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HomeMy WebLinkAbout06-6285 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 6285 PLUMBING PERMIT .. i' .��• .mad.�. - � C� 2<..a.: J' . Permit Number: 6285 Address: 39825 ALSTON AVE Permit Type: SEWERLINE REPLACEMENT ZEPHYRHILLS, FL. Class of Work: SEWERLINE REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: Improv. Cost: Date Issued: 12/01/2006 Name: CITY OF ZEPHYRHILLS Total Fees: Address: 39825 ALSTON AVE Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: Phone: Work Desc: WASTEWATER TREATMENT ADDITION- NO CHARGE PER BB WHARTON SMITH INC, GEORGE c 4.tak0c FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b)condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d)work not ready for inspection when called e) permit not posted on job site f) plans not a job site g)work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." ALL PLUMBING SHALL REMAIN EXPOSED PRIOR TO INSPECTION CONTRACTOR PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 02/05/2008 11:18 8136284288 FRENCHS AC _ . _- PAGE 01 FHB/05/2007/MON 09:07 AM ZEPHYPHILLS BUILDING FAX Nc. 8I3-780-002; P. 001 till f���Fr� � � ..j...•...... j•�I�I�illl ll:: 11; 1 ii,. II City ofzephyrhills --- B.uilding..Department 5335 8th Street PH: 813-780-0020 x3513 Zephyrhills, Florida 33542 FAX: 813-780.0021 bate: 2-5-08 French's Air Conditioning 1O : 7(aren II Email: kmilleracizephyrhi Is.fl.us 1[ FAX#: 813-628-4288 # PAGES: 2 Message: 3 Good morning. I have received your documentation.and have updated our system. The attached permit application needs the license.holder's signature on it. Please re-fax it back to my attention, Karen, at 813-780-0021. If you have any questions, please contact me. Thank you. 3c\ \ cxrc\ 5 02/05/2008 11:18 8136284288 FRENGH5_;AE PAGE 02 F3/05/,007CN 09:06 AM ZEPHYRHILLS BUILDING PAN.c,"B:l3-76.C-0021 ?, 0C.2 r„fk( Q prranrt�enhletfe PrnnMl � } I ly ownw;i'hnna'Nurntler .64tsNemr :t sa I' r Owner Phone Number • Owner phaM Number Far GimPletTllleholder Nearw FS BMnpk 7uhhakiWAddrese • LOTS JOBADDRESS 4/ vnuc SUBOrvIBION PARCEL 1DM (dnfAllRp MOM peOrEICFv TAJLN0Y1CR1 .SIGN' [] . MOVE T-1 b MOLIS 4 WORKPROPoswaO NfiWCONSTR ADO!ALT� REPM ' R +�—+ �; 1N9TALL PROPOSE4USE • Q BFR [� COMM . J OTHER TVPiar{O MTMUC" Q BLOCK. L7 I� GTL p DE9CRIPTItJN OF WORK sp pUILDINa 911E DOTAef: 1111 NEIGHT El . • BUILDING VALUATION OFTOTAL COMETRUCTIOH .Atdp oFRVICE PROORBSS JOY Q W.R.E.C. Gl.t:oTalcA1 � � •. • PLUMBING S •• MGCMANiCAL VALUATION OF MECHANICALINSTALLATION /., hiGAS I� ROOFING 9PEMALTY r7 OTHER FLaOC 20NE AREA• =YES ©N0'"a �FINtsFtGO•F�OORLEVA7ONS •• �'�:. NY �f r tons ;�f, xn GxS ewLella �� CR O�arED � �cNro�Hre I SIGNATURE LL 1 Addnlr2 L122 L 21,Z/ ;LIIiIUucoeeff Lsl. L e'e.- �Vf:, o,A �GLRGTRICIAN • ftfM1 O - Fs6OInrIrM,- .,TIN " S fy6ffA7rIR5 Addreee Lloe w go AFB, J cIJY1P/ANY . --- �LUMrl1R 1 I�McanRENT' P!"ATURG - Ads 4 id-2(_I Uciwaf{ i. '�• c S IYECfiANICAL COMPANY p� I N IsroNA7uae Ret7a,ev:co �l.... . .•fi -Address •1b .Vc+1l Ti ç, uoerlse# 61.( -oTfiER a NP M 81 EtAMneNi '' . �rlN 0(IATURE ' 6 • Ueeuea# 4i'„ Addeara . (RE9)DElfT1AL AI41.f1(2)PIM PI*2(2)eats of BlAlalfg Pimtsl(1)eat of Endgy forma;R•aW Permit ferrrew Wnab• ua2oi+, Mlntmum tan(t0)wendna days after eubmllml dal.. Ret(ulred eraNg,Oonebudlop plapa,etommv.Aer Ptarrs• Ill Ferree InalaEed, • 6rrdmry Pacts lee Al dumps*t Sla work Pantlt for IIAdlvtelOne ergo prtdBtxs COMMERCIAL At1erT(s)fob of tiiAdfrg Planr,(1)eel of Strerpy Forme. .O.W Pennlliernem oonokuotion. A Mnknum Ian Faci11(1 0)vddrO diy.aft liee d 1 dtaap"aw.Site Wa�Pal e:Reams vW .C etinttforafl AM eIPlane. 'ufrllanl5 must ' !• qa innaNlpd. • SIGN PERMIT Atlaeh 14)eels of tirlOlneered Plane. v PROPERTY SURVEY regtMrd for M NEW oomtnralan, 'Afro one: ." . . Fig out pPpllrmllen •oemplelely. ,.. %R;; Owner&Cprdr da'elan ha of eppentan,nrbtdsed if over 42lae,a Nonce of Commaneeman Y►*A-d•(APC upgredee over 2110110) - Agent(for 1fM eanlmdsh a Power-Almney(for the ewni)would be aemedne v s nctsdted letter Item.ogre(euhertrlrg some• OVST)4RtxUNTL+R ERMrf71N0 (FvtxaofAspilwrion0my) Ro ol. Bewaa iervbe Upamee. A/C Fences{PlabsWi YrFootaa) Drivewaye4Nol over Ow l&It an public roedwoya.•needr ROW • (,•Nk Rio City of Zephyrhills — Building Department 5335 8th Street PH: 813-780-0020 x3513 Zephyrhills, Florida 33542 FAX: 813-780-0021 Date: 2-5-08 TO: French's Air Conditioning FROM: wren Email: kmillerc ci.zephyrhills.fl.us FAX #: 813-628-4288 # PAGES: 2 Message: Good morning. I have received your documentation and have updated our system. The attached permit application needs the license holder's signature on it. Please re-fax it back to my attention, Karen, at 813-780-0021 . If you have any questions, please contact me. Thank you. Building Department �(pZ ,rved 2— 6 Phone Contact for Permlttin — Owner's Name C i} o 2 a r�.1)s Ownet Phone Number Owner's Address LIII Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS �gZ S A IS�on Adenue LOT# SUBDIVISION PARCEL 1D# ' + (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR LL a ADD/ALT . j REPAIR SIGN = MOVE = DEMOLISH PROPOSED USE = SFR = COMM _Q OTHER - TYPE OF CONSTRUCTION = BLOCK = FRAME //= STEEL- = OTHER L DESCRIPTION OF WORK 4d1;/; ..s BUILDING SIZE -SQ FOOTAGE I HEIGHT El BUILDING $ VALUATION OF TOTAL CONSTRUCTION = ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. = PLUMBING $ = MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION = GAS = ROOFING = SPECIALTY = OTHER FINISHED-FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO BUILDER COMPANY r�p Sin # Zn SIGNATURE '�t G REGISTERED Y N I FEE CURRENT I Y/N Address P0 1O .F L a e F 277 7 I License# c6 3 (o to ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N I FEE CURRENT Y/N Address I License# PLUMBER L? COMPANY ILI& %S AC,mBlnG C o,/ -/ SIGNATURE L REGISTERED I Y/ N I FEE CURRENT I YIN Address -(G r AFg Elm DL. &Prod Q L S7 License# MECHANICAL F COMPANY SIGNATURE REGISTERED I;Y �FEE Y/N Address License# OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal.date. Required onsite,Construction Plans,Stormwater Plans W/Slit Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. "'*PROPERTY SURVEY required for all NEW construction. 11111 1111111 IllIUlIltIll lllllllllllll IllIlIllIlIll IllIllIllIll IllIllIlIlIll llllillluul 1111 IllIllIllIll IlIllIllIllul IlIlillIlillI lIllIlIlItlI 111111 Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement Is required. (A/C upgrades over$5000) Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) `\ Driveways-Not over Counter if on public roadways..needs ROW U`� l �r TRANSACTION REPORT P . 01 /01 FEB/05/2007/MON 09 : 08 AM FAX ( TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 FEB'/05 09:07AM 96284288 0:01:01 2 OK ECM 6251 City of Zephyrhills — Building Department 5335 8th Street PH: 813-780-0020 x35.13 Zephyrhills, Florida 33542 FAX: 813-780-0021 bate: 2-5-08 TO: French's Air Conditioning FROM: wren Email: kmiller@ci.zevhyrhills.fl.us •FAX#: 813-628-4288' # PAGES: 2 Message: Good morning. I have received your documentation.and have updated our system. The attached permit application needs the license holder's signature on it. Please re-fax it back to my attention, Karen, at 813-780-0021 . If you have any questions, please contact me. Thank you. I.. W 0I- .2. J w 0 !J Q 7d O 4 w0 W C2 o Z � W ,O W o ,� LLJ & O m 06 v W O QZ � a a� 3 u O p o o d Q _ ` o ~ 3 moE 0 Q W o n e U m n U m LL \ H ) o Q NCV n O y M O m-_ ILA < � o_ ^ Z o O v > .2 2 S u, >o'm U Q.fV\ f-- = O ZE O W N TIERRA 7806 Professional•Place Phone: (813)989-1364 Tampa,Florida 33637 FAX: (813)989-1365 REPORT OF SOIL DENSITY TEST CLIENT: Mr.John K.Evans DATE TESTED: 09/11/07 MWH Americas Inc. JOB NO: 6111-06-092 1000 N.Ashley Drive,Suite 1000 TEST METHOD: ASTM D 6938-07 Tampa,Florida 33602 PROJECT NAME: City of Zephyrhllls Water Treatment Facility ..»._»»..................».»..».» -....»....» Test Wet Wt Percent Density Percent Compaction Approximate Test No. PCF Moisture PCF ` Compaction Required Location Elevation Operations Bulidkia:Building Pad 65 120.0 11.0 108.1 1 95% 95% North Side of Pad: Center of Building Finish Grade 66 123.5 10.5 111.8 .1 98% 95% South Side of Pad: Center of Building Finish Grade TESTS COMPARED TO: (i Moisture/Density Maxinium Dry Optknum Relationship No. Density Moisture %) Method of Tee 1 113.5 9.0 ASTM D-1557 y U rr�� 2 114.0 9.5 . ASTM D-1557 /V 3 113.0 9.5 ASTM D-1557 4 124.0 9.5 ASTM D-1557 RA,I LBR#1 116 12 FM5-515 Copies: (1)client (1)Wharton Smith via email to Brandon Baker (1)robert.o'dell©mwhglobal.com 02/05/2008 @8:41 8136284288 FRENCHS -AC BE:: PAGE 01 FAX TRANSMJTTAL TO: City of Zephyrhills FAX: 780.0021 ATTN: SUBJECT: Certificate of Insurance,Tax Receipt& Copy of License FROM: Don Gibbs FAX: (813) 628-4288 PHONE: (813)626-4630 DATE: Februarys,2008 PAGES INCLUDING COVER: 3818 N. 40"St Tampa, FL 33610 Office(813) 626-4630 CACO57826 Fax(813) 628-4288 c O O d O n �y, z c r °' UO o.:. 0 - �.. Q o CO M i7 Z 'n ..H-4 LL O: QED a-: �'•.; '•.r `•• _ .0,^ O _,,..• w o a Zoe W }H (, p H �� Cf7?. - wo � UQQ VNW Q _:. aI 4 d�a J a H w N v�,.:.•H- O . . a C7 9 * ^ . m O O a QF+ m z W ' Cop O A _ oaH xa o N o W " a'A�'ro pR3Z ww < h o c o ;v b . a: m.� iErEE0 S9Vd 9C SH9N 88Zb8Z98t8 tb:80 8OO /90%•Z•0S '3 t 02/B5/2008 08:41 8136284288 ERENCF SAC PAGE 02 1F8;L ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID 3W DATE(I 0VVYm ''RSNC-1 02 04 09 PRODUCER.__-- iHI5.CERIIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Florida Insurance Canter Inc HOLDER.THIS CER IWICATE DOES NOT AMEND,EXTEND OR 414 N Alexander p treet ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. plant City FL 33563 Phone:813-754-3561 lax:013-764-0402 INSURERS AFFORDING COVERAGE NAIC 8 INSURED INSURER A. %wtwd rum c ca.wlty CNNptAr 13021 INSURE3R 0. Zenith Insurance C any Iranch•a Air-Conditioning Inc Nvs JRER C: 3828 N 40th Street INSURER D: Tampa !I. 33610 MgURER E COVERAGES THE PCUCIES OF INSURANCE USIED BELOW HAVE B ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NO WITHSTANDING ANY REQLNREMSNT.TERM OR CONDITION OP ANY CONTRACTOR Of OOCUMENTW TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INOURANCRAFI 0RWS)BN THE POUCIE$DESCRIBED HEREIN 18 SUBJECT TO ALL THETE3EMS3,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGOREGATE LIMITS SHOWNMAYFIVE .REDUCEDBYPAIDCLAIMS. LTR ! ! '/ EOFINBUAANEE POLICYNUMBER Ij1TE LIMTS GENERAL LIABILITY EACH OOCURRENCE $1,000,000 A ii COMMERC(ALGEERALUABIUTY 60081001 06/15/07 06/15/08 PRERISFS awmn ) 5100,000 CLNMSMADE =-- 'OCCUR Mg)ELP(Mlywm Vm'OI) 85,000 X ICentractua.1 Liab. PERSONALaADVINJURY 31,000,000 Z Broad )form P.D. GENERALAGGRBBATE $2,000,000 GENI.AGOREGATEUMr1APPLIESPEIt PRODUCTS-CONPIOPAGG s2,000,000 FQ ICY S Lac AUTOMOBILE LAAONUTY COMBINED SINGLE LIMrc A x ANYAUTO 60081001 06/15/07 06/15/0031,000,00o ALL OWNED AUT09 BODILY INJURY SCIEDULEDAUTOA (P.rpenen) $ HIRED AUTOS BODILY «INJURY X S NON-OIMIEDAUTOS X Sired Phys DatD+ge PROPERTY DAMAGE $ (Pr mIft *ARAGE Li IUIY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN PA ACC $ AUTOONL'r AM 3 E)I UMBRELLA LABILITY EACH OCCURRENCE $5,000,000 A ocCUR EIct.4INSuAnE 60081001 06/15/07 06/15/08 AGGREGATE $5,000,000 $ DEDUCTIBLE S R RE ENITON $10,000 MpRRBRS COAOERSATION AND E TORY LIMITS E:R B fiRTETORPove ITY 8068977201 04/01/07 04/01/08 ELEACHACOOBNR s500,000 OFRCERAAEMBet EXCLUDED? EL DISEASE-E&EMPLOYE S 500,000 Rya!O P005'KItlN1 EL OISFJISE-FOLICYUMIT 3 500,000 SPECIAL PROVISIONS pNlnw OTHER A I..aaed/Rantal EQ 60081001 06/15/07 06/15/09 List: $100,000 Dad: $500 DeOCRI10TION OFOPSRATIONS I LOCATIOM lye L.. ?EXCLUSIOIAB ADD®BY SNSORBE ANTI 3PBCIAI.PSLVlgNS A 10 day notice of cancellation can be sent for non payment of prem:Lu s. CERTIFICATE HOLDER CANCELLATION CITFEp BNDULDNAY OFTHE ABOVE 011SCRIBEO POLICIES BE CANCIl.1.SLI SWORE THE EXPIRATION DATE THEREOF,THE ISSUING PISURER WILL LEIOSAVOR To NAIL 30 DAYS WRITTEN City of S.ph yrhi1la NOTICE in THE C98TIFICATE HOLDER NAKED TO THE LEFT.BUT FAILURE TO 00 90!HALL Building Dapartalent NNPo No OSLIOATIDN oR LIM UTv OP ANY IOND UPON THE NOURBR.ITS AGENTS OR 5335 8th Street Sephyrhills FL 33542 REPREBEMTATTVES A RlPRIBrE ACORD 26(200148) 0 ACORD CORPORATION 1088 Feb. 8. 2008 3: 10PM B L SMITH ELECTRIC No, 7024 P. 1 B. L. SMITH ELECTRIC, INC. DATE: 2-8-08 Send to: Karen Mills From: Carolyn Sheek[CS(hb1.snithe1ectric.com1 Job Name: Covv of License NUMBER OF PAGES: 3 ❑URGENT D REPLY ASAP 0 PLEASE COMMENT 0 PLEASE REVIEW 0 FOR YOUR INFORMATION COMMENTS: fax cover [if you do not receive all the pages as included above, please call 863.439.7401 as soon as possible] B.L.SMITH ELECTRIC INC. i 29716 US HWY 27 DUNDEE,FL.33838 PROVE NUMBER 863.439.7401 i FAX NUMBER:863.439.2045 j ESTIMATING&PROJECT MGMT. FAX:863-4393853 SPECIALIZING IN INDUSTRIAL AND COMMERCIAL ELECTRICAL APPLICATIONS J W W W.BISM1 rKELECTRIC.COM r• i1 `4T1• t - k -: - •: S\C (I ct1L' a�� - Ham.. • - - ,y�.. 1 �Y,r)•: . :. : •- • �",,.. 'grlr•.''�.":,�1.-; '�' .•. [.(t�{�,�..t•� �C•,�;::-4�`1rw,f`'�'ir�'s^�`�•�,�; . i!iii tli: ' - F:�..l:.w: I �•t'<i. fit"'•%%�� •ter. (Ss1•�9"', �\'•,� , `. .�..rte'..�;.,;:'1�' \�'`�_ ., `r,�' .Lti.` is`: ,,:•t:,. v'h 'f '}Y•r� `^yi'/'.:s• :r.•1^,.'f'•c�>•;T,_7'�.1� I '? il_� y. /M1T+'v ya '1t:1„ ,r1• ?'S�.,"�.-.r .�•'i,m._,� ti�s fly.... �: <��`�~ i.' �:.:: '"S• &i,'::-:�., :.iii..• ��1c1 d UL °N DINI�313 HIIWS 1 8 Ad0I'.E ':8UU '8 'q q J M (A '♦ W v O ~ N } J .al N W I W C a U J v7 Ui J z Q rr; ` ON � a_c W iJ o `" f W ru U tm p O Z w LU J NW H } M O o }off o• a " z rZ) • x o J tiO J 0 * Nf7m Q O • Q W o a t≥ o J O W o . r F u c a W O tL }!i �G 0 d tilUL °N l . 'S 3I131 HIIWS 1 8 Wd0I E 800b: '8 _'9ad 813-780-0020 City of Lepnyrnills rermit Hppnuauu►t Building Department Date Received ( 2 IIJ Phone Contact for Permitting i1iTiit' . s Owner Phone Number Owner's Name E' i o c r Owner Phone Number Owner's Address Owner Phone Number Fee Simple Titleholder Name Fee Simple Titleholder Address [ I LOT# JOB ADDRESS 3 9 z S A Ioi' e n"e SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) B WORK PROPOSED NEW CONSTR ADD/ALT SIGN = MOVE = DEMOLISH e INSTALL REPAIR PROPOSED USE = SFR = COMM ,C/7 OTHER TYPE OF CONSTRUCTION = BLOCK = FRAME {= STEEL = OTHER DESCRIPTION OF WORK ��S �"e�'��fe TcQ F 1' e"ri C Acid;Pi• BUILDING SIZE L •SQ FOOTAGE HEIGHT LIII BUILDING $ VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. PLUMBING $ = MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION LIII GAS = ROOFING = SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO 411•III'IIlII I''lII 'II'"I'''1'1I ''II'' ''''1111111 lIIIlI,uIIflI ii''iiI 'tuu'IIII I 1111111 I lllhlhIIhIIIuhl1hh1 i' i''IIII'IIl'IIuIhIIu1u111 BUILDER COMPANY (�N r fG S . i-I Tit SIGNATURE 22_-__- REGISTERED Y N FEE CURRENT Y/N Address PG L }I u2 8 L c, n e F ?27 7 I License# (_6 c c z ELECTRICIAN �^I COMPANY e t- �6 �h �� " SIGNATURE —' C.J J REGISTERED I Y/ Nj FEE CURRENT I Y/N Address I �1, License# PLUMBERS /z COMPANY fX►is `'"1B"1G C� 97Pn'( f SIGNATURE REGISTERED Y/ N I FEE CURRENT I Y/N Address k ,,o i, ELL D Oct( �L I / License# MECHANICAL COMPANY IQ .'�S SIGNATURE ( REGISTERED Y/ N FEE CURRENT Y/N Address License# OTHER �}� {r� COMPANY SIGNATURE Lam`''"' REGISTERED I Y/ N I FEE CURRENT I Y/N Address I I License# RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal.date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, Sanitary Facilities& 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) �a Driveways-Not over Counter if on public roadways..needs ROW 0k `c The ersigned s that may be ject to "deed" restrktions" whichNOTICE DEED RESTRICTIONS:County regulations. The undersigned this permit responsibility for compliance with any which may be more restrictive than C y applicable deed restrictions. the owner has UNLICENSED CONTRACTORS AND CONTRACTORto be RESPONSIBILITIES:e d inacco dance With state and hired a regulations. ifrthe contractors to undertake work, they mayrequired contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirerpents may apply for the intended work, they are advised to contact edea contracasco tor ty orB contractors, he l is n dvised to Division—Licensing have he c ntractor(s) sign 7- 8009. Furthermore, if the owner has h portions of the "contractor Block",of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY construction FEES: The o new undersigned b n Understands of that Transportation Impact Fees and Recourse Recovery Fees may apply to number use in existing buildings, or expansion of existing buildings, as specified in Pasco County Orwill ihance identified at the time89-07 a d beo 90-07, as amended. The undersigned also understands, that such fees, as may be due, permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the.fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County,ordinances. CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the"owner" prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. Southwest Florida Water Management District-Wells, Cypress Bayheads; Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone"V" unless expressly permitted. If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building Using stem wall construction, I certify that fill will be used only to fill the area within the stem Wall. if fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas;'or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S. 117.03) OWNER OR AGENT k — CONTRACTOR2��fflrrne6�= A Subscribed and sworn to(or affirmed)before me this Subscribed and st s by by Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as identification, as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped FEB-15-2008 15:31 +-QUALITY METALS INC =407330 0403 P.02 B1&7100020 "y"•:_�q.:y.... _•.—-; -. •. -' .: . V VL1 • , uvi BcoldNtg Oepprbfrenl ��� Gala RocMved Phom COnlacf foPi11• Owner'Name t i Q r�' s Oemef ioM Nurrltaer Of1Nf Phone NUraber Owmes Addy - Kee Slntple TJllrholdef Owner phone Number Fee Simple TIWRoIderAddress JOBAOOREse 1i' S IS}ow Aecn a Lot* L SUBDIVISION PARCp,L ID1 . (osTMNwD FROM PRO tr TAX NOTICEI WORK PROPOSED fI�--11 NEW CDNSTR ADD/ALT SIGN' Q' • MOVE•C) O9FAOUSH ll INSTALL REPAIR PROPOSED USE SFR. : [� COMM .. J O'THER L • TYPE of CONSTRUCTION ( J BLOCK.. [ FRAME [] STEEL. 0: OTHER — � t>E5CRIPTION OP WORK • i♦'t wo F Tn ci.,it A :/;�w S • BUILDING SIZE SQ FOOTAGE HEIGHT' Q BUILDING j VALUATION OF TOTALCONSTRUC ION ' D ELECTRICAL. $ AMP SERVICE PROGRESS ENERGY' W.R.E.C. Q PLUMBING MECHANICAL N: VALUATION OF MECIfAWCAL INSTALLATION • OAS Q ROOFING . [ SPECIALTY ] OTHER • FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES BUILDER COMPANY W r TDn SM ►T+ SIGNATURE Iy j .N rgeCLnneNf Addrefra PO N j N0 & lad o F '?3 Lkalros • ELECTRICIAN • • COMPANY L- fr� SIGNATURE $g.__ (v-+�.s+u nee I Y/ NJ FEE aslnOdT I _J Address Q_ LlorllsO t# � PLUMBER //J� / f� coMPANY BIB+ C70ySAty/+1Qii1� GO�IDPAAa/ NEotSW Lri N , rI! CURRENT YIN Aodre kplA t. ifMOdt 1L ii] Uceneelr MECHANICAL n• COMPANY IreAIBS p t 2+ -w a i n SIGNATURE Size_ 1 =&A. k•••& RCOISI'efEO I YIN J F I YIN Addrew • Ucenw ft OTHER COMPANY' VAL ih1 S C III SIGNITU I REeI6TEASo L!L!LJ Fee CURRErrr YIN I Address - Ucelisef ieee. / Zs7fl RESIDENr1AL Math(S)Pbt Plana;(2)eels of 6uldhtg Plaiw;(1)sal of Energy POWets:R-O-W Permit Vein W Conelwclon. Mkrrrsen tan(10)vwklnp dive after sutaNNa)dote:Required onaNe.ConebuCEOr Flirt.Sbtmweler Plans WI SNI Fence Installed. • Salolmy FadNles¢1 durnpeter:Silo Work Pem ll for wbMekloaelblge pmlads . COMMERCIAL Mica(3)OetC of Buld(ng Plans;(1)Gel of Encr y Fofine.R•O.W Permit ter now cone ruelOn. Minimum tan(to)tworket0 gays after arrhaltelpate- Required onsib,Cen*ucd n Plans,S1mmweter Plano w/Slit Fence InstaQod, Salta,Faallliee&I dumpaler.site Woik Peiroll for all new pmjacte.All Commercial requlrmnenta mud meet mmplance SIGN PERMIT Alltdt(2)WE orEn5kleerad Pone. • ""PROPERTY SURVEY repined fm eN NEW awtuclon. D;rrpcllmre: - . Fill cut appkstlon completely. Owner A Conwelor algn bade of appoaeeon,nohutaed . R over$7500,a Notice of Cemmeneereent V required.(A/C upgradei ewr 550D0) - Agent For Rre Contractor)er Power of ANomey(for the owner)would be someone vtill nelpdyad It"Gr frore after elartodsing Came OVER THE COUNTER PERthrrTING IFrmlt orApplicaraa Only) Reroafi Sewers Service Upgredeo A/C Fences(PWV9wveyIFoobge) •/�!\f Ortvswaysllol over Courlor lien public reeOweys-nmdd:ROW '/l\`\ ,�+•� . FFR-14-7ggfi ld•AZ Cit+ 'Am arr7t ---- - 7ct' 0 ....— B/CFeb._11: _20083. 8,50AM ZE,B L SMITH ELECTRIC FAX No, 813-780-0021 NA'.L:7C51_. PP1/001 •02/0572008 1118 6136284298 FREMCf15JC - .. _ PAGE 02 fl3Y' 2flMON 09:08 Ate 2EPBYRHILLS BUILDING _Ai ►Nc; 7&-•.0D21 ?, O.C.2 otaterPltotaellr. �r• . .� sAddlOee -.oeeefPllMwbh.h07 ' 3 - , w.taetp�'tlu.naea. pe uneu'r►t luaaders1 .Lno °PAI(CR4 jepA�lAte,lEp NOItCEl auaet+►ieloN ,,. MOVE; oi�M0USN • AaofAirT . NloitK P •Rt�Po4£dt E3, MJt7t '• O" • TrIR p• '., C7 'nAM� p 61L• .p ,.�9CRI�I�IQ(tMbRft, J�L•tAI� �/! 0 (''��n•' ;eo root 1 1 T `—'�— o VALUA MOMYALco tal trclacAt. sswwt:s •Q �'°° O w.e eta, ;d Pt.* IN II1 , V, t01OFOW4#86ALItasTAW110N JS ,w . 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'trwwa M.a%aweMgmttee �app���yati• ' ' " Aced milli nIPMeMry d POMterel AMtn1�(rpryae,eN�)Ytetrd tieNWtlMvtNt no • • • . t�vsA'!IM eouNrde teClrtRilKO IMteN dw0t.pen ► PeeoeelPbtA ?eO�°a Attnere tiwteo DMNee Wtlee++ �(, ' � �►Oe.tlert►eeYrAtte,mdetNer.�cl�GNt _ �G �• Received Time Feb. 8. 3:23PM P . 0 TRANSACTION REPORT 1/01 FEB/08/2007/THU 03 : 28 PM FAX ( TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE 01 F.EB/08 03: 27PM 818634392045 0:00:25 1 OK SG3 6278 .02/85'/2088 11:18 8136284288 FRENCM __. PAGE 02 ^` E3/05/2U077%MCN 0908 AM -ZEPHYRH1LLS BUILDING _A 'Nc•;`E 78C-0.021 ?. 0.Ci • �; a�dng'O�Ieesni '�� '• /' ' "own•tFhpne'lluraeet �dwNaYs Name O,prwr Photw Nuote. Ownc►'eAddfee . . (weer rAaha lrylmba FSOONpThleh•Idar Nlpa Pao earlPb711Uh•IdaA�dres5 L01•N I - •1ppA0DRE55 9P 5 Fen '�vnM - • PAdCEUWN reoMpeoM aTY, tN• QfICQ tsucomialON AOQSALT [ :6pRoaC] • M ?� O MOLIBH "ORK PROP0 • [ I CCNtTR • Q' IEPAIR L„1 N9TAlL rL�J COMM OTHt ROPoIrI.u,e I• 5FR J •p TYPI OP4�ON3TRUOTION .CI •MLODIC. •:•, pt 9CR!FflN OP WORK \ [ • r'rn r� aq N00T;A00 MONT L,-—�-�� 81RLOINO dIIE � • 9►lIL0M0 VALUATION OFTOTA4 ctiNiTRUCTroN e►ECTRICAI• •• Rv3C ,r,•� pfm0FW s Y ) WRtl•0 AIAP 96 q •� PLUMBING • : • • • VALUATION OF MECNANICAI-INSTAI•f.Ar"• I'•, IQ MilolrATNCAt s _ • (�. Ro0FM10 [� GALTY Q VTN2a No�. fw4a RDonioNaARlA, []YIN Q Ii��•p,.�DRr:Lf=vAnoNs . { CDf ANY InI r�a s f 16180TU �� eooNnenro aIONATtlRIE n� (fo�• N, (� � IAaeroes . CWMPAMT �Jyr l�. 1LAWMCIAN 106p>A N► 1l� S ' hsed Addrr•s • •. .____ 1L. - r ATURtf I N �ddre.. o B(ao �en SS A,.r 4�r IMpf.., IM6cRANICAL COMPANY MECUKAIIR ti I N IIYIONAtURO oawt>3aEo LbMBN11 ��•`• �Nb 4Jt1J T } aadrors °. • .L� COMPANY �ecuweN'r ' rN • I .aN10/i►00 BOK `aRi11RE � 1 k AddMOr+ bre5lDEyTIAL AIMeh IEI Pbl PWm.(2)low of wile N Perm;Iq M!of'mew 1'anna;RO YY Pt�tNetforrbw parnA Melded, hed dale.N !O ,OaneoueWon Plante,eleeawoterPhrns,f• t �TlnMruMe va+(10)wer•a1()eeys alkr euem kunmereo Nrd �: BpaloerypaoMpeettid kl:glaWekPenoM�.F►o•wnenretldneurwne4uoNon, COMMERCIAL )0w10. A"No �asubmNlelf+le RotlhadOgMlO�Cem�PlW 'Ier :: rMed. sedy�y P••IAYae 6 e dWnpeler.ales WUIK PaNIII Tor an he.y Pral�r*•AN �4 ;4. I JMN PERMtr AIhoM i4)care al lrMrr gene. i '•PROPERTY ilia ?& d for d t W eolNMdell • Fll•tn 0111 Neh ephpl•leb 'I < ': • •ppeaeoo•ti•bldsd • 'rf ever X11100, a MoOCe of Oemmarroemarll el, qtere•NUo epy ado•werSno) 1• �- Agent(IorUle.I ImClen er PowervtA0arh0Y(la eA orm�e�would d• eme6M wNh roled Isl10r eW+at eWhalrJnp same' cWffK71e1 e0uWrfiR t+EtN4WrltNO (Mwd of A•pQ0Wwn IVC Fence move gylP 04 . • • •. • • Reroero 90rrM7 Bervbe vowed•• �INt l c• _. .._._,...n•ourllnnoubnorcedwan••�esd_NOW • T 1.�P�n. ; Nom■ Information IG eit S"` 1 2! ®To Build On 4 ' Engineedn9•Consulting•Testing -, Pl ycI I'1 FL July 31, 2008 Mr. Brandon Baker Wharton-Smith, Inc. 4912 West La Salle Street Tampa, Florida 33607 Phone: (813) 477-5148 RECEIVED Facsimile (813) 288-0371 AUG 04200 RE: NESHAP Asbestos Demolition Survey Existing Head Works Structure located at the WHAIRTON-SMITH Zephyrhills Waste Water Reclamation Facility TAMPA, FL 39828 Alston Ave Zephyrhills, Pasco County, Florida PSI Project Number 552-8A058 Dear Mr. Baker: Professional Service Industries, Inc. (PSI) was contracted by Wharton-Smith Inc. per a signed Notice To Proceed Form dated July 29, 2008 referencing PSI Proposal PO-552-8A0072 dated July 28, 2008 to perform a National Emissions Standard for Hazardous Air Pollutants (NESHAP) asbestos demolition sampling survey. On July 30, 2008, PSI representative Mr. Eddie L. Anderson conducted the asbestos sampling survey of suspect asbestos-containing materials associated with the existing head works structure located at the Zephyrhills Waste Water Reclamation Facility at 39828 Alston Avenue in Zephyrhills, Pasco County, Florida. At the owner's request, the survey was limited to the existing head works structure and associated stairs and sidewalk. During the NESHAP asbestos demolition sampling survey, the inspector collected a total of seven (7) samples from three (3) homogeneous areas suspected of asbestos-containing materials. Samples were laboratory analyzed by Polarized Light Microscopy (PLM). The following chart lists the materials sampled, sample locations, approximate quantity of materials located throughout the surveyed area and percentage of asbestos fibers found in the materials sampled. The results of our analytical testing are discussed in the following table: HOMO. SAMPLE MATERIAL SAMPLED APPROX. %ASBESTOS NESHAP No. No. DESCRIPTION LOCATION QUANTITY TYPE CATEGORY 01 01 Beige epoxy coat and North end column 10,125 sq.ft. NAD N/A gray concrete (associated 01 02 Beige epoxy coat and Center area near box with the NAD N/A gray concrete exterior and 01 03 Beige epoxy coat and South end near stairs support NAD N/A gray concrete columns of the tank) Professional Service Industries,Inc.•5801 Benjamin Center Drive,Suite 112•Tampa,FL 33634•Phone 813/886-1075•Fax 813/249-0301 FL Engineering Business 3684 Wharton-Smith, Inc. July 31,2008 NESHAP Asbestos Demolition Survey Page 2 PSI Project No:552-8A058 HOMO. SAMPLE MATERIAL SAMPLED APPROX. %ASBESTOS NESHAP NO. No. DESCRIPTION LOCATION QUANTITY�1) TYPE CATEGORY 02 04 Gray concrete South end sidewalk 80 sq.ft. NAD N/A leading to stairs and tank 02 05 Gray concrete South end sidewalk NAD N/A leading to stairs and tank 02 06 Gray concrete South end sidewalk NAD N/A leading to stairs and tank 03 07 Black expansion joint South end were 1 sq.ft. NAD N/A sidewalk meets bottom of stairs (1) Approximate quantity located throughout the surveyed area;sq.ft. =square feet; lin.ft. = linear feet (2) NAD= No asbestos detected (3) N/A= Not applicable Reference attachment for laboratory analytical results. The U.S. Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) define asbestos containing material as any material which contains greater than one percent asbestos. When samples analyzed by Polarized Light Microscopy contain asbestos in amounts less than ten percent (< 10%), a more exact method of analysis called point counting may be performed at the client's request. The EPA point count method allows a sample in which asbestos was visually detected, but which is visually estimated to have 10% or less asbestos, to be quantified using a point count procedure. If not point counted, a sample in which asbestos was visually detected and estimated (including trace to ≤1%) must be assumed to be greater than 1% and treated as an asbestos-containing material (ACM). The EPA point counting procedure is as follows: an ocular reticule (cross hair or point array) is used to visually superimpose a point or points on the microscope field of view. A total of 400 points superimposed on either asbestos fibers or non-asbestos matrix material must be counted over at least eight different preparations of representative sub-samples. If an asbestos fiber and matrix particle overlap so that a point is superimposed on their visual intersection, a point is scored for both categories. Point counting provides a quantification of the area percent asbestos. Per EPA's regulations, materials which have been point-counted, and therefore quantitatively determined to have less than or equal to one percent (≤1%) asbestos, can be treated as non- ACM. No samples were point counted during this survey. This report may not be used by the client to claim product endorsement by NVLAP or any agency of the U.S. Government. Method used: EPA Method for the Determination of Asbestos in Bulk Building Materials (EPA/600/R-93/116, July 1993). N.-Pi Wharton-Smith, Inc. July, 31,2008 NESHAP Asbestos Demolition Survey Page 3 PSI Project Na. 552-8A058 None of the three (3) homogeneous materials collected and analyzed during the NESHAP asbestos demolition sampling survey was found to contain asbestos mineral fibers. The EPA requires a ten working day notification prior to demolition activities. If during demolition activities, materials are found that have not been listed or tested as a part of this sampling survey, or if any additional suspect materials are found, which were not visible at the time of this sampling survey, they should be assumed asbestos-containing until laboratory testing proves otherwise. The demolition contractor should provide oversight to ensure that additionally found suspect materials are properly tested. The contractor must keep a copy of the asbestos survey onsite during the asbestos abatement and demolition activities. After your review of this information, if you have any questions or concerns, please do not hesitate to contact Mr. Keith R. Kartovicky at (813) 886-1075. Respectfully submitted, PROFESSIONAL SERVICE INDUSTRIES, INC. Eddie L. Anderson Andre ichmo 7� Certified Asbestos AHERA Inspector Prin p Con9jtnt Scott S.Crandall 2008.07.31 / FL PE No.44650 18:0230-0400' ith R. ICa o y Scott Crandall, P.E. Senior Project Manager Florida Licensed Asbestos Consultant License No. EA-0000060 P:\552-Env\2008\A-Reports 2008\8A058\8A058.doc PLM ANALYTICAL LABORATORY RESULTS Nei Informatioli rpa�11.1(Z"1411LI Ore Eingln.,.,Ing•Consulting• Testing REPORT OF BULK SAMPLE ANALYSIS FOR ASBESTOS TESTED FOR: PSI, Inc Project ID: 552-8A058 5801 Benjamin Center Drive Suite 112 Wharton-Smith Tampa, FL 33634 Zephrhills Waste Water Attn: Keith Kartovicky Reclamation Facility Date Received: 7/30/2008 Date Completed: 7/30/2008 Date Reported: 7/30/2008 Analyst: DA Work Order: 0807733 Page: 1 of I Client ID Lab ID Sample Description Asbestos Non-asbestos (Layer) (Color,Texture,Etc.) Content Fibers Analyst's Comment (Percent and Type) (Percent and Type) 01-01 001A (1) Beige, Other, Homogeneous NO ASBESTOS DETECTED None Reported Epoxy (2) Gray, Concrete, Homogeneous NO ASBESTOS DETECTED None Reported 01-02 002A (1) Beige, Other, Homogeneous NO ASBESTOS DETECTED None Reported Epoxy (2) Gray, Concrete, Homogeneous NO ASBESTOS DETECTED None Reported 01-03 003A (1) Beige, Other, Homogeneous NO ASBESTOS DETECTED None Reported Epoxy (2) Gray, Concrete, Homogeneous NO ASBESTOS DETECTED None Reported 02-04 004A (1) Gray, Concrete, Homogeneous NO ASBESTOS DETECTED None Reported 02-05 005A (1) Gray, Concrete, Homogeneous NO ASBESTOS DETECTED None Reported 02-06 006A (1) Gray, Concrete, Homogeneous NO ASBESTOS DETECTED None Reported 03-07 007A (1) Black, Other, Homogeneous NO ASBESTOS DETECTED 5% Cellulose Fiber Expansion Joint Report Notes: (PT) Point Count Results Quantitation is based on a visual estimation of the relative area of bulk sample components,unless otherwise noted in the"Comments"section of this report. The results are valid only for the item tested. This report may not be used to claim product endorsement by NVLAP or any agency of the U.S.Government. Method used: E.P.A.Method for the Determination of Asbestos in Bulk Building Materials(EPA/600/R-93/116 July 1993). Polarized Light Microscopy is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically bound materials. Quantitative Transmission Electron Microscopy is currently the only method that can be used to determine if the material can be considered or treated as non-asbestos containing. Samples will be disposed of within 30 days unless notified in writing by the client. No part of this report may reproduced,except in full,without written permission of the laboratory. The reporting limit is 1%by weight. NVLAP Laboratory#101350-0. Respectfully submitted, PSI,Inc. '�t"�swr•'�11r� Approved Signatory Maureen Sammons Professional Service Industries,Inc. 850 Poplar Street, Pittsburgh,PA 15220 Phone 412/922-4010 Fax 412/922-7289 lum BULK FIELD LOG (ASBESTOS) `•'4 �,S-� HOMOCENCOUS SAMPLE MATEq.AL SAMPLE APPROXIMATE x ASBESTOS NESHAP AREA NUYeCJ1 OESCRiPnON LOCATION (I) OUANITY (2) TYPO CATEGORY COMMENTS QQd cke... I \4Cc 4 II_______________ I LfL03I I I' J ___ _c 1JIC��a�L � � ( y Cc. �cis e - 1 - 41 I 1Cc j I - iI I i I _ STAFF CERTIFICATIONS Nom' 9 \ __ M gg o o • O o o� _ N I lh o H .. p X a c • W W o II LL X o i-.� v •I� p V U ci v ti O O b O o� d � b Q y Hwy ? Q F' � I STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ASBESTOS LICENSING UNIT SEQ#L06112100899 LICENSE NBR [11/21/2006 068088064 EA0000060 The ASBESTOS CONSULTANT ENGINEFR Named below IS LICENSED Under the provisions of Chapter 469 FS , Expiration date: NOV 30, 2008 CRANDALL, SCOTT S 3600 10TH ST NE ST PETERSBURG FL 33704 JEB BUSH SIMONE MARSTILLER GOVERNOR DISPLAY AS REQUIRED RY LAW SECRETARY # 3496154 - ---- - D=PAR'lfflpT CCCf�' g�RIo kL R*A�JLATION - J IXCJTW SEQ#L07101901893I 10 19 2007 070219349 ZA101 The AS$E8TOS BUSINESS ORGANIZATION Named below IS LICENSED Under the provisions of Chapter 469 FS Expiration date: NOV 30 , 2009 PROFESSIONAL SERVICE INDUSTRIES INC CAUGHEY, TIMOTHY 5801 BENJAMIN CENTER DR STE 112 TAMPA FL 33634 CHARLIE CRIST HOLLY BENSON GOVERNOR 8EC>IARY DISPLAY AS REQUIRED BY LAW MM ® National Voluntary w�� Q Laboratory Accreditation on Program SCOPE OF ACCREDITATION TO ISO/IEC 17025:2005 PSI 850 Poplar Street Pittsburgh, PA 15220 Ms. Catherine McNamee Phone: 412-922-4010 x286 Fax: 412-922-4014 E-Mail: cathy.mcnamee@psjcorn URL: http://www.psiusa.com BULK ASBESTOS FIBER ANALYSIS(PLM) NVLAP LAB CODE 101350-0 NVLAP Code Designation/Description 18/AOl EPA-600/M4-82-020: Interim Method for the Determination of Asbestos in Bulk Insulation Samples 2007-07-01 through 2008-06-30 Elective dates For the adonat to ute of Standaoals and Technology Page l of I NVLAP-01S(REV.2005-05-19) H") N N O�+ a a N ` 8 goo r' cc � � 12 Ij 'c !Jm A •• a � W � ,O 0 111 `°U t?4 ) H 11H1 cc Q 1911 Hg tom. H Iw y O J0 FIELD DRAWINGS t e Cl c(� 4 BUILDING CITY OF / / DEPARTMENT ZEPHYRHILLS OF, ADDIT ION OR CORRECTION ADDSS ATE PERMIT f S NOT BEEN COMPLETED. The following additions or corrections shall be mode before the job THIS JOB HA will be accepted. J 1T ® Fi$ Dc1 ( 'Thf fl4'DL JYfl)t i /? O / 9ts nv7 AFTER CORRECTIONS ARE MADE CALL It is unlawful for any Carpenter,contractor.Builder,or other persons,to 780-0020 FOR RE- INSPECTION 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 the installation. h OFFICE HOURS 7:30 AM-5 PM MON.-FRI. INSPECTOR