Owner shall pay the Contractor the Co ract Sum in current funds for the Contractor's ormance of the Cont t.The Contract Sum shall be ($ , ),subject to itions and deductions as provided in the Contract'Documents. §4.2 The Contract Sum" ed upon the following alternates,if any,which are described in the Contract umen ereby accepted by the Owner: (State the numbers or other identification of accepted alternates.If decisions on other alternates are to be made by the Owner subsequent to the execution of this Agreement,attach a schedule ofsuch other alternates showingthe amount for each and the date when that amount expires) s z•„ r^ . ga s ` AIA Doe,ent A101w-1997. Copyright O 1915, 1918, 1925, 1937, 1951, 1959, 1961, 1963, 1967, 1974, 1977, 1997, 1991 and 1997 by The American Institute of Architects. A11 rights reserved. NAANINC This AIA` Doc,ment is protected by U.6. copyright flaw and International Treaties. Unauthorized reproduction or distribution of this AIA' Doctment, crane portion of it, nay result an severe civil and criminal 3 penalties, and will be prosecuted to the muinaws,extent possible under the law. This draft was produced by AIA software at 16:08:07 on 08/19/2008 under Order No.10003211961 which expires on 9/13/2008, and is not for resale. User Notes: (3303019566) §4.3 Unit prices,if any,are as follows: Description Units Price($0.00) ARTICLE 5 PAYMENTS §5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment vnvu5 Bank b theontractor and Certificates fez§ P PP submitted to th o — by C --_ --_ -_ i Deleted: Architect Payment issued by the,5vnovu4 Bank the Owner shall make progress payments on account of the Contract Sum to Deleted:Architect the Contractor as provided below and elsewhere in the Contract Documents. §5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month,or as follows: 411 E -; �"' `& ,� •. y .fie 3•o;��. E r3 e's -e�a� �,d' '* �� u�'aanh,..:: a.....��u x___�_-,_N»A' �.u�.. snz„.�. z✓�,, E,n....a.�.__ � _,« .�+.b� -- as.�L�,__._- t;_5. §5.1.3 Provided that an Application for Payment is received by the,Syno us Banknot later thin the Deleted:Architect day of a month,the Owner shall make payment p yment to the Contractor not later than the day of the month.If an Application for Payment is received by the SXnpynt_Bank after the application date fixed above, -a Deleted:Architect payment shall be made by the Owner not later than ( )days after the1Synovus Bank receives the Deleted:Architect Application for Payment. §5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by the Contractor in accordance with the Contract Documents.The schedule of values shall allocate the entire Contract Sum among the various portions of the Work.The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as the Architect may require. This schedule,unless objectedterby the . khoyi}s Bank shall be used as a basis for reviewing the Contractor's Applications for Payment _ .-- { Deleted:Architect §5.1.5 Applications for Payment shall indicate the percentage of completion of each portion o"the'Work as of the end of the period covered by the Application for Payment. §5.1.6 Subject to other provisions of the Contract Documents,the amount of each progress payment shall be computed as follows: .1 Take that portion of the Contract Sum properly allocable to completed Work gs�deterriiined by multiplying the percentage completion of each portion of the Work by the share of theeContract Sum allocated to that portion of the Work in the schedule of values,less retainage of ).Pending final determination of cost to the Owner of changes in the Work,amounts'not.�in dispute shall be included as provided in Section 7.3.8 of AIA Document A201-'1997; .2 Add that portion of the Contract Sum properly allocable to materials and equipment deliveredsand suitably stored at the site for subsequent incorporation in the completed construetion-(or,if approved--- in advance by the Owner,suitably stored off the site at a location agreed upon in writing) less mmme retainage of ( _... ); .3 Subtract the aggregate of previous payments made by the Owner;and .4 Subtract amounts,if any,for which the Architect has withheld or nullified a Certtftcate for Payment as provided in Section 9.5 of AIA Document A201-1997. §5.1.7 The progress payment amount determined in accordance with Section 5.1.6 shall be further modified under the following circumstances: .1 Add,upon Substantial Completion of the Work,a sum sufficient to increase the total payments to the full amount of the Contract Sum,less such amounts as the Architect shall defer nine foi incoinp7e Work,retainage applicable to such work and unsettled claims;and AIA Doelasnt klol -1997. Copyright O 1915, 1918, 1925, 1937, 1951, 1956, 1961, 1963, 1967, 1974, 1977, 1987, 1991 and 1997 by The American Institute of Architects. All rights reserved. WARNING: This AIA` Decuarnt is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA" Doeumant, or any portion of it, may result an civil and criminal 4 penalties, and will be prosecuted to the maaimom extent possible under the law. This draft was produced by AIA software at 16:08:07 on 08/14/2008 under Order No.1000321196-1 which expires on 9/13/2008, and is not for resale. user Noes: X3303019566) (Section 9.8.5 ofAL4 Document A201-1997 requires release of applicable retainage upon Substantial Completion of Work with consent of surety,if any.) .2 Add,if final dmpletion of the Work is thereafter materially delayed through no fault of the Contractor,any additional amounts payable in accordance with Section 9.10.3 of AIA Document A201-1997. §5.1.8 Reduction or limitation of retainage,if any,shall be as follows: (If it is intended,prior to Substantial Completion of the entire Work,to reduce or limit the retainage resulting from the percentages inserted in Sections 5.1.6.1 and 5.1.6.2 above,and this is not explained elsewheremin.lhe-.,Contract _.. Documents,insert here provisions for such reduction or limitation.) §5.1.9 Except with the Owner's prior approval,the Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. §5.2 FINAL PAYMENT §5.2.1 Final payment,constituting the entire unpaid balance of the Contract Sum,shall be made by the Owner to the Contractor when: 1 the Contractor has fully performed the Contract except for the Contractor's responsibility to correct Work as provided in Section 12.2.2 of AIA Document A201-1997,and to satisfy other requirements, if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by the Architect. §5.2.2 The Owner's final payment to the Contractor shall be made no later than 30 days after the issuance ofthe Architect's final Certificate for Payment,or as follows: 5�'� 4 ARTICLE 6 TERMINATION OR SUSPENSION §6.1 The Contract may be terminated by the Owner or the Contractor as provided in Article 14 of AIA Document„ A201-1997. §6.2 The Work may be suspended by the Owner as provided in Article 14 of AIA Document A20 rI99,7, ARTICLE 7 MISCELLANEOUS PROVISIONS §7.1 Where reference is made in this Agreement to a provision of AIA Document A201-1997gor anotherContract Document,the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. §7.2 Payments due and unpaid under the Contract shall bear interest from the date payment is due•at-the-ratefstated w,•A. below,or in the absence thereof,at the legal rate prevailing from time to time at the place where the Project is located. (Insert rate of interest agreed upon,if any.) (Usury laws and requirements under the Federal Truth in Lending Act,similar state and local consumer credit laws and other regulations at the Owner's and Contractor's principal places of business,the loation of the Project and elsewhere may affect the validity of this provision. Legal advice should be obtained with respct to deletions or modifications,and also regarding requirements such as written disclosures or waivers) §7.3 The Owner's representative is: (Name,address and other information) AIA Document A101-- 1997. Copyright 0 1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991 and 1997 by The American Institute of Architects. All rights reserved. NANNINO: This AIA"' Document is protected by U.S. Copyright Law and International Treaties unauthorized reproduction or distribution of this Ark` Document, or any portion of it, may result in civil and c slsins1 5 Penalties, and will be prosecuted to them extent possible under the law. This draft was produced by AIA software at 16:08:07 on 08/14/2008 under Order No.1000321196-1 which expires on 9/13/2008, and is not for resale. Deer Notes: X3303019566) • - Deleted:feski , 3 �.. ... ... .:.�� <.s•. --_d .;� -.a.ae -.mod-<< -.ia9.,�... .✓ x,. ,WP?�..:.'.� .,.:...:� .n, o� t §7.4 The Contractor's representative is: (Name,address and other information) �.. -. .y a �€. "� "... .3a d +'' ..�,.<�..r� ,.."s' �a9 t.-,,",3 ,e`.��°»:• ..,.. .4�a`.,rz da€ t':,�,'iw ... §7.5 Neither the Owner's nor the Contractor's representative shall be changed without ten days written notice to the other party. §7.6 Other provisions: ARTICLE 8 ENUMERATION OF CONTRACT DOCUMENTS §8.1 The Contract Documents,except for Modifications issued after execution of this Agreement,are enumerated as follows: §8.1.1 The Agreement is this executed 1997 edition of the Standard Form of Agreement Between Owner and Contractor,AIA Document A101-1997. §8.1.2 The General Conditions are the 1997 edition of the General Conditions of the Contiact'br Cettgtniction,AIA Document A201-1997. §8.1.3 The Supplementary and other Conditions of the Contract are those contained in the Project Manual dated.:,, and are as follows Document Title Pages §8.1.4 The Specifications are those contained in the Project Manual dated as in Section 8.1.3,and are as follows: //Either list the Snneci cations here or refer to an exhibit attached to thts Agreement) S., �.:• its..:t+a�. §8.1.5 The Drawings are as follows,and are dated unless a different date is shown�below ��•�••"• •,,,�. (Either list the Drawings here or rer to an exhibit attached to this Agreement.) §8.1.6 The Addenda,if any,are as follows: .n Number Date Pages Portions of Addenda relating to bidding requirements are not part of the Contract Documents unless the bidding requirements are also enumerated in this Article 8. §8.1.7 Other documents,if any,forming part of the Contract Documents are as follows: (List here any additional documents that are intended to form part of the Contract Documents i1TAocumeril A707= 1997provides that bidding requirements such as advertisement or invitation to bid,Instructions to Bidders,sample AIA Doeasant A101.-1997. Copyright 0 1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991 and 1997 by The American Institute of Architects. All rights reserved. W7.P25I5G, This AIA" Document is protected by U.S. Copyright Lae and Intatnatsonal Treaties. Unauthorized reproduction or distribution of this AIA" Document, or any portion of it, say result i r and c iinal upossible 6 penalties, and will be prosecuted to the m extent under the law. This draft was produced by AIA software at+ m 16:08:07 on 08/14/2008 antler Order No.1000321196_1 which expires on 9/13/2008, and is not for resale. User notes: (3303019566) forms and the Contractor's bid are not part of the Contract Documents unless enumerated in this Agreement. They should be listed here only if intended to be part of the Contract Documents.) This Agreement is entered into as of the day and year first written above and is executed in at least three original copies,of which one is to be delivered to the Contractor,one to the Architect for use in the administration of the Contract,and the remainder to the Owner. OWNER(Signature) CONTRACTOR(Signature) ,-, iU 41P � H' Deleted:f (Printed name and title) (Printed name and title) AIA Document A101--1997. Copyright 0 1915, 1918, 1925, 1937, 1951, 1959, 1961, 1963, 1967, 1974, 1977, 1987, 1991 and 1997 by The American Institute of Architects. All rights reserved. 5000200: This AIA" Document is protected by U.S. Copyright Law and International 7 Treaties. Unauthorised reproduction or distribution of this AIA' Document, or any portion of it, may result in soil and criminal penalties, and will be prosecuted to the eeasassml extent possible under the law. This draft was produced by AIA software at 16:08:07 on 08/14/2008 under Order No.1000321196_1 which expires on 9/13/2008, and is not for resale. User Not..: (3303019566) FROM :ECC FAX NO. :4073651901 Dec. 01 2008 04:16PM P2 AC# 3950038 ,•;''; ,r, �i1 39500 8,' ` DEPAR ' < '� R II89IONAL REOi7LATION .� •�� ti• 'n�'. ,ii ._r u; �. �r s .;�f.*.r .,� �; L08082701550 108/27/2008 ' r• - rl t. The BUILDING CQNRACI;.y)r. Named below:':'X S QB ►d IF .r,� �� = s; Under the ..�ti�.. pro�rp;a.ote :o ,Cha iF� F : . Expiration date'.: :•.AUG 31. ' :�► y ^�,►i`� i ': _ It `_ ,,,,..' , �' _ „ F•,:... ;: ELFRINK, p, Ih F CU 1'9'�'OP R L: 'n 726 DNS LOW AVE'' �!.,n l?_F1'�:..c;.:•tx�)•, t `'�`� i`:,,. OVIEDO. ' CHARLIE C',...... ','i. '' r,''r, ^•'. , ,1 •;�rrC sc i . Sr .r'; • ='-':. CHARLES W. DRAGO GOVERNOR . . r'' c:. ' 7;:ri�!' =rti ',..A.�' SECRETARY WL O.... STATE OF FLORIDA AC#,: 7 t�_... j.(,wj. DEPARTMENT :OF' BUSINESS i1'..• m.�.�7-:,;... PROFESSIONAL RGLTIiTTti.r,'_ CDC033246 08/27./0`8 D 0!O Q '3S4' .................. ERTIFIED BUILDING. CONTRAOZt,q ZLPRINK, CHRISTOPHER L. ELFRINK CUSTOM CONSTRUcTI.O;Q'`> IS CERTIFIED uad.e"elu.proviuoF' RiC�!'• .Q'9:IR:': a*pir4kioo t. AUG -31,: 2010 irQAO'6 !16155Oi• ��+'�` r,•�, SEMINOLE COUNTY BUSINESS TAX RECEIPT RAY VALDES, SEMINOLE COUNTY TAX COLLECTOR PO Box 630 ■ Sanford,FL.32772-0630 ■ Telephone: 407-665-1000 www.seminoletax.org VALID THROUGH - 09/30/2009 Business Name: ELFRINK CUSTOM CONSTRUCTION INC Account#: 030842 Business Address: 726 ONSLOW AVE City, Slate,Zip: OVIEDO, FL 32765- REGULATED State Lic ,R - CB C033266 Owner(s): CHRISTOPHER L ELFRINK Receipt#: OLHS2008082802606 Amount Paid:45.00 Dale Paid: 08/28,12008 FROM :ECC FAX NO. :4073651901 Dec. 01 2008 04:15PM P1 IdIã ELFRINK CUSTOM CONSTRUCTION, INC. Post Office Box 621756,Oviedo,Fl, 32762-1756 Office 407-365-6538 — Fax 407.365-f 901 ELFR 1NXCU.STC)M@BELLSOi]TI I.NET No FAX AUV N"R NC:MAY PF.UNT'iTi THl9 NUMRRR FAX TRANSMITTAL COVER SHEET TO: Jackie COMPANY: ..` FAX NO: 813-790-0021 DATE: Dec 1 FROM: Lynn - L arc gA@q.L h inkcue.ton.tom RE:__VaUty_Queen - Whynh W --- ... The atce__.the .6ub.6- that we have on the job•_. .We w not i.6ryr ou_ of ,the e.2e.e�t�r i c ian, within the next day, on two.. We Witt._at. Q.. .bend .a copy off. thecanthact. yo.u._.._._-..... Ad 6_L . Roo6ing..." 813.-986-6683phh 813-986-6779 x .-.... Pnuny HVAC '' 407-365-6164ph 407-365-3.127 x PdAtin P�wnb.ing '' .,407-578-9555 3pki..._ 4.07-578-9396x TOTAL PAGES VNCI UDTNG COVER SHEET: ._ ... IF YOU DO NOT RECEIVE ALL PAGES.PLEASE CALL US .State Certified Building Copu►•acmr Commercial 4.*v-k&,rltial EXISTING BUILDING BEING REMODELED NO ADDITIONAL SQUARE FOOTAGE OR INCREASED ELECTRICAL SERVICE ADDED EXISTING HVAC SYSTEMS TO REMAIN NO ENERGY CALCULATIONS REQUIRED Florida Building Code Online 0^' T w Yta S Page 1 of 2 Product Approval USER: Public User Product Approval Menu > Product or Application Search > Application List > Application Detail FL # FL6304 Application Type New Code Version 2004 Application Status Approved Comments Archived Product Manufacturer Arch Aluminum and Glass Co., Inc. Address/Phone/Email 10200 NW 67th Street Tamarac, FL 33321 (800) 432-8132 ext 300 ENG-TAMARAC@archaluminum.net Authorized Signature JIM MCCOOL ENG-TAMARAC@archaluminum.net Technical Representative JIM MCCOOL Address/Phone/Email 10200 67TH STREET, TAMARAC, FL 33321 (954) 724-1775 ENG-TAMARAC@ARCHALUMINUM.NET Quality Assurance Representative Address/Phone/Email Category Panel Walls Subcategory Storefronts Compliance Method Evaluation Report from a Product Evaluation Entity Evaluation Entity Miami-Dade BCCO - EVL Quality Assurance Entity Miami-Dade BCCO - QUA Validated By Miami-Dade BCCO - VAL Certificate of Independence FL6304 R0 COI 05090201 - FG4500 - Nl.pdf Referenced Standard and Year (of Standard Year Standard) http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDquQX8AcxAgwB... 5/8/2006 Florida Building Code Online Page 2 of 2 ASTM E283 2002 ASTM E330 2002 ASTM E547 E331 2000 TAS 202 2004 Equivalence of Product Standards Certified By Approved Evaluation Entity FL6304 R0 Equiv 05090201 - FG4500 - NI.pdf Sections from the Code Product Approval Method Method 1 Option C Date Submitted 03/03/2006 Date Validated 03/03/2006 Date Pending FBC Approval 03/11/2006 Date Approved 03/22/2006 Summary of Products FL # IlModel, Number or Name IlDescription 6304.1 FG 4500 FLUSH GLAZE 1 3/4" X 4 1/2" CENTER SET FRAMING FOR FOR 1/4" GLASS 1/4" GLASS Limits of Use Installation Instructions Approved for use in HVHZ: Yes FL6304 R0 II 05090201 - FG4500 - NI.pdf Approved for use outside HVHZ: Yes Verified By: Miami-Dade BCCO - EVL Impact Resistant: No Evaluation Reports Design Pressure: +54 /-54 FL6304 R0 AE 05090201 - FG4500 - NI.pdf Other: PSF LOADS VARY - 48" X 120" APPROX 54 PSF - CHECK NOA FOR SIZE LIMITATIONS http://www.floridabuilding.org/pr/pr_app_dtl.aspx?p aram=wGE V XQwtDquQX8AcxAgwB... 5/8/2006 M I A M FDADE MIAMI-DADE AM I-DAD E COUNTY,FLORIDA METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603 PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2908 NOTICE OF ACCEPTANCE (NOA) Arch Aluminum&Glass Company,Inc. 10200 NW 67'"Street Tamarac,FL 33321 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify,or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code, including High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Series"4500"Flush Glazed Aluminum Storefront System—N.I. APPROVAL DOCUMENT: Drawing No.00-13,titled"Series 4500 Alum Flush Glaze Storefront SYS.",sheets 1 through 8 of 8,prepared by AL-Farooq Corporation,dated 07/06/00 and last revised on 12/02/05,signed and sealed by Humayoun Farooq,P. E.,bearing the Miami-Dade County Product Control Renewal stamp with the Notice of Acceptance number and expiration date by the Miami-Dade County Product Control Division. MISSILE IMPACT RATING: None LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product, for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises/renews NOA#00-1220.05 and consists of this page I and evidence pages E-1,as well as approval document mentioned above The submitted documentation was reviewed by Herminio F. Gonzalez,P.E.,Director,BCCO NOA No 05-0902.01 LDO( 0 61 Expiration Date:March 19,2011 { Approval Date:January 26,2006 Pagel Arch Alumium & Glass Company,Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No. 00-13,titled"Series 4500 Alum Flush Glaze Storefront SYS.", sheets I through 8 of 8,prepared by AL-Farooq Corporation,dated 07/06/00 and last revised on 12/02/05, signed and sealed by Humayoun Farooq, P. E. B. TESTS 1. Test reports on 1)Air Infiltration Test,per FBC,TAS 202-94 2)Uniform Static Air Pressure Test, Loading per FBC,TAS 202-94 3)Water Resistance Test,per FBC,TAS 202-94 along with installation diagram of an aluminum storefront system prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL-1548,dated January 15, 1997,signed and sealed by Gilbert Diamond, P.E. "Submitted under NOA 00-1220.05" C. CALCULATIONS 1. Revised Anchor Calculation and Structural analysis,prepared by AL-Farooq Corporation,dated 08/23/05, signed and sealed by Humayoun Farooq,P.E. Complies with ASTM E1300-02 No 1/3 stress increase used in anchors into masonry or steel substrate. 2. Mullion calculations and structural analysis,prepared by Al-Farooq Corporation,dated Nov. 16,2000, signed and sealed by Humayoun Farooq, P.E. "Submitted under NOA 00-1220.05" D. QUALITY ASSURANCE BY 1. Miami Dade Building Code Compliance Office(BCCO). E. MATERIAL CERTIFICATIONS I. None F. STATEMENTS 1. Statement letter of conformance and no financial interest,dated 08/23/05, signed and sealed by Humayoun Farooq. G. OTHER I. Letter from the consultant,dated 11/14/05,stating that the product is in compliance with the Florida Building Code(FBC). 2. Notice of Acceptance No. 00-1220.05, issued to Arch Aluminum&Glass Company for their"Series 4500 Alum Flush Glaze Storefront SYS", approved on 04/12/01 and expiring on 03/19/06. v/ I Herminio F.Gonzalez,P.E. irector,Building Code Compliance Office NOA No 05-0902.01 Expiration Date:March 19,2011 Approval Date:January 26,2006 E- 1 3YYf1-OO cszs—►zc(.ss) •xve ZCIS-LC1(ooa)'L31 acs9—zpz(cot)xvi Ooia—,ac(SM) -tX tZfff 14 '3WV)W.lF1III t) m SIY31YIO7 OD7Y YL'NY SOZGLI 'y r lb tilt rvaaO'u V W 133HIS HL19 LS3MHINON OOZOt ,NY.olWN sr�/l 3 c NNS3O ionOONd 3P SZtUN" '51l33NION3 'O� SSV1 W(1NIIM( TV H MV M root MOJ Y7pWn Gw r .o-.1-.u/ :.w. t OIl AIOILV 1O&I0� 8002IV�-7V 'SAS)1�0a�i)a0IS 3ZYl0 turn)WN 00SY S3Og5 ua :sYO.IA 00-90 • 11ii / ii \ / mgY+ i {� II 1 \ / W 1 1 01 \ / 1 1 1 ------------------------------. m iou O \\ OtN W / H Wz O O K V W •' O UU�F IA \ \ • II O ryl 1W pZwW n_ m 1^ gW O W W 0 W W Q a —.- W rjj OOC Q �ja In o \ 3 w O J L® _____ c� O z O O SM3NL0J eWvr O sew r 1v pp u W C 'IfrYl.9 ••.p1 F C Z =z o„ J 1� _ S u 'Sao TO a L. o c" 9 IP S'SUS 33S • 9� U K WO m 3 z o W •� 1/C113H Nom11W/3,mi •♦ O O W z _ w z a z o DO SZ2 qq G O♦ n.O O� 2 N 1.$C`0 y O \+ "p g u V Z U fO�Fs W N yr1 W 3 3 . 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Address/Phone/Email 10200 NW 67th Street Tamarac, FL 33321 (800)432-8132 Ext 198 fdeato@archaluminum.net Authorized Signature Bong Deato fdeato@archaluminum.net ti Technical Representative FROILAN BONG DEATO Address/Phone/Email 10200 NW 67TH ST TAMARAC, FL 33321 (800)432-8132 Ext 198 fdeato@archaluminum.net Quality Assurance Representative Address/Phone/Email Category Exterior Doors Subcategory Swinging Exterior Door Assemblies Compliance Method Certification Mark or Listing Certification Agency Miami-Dade BCCO - CER Validated By Referenced Standard and Year(of Standard) Standard Year FBC 2411 3.2.1/TAS 202-94 Force Entry 2004 TAS 202 Air Infiltration/Uniform Static Air 2004 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 04/25/2007 Date Validated' 04/25/2007 Date Pending FBC Approval 05/14/2007 Date Approved 06/27/2007 Summary of Products FL# Model, Number or Name IDescr1ption 8791.1 MEDIUM STILE ALUM ENTRANCE IMEDIUM STILE OUTSWING ALUMINUM ENTRANCE DOOR DOOR WITH TRANSOM-NI IWITH TRANSOM (NON-IMPACT) Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL8791 R0 C CAC 06112902.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No Design Pressure: +108/-108 Installation Instructions Other: MEDIUM STILE OUTSWING ALUMINUM ENTRANCE FL8791 R0 II 06112902.pdf DOOR WITH TRANSOM (NON-IMPACT) Verified By: Miami-Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 8791.2 WIDE STILE ALUM ENTRANCE WIDE STILE OUTSWING ALUMINUM ENTRANCE DOOR WITH DOOR WITH TRANSOM-NI RANSOM (NON-IMPACT) Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL8791 R0 C CAC 06112901.pdf Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date Impact Resistant: No Design Pressure: +122/-122 Installation Instructions Other: WIDE STILE OUTSWING ALUMINUM ENTRANCE FL8791 R0 II 06112901.pdf DOOR WITH TRANSOM (NON-IMPACT) Verified By: Miami-Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: MIAMI• MIAMI-DADE COUNTY,FLORIDA METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603 PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2908 NOTICE OF ACCEPTANCE (NOA) www.buildingcodeonline.com Arch Aluminum & Glass Company,Inc. 10200 NW 67`h Street Tamarac,FL 33321 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code, including the High Velocity Hurricane Zone. DESCRIPTION: Series "Medium Stile"Outswing Aluminum Entrance Door w/Transom—N.I. APPROVAL DOCUMENT: Drawing No. 05-319, titled"NI Series Aluminum Medium Stile Outswing Door Non Impact", sheets 1 through 9 of 9, dated 10/02/05 and last revised on Apr 18, 2006,prepared by EngCo Inc., signed and sealed by Pedro De Figueiredo,P.E.,bearing the Miami-Dade County Product Control Renewal stamp with the Notice of Acceptance number and expiration date by the Miami-Dade County Product Control Division. MISSILE IMPACT RATING:None: Approved Hurricane Protection Devices,complying w/FBC are required Limitation: 1. Option 1:The 3-point&2-point multi ply lock system is manufactured by Adams Rite Mfg.Co. 2. Option 2:The 2-point 2086 Concealed Vertical Rod Panic exit device is manufactured by Jackson Co. 3. Storefront& curtain wall is not a part of this approval LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo,city, state and following statement: "Miami-Dade County Product Control Approved", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product,for sales, advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA#05-1012.05 and consists of this page 1 and evidence page E-1, as well as approval document mentioned above. The submitted documentation was reviewed by Ishaq I. Chanda,P.E. NOA No 06-1129.02 Expiration Date:December 31,2011 Approval Date: February 01,2007 NA Page 1 Arch Aluminum & Glass Company,Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS (transferred from file#05-1012.05) 1. Manufacturer's die drawings and sections. 2. Drawing No. 05-319, titled"NI Series Aluminum Medium Stile Outswing Door Non Impact", sheets 1 through 9 of 9, dated 10/02/05 and last revised on Apr 18, 2006, prepared by EngCo Inc., signed and sealed by Pedro De Figueiredo,P.E. B. TESTS (transferred from file#05-1012.05) original test conducted per SFBC, PA 202-94 now known as TAS 202-94. 1. Test reports on 1) Air Infiltration Test, per FBC, TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC,TAS 202-94 3) Water Resistance Test,per FBC,TAS 202-94 (Not performed) 4) Forced Entry Test, per FBC 2411 3.2.1 and TAS 202-94 Along with installation diagram of aluminum out-swinging impact entrance door with fixed light prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL- 1510, dated 12/06/96, signed and sealed by Gilbert Diamond, P.E. 2. Additional Re-verification test per TAS 202-94: Test report No. FTL 5072 dated 10/16/2006, issued by Fenestration Testing Laboratory, Inc, signed and sealed by Edmundo Largaespada,P. E. C. CALCULATIONS (transferred from file#05-1012.05) 1. Anchor Calculations and structural analysis, complying with FBC-2004, prepared by EngCo Inc., dated 03/09/06, signed and sealed by Pedro De Figueiredo, P.E. 2. Glazing complies with ASTM E1300- 98 &-02 D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office (BCCO). E. MATERIAL CERTIFICATIONS 1. None F. STATEMENTS (transferred from file#05-1012.05) 1. Statement letter of conformance and no financial interest,prepared by Engco Inc., dated 10/10/05, signed and sealed by Pedro DeFigueiredo, P.E. 2. Statement letter of compliance, part of above referenced test reports. G. OTHER 1. This renews NOA#05-1012.05 expiring December 31, 2007. 2. Test Proposal#06-0273 approved by BCCO. 3. 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W m a\ S¢I1 ¢W C7=H m a Product Approval USER: Public User Product Approval Menu > Product or Application Search > Application List> Application Detail FL # FL5221 . Applicattjon Type New Code Version 2004 Application Status Approved Comments Archived Product Manufacturer Firestone Building Products Co. Address/Phone/Email 525 Congressional Boulevard Carmel, IN 46032 (317) 575-7000 ext 7199 brandtgregory@firestonebp.com Authorized Signature James L. Buckner, P.E. @ C-Buck, Inc. jimmy@cbuckinc.net Technical Representative Gregory A. Brandt Address/Phone/Email 525 Congressional Blvd. Camel, IN 46032 brandtgregory@firestonebp.com 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) TAS 110 2000 Equivalence of Product Standards Certified By Sections from the Code 1507.12 Product Approval Method Method 1 Option A Date Submitted 09/02/2005 [gate Validated 09/02/2005 Date Pending FBC Approval 09/30/2005 Cate Approved 10/11/2005 Summary of Products FL # Model, Number or Name IDescription 5221.1 1- UltraPly TPO Applied to Steel Decks Single Ply Roofing Limits of Use (See Certification Agency Certificate Other) Installation Instructions Approved for use in PTID 5221 I 1- HVHZ: UltraPlyTPO SinglePlyOnSteelDecks NOA02052001 pdf Approved for use PTID 5221 I 2-EPDM SinglePlyOnWoodDecks NOA03062511 pd outside HVHZ: PTID 5221 I 3-EPDM SinglePlyOnSteelDecks NOA03062512 pdf Impact Resistant: PTID 5221 I 4- Design Pressure: +/- EPDM SinglePlyOnConcreteDecks NOA03062513 pdf Other: Install product PTID 5221 I 5- per NOA 02-0520.01 EPDM SinglePlyOnRecoverDecks NOA03062514 pdf PTID 5221 I 6-EPDM SinglePlyOnLWCDecks NOA03062515 pdf PTID 5221 I 7-EPDM SinglePlyOnCWFDecks NOA03062516 pdf PTID 5221 I 8- EPDM SinalePlyOnPouredGypsumConcreteDeck NOA03062517 pd Verified By: 5221.2 1IEPDM Single Ply Roofing Applied to Wood Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625.11 5221.3 13- EPDM Single Ply Roofing Applied to Steel Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625.12 5221.4 4- EPDM Single Ply Roofing kpplied to Concrete Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625.13 5221.5 5- EPDM Single Ply Roofing Applied to Recover Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: -Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625-.14 5221.6 6- EPDM Single Ply Roofing Applied to Lightweight Concrete Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625.15 5221.7 7- EPDM Single Ply Roofing Applied to Cemetitious Wood Fiber Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625.16 5221.8 8- EPDM Single Ply Roofing Applied to Poured Gypsum Concrete Decks Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: Install product per NOA 03-0625.17 MM IAM MIAMI-DADS COUNTY,FLORIDA MEIRO.DADE FLAGL BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) ER PRODUCT CONTROL DIVISION 140 WEST GLRR STREET,SUrM 1o3 MIAMI,FLORIDA 33130.1563 (305)375-2901 FAX(305)375-2908 NOTICE OF ACCEPTANCE(NOA) Firestone Building Product Company 320 Innovation Way Wellford,SC 29385 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Firestone TPO Single Ply Roof Systems over Steel Deck LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo,city, state and following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. •TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product, for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This consists of pages I through 8. The submitted documentation was reviewed by Frank Zuloaga,RRC v „ NOA No.:02-0520.01 Expiration Date: 11/27/07 Approval Date: 11/27/02 Page 1 of S ROOFING Sysm APPROVAL Category: Roofing Sab-Cateaorw TP0,Single Ply Roofing Dec : Steel e -52.5 psf Fire Ctloo: See General Limitation#1 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TABLE 1 Product Dimensions Im Product Descriotlon SDemeatlons UltraPly TPO Various TAS 131-95 Reinforced TPO 0.045"or 0.060" UltraPly TPO thick membrane .060 x 24"x 50' TAS 131-95 Un-reinforced TPO Unsupported Flashing UltraPly TPO T-joint .060 x 4"x 4" TAS 131-95 Un-reinforced TPO Cover UltraPly TPO Cut Edge 11 oz.Tube Synthetic Rubber Sealant Pourable Sealer S-10 1 can of Part A to Two part Polyurethane sealant Part A&B 1 can of Part B Water Block Seal(S- 10 oz.Tube Water Sealant 20) UltraPly TPO General 10.3 oz.Tube Butyl Rubber Sealant Purpose Sealant TPO QuickSeam 5-3/4"x 100' Flashing material with pre-applied Flashing adhesive UltraPly TPO 1 gallon&# Primer for TPO QuickSeam QuickPrime gallon Flashing UltraPly TPO Small Small and large TAS 131-95 Un-reinforced TPO molded TPO and Large Pipe Flashing pipe flashing UltraPly TPO Inside& Pre-molded TAS 131-95 Un-reinforced TPO molded TPO Outside Corners corners inside and outside corners UltraPly TPO Coated 4' x 10'sheets TPO coated metal Metal Metal Insulation Plate .017-.023 x 3" FM 4450 round Termination Bar .087 x 1.08"x 10' 3003-1114,3105- Aluminum bar for flashing H14 or 6063-T5, terminations or T6 Aluminum Edgegard System Various Various Flashing materials and assemblies UltraPly TPO Walkway X 50' Recycled thermoplastic Walkway Pas Pads Splice Wash SW-100 5 gallon pail Clog and prep solution for TPO NOA No.:02.6520.01 Esptratbn Date: 11117/07 Approval Date: 11/27/02 Fag 20f1 of 1 APPROVED INS[7LA'1'IONS: TABLE 2 Product Name Product Description Manufacturer ISO 95+GL (With Current NOA) Polyisocyanurate foam insulation Firestone Bld.Pro.Co. ISO 95+GL Woodfibcr Composite Polyisocyanurate/woodfiber insulation Firestone Bid.Pro.Co. ISO 95+GL Perlite Composite Polyisocyanurate/perlite insulation Firestone Bld.Pro.Co. Firestone 3/8"Dens-Deck Fire resistant rated gypsum Firestone Bld.Pro.Co. FiberTop Woodfiber insulation board Firestone Bid.Pro.Co. ACFoam II Polyisocyanurate foam insulation Atlas Energy Products High Density Wood Fiberboard Non-asphaltic fiberboard Insulation Generic Sturdi-Top/high density Wood Non-asphaltic fiberboard Insulation Georgia-Pacific fiberboard E'NRG'Y 2 Polyisocyanurate foam insulation Johns Manville Multi-Max FA Polyisocyanurate Insulation RMAX APPROVED FASTENERS: TABLE 3 Fastener Product Product Manufacturer Number Name Description Dimensions (With Current NOA) 1. Firestone HD Fastener #15 Fastener for steel, N/A Firestone Bid.Pro.Co. Wood, concrete decks 2. Firestone AP Fastener #14 Fastener for steel, N/A Firestone Bid.Pro.Co. Wood, concrete decks 3. UltraPly TPO 2-3/8" Membrane seam 2-3/8" Firestone Bid.Pro. Co. Barbed Seam Plate attachment plate diameter 4. Hex Insulation Plate AZ 50 Galvalume steel 3-''4"x 2-7/8" Firestone Bid.Pro.Co. stress plate 5. Pre-Assembled AP #14 w/insulation plate for N/A Firestone Bid.Pro.Co. fastener&plate steel,Wood,concrete decks 6. Pre-Assembled HD #15 w/insulation plate for N/A Firestone Bid.Pro.Co. fastener&plate steel,Wood,concrete decks EVIDENCE SUBMrr'rED: Test Aesucy Test Identifier Underwriters Laboratories Inc. 01NK17982 Fire Classifications-ice current June 5,2001 Underwriters Laboratories Inc. 00NK43467 Fire Classifi oos-sa current January 22,2001 y a NOA No.OZ45UA1 Zxpirafon Date: 11W197 Approval Date: 11127102 Page 3 of I Tat IdeNlAwrDua Underwriters Labor is.Inc. 99NKS401 Fire Classifications-see current August 17,1999 Underwriters Labaatocies Inc. 99NK3276 Fire Classifcatims•eee current March 30,1999 Underwriters LabocaL es Inc. 98NK39140 Fire Classificatioos eee current May 13, 1999 Underwriters Laborat ties Inc. 98NK2S593 Fire Classifications-see current September 1998 Factory Mutual Research J.L 3006983 Wind Uplift February 8,2000 Corporation Factory Mutual Research J.L 3004249 Wind Uplift November 3, 1999 Corporation Factory Mutual Research J.L 3003830 Wind Uplift May 26, 1999 Corporation Factory Mutual Research J.L 300192S Wind Uplift May 24, 1999 Corporation NOA Now p.41 Expiration Data: 11/s7/i07 Approval Data 11/27/2 Pegs 4ofS APPROVED ASSEMBLJES: Membrane Type: Single Ply,TPO,Reinforced Deck Type 2I: Steel,Insulated,New Construction,Reroof Deck Description: Minimum 22 ga.Grade E steel deck secured to supports space at maximum 6 ft o.c.with TTW Buildex Traxx/5 spaced at 6"o.c. Side lap fastened with 1'1:W Buildex Traxx/1 spaced at 24"o.c System Type D(1): Membrane mechanically attached over preliminary fastened insulation. All General and System Limitations apply. One or more layers of any of the following insulations. Base Insulation Layer Insulation Fasteners Fastener (Table 3) Density/fts ISO 95+GL,ACFoam H,E'NRG'Y H,Multi-Max FA Minimum 1.5"thick N/A N/A (Optional)Top Insulation Layer Insulation Fasteners Fastener (Table 3) Density/fe Dens Deck Minimum¼"thick N/A N/A FiberTop C or E,High Density Wood Fiber,Sturdl-Top/High Density Wood Fiber Minimum Y2"thick N/A N/A Note: All insulation shall have preliminary attachment,prior to the installation of the roofing membrane at a minimum application rate of two fasteners per board for insulation boards having no dimension greater than 4 ft.,and four fasteners for any insulation board having no dimension greater than 8 ft. Barrier: None. Membrane: Firestone UltraPly TPO Reinforced Membrane attached to deck through the preliminary attached insulation as specified below. Fastening#1: Membrane is mechanically attached using Firestone HI)Fasteners and 2-3/8" Barbed Seam Plates spaced 12"o.c.within minimum 6"wide laps. Laps are spaced at maximum 72"o.c.and sealed with a minimum 1.5"wide heat weld. (Maximum Design Pressure:-4S psf,•See General Limlladon#7.) Fastening#2: Membrane is mechanically attached using Firestone HI)Fasteners and 2-3/8" Barbed Seam Plates spaced 6"o.c.within minimum 6"wide laps. Laps are spaced at maximum 72"o.c.and sealed with a minimum 1.5"wide heat weld. (Maximum Design Pressure:-SZS psf;See General Limltatlon#7.) Maximum Design Pressure: See Fastening options above o NOA No.:02- 52t11 Expiration Date: 1l/27I7 Approval Date: 11I112 Page 5 of 8 Membrane Type: Single Ply,TPO,Reinforced Deck Type 21: Steel,Insulated,New Construction,Reroof Deck Description: Minimum 22 ga.Grade E steel deck secured to supports space at maximum 6 ft o.c.with 1TW Buildex TraxxI5 spaced at 6"o.c. Side lap fastened with If W Buildex Tnxx/l spaced at 24"o.c System Type D(2): Membrane mechanically attached over preliminary fastened insulation. All General and System Limitations apply. One or more layers of any of the following insulations. •Base Insulation Layer Insulation Fasteners Fastener ISO 95+GL,ACFoam II,E'NRG'Y II,Multi-Max FA (Table 3) Density/fe Minimum 2"thick N/A N/A (Optional)Top Insulation Layer Insulation Fasteners Fastener (Table 3) Density/fts Dens Deck Minimum'/."thick N/A N/A FiberTop C or E,High Density Wood Fiber,Sturdl-Top/IIigh Density Wood Fiber Minimum Y:"thick N/A N/A Note: All insulation shall have preliminary attachment,prior to the installation of the roofing membrane at a minimum application rate of two fasteners per board for insulation boards having no dimension greater than 4 ft.,and four fasteners for any insulation board having no dimension greater than 8 ft. Barrier: None. Membrane: Firestone UltraPly TPO Reinforced Membrane attached to deck through the preliminary attached insulation as specified below. Fastening: Membrane is mechanically attached using Firestone H])Fasteners and 2-3/8" Barbed Scam Plates spaced 6"o.c.within minimum 6"wide laps. Laps are spaced at maximum 114"o.c. and sealed with a minimum 1.5"wide heat weld. Maximum Design Pressure: -52.5 psf (See General Limitation#7) NOA No.:02-0620.01 Expiration Dab: 11/277 Approval Dab: 11/27/02 Page 6of8 STM Dzcu SSYSrIM L MrrATio is: 1. If mechanical attacineent to the struct* al dock through the ligitweight insulating concrete is proposed,a field Wid dmwai i " ce $t.u$shall be performed to determinefastener patterns and density. All testing TA S OS and and design shall be in ccui with Testing Application Standard TA � . Roo�Application sbndatd RAS 137,caleu>atioa:shall be signed and sealed by a ti d ,Architect,or ReRislomd Roof COUI$U1teUL 2. For steel deck won where specific deck 000sliuctJnn is not referenced: The deck shall be i minirnw 22 gage attached with S/8"jdd1c welds with weld washers at every flute with maxiamnn deck spans of 5 R o.c. • NOA N . 02-IS2O. 1 Zq*vda Date: 11/27/07 Approval Date: 11/27/02 Page 7of8 GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbsJsq.,or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt,panel size shall be 4'x 4'maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12'in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbsJsq. Note: Spot attached systems shall be limited to a maximum design pressure of-45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force(F)value of 275 lbf.,as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field-tested, are below 275 lbf.insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required,as determined by the Building Official,a revised fastener spacing,prepared,signed and sealed by a Florida registered Professional Engineer,Registered Architect, or Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. Calculations prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant (When this limitation is specifically referred within this NOA, General Limitation #9 will not be applicable.) 8. All attachment and sizing of perimeter nailers,metal profile,and/or flashing termination designs shall conform with Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones(i.e. field,perimeters, and corners). Neither rational analysis,nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters,extended corners and corners). (When this limitation is specifically referred within this NOA,General Limitation#7 will not be applicable.) END OF THIS ACCEPTANCE NOA No.:02-0520.01 Expiration Date: 11127/'07 Approval Date: 11127/02 Page 0 of'S FROM :ECC FAX NO. :4073651901 Jul. 28 2008 10:52AM P3 From:Kimberly Fishberg At[crown&Brown oT Florida,InC, FaxlO;407-66Q-2012 To:Elfrink Custom Construction Date:07I1('/0A 0'1.47 PM Puge. ACOR_D_ , CERTIFICATE OF LIABILITY INSURANCE OPID DATEfMMVDOIYYYYI PA ODUCE R TM9 CERTIFICATE II8193UED AS A MATTER OF EJNF:OFtMA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brown i Brown of Florida, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 2 600 Lake ,Lucien Dr. , St.. 330 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Maitland FL'3$751-7'234 Phone: 407-660-8282 Fax:407-660-2012 INSUNERSIIFFORDINGCOVERAGE INSURED .. ---....... NAK'0 INSI IMIH A: AeweLnwew W>•.uwi [n�runon Co •_ 23396 r312'R RS: FCCI Insurance Company 10178 Elfrink Custom Conatructioa IP.O_ Box 621756 Ar�—_ --- Oviedo FL 32762 R E: COVERAGES THE POLICIES or INF,LIRAN/;F_LLSTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMGD ADOVF FOR 1 HE POI.ICY PERIOD INDICATED.NOTWRI fD'TANOiNC; ANY HHOUEHEMENT•TERM OR CONDITION Or ANY r:ONTAA(:T OR OTHEN DOCUMENT WITH RESPECT TO WHICI I TI 11^u I:CRTIr.IoATF MAv tlE iSSUF.0 GR MAY PERTAIN.THE INSUHANCE AFFORUEO BY THC POUCIED DIiDCRIRF,q HEREIN IS RLX:I,IECT TO ALL IRE 1'bpu9,EXCLUSIONS AND CONDITION;or SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS _ TYPE OP INSURANCE POLICY NUMBER D . V' X}�ppEIpA�'T .-.---- LTR ----..---- DATE DIY! DA !J!! D7Y GENERALLIABLITYENGt j 1,000,000 A X I:DMMFRCIAI_ NFRAIHIARIIffY GL 2053403 04/21/08 04/21/09 r11-11 a) s300,000 CI AIMS MADF I"' OCCUR .._..--_—.-....... MEUEXP(MYonaPalYw,) !j 10,000 - •- -•••-- PCR;ONAI AADV1911IRY j 1, 000, 000 Or-NFRAI ARCRF.rp'Ik j 2,000,000 DEN'LADOAEOATELIMITAPPI.IES,PrR: NHONura t:11MrKI✓nr;f r• 2 000, 000 -71"6 LOf. _i._.._.r.. AUTOMOBILE LIABILITY '---•,....:_•._ I ( I 1 1 l 000,000 ANY AUTO Cl/Mf)INfUfiIN131.�:LIMIT rn mrinmrt r ALL OWNCO AUTOS -- SCHEDULED AUTO^ ('n,RO,p v,1,1; HY 'Irwny A X HIFIEUAUTOS CA 2053402 04/21/08 04/21/09 nODILY INJURY A X NON-OWNf..D AUTOS (POI wAdo,A) _............... . PROPrRTY OAMArr (PnI nririnnl) OARAOE LIABILITY AUTOONLY-FAAC,f,OMI j ANY AUI O ..-__ _..... OTI II'M IIN rA ACCC I Al l TO ON$Y' A(;G j EXCESS/UWAMMLA LIABILITY ._.._. ..... ...... rAMI.(W. ,0.RHENCE j 2,000.000 A X OCf UR �I:IAIMSMADE CU 2053404 ",I). 04/21/08 04/21/09 Ar(H1r;Au j 2,000,D00 nrnur.rnnl Excess of GL, 8NO X RETENTION FQ wC WORKERS COMPENSATION AND •-....,,.,. # X B ANVF,MPLOrERS'11ABLlTY �TnRY1�IM S rH PRDPRIETOWNAM I NtWE%ECl1TIVE 001—WCOBA47804 01/01/08 01/01/09 t.L.EACHACCIDLNT ' 1,000,000 000,000 OFFICERM/EMRFR Fxr.1(Inr.OT ... IIyes.OaapIODUR11Or F- .-----k-EAtMPLOYEa 3 1, 000,000 SPECIAL PROVIRION,S nalOw .----- .. OTHER _,,..� F.I.f)ISF.ACF.PCN.ICYLIMIT t1,00. 0,000 DESCRIPTION OF OPEAATIONE I LOCATIONS/VENICLfsS/EXCLUSIONS ADDED B!E 0REEtliEIdT/9 ,IP6 AL PROVISIDN6 *10 days notice for non-payment of premium. CERTIFICATE HOLDER CANCELLATION ZTPHYR1 SHOLA.D ANY OF TIIE ANOVF.nE_SCRaw POLICIES BE CANCELLED BEFORF THE FxPW ATInN GATE fHENEOF,THE OOUWO INSURER WILL ENDEAVOR To MAL *30 nAYS WNRTEN City of Zephyrtml1sent NOTICR TO THE CERTIFICATE HOLDER NAMED TO'trW LEFT.BUT FAILURE 100050 SMALL Building Department 5335 8th Street JMPOSE NOOSLIOATION ON LIABLNY OF ANY AND UPON THE INSURER.ITS AOCNTS OR Zephyrhills FL 33542 AEPRESENTATIVEH AUYNOIpED NEPRE.SEN TIVE —........ ..... ACORD 25(200 1,08) 1. /p ACORD CORPORATION 198n FROM :ECC FAX NO. :4073651901 Jul. 28 2008 1053AM P4 30► 2007 Acccluhts_030$42ttOUNN OcC'UPAIpIAL UGENSE •\, :,f'lu ION INC� � �RAYiZ', f8it)(COLLECTOR / J 4 ' :....... -L` �t? •q� :1•h i v 1 r / ,i.j# TO ENGAGE IN �1 E 5 fr) t4FRINK ✓A UCT .�-,f., ;, : i c6 ON40 ;, ,,., t ;. � State L #`=`L-'�8 033246 L E F L •�,,�;�y-'.;'�k .. :1.. . L RIN j.(l)1� ER A . =\ :t�'W'' ELFRXNX, CUS1OM1'CON8TRUCTION'-INC i; L111111611o1L�r� hr'�l((�I,IdIhdLIXOXX XI�M1•��` '�� Amount Paid: D 45.00 0LH62006010t04817 41 ''AEI' Z#k •Epp W8,S�' � '.k4ki. £k k'it ' SEMINOLE COUNTY BUSINESS TAX RECEIPT RAY VALDES,SEMINOLE COUN-1-X'FAX COLLECTO1t PO Box 630■Sanford,FL 32772.0430■Telephone:407.665.1000 4Q www.seminolelax.org VALID THROUQH -- 01/30/2008 Business Name: ELFRINK CUSTOM CONSTRUCTION INC Account#: 030842 Business Address: 726 DNSLOW AVE �Business e,Zip: OVIEDOr FL 32765- REGULATED State Llc.0 - CS C033246 Owner(s): CHRISTOPHER L ELFRINK Receipt#: OLHA20070623019 t 6 Amount.Paid:45.00 Date Paid: 09/23/2007 7 7 Ii 1 err {r tr��lla 1l 4x l/r�l r ri rn / ,way 12/04/2008 19:07 4073653127 DRURY AC PAGE 01 ,IDEL:/05!2C , JD 04;28 Ph1 ZEPHYPHILLS BUILDING FAX No, 813-780-0021 P. 002 FRft :ECC FAY. NO. :A69365190i Jul. 26 2009 10.52A1'1 P1 Bi&78O oozo Clty of Zephyrhilk>3 PeMI tApplfcatlori paM RgMked P O own.r.Nsme :at 1Aooiry own.►Phsnetileder 813—?802826 OplpsthAA4lsee 37930 Meldical Arta t.ZeohyzA I I. <,FmeunwwphwpkwMa Pee simple TNI@oWdlr Nam • O1weePllalle Nadilel Fee�Ilnpla TItleNddar alatwP al)t3AosRceS 31930 Medical Arts Ct. Zephyrhxl3:s~ FL LOY1 ORAM IBN]N L FARCPI lOf} . (0PrAMiPnmM► riTAllllelleq WORK m6po EA I46'f CON9TR REPA RT Q 910N Q Mo)l� Q amMOU9N AROPOMo USE C1 9FR Q GQMM Q oTf A • TYPE OFGOMsfRUCTION. © FLOCK ] PMME •[ J SMI. Q OTHER DRSGRrPTItmOFWOAK Ransodel Type IT taUS DING SrnlV V SA Foor*ue 2 659 NmloNr 21 ' • Q. BUILDING 3 61 Q0 0 VALUATION Op TOTAL CONSTRIICYIOt • sI TRJcAl. L42, AatP66RVICE PROIfEQBSEiEY [a wJ.Ea EJ PWMDINta a ,11 006 [j MECHANICAL ; 0' VALUATION Oil MICMANICAL INSTALLATION . GAS ROOFING C] BPFCIALTY[] OTHER HNI9►lED TLOOR ELEVATIONS PLoOO ZONE AACA ' ©YE$ QN° -rXiEtXfle EUL=k COMPANY 1 a �yi4�eo111 hA •e n, rtd A MAT1A16 NL'eleTeneD [�f n f FBE Addreei 7 6 npL7JlJ Ueeepa'! CbC033246 TI COMPANY allGlf TA tt#E dlleMeLaese LYI r! Q 'R YI Addn$t �. V - Li eA PLUMAdt j 1 COMPANY 1 WNATIMIii MSG161eRW Tyir i csP Addleee ( _j Lice,"d ✓. SM1NA \ r i7 Y nttwt YINN'�'� Ad ktlsrlee/ I. - OOMPANII -a t• tttGISYi116C illOte111N Yl _ MAtel� I� • LJIMIM>) ' FEUD (TML Moth 12)Plot Fran,(21 eels or&Nk q PIvio(Ti set o1 EMrpy Fo mr..R•0.W Panef f v Mw-wilts Eon. . • MlfMmpn Ion(10)wmlln9dive slier eubsll l fills. Required onell e.Culklfucllsn Plwlo,9temiwaler PMts w)Slit Fsnoc Inelelled. 9enl sly Fsdldos 61 dbmplet ENeW E Pom fl M►.S tMvew.m'.prelade COMMERCIAL , Atboll( cwttPlele Bole of selkbg Plane elite a LIa Safety Papa,(1)eel of EnoMy Fbrmo,RO-W PermN e?new eanoeoeoeh. Mnhlnum len('70)worklnp dgewfer etdl,Meal del. 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(AAC Wperadu ever Meet "' Apertt(for tna CWM=W)W PoW MA1Mfney trw M o,M wtwb be eolpeMlla WIN tM Woad letter loaf Pfau)aulhertrinp eetea OV�LTREOOOIITmtPBIg11TdM8 (Fmnt1App0ralottOnly) Rerodl>; $ewsra 9ervtoa Upei)Iew AM t+elteee(P nbautveyn'oewpe) TMvwpaye.Net ever Cdun wIf en pMie raadMatye«MedP ROW DEC/05/20071WED 04:25 PM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P, 002 /,FROM :EC FPx No. :407 6J1991 Jul. 2B 2080 &ø: :WAM PPlwrs► City of ZephyrlNils'Permit ApplicetlDrl )! r i Dw peaWed P e COM"Im P J �.,n Q�` ue Osw,K)>floaeNallle9r D1�-7Q0— 26 ^,�(,� �"' pWnal'e Neale Air Mai �� (� -- --II X11/ I� ptelteriAddlaaa 37930 Mealiop] its LC geDllvlis,V>Hw1r►plalrNalniar�—^�—�— Ovq Piwn1 Nuniller Pee allaple Tltlahelder Pw e1M11ph TIMaMalder Jlddnae . .IDBADOREss 37930 t;edicaL p,>rt a ct. Ze h hills ' SOT! eYeOIVIlION ' IeprAaraew�ellatalvelnt No1axJ p CONiTR ADDIALT [Q •I N Q MO YB DRMOM WORN PIIdPDetx1 R INS ALL REPAIR. PRDPOsmuse SFR oO%W OTW$ ETIi., _ • TfPeOFCOMe1RUCTION: ] BLOCK Q PPM6 OTh ER pt'SCRMTION OF WORK R;; ;;: T;e 3I �uIIOINoenes " eoPI10r11DE 2659 )IEIOIIT Z1 • RuLDNIG e' 000 - VALUATION oP TOTAI,UWATRUCTION• - - AI,IPsEIaAOE i PRaDRE96@a:RoY [� WA P- 0 EZ>?""AI. i 42.000 PWMpINO t: 11,000 MEctIANIoA� WAWATION OP MECHANICAL IM6T LATaP , 6000• , Gpg ( 3 ROOPIN6 [� OVECALTY Q OTHER - FINISMED FLOOR I1VAT1ONs FLOoo ZONE AREA QYMB ©No 1RX16 ' 11udOrat if_in_x_C Bt omT ��_Ar 8gNA7URE Addlee� T Ucaaee 1 co33246 ALiOiRMNAPI iJ 1l1leeAO" Yi Ollluelq IN MNIATIMI! 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' FaaaJM.o a I dmnppw.eqq ywelO Pan1d1 for au new/,o)sels.AM.elanNnaaf IsQlAoemrnb aalecaTaet wepllwNe - u RN PCNIMV pb ar Dowd PkMR p PatTY BLetVEI rogaMad ar e1t NEW eanMnlGan 11 out vn mn1P Y • Owner a Ganaealot NOO RON{01 appAa0OM1,MWrRAd • N awr mo.i N4ee et CrNaaMNnad b rooNwd.(@IC u1M„Me swot tleoea) - "" ApwM(tar Vie am)o►Power of A1bme1(Iar ON avaalf wA1Ole to ewneww 11511111 pie 1NMrfrom olrnK aueegbllw same Ovdl'f1am1MRuInpM1rONII (Etnnlgt?pNlcadonOnly) - RNode Sewa5 euniae1Jfs51InII A Fein(PIeUSlanpl aglapq 011velpfs-Plat avercounbrEwlPun +Yo.ne9ft NWN 12/05/2008 09:30 7273282099 AMPERE ELECTRICAL PAGE 01/01 DEC/06/2007/TUU 09:32 AM ZEPIIYAHILLS BUILDING PAX No, 813-780-0021 P. 002 /...\FROM :E FAX PIO. :4W73651901 Ju 1. a$ 8898 8:621 Pi e13 T�oaxo ' Gly of Zephythils-Pemlit AppllCaporl . ra>wa17s.,r �3 Orm Rowived Ple na Cepldet I Owru1.rLir Man tin Dairy OrwterPPareNarrMer 813-78O-2026 OwiMr'dAd%NM 37930 Medical •As Ct.Zephyril ,F1AdaI rPMad(rNyndlar Pw al.rple T)BoMMe/W AV J. • Odme-riir;o NMrdW1 Fn Dlnlplq Tklanoldor Addm.s • ,oADOfl 5 3779930 Medical Arta co . Sephy ie rbil . FL LOTA BUelf1VIIION I PMCP�IOIII • tapTAI P1ROMPkOarlfT.*XMmVICEI wow PI11iPO O - - I..1 IN6TALL B1R RAO ALT D SON Q MOVE Q DAIOL1eM PROPOIDUNE LL[�JJ 8PR Q -COMM OTTIEA TYP'R OFCONSTNUCtItNI; IJ 21.00k [� PRNNE ,�J STEEL Q OTHER f-��J'"l OEBCIIk'T►ON OF WORK A®plode1 Type IT .ouODwa,RR aa. ioraorl L 2669 NelaNr 1 .._ . UILOAIo 361.000 . VAWA1 Dt4OPTOTALCONSIRUCTION 5J 111CAL $ 42 000 AMPSERwOE PRocREeSEN�lar Q W.RLQ PWMOINO a 11,000 Q MECHANICAL s Oaa UATION O1'MECHANICAL INSTALLATION ' VA GAS [ j ROOPAN6 E= 8PMCIALTY Q OTHER PINIeHED FLOOR ELEVATIONS FLOOO AON2 AREA YES QNO tN011ER .COMPANY C s,10alATURe IayaeTj_ ' irtel � ��►� ' Ad55r726 on - u nu.s C,8C033246 ELBUTI ICIAN /}� rOOaIPANV I firKF,G✓c�E� `1'' G/�9L-v�dlYr.P�/c7v �hCi small UWI ✓ Ah01St0111p Yf N 1DI3� u l � A*Meeq — ►kuao iCDOO tlN11T1NI •' I tl Iglro Y'N I r!L'CIRP NI • AdrNerre Lkonar i SI✓ p11AT1N \ I BIwee [j1Li FEr a NT TIN Addnaa LdderteetxLIII COMPANY t11NQ REG TI LYJJ4 IYI Addrye LlcerlM ReOIDPNrIAL Aitedr(a)PIN Ric(21 wile or eAA0AIM PWM(1) (m>rte11y Paaal R4 W PeMI(or 1PM aenekllaYon. • MMI mpn 16R(1Q)weIHEO days akar au mI dote.Raquked nmke,OV MWCYan Ppos,SNmanko PPne wl Sik Paue 6KIaNNI, Oiw iy PodlMlee 61 tkwlplAer,9ke Wdik PaOMI(n?dllelNMPke)eAalaa'a sc COMMERCIAL . Atkd)(3) Ie am d(Ba1MMa Plme pkw o LOd OMfery Page(1)eel 01 Enotgy Parole.R•O W Parful braew O CeouMlon. • MkWP01n R(i0)woddnD deye uIW.Yb,iMiel de4h RI *ed tw 1M Cana tlumbn PIafp, Mnn. Pkma NY 8M Pen InehIad. 9 FooEi eu!l 1 am pMrr.ikg l d1 br all tow PM v4e.M ooam ap ernlel iMamenb nwat RiM oSN ��PQ *q m PWOW A1tilo d BeRrrpeleem0 Plwte • ERTYSI,,RVOYRq*.dforallN!Wtomlrwllan, ' matte . - cm vu1 Mppeft"Ma rownwy- OwMre Cantdelo►dgn book drappyceIl m,ns atMRC • Now CNN..HOOte of CAPNnaae.n e,*Iu npulred.(A)C upSradao Her aStlS) Aaait(ter ate egitreeta)ar fewer e/Albmiy(P,r M..warer)wnuId lea A.weane win nMeMRd leper k"owwrarne•ddro erne - , OV@AtTH eOU$rn tPOflM1TTl10 Jac,tAaablbnaab) - Aamola Oanera 9eNkeupkl�oxx NC Panon(PUOMuvey,Po0lpe) DAra1/ge Not ovo/OounW Uon pc roodwnyewea ROW DEC-08-2008 11:45 From:407+578+9396 Page:1'1 DEC/09/2007/STJN 11 :52 AM ZEPHYRRILLS BUILDING FAX No. 813-780-0021 P. 002/002 j. F'Wf 14 :ECC FAX ND. 4073651991 •Jut. 28 2020 L0:5 $ pl e1>7e0.0020 City of Zephyrhille'Permit Appllcotloti ran-els-raureul OAr.R.odv.d rll.rw Ce1d.sl Wr.rNlln ' oealw.N.ala AL M1i71te0wnn d�ba g��ry auenn_ ^^�� Olmn•Phm1.Nw.lear 913-780-20x6 OWMr.Aaip.. 1793C Medical i►st let.Zaohvr 1Ld,r w11ak6.n.Mpally� Pea 7hrrpla 1k1e1wId0T NOa • OWE*PAoe.?MnribSc l I F1e 8e tNlslreplr Mthu.a - JoeAnWlerRs 37930 Medfoa1 Arta Ct. tephy:ehll1s, tL ` LordrT_1 SUMMON PAMIL 1 E . � • Rlowran.eltTrTAxllpnaR WORN PROPOdM a NEW CON�T'R AD"Y [] SIGN MIJ11E Q D!•b1O18I1 WSTALL REPAW PROPOS D WE GFM Q Q .vvMM OTHER • tY7E 0P CON3TRYCIION:t BLOCK Q FNAMe STS Q CTHER( `I 003CRIPJ1ONcPWORK . Rele48el Type 11 •6U0.OINt10t>m 04POOTA06 2659 11EIGNT 1' OURDYdG E5 J e 1 000 . wALUATION OF TOTAL OONOTRUCTION © ELECTRICAL 42,000 AI,IPltVil.'E Q Pwala�RCoa NGItrTC Q W,R.E• .Q Q PWM81fN3 i i,000 • MECHANICAL i VALUATION OP MECPWACAL INSTALLTI AON 6,000' _ [7 ROOFBie Q 6PEIaALTr OTHER FTNISNYD FLOOR ELEVAT10N9 ROOD LONE AREA ' [jyE9 ONO xxi 'A YtlILOiR COWA y 'lf fnk C tort c ns rur_hin Tn.. aI.NATIIRE Irow►telle. „r 27-1, Addrovi 72 n a..11.. CDC033246 mioTR,WER AcoJIPAMr _ARC BTIIP! REaBIEKo ►IlkqVTNJ —' - T' Ad°Mq utwo i � vlaw►rule • . ,. 1 aoMPaidr [ .. my cuagur ,d Lp•.elu. >tIeINIT411E �•l• lua,releoUD. I T i.YIN Addr..c upm"t (trA IWi 1 ♦1r_P caIPANI I aasrereAra 'r fee OlnarrNT. dwss L . - • uaalw.p I Reem1NTw• Allech 12)Plot PIanc(7)t ii w ewldrro PIem:II)sal s?in ,,Pang;R-O-W Pam*for naw.orokaodsn. • MInflUII Ifn(1W .,kb aere am ellhrelltal dam.Ilaaulrod nrwke,CellatnxEon PI ,8lorllwialr Ptale wd alll Perna metaled, 8adt.y Foots/..t!1 drwrpeltr,alb Wwk Pwmo(aIwbdwkh.wal0.pr,, ph COIrMERC&L , AMPAi 1�)c,opIoto owp er odwhM Plan pW*a urn 6.f.,page-(1)set or lnalpr P.rme,RAW Pwnd1 Ir new caunwron, MMlmae Ian(10)wcd deys 140 ai iEtd d.M.H$SI ad lmule,Oavlpumoa►•rani,lbnawwr Fling w sw Pen,.Imed OwdWy Fi Iuu A I drw"W.gne Tyrrrn Pw rb( .R nsWpcMala.Al aI111tldal wgianwa w11Atn1sel10rlpeawea SIEN P611MW ,Atredr(q)ple tl Endrlaw.d Pbrw; -.PROPURTV SURVEY rapu id for d NEW mnMmakn. ' ad1O110; hMMM►flNi{MMM11111ftiMMFM};Ni�{l/1F1nIMl1+1K1�1N�j.M+f • pw ar 17ooae 6"sloe W Corww.ro..tal It r.Wh1d. WC worade.wer Hppp) P .d(tic the agnsadw)a•Power of Allenuy Am'dw ewrleq WoI0 p.eemeene ad.rwlwpad Iwtr from owear.uIm(aktp r1w • _ 1flaTTla4RTAILPltIpIIITTWa (Fawrl'aTlrfllollirOpy) Rweeb 6awure Dii o.Aid.I AIC FePoee(PkNhr/vgrlFs.IsB•) on+.Mlds-Mol over cowdw 7 011 public MaiwaW„rwe0c AOW . 12/05/2008 08:59 7273282099 AMPERE ELECTRICAL PAGE 03/03 CITY OF ST. PETERSBURG, FLORIDA LOCAL BUSINESS TAX RECEIPT ACCOUNT NO. DATE 2009 13146 EXPIRES 9/30/2009 September 12, 2008 BUSINESS: st.petershurg www.stpeta.org AMPERE ELECTRICAL CONTRACTORS INC 2861 20TH AVE N SAINT PETERSBURG FL 33713-4201 09-00005348 DESCRIPTION OF OCCUPATION,PROFESSION,OR BUSINESS ELECTRICAL CONTRACTOR 65.00 #IEC0002340 0,00 091008 65.00 1005958 TOTAL 0.00 MAIL: AMPERE ELECTRICAL CONTRACTORS INC 2861 20TH AVE N SAINT PETERSBURG FL 33713 ---------------------------------------------------------------- Thislocal business tax Changes in business name, address, mailing name or address, as well as receipt does not allow the additions to the business activity, may require additional applications, holder to violate any city Please contact this office before making changes or if the description on law, ordinance or this receipt does not reflect your entire business activity. Additional regulation. It is not an activities may require additional taxes, endorsement, approval or Failure to renew before the expiration date may result in penalty fees being disapproval of the holder's assessed, skill or competence or of Display this receipt conspicuously at all times in the place of business, the compliance or non- If there is no place of business, this receipt must be presented to any compliance of the holder police officer or officer of the city upon their request. with other laws, regulations Many business taxes are transferable from one owner to another, or one or standards. location to another,To transfer this receipt, contact our office for information and price, and fill in the following. 1, hereby assign all my rights, title and interest in local business tax receipt # to (name of new owners (signature of previous owner Office hours=Monday through Friday, 8:00 a.m.to 4:00 p.m., and Wednesday, 8:00 a.m.to 3:00 p.m. Phone= 727-893-7241 12/05/2008 08:59 7273282099 AMPERE ELECTRICAL PAGE 02/03 uec U4 Ut3 UO:U4p p.2 CERTIFICATE OF INSURANCE ,..., This certifies that ❑ STATE FARM FIRE AND CASUALTY COMPANY,Bloomington,Illinois ❑ STATE FARM GENERAL INSURANCE COMPANY,Bloomington,Illinois MwM ❑ STATE FARM FIRE AND CASUALTY COMPANY.Scarborough.Ontario ® STATE FARM FLORIDA INSURANCE COMPANY,Winter I-iaven, Florida O STATE FARM LLOYDS,Dallas,Texas insures the following policyholder for the coverages indicated below: Policyholder Ampere Electrical Contractors Inc. Address of policyholder 2961 20th Ave N St P•etersburg i'L 33713 Location of operations Description of operations The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms.exclusions,and conditions of those policies.The limits of liability shown may have been reduced by any paid claims. POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date ; EspiratIon 000 (at beeginning of policy period) 98-T3-0886-7 2 Comprehensive 03/09/09 03/09/09 BODILY INJURY AND Business Uatr q PROPERTY DAMAGE This insurance includes: �Produds-Compieled Operations Contractual Liability Each Occurrence $2,000,000 ®Personal Injury Advertising Injury GefleralAggregate $4,000,000 OProduce—Completed $4,000,000 ❑ Operations Aggegate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Dade ; E ofion Date (Combined Single Limit) ❑Umbrella Each Occurrence $ [(Other Aggregate S POLICY PERIOD Part I-Workers Compensation -• Statutory Effective Date . E xir'a6on Dale 98-TX-6063-6 F Workers'Compensation 03/09/08 03/09/09 Pert II-Employers t.iabtlity and Employers Liability Each Accident $1,000,000 Disease-Each Employee $1,000,000 Olseasa-PolicyLimit $1,000,000 POLICY PERIOD UNITS OF UABILITY POLICY NUMBER TYPE OF INSURANCE E fective Date ; E,qilralion Date (at begInning of policy period) 122 6500 i►IITO 11/01/08 i 05/01/09 12*4/1Z- 1/500 156 5330 AUTO 09/05108 03/05/09 114ft/11 /500 711. 7406 AtTTO 06/29/08 02/2.9/09 lt*t/3MM/500 THE CERTIFICATE OF INSURANCE IS NOT A CON'T'RACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS,EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder If any of the deacnbed policies are canceled before City of Zephyrbills- Building Dept. their expiration date,State Farm will try to mail a 5335-8 St. written notice to the certificate holder 10 days before 2eptsyrhills, FL 33542 cancellation.If however,we fail to mail such notice, Fng or Rattily wt9� on State c�rep es� Signature of ohzedReptesentative 12/04/2008 Agent Title Date Sylvia F. Rusche• Agent Name Telephone Number 727-502-9417. Agenre Code Stamp AgentCcde 6617 AFO Code F355 558 a.5 Ren,¶1-o8-9004 PAn1ed M USA. 12/05/2008 08:59 7273282099 AMPERE ELECTRICAL PAGE 01/03 O AMPERE 2861 20"' Ave. NI . . ELECTRICAL St. Petersburg, Fl. 33713 CONTRACTORS C7PhoneB& Fax INC. r::rN'r' AL_ r"ERM:C'rT1:Nt:i DATE.,: 09/ t /0e T:I:ME.. 14:;O:1. PASCO COUNTY, 1»'I_.ORIDA F,AGE: 1. O1»' 1. CONTRACTOR #6.: 001.272; ISSUIc: (Jn=''ICEi::; P NAME 1-IARRY F't JOHNSON RECEIPT N(JMEBR» O1.:1-OF374() ADDR., ;1:5O 5 RD sir N O4:: OFFICE'% PUBL.]:(: WF:4:.E> IiB1_,T) C/ST» '::>'r PETERSBURG FL 37:1.OOOOO Cllr, L_OCAI_- I_.TCENSEC STATE RE:oIS'r. EC00023 CHECI:: ## CASH RENEW CERT ELECTRICAL CONTR ECO00'2340 EXPIRES OF3/; 1./:L o CONTRACTOR:: 00127~; HARRY R JOHNSON TOTAL AMOUNT» 0,.0O ACCNT COMF'NY ACCOUNT CENTER AMOUNT DESCRIPTION/F'ERMT DATA DR/CR 10.4 1-+1,04 -- 3:,21200 W' 2 5O. OO CONTRACTOR ST/LOC 60 RECEIVED BY ;�`7U `S3IIYDNAI, REGULATION .v: ;Y .1 v/, .1,.•r' .. r4` 1. ✓ •►FIp: :nl.v,,�'},'_ _:,,: ,y�.;: SE 8062 00 1110 0 6"' 0' 'dcr b -6 ti:`. p �: z ,.raj).;�:;:!. ' tee- ._ :;: ,� . :, . . '=f,• Ui de the `:1./',a, [1/�tr� 1'x ,.a' ,r• .n�,-Y - ::� ,.. 1�H7 .yi�:.l .h::F:iti:�.t-• .. :�..- ^i��:'tnr�Tt1 �',j�V ry �7 'k� •Yv (�•4 'b .�.�t'( r,�;'�•• - . :t?1 ✓.� r( ir7rerlc �,�"/�,rr (1 `' �(•t wr {GOVERNOE•.7i INTERIM SECRETARY:'` :tir.:-. btyofZephyrhills: AI ! Building Department Phone: (813)-780-0020 Fax: (813)-780-0021 �s4 3f. ..„-----------------------.. ---------W----------------.-- «.— ------«- TO: Ampere Electric FROM: Jackie I , FAX#:727328-2099 FAX#: I p DATE:12-5-08 # OF PAGES including cover sheet: 2 I , I , I , MESSAGE: I r Attached is the permit application I need the contractors signature placed in the area of the I r star(electrician) and fax it back to our office at the fax number listed above. I I I , I p I , Jackie TRANSACTION REPORT /0i DEC/05/2007/WED 03 : 45 PM FAX (TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 DEC/05 03s44PM '817273282099 0:00:51 2 OK ECM 7933 e -fir ��, �P. J :Cit••y•of Zephyrhills: " ............ Budding Depax�nent :�;rw`< LG' r��: �4�� .::........... ......!+¢�, ems.'".:..,,,•„ .::..:.:..... lIIttttttlI Phone: (813)-780-0020 " Fax: (813)-780-0021 .r: TO: Ampere Electric FROM: Jackie FAX#:727-43 -590-- FAX#: DATE:12.4-08 #OF PAGES including cover sheet:2 MESSAGE: Attached is the requirements needed to register contractor for the Dairy Queen project here in the City of Zephyrhills.Please fax everything over to the fax number listed on the requirement sheet we do not need a cover sheet.No fee is involved as you.will see and once I get all the information into our system I will be faxing over the permit application so that � r we can get the contractor signature. Thank you Jackie -----------------------------------------------------------------4 TRANSACTION REPORT P • oi/ol DEC/06/2007/THU 0933 AM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 DEC/06 09:92AM 817273282099 0:01: 13 2 OK ECM 7940 • i • I City p of.Ze h bi11s: -Yr Building.Department , 4.�..,.., � ,, , :::::............... ,.?::..............,.. Phone: (813)-780-0020 _: Fax: (813)-780-0021 �1-_--- TO: Ampere Electric FROM: Jackie FAX# FAX#:727328-2099 DATE:12-5-08 #OF PAGES including cover sheet:2• MESSAGE: Attached is the permit application I need the contractors signature placed in the area of the • star(electrician) and fax it back to our office at the fax number listed above. Jackie - 1 • I • . • S • I-- - -_-_ - --- ____---- ._..___------- ---------__-_---- 1 City of Zephyrhills: €E. Building Department �s Phone: (813)-780-0020 Fax: (813)-780-0021 TO: Ampere Electric FROM: Jackie FAX#:727-432 FAX#: { DATE:12-4-08 #OF PAGES including cover sheet: 2 E € i € i { F € { MESSAGE: Attached is the requirements needed to register contractor for the Dairy Queen project here I , in the City of Zephyrhills. Please fax everything over to the fax number listed on the I I requirement sheet we do not need a cover sheet. No fee is involved as you will see and once i € I get all the information into our system I will be faxing over the permit application so that we can get the contractor signature. , € I I Thank you 4 € I € E € { € Jackie € € € € E € i { Z € { € , € 4 € I € C € 6 € S € { € I € TRANSACTION REPORT P - 01/01 FAX (TX) DEC/05/2007/WED 03 : 16 PM # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE O1 DEC/05 03-: 16PM 814075789396 000:26 2 OK SG3 7927 `mot • :ii� C' of,Zephyrhixls: r : __,:.�,�'[;':1u'1"W'fii:-r�+d.uf,f a;S:..rr.�,L `•��'ii......, .iii�``:!it.a_•s,me. ... Building Department Phone: (813)-780-0020 Fax: (813)-780-0021• ya:t --•-----------------------.—�-. �— .------- ----, �a —1 1 TO: Partin Plumbing FROM: Jackie FAX#:407-578-9396 FAX#: DATE:12-4-08 #OF PAGES including cover sheet: 2 i i MESSAGE: Attached is the requirements needed to register contractor for the Dairy Queen project here in the City of Zephyrhills.Please fax everything over to the fax number listed on the requirement sheet we do not need a cover sheet.No fee is involved as you will see and once get all the information into our system I will be faxing over the permit application so that .I we can get the contractor signature. Thank you Jackie II ------------- �------------- --- ------ ------------'-- P TRANSACTION REPORT . Ol/O1 DEC/09/2007/SUN 11 : 53 AM FAX (TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 DEC/09 11:+48AM 814075789396 0:00:29 2 OK SG3 7952 S^2 City-of:Zephyrhiils-: Building Department � v� ::::::°.. s,......... , ;-....................... Phone: (813)-780-0020 �k.�. Fax: (813)-780-0021 ^1 ----...-----.-------.----- �------ .-.---------..� �.....-., TO: PartinPlumbing FROM: Jackie FAX#:407-578-9396 FAX#: DATE:12-8-08 #OF PAGES including cover sheet:.2 MESSAGE: Attached for your signature is the permit application. Please sign where the circle is located the plumbing signature area.Fax back to fax number listed above. Thanks Jackie ________________________ ____ _ .1 City of Zephyrhills: Building Department �_n Phone: (813)-780-0020 Fax: (813)-780-0021 TO: Partin Plumbing FROM: Jackie FAX#:407-578-9396 FAX#: DATE:1-2--4-9$ I Z—`c3-L #OF PAGES including cover sheet: 2 E E N E i 1 MESSAGE: Attached is the requirements needed to register contractor for the Dairy Queen project here in the City of Zephyrhills. Please fax everything over to the fax number listed on the requirement sheet we do not need a cover sheet. No fee is involved as you will see and once I get all the information into our system I will be faxing over the permit application so that we can get the contractor signature. d E 1 ! Thank you w t e E o s E t Jackie E E 6 I [ p t 1 F I I E 9 E ( E 1 E i E City of Zephyrhills: Building Department Phone: (813)-780-0020 Fax: (813)-780-0021 TO: Partin Plumbing FROM: Jackie FAX#: 407-578-9396 FAX#: DATE:12-8-08 #OF PAGES including cover sheet: 2 ! € MESSAGE: Attached for your signature is the permit application . Please sign where the circle is located the plumbing signature area. Fax back to fax number listed above. Thanks Jackie r ! r € ! € ! ! r r I € ! ! r € € € ! € ! € i € E r i € ! r t € 1 ! 1 € ! i r r 9 € ! E ! € E E I ! DEC-08-2008 11:19 From:407+578+9396 Page:1'4 Warti%.uming Services, Inc. 6110 EDGEWATER DRIVE• UNIT J •ORLANDO, FLORIDA 32810 (407)578-9553• FAX(407) 578-9396 December 8,2008 City of Zephyrhills—Building Dept. 5335 8"Street. Zephyrhil.ls. Fl 33542 Cti3t.C C)G To Whom It May Concern: This letter is to authorize William W. Partin to sign/piclk-up permits for Partin Plumbing Services, Inc. Thank you, Regina Partin State of Florida County of Orange Sworn to and subscrib eCore me by Id ication or personally known and who did take an oath this -- day of ' 2008. R D, EEKS NOTARY PUBI,TC:N 1 FlOrida My commission expire ! m• P. O$f. 5, 2009 Comm.No.DD 4T8990 o� a '° m a� g m V w • n�9 NP M m` a C.) to �. `'•-� ;a,• o''d'�j�.t r- , W. i` rn�GaiS.' C. •�, 1 . .�y. , . a. r - -J Ln :o; V G ON SOO: N�i . 6O0 . o ' WM4 O C E - y.. Q Yi J Z N.2:= �W. W'p 1-OG. 0 . J W W9 b,£;a6ed 9626+8LS+L0b:WOJd 6T:TT 8002-80-030 DEC-08-2008 11:19 From:407+578+9396 Pa9e:4'4 Date: 12/4/2008 Time: 3:11 PM To: @ 9,4075789396 Pa e: 001 ACORD, CERTIFICATE OF LIABILITY INSURANCE DATEPMMIDONYW) PROOUCEn 12/04/2008( O)Z88-3000 FAX (407)788-7933 THIS CERTIFICATE 19ISSUED AS A MATTER OF INFORMATION Insurance Office of America, Inc, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.0" Box 162207 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Altamonte Springs, FL 32716-2207 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE NAIC# INsuFeD Partin Plumbing Services, Inc. INAI.FIERA Oh io Casualty Group 24074 William W. Partin INs'. O Brid Afield 6110 Edgewater Dr. Unit J 9 Employers Ins, Co. = 10701 IN;iI pFf{ Orlando, FL 32810 IN.I D AGES THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER100 INDICATED.NOTRMTH TANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER r)0CUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BYTHE 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. TYPE OF INSURANCE POLICYNUIrBER Po4CYEFFECTNE POLICY EXPIRATION' GENERAL LIABILrTY W(00953451943 02/1.3/2008 02/13/2009 �AGHGca�RRCNcr UPAITS X CC+nMERCIFl GENERAL LIf I n Y 6 1 000,D I luuwCE Tr RENTCD • c�IMs MA rt XO ocCUR sEs csd�c 6 300,0 A MEO Exr(a v a o PO ) 6 10,00 IW oNALsADvINJIMr s 1,0O0,00 GENL AGGREGAII IMI I nr+Fl IF,F PER: CFTERAL AGGRFGAU- 2 000r wne;v X IFRT Iy NI'1U.X. -COMP/OPAC,t4 f 2,000,001 C AU TOM OBILELUBLRY BA009T3451943 02/13/2008 02/13/2009 X ANY a nq r:�:%MNINcr.SINGLE LIMB AUTO ALL sank.. (Cn:,rn,fonll — 1,000,0 A SCHEDULED AUTO^, (PrIn -)JItY X I II 7CD N.JTW, X NON-CT NEoAUro., furl III Y Ir,t) (Po xridrm) PROPFR'Y UAMAGE (Pr.r. arrinnm) GARAGE UABLITY AUTO"N Y.FA ACCIDENT ANY AUTO- - I 01} I t THAN a'TO:N Y A{G EXGESSNMBRELLA LIABL nY CACI I(Y'-^.jjR ttN�R: 6 OCCUR E CI AIMS lAk:f K+.W3Alt I DEDUCTIBLE .. •- RrTrNT r,N 6 i WORKERS COMPENSATION AND 83029840 02/13/2008 02/13/2009 X wC SIAut OTM- EMPLDYERS'LIABILITY _IMITS B ANVPROPRIETJR,v RTNCrJrxrfuTiv� F i rA�.N,ot.:raDENT t 500,00( OFFIC +£PACMDCR CXCLUD'M II yyes.dewilln irulrr EL ____A C-CA LMNI c-1 1. 6 500,00 ( C,Pr('W PROVIMON;hebw — .. OT ER t LEASE-P01 I'Y I IMIT $ S00,0D A Inland Marine BK00953451943 02/13/2008 02/13/2009 Scheduled Equipment - S29,635 $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VENICLEs I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS SNOULO ANY OF THE ABOVE DESCRIBED POUCIEB BE CANCELLED BFFn RE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WLL ENDEAVOR TO M . City of Zephyerhi l l S 10 DAYS wRITTEN NOTICE TO 1)45 CERTIFICATE HOL,pe R NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL MIPOSE NO OBLK;A I IUN OR LIABILRY 5335 8th St. OFANYKINOUPDNTHEINSURER.ITSAGENTSORREPRESENTATIVEB. Zephyrhills, FL 33540 AUTHORIZEDREPRESENrATIVE Heath Ritenour/TRICIA - -A2I Im3 ACORD 25(2001/00) ®ACORD CORPORATION 1988 DEC-08-2008 11:19 From:407+578+9396 Pa9e:2l4 Ad 3.8639 9,x: s l STT0F.FLO IDA• : 5 I. die PLI '`C Cl"f3R /,:' .',ti_ ._ Named beLbw ZS ;' ' r.4{ T�F •t 7I ,l 'n'�, ,, _ .Viider 'tide.:g` vie.ona .d Ch - = t _ Expiration date: lei > ==_ �9-_ ih. ;may,. i:•' .L ! �L t/ 1't. G 5 y . �' '�' j :.« l tf"�tt f" r~•_ �' .� PA$ 1 611' �`''►: .r�, ORLANDO ..FL .3'.Z !r>.•~. -, / ART CHRLZE . r. t :Y tt "O . ' y t Rr[! .r /'• NTBRIM SECRET R( -- - - �g .�•_� QUIRE{�13Y LAW -. P . 0 TRANSACTION REPORT 1/01 DEC/05/2007/WED 03 : 10 PM FAX (TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 DEC/05 03:09PM 814073653127 0:00:52 2 OK ECM 7925 City of Zephyrhills: � , Building Department :ter. r, Phone: (81.3)-780.0020 � *4 Fax: (813)-780-0021 ------------- -------------�------- ------ '`{.---- TO: Company of Drury HVAC FROM: Jackie • FAX#:407-365-3127 'FAX#: DATE:12-4-08 #OF PAGES including cover sheet:2 MESSAGE: Attached is the requirements needed to register contractor for the Dairy Queen project here in the City of Zephyrhil1s. Please fax everything over to the fax number listed on the requirement sheet we do not need.a cover sheet.No fee is involved as you will see and once I get all the information into our system I will be faxing over the permit application so that we can get the contractor signature. Thank you ' Jackie 1 --------------------------------------------------- - City of Zephyrhills: Nq, Building Department ��,, Phone: (813)-780-0020 Fax: (813)-780-0021 TO: Company of Drury HVAC FROM: Jackie FAX#:407-365-3127 FAX#: DATE:12-4-08 #OF PAGES including cover sheet: 2 MESSAGE: Attached is the requirements needed to register contractor for the Dairy Queen project here in the City of Zephyrhills. Please fax everything over to the fax number listed on the requirement sheet we do not need a cover sheet. No fee is involved as you will see and once I get all the information into our system I will be faxing over the permit application so that we can get the contractor signature. I I I I Thank you i I 3 i p € I I Jackie I I B I I 3 I I C � I I I I 3 I I I I I I I 12/04/2008 03:12 4073653127 DRURY AC PAGE 06 Ilec O4 O9 O4: lop Tmc 1234567890 p. 1 d 417rjo0i/.cr an.... + 12/34f2ddk! seating&Air Condiltioning,Inc 1220 Bnbwbite Treil Chutuoitn,FL 3x766 (41)365-6164 ram(467)365-3I27 12/04/08 City of Zephytttills 5335 8'"Strect Zephyr ills,FL 33542 Re:Autod�atios1 letter for petonit Dnuy Heating dt Air Conditioning,Inc.gives the autority for Joe Drury,Rubett Unary or Mark Dewy to sign and pick up molts. you, cryl D Ot ce Manager Drwy gcating&.Air Conditioning,Inc. Statc ofFl , n Comity of is fore ' fAsbmna+�way edaaoW1e4 d by me dtis� d� of_______e200 sd ysh E who is aspp, p kngWR and OT 11BB Nom,g r.v� rise N. _.=Lt7 nn�� ,�►,,� NalaryPu�k Stale olFrodae Laura W Skinner p My Commbeion 0DS37915 /O 'IMP Exphe9OOM010 My CorIlWssicM lExpim: �' Fax Server 12/4/2008 3 : 09: 55 PM PAGE 2/003 Fax Server Clients:25634 DRURYHEAT ACORDTM CERTIFICATE OF LIABILITY INSURANCE D TE(MIDDJYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CNA Sales&Service Center ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO Box 946580 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Maitland,FL 32794-6580 877 724-2669 INSURERS AFFORDING COVERAGE NAIC 8 INSURED INSURER A American Casualty Company Drury Heating&Air Condkioning INSURER B: Transportation Insurance Company 1220 Bob White Trail INSURER Q Chuluota,FL 32766 INSURER D: 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 PERTAN,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 PAD CLAMS. P. TYPE OF NSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE, ,Daiyy DATE ImSIYy LIARS A GENERAL LIABILITY 2066424754 01/06/09 01/06/10 EACH OCCURRENCE 11.000.000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $300 000 CLAIMS MADE 5Z OCCUR MED EXP ma arsan s10.000 X PD Ded:250 PERSONAL BADV INJURY $1,000,000 GENERAL AGGREGATE s2.000.000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPPOP AGG $2000000 X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea aaciMH) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Pr Pram) HIRED AUTOS BODILY INJURY NON-ONN AUTO S TOS (Pr Sadden) $ PROPERTY DAMAGE S (Pr acddarr) GARAGE LIABILITY AUTOONLY-EAACCDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG S EXCESSNMBRELLALIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND 2066424768 01/06/09 01/06110 X vrc STATU- OTH- EMPLOYERS'UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCDENT $100,000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 5100000 Rya,daaibe undr SPECIAL PRONSIO4S E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES!EXCLUSONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of ZephyrhiNs Building DATE THEREOF,THE MSIIHIG INSURER WILL ENDEAVOR TO MAIL _30_ DAYS WRITTEN Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL 5335 8th St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITSAGENTS OR Zephyrhills, FL 33542 REPRESENTATIVE& AUIH PRESENTATIVE ACORD 25(2001/08)1 of 2 #240092 VIES O ACORD CORPORATION 1988 12/04/2008 03:12 4073653127 DRURY AC PAGE 01 ' k Yiii ( ) 1220 Bobwhite Trail Chuluota,Fl. 32766 Phone (407)365-6164 Fax (407) 365-3127 Facsimile T To Jackie fax 813-780-0021 Fva,^: Cheryl Drury oa*: 124/08 Re: Company Info Pages �? CC: 12/04/2008 03:12 4073653127 DRURY AC PAGE 04 Fax Server 12/4/2008 3! 10 PM PAGE 2/003 Fax Server C i�nt8 25824 DRURY11!AT PATE(MMroOIWYr) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1„a/o6 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CNA Sales S.Service Carter ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 946580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Maitland,FL 32794-6580 877 7242669 INSURERS AFFORDING COVERAGE NAIC S INSURED INSURER A. American Ceaudy Company Drury Heating&Air Condllonir>g NwR B; Trials rtatlon Insurance Com 1220 Bob White TraN NSURER c Chuluota,FL 32166 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NSUREI NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY RECUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCIAIeIT WIT H RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY P RrAOG REGAT LIM THE RB SMOW R Eb HAVE PoLicE t1 ESCIMED ACL N IS SUBJ�ro ALLTHETER1d3,EXCLUSIONS AND CONDITIONS OF SUCH E EF FXPaIM N TYPE of NiUMNCe POUCrmwBER LIaTI A GENERAL LABILITY 2066424754 01/06/08 01106/10 EACH OCCURRENCE a 00000 X COMMERCML GENERAL LIABILITY GE TO RENTED $300000 CLNMS MACE FX-1 OCCUR MED EJ V anan 0000 X J PD Dad:250 PERSaMAL 4ADV INJURY 91 000000 GENERAL AGGREGATE 12.000LODU OEN'L AGGRBOATELIMTAPPUES PEN: PRODUCTS•COMPiCP AGO sz,000.080 x POLICY flPitafl LOC AUTOMOBILE LIABUTY COMINED SINGLE LMT (EA amarll) ANY AUTO ALL OWNED AUTOS IOOLY INJURY SCHEDULED AUTOS (Pd Pw) HIRED AUTOS BODILY IN,AIRY (Pe aatloanl) NON-GAMED AUTOS PROPERTY DAMAGE 5 (Pradd.nq GARAGE LM , AUTO ONLY•EAACCIDENT R ANYAUTO OTHERTHAN EAACC AUrOCI&Y: AOIa R EXCESEIUMBRELLA LYIIII TY EACH OCCURRENCE i OCCUR CLAIMS MADE AGGREGATE i OEOUCTISL.E RETENTION i B WORT MS COMPEIIIATION AND 2066424768 01/06109 01!06/10 X °TH. EMPLOYERS UABILRY El EAQI AOCDENT i'TOO COI) ANY PROPRIETOR/PARTNERIEJIECUTIVE OFFICERIMEMBEREXCLUDED? E,L,DISEASE-EAE 9190000 I!y4 Ca.ulbe unar EA..0 -POLICY LMAR i600 QOO OTHER DeSORIPTIDN OP OPERATIONS,LOCATIONS,VEHICLES I EXaIJaIONSADDED BY ENDORIIEMENT r SPECIAL PROM ICNE CERT1FICAmIIOLDER CAN ON MOULD ANV OF THE ABOVE DE CRIMES POLICIES BE CANCELLED BEFORE THE EXPRATTON City of Zephyrhtlls Building DATE THEREOF,THE RIBuNGINBURdIwILLENOSAVORTOMAE. _.30_ DAYS WRITTEN Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE 10 0050 RHALL 5335 8th St IMPOIE NO OBUGATION OR LLBL1TT OF ANY KIND UPON THE INSURER.REAGENTS OR ZephyrhNb,FL 33642 r"mmNTATNEa H9 D PRULNYATNE ACORD 25(7061/06)1 of 2 6240092 VEB 0 ACORD CORPORATION IBIS 12/04/2008 03:12 4073653127 DRURY AC PAGE 03 c°`�tiT}* rat SEMINOLE COUNTY BUSINESS TAX RECEIPT o = RAY VAi..DES, SEMINOLE COUNTY TAX COLLECTOR a r PO Box 6311 ■ Sanford.FL 32772-0630 • Telephone: 407-665-1000 www.scminoletax.org VALID THROUGH 09/30/09 DRURY HEATING&AIR Account#:1.04155 CONDITIONING INC 1220 BOB WHITE TR. CHULUOTA, FL 32766 REGULATED JOSEPH B DRURY (OFFICER) State Lic.#-CAC056957 Qualifier-JOSEPH IEIARRELL DRURY Receipt#: 10402008081402989 Amount Paid: $45.00 Date Paid:08/14/2008 BUSINESS OWNER, PLEASE NOTE THE FOLLOWING: o DISPLAY THE ABOVE RECEIPT PROMINENTLY: This .Business Tax Receipt shall be displayed. conspicuously ii.the place of business i.n such a manner that it can be open to the view of the public and subject to inspection by all duly authorized officers of the County. Upon failure to do so,the business shall he subject to the payment of another business tax for the same busincss or profession. o RENEW THIS TAX BEFORE iT EXPIRES: Pursuant to Florida.Statutes,all Business Tax Receipts shall he issued by the Tax Collector beginning July 1" of each year.and it shall expire on September 30''of the succeeding year. Those Business Tax Receipts issued as renewal accounts beginning,, October 1" shall be delinquent and subject to a delinquency penalty of 10%for the month of October, plus an additional 5% penalty for each month of delinquency thereafter,until paid, provided that the total penalty shall not exceed 25%of the business tax for the delinquent.establishment(Florida Statute [FS]205.053 [1]). A 25%penalty shall he imposed on any individual engaged in any new busincss or profession without first obtaining a Seminole County Business Tax receipt. ([FS] 205.053 [2]) This Business Tax Receipt is only a receipt for business taxes paid. It does not permit the taxpayer to violate any existing regulatory or zoning laws of the state.county,or municipality, nor does it exempt the taxpayer from any other required licenses, registrations,certifications, or permits. Business Tax requirements arc subject to legislative change. o REPORT ALL CHANGES: The bolder of this Business Tax Receipt is required to report a change in the following: Ownership,Business Location,Mailing Address,or any other information that would alter the status of the current year's taxes. This includes,but is not limited to.the loss of or a change in a State License which was used to qualify for the business activity and/or occupation identified on the current County Business Tax Receipt. If you have any changes to report, contact the Business Tax Department at 407-665-7636. DRURY HEATING&AIR CONDITIONING INC 1220 BOB WHITE TR CHULUOTA,F1, 32766 County Services Building Wilshire Plsza Oak Groves Shoppes ShclMar Pr'ofessiona)Center 1.101 E, First Street 384 Wilshire Blvd. 995 N SR 434 Suite 505 1490 Swanson Drive,Suite 100 Sanford, FL$2771 C:assclber+y, .1•'L 32707 Altamonte Springs, FL 327.14 Oviedo.FL 327Fi5 12/04/2008 03:12 4073653127 DRURY AC PAGE 02 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 DRURY, JOSEPH HARRELL DRURY HEATING & AIR CONDITIONING 1220 BOB WHITE TRAIL CHULUOTA FL 32766 STATE OF FLORIQa AC# •Con ratulationsl With this licenseyou become one of the nearly one million g -b'5$�LR'L'1i Off' Floridians licensed by the Department of Business and Professional Regulation. Ro 'E SIONrp;L ",REGUL ICp Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants, and they keep Florida's economy strong. 'CA&D 5 6 5.7 06./2410-13- 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,corn. ,,is; I ' > } .iIkZ'R CO» COUV There you can find more information about our divisions and the regulations that kYp - 'OSRPH Ii ltRR L impact you,subscribe to department newsletters and learn more about the tiJ '� & Ate CtS1thITIOi7 > G Department's initiatives, .- :;r Our mission at the Department is:License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can serve your customers, :%S'•C>r> ar!'Yffib nnaue the previs4oe: Riot dh-.'*99 1 Thank you for doing business in Florida,and congratulations on your new license! Y llepireE:l'ee pua_ AVG 31, 201.0 L066*000.0'R91 DETACH HERE 823 975 - �`^ S�.t�AL. R�G�f�.ATI01P�``I, - - •.�''-- � BOARD �3F _.._•_•._. •,_ �:':�> >' te; '--•'�.'' .� .4- / _ _ - .,..✓,.fit., ,�''�.�OMIC•��" ,�F.�' L,'� '..:: _ ___ _ :r"'"'�i'�Y'I`�';�'•.i mil. 1•.w � +,r' 7....��{ , . OE!:'SItA ':MYG:`�' `ri@1 :�:`.:• rakis' �X1i rro.Jl! ^�'-�.' `�;d; .. •'il� .�-� C�;� :._` .�: I' ': .:J�r y�� yw i��.,-�.o. Ivl.:.• ;..,F,j,. :,lh:�?. Yl.i-' ,-.'1' ..rIT•r:,.,::'` �,r :`� .:....y,,-•F - � ix .j•.'ti�.:.- �G ;fl!,::;•i.t'yN' "'w`:" �Y' ;:. R ,. . ` c �. . Dom. '"1.+.:.'•11]: `-'Ql.y •'f. =if7 n,`;.:(-;ct.. :_-l''`Y : ' ^•:L `� ':� � :,�`.•'_.''' „•7 fL≥ 'IEC .•.,.?_,- �'r` :M�r.:: � �c' 3;,,, - , : S CREARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MELLETTE, JAMES RICHARD JR AFFORDABLE ROOFING SYSTEMS INC 12573 N US 301 THONOTOSASSA FL 33592 AC# � wv' STATE OF FLORIDA Congratulations! With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. ¶ PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. CCC1326722 6 7 2 2 •:0 6/18/08 078168098 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. CERTIFIED :ROOFING CONTRACTOR There you can find more information about our divisions and the regulations that MELLEME, .JAMS RICHARD JR impact you,subscribe to department newsletters and learn more about the = :AFFORDABLE.ROOFING SYSTEMS INC 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. IS CER'T.IFIED tmaer the psovimions of Cn.489 Fs Thank you for doing business in Florida, and congratulations on your new license! Respiration, date= BUG 81, 2010 L,oeo6180oso8 DETACH HERE -' Cj x:. DE-PARTMENT OS1SS. ANDPROFESSIONAL REGULATION ST 1 x TRY ..LICENSING BOARD SEQ#L0.8061800 808 0621. 81ga s The ROOFING CO!fTl 'c" ":,'`_ Named below::._IS: `C ..,, . - +�•_ �... ',•� :�- a ti 17sider the p:�G øv sons d C h �.r,:;•`.. Expiration date: AUG 31, 2010 , ± 2T:, • MELLETTE,. JAMES RTOAR1 JRw AFFORDABLE ROCIFINCSM$ -_ . ^`'- • 12573 NUS 301 �_ c'„. ... =.ys :•> -.; THONOTOSASSA FL 33592 , Z CHALI C2I fi ; CHUCK DRAGO GoV:ERaYR =,`' : ;t' INTERIM SECRETARY • I31 f'L-A'i =SAS t EOUIRED BY l.A1rV' Doc 04 2009 4:00PM HP LASERJET FAX 8139651198 p. 1 a >r CERTIFICATE OF LIABILITY INSURANCE 71118 CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION rttootxxle ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3836professional InsurenceBeMcee Inc �E THIS OVERAGE AFFORDED BY ICATE DOES THE POUCIES BEEND, LOW 3888 W.Humphrey St Tampa FL 33614 INSURERS AFFORDING COVERAGE filUC P:813-963.4701 Eels 366-0981 mimumb AffOnbble Roofing Systems Inc. p A: NORTH I INSURANCE 12673 N.US Highway 301 FIRST NATIONAL AL INSURANCE p: 81ECHIGAN CONSTRUCTION Thonotoeaeee FL 33692 URER& COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IBSUE )TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTYY(TM9TANDINO ,qM/ REGt11REMENf TERRA OR CONDn10N OF ANY CONTRACT OR OTHGR DOCUMENT WITH RESPECT TO WHCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, F)cGI-USION9 AND 0DEORI0NB OF SUCH POLICIES.AGERSATEUITS SHOWN MAY HAVE BEEN REDUCED BY PAID CWMS. IJMIII AEERAL p I 1 000 000 UmLay 08/0BI2006 08!08/2009 a TO T�NTTD 100,000 A X OeNEge�CTY 209,01'18682 t)LM BkMOE X we 6000 1.0 000 ___ OM 000 TS-C A 000000 L AGC3AE Tr LfMRApp a PIR. p LO "y COMEINED SINSLE LMT i 300,000 B X ANY AUTO 01 CH78787810 04/17/2005 041171200E9 BODILY INJURY ALL ONMEOAUTOS (Perpama") BC l 3IAffJ AUTOS URY NIREDAVTOB f NON-0NMEO AUTOS PROPERTY AE (Perreaq I) ONLY- NT NAILMY ffO ANYAUfO O O114AN EA Pi 5 NLY f OTHER ACWOC(LR Ao5OCCUR CL MS W IM REGATS tiCDUC'TELP WC BfATU.JPRNuA•flERBMNDYI w UASLITY /1110 C WC100-0012508.2008,0 08/08/2008 08/08/2008 EL EAO4 Roc 100.000 oc1cEwEIR FA CTEL DISEtIB.I&ISLc 100,O00 Eyes.desuoe uldw E L ICY Uh 4 500,050 aT1� D�CIUP11oN OF OMRATIOM6/LOCATIDNf I VE NOLM I BXELUBowI AMID By INDO t8ORNT I SPNOML pkO ft$$ONE city of Zepa%ylfillls Is named u Additional insured with respect to eneiiI IlabU ty. cERTIFICATE HOLDER CANCELLATION HOULtIANYOrTNEA.OWPISCA PDLlgiB5EGWOGLSDaRP0 B1 SERRR&RO4t City of Zr9Ph7Rh111>1 PATE 1NSRIOF,mu 14I1111K1$ERI t Will.SNISAVOR 10 MAR iL.DAYS WRITTM 5338 9th Stroat LtoTlt:s 10 ThEDERTTnCATI NOLOPR N*sou TO IN E LEFT.BUT PAf uRET000 90 MNALL tMPOSU NO 0lLN1ATi0N OR LIASNJTY Or ANY RAID UPON THE B*II ITS AGENTS OI Zap$yrt INi,FL.33542 ATlrae. A111 ISZEO IePRicnl IEA �MP> ACOR13 26(a0U1/QS) 0 ACORD CORPORATION 108 2008-2009 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9-30-2009 FOLIO NO. FgG1U IES OR MACHI R S RATS FM LOY 0 0 0 1 RENEWAL 169790.0000 OCC.CODE BUSINESS TYPE N.WASTETAX SURCHARGE 090.000 y . CONT OFO8 40.00 18.00 a iii kXs a:x � BUSINESS 12573 N 301 HWY LOCATION THONOTOSASSA 33592 NAME MELLETTE JAMES RICHARD JR MAILING AFFORDABLE ROOFING SYSTEMS INC ADDRESS 12573 N 301 HWY BUS THONOTOSASSA FL 33592 BU SINESS T RECEIPT DOUG BELDEN,TAX COLLECTOR PAID-147958 -85 HAS HEREBY PAID A PRMLEGE 1c TO ENGAGE 813-635=52pfl 07/24/2008 58,00 IN BUSINESS.PROre3SON,OR OCCUPATION ePECIFIED HBRROH. THIS BECOMES A TAX RECEIPT WHEN VALIDATED, 12573 North U.S.301 ROOFING SYSTEMS Tn notosassa FL 33592 813-986.6683 FAX 813-986-6779 . Iv Jackie rosI Stacy Fax: (813)780-0021 Pages: 4 Phone: Date: 12-04-08 Re: CC: ❑Urgent ❑ For Review ❑Please Comment ❑Please Reply O Please Recycle e Comment= Hi Jackie- Here is the updated Insurance infomnation as you requested. Should you have any questions, please do not hesitate to contact us. Have A Great Day!!!! Sincerdy, Stacy (,O cZko a CP�d -- TRANSACTION REPORT P . 01 /01 DEC/05/2007/WED 04 : 25 PM FAX (TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE IFILET 01 DEC/05 04:23PM I9866779 0:00:25 2 OK SG3 7935 ROOFING SYSTEMS =Thono�waFL 33592 813. 868883 FAX 813-9866779 Jackiei.isrstacy Fax: (813)780.0021 Pas" .4 p Date: 12-04-08 pa CC: O Vnsnt D Per Review O Please Comment O Please Reply O Please Recycle e Con mentsr HI Jackie- Here Is the updated Insurance IrMbcmation as you requeet�ed- Should you have any questions,peam do not hesitate to contact us. Have A Groat Day!!!! - Sincerely, Stacy kLt cONrr' . M` ii CAST d c" Wes. 2E ko are ) prk4d n %r Fax Server 12/4/2008 3 : 09: 55 PM PAGE 1/003 Fax Server CNA Facsimile Cover Sheet -�O ? Name: City of Zepherhills Bldg Dept Company: Phone: FAX: 8137800021 -10 FROM Name: Sales & Service Phone: 877-724-2669 FAX: 877-763-5122 Date: Thursday, December 04, 2008 3:09:36 PM Pages:03 (including this page) Note: k pe iP 4Sr Si Is �cccec� �nc � efL !►'lark t 5 to c `I2d ii ItaC�. g13-'7 c - Ob Z4 CONFIDENTIALITY NOTICE The information contained in this facsimile message may be legally privileged or confidential information intended only for the use of the individual or entity named above. If you are not the intended recipient,you are notified that any dissemination, distribution,or copying of this facsimile is strictly prohibited. If you have received this facsimile in error,please immediately notify us by telephone so that we can arrange for its disposition. G-117310-A TRANSACTION REPORT P . 01/01 DEC/05/2007/WED 04 : 28 PM FAX (TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 DEC/05 04:2'1PM 8.14073653127 0:00:50 2 OK ECM 7936 :Fax Server 12/4/.2008 '3:09:55 .PM :PACE 1/003. Fax Server Facsimile Cover Sheet Name: City•of Zepherhills.Bldg.Dept Company: Phone: FAX: 8.13 7800021 �A610f, Name: Sales &.Service Phone: 877-724-2669 FAX: 877-763-5122 Date: Thursday, December 04, 2008 3:09:36 PM Pages:03 (including this page) Note: • • 13- 7 o--O t Z4 CONFIDENTIALITY NOTICE DEC/05/2007/WED 04:25 PM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P..001 ROOFING SYSTEMS Tom •:^ 3302 In FN(613.9Ye•9Tl8 Fax Pam (813)780.0021 Psm A PNonao Ilial� 12-0408 flrw CC: O LiiK O For Pallow CI Pismo Comment 0 Plssse Reply ❑Meow Recycle e 6oanakenta M .ladder Here Is the touted Insunsnoe trrbrmatian as y u requested. Should you hwo any quas�ans.peace do not hesitate to contact us, HaveAGrdatDaytP! Slnorely, �Y •kiA kut 06 - A0- . W"AA, r I CITY OF Ii / / BUILDING ZEPHYRHILLSNI OT I C DEPARTMENT OF ADDITION OR CORRECTION ADDRESS DATE PERMIT# 3-2 93e Y - / 3 -f-_07 / 73 THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be mode before the job will be accepted. ) 7J;1i11 S !T It is unlawful for any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL cover or cause to be covered,any part of the work with flooring,lath,earth or other material,until the proper inspector has had ample time to approve 780-0020 FOfl RE-INSPECTION the installation. �� OFFICE HOURS 7:30 AM-5 PM MON.-FRI. INSPECTOR -