HomeMy WebLinkAbout08-7841 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 7841
BUILDING PERMIT
Permit Number: 7841 Address: 5131 GALL BLVD
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: 11-26-21-0010-18500-0030
Improv. Cost: 217,581.00
Date Issued: 5/28/2008 Name: BBHARTI INVESTMENTS INC
Total Fees: 2,016.60 Address: 2151 SOUTHERN OAKS LN
Amount Paid: 2,016.60 LAKELAND FL 33813
Date Paid: 5/28/2008 Phone: (863)409-6422
Work Desc: INTERIOR REMODEL 3,900 SQ FT
SOUTHEAST DESIGN INTERNATIONAL I BUILDING FEE 850.68 ELECTRICAL FEE 187.65
RUMORES ELECTRICAL SERVICES INC PLUMBING FEE 125.10 MECHANICAL FEE 87.57
OLIVER PLUMBING LLC RADON 39.00 FIRE PLAN REVIEW FEES 464.40
SPI MECHANICAL FIRE PLAN REVIEW FEES 232.20 FIRE INSPECTION FEES 30.00
Q0
-hem_____ _ — ______
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
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recordi your notice of commencement."
CO TRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Cepartment 7 5(ft
Date Received —d Phone Contact for Permitting ( liii 1
Owner's Name 1 LI Owner Phone Numb r O
Owner's Address q A Owner Phone Number
Fee Simple Titleholder Name I Owner Phone Number
Fee Simple Titleholder Address I
(�
JOB ADDRESS 5 l 3 O' €/ V LIL I LOT# CI
SUBDIVISION I PARCEL ID# I/-24- Z'- Oo/O~ / 3 e'-. 0 03a
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR ADD/ALT SIGN = MOVE DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR [ COMM = OTHER t I UIcT6 `
TYPE OF CONSTRUCTION = BLOCK FRAME = STEEL = OTHER
DESCRIPTION OF WORK "Ti U'` AO L._.-•
BUILDING SIZEI • • ••••J. SQ FOOTAGEL .,,,,,,,,,, I..HEIGHT 20
BUILDING VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ 2eQoo AMP SERVICE = PROGRESS ENERGY LIII W.R.E.C.
PLUMBING $ v.
MECHANICAL $ 2D oc o VALUATION OF MECHANICAL INSTALLATION
= GAS ROOFING = SPECIALTY = OTHER -�S ✓
FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO CI
I i4
BUILDER I COMPANY
SIGNATURE REGISTERED IY/ N IFEE CURRENT Y N
Address 21!( Qo) License# I C
ELECTRICIAN _p\ COMPANY S ('
SIGNATURE I V REGISTERED Y/ N FEE CURRENT N
Address License#
� �' d'�IVE�2 �OLKiYt/j/N� LLG
PLUMBER �� ��� � COMPANY
SIGNATURE f REGISTERED / N FEE CURRENT Y/N
Address I License# C;FC 4')-(o1 i-1
SIGNATURE MECHANICAL ,T l?t> ? • J • ��,J_� COMPANY c Y/N f IFEFEE"hR t N
Address �(J� License# I
OTHER I COMPANY
SIGNATURE I I REGISTERED I Y/ N I FEE CURRENT IY/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&I dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets 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 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.
IIIIIIIIIIIIIIIIIIIIIIII
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000)
Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner" prior to commencement.
CONTRACTOR'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 IMPRVEMORS TO YOUR PROPERTY IF YOU EY BEFORE RECORDING YOURNT TI D TO ' CONSULT
TICE OF COMMENCEMENT.
WITH YOUR LENDER OR A
FLORIDA JURAT(F.S. 117A3) 7
CONTRACTOR
OWNER OR AGENT Subscribed and wor affirme efor is
Subscribed and s (or affirm
f th o by
N by o is/are personally kno o me or has/have produced
Who is/are personally k wn to me
identi have produced F - as identificatioZbtgn.
Notary Public
Commission No
Commi
Commission DD 734406 Commission DD 734406
Name * e 9 Name of Notary Br4wthnitroyl0 a' 7019
Florida Energy Efficiency Code For Building Construction
Florida Dep meet f Community Affairs
EnergyGauge FLA/COM 2004 v3.00 -- Form 400A-2004
Method A: Whole Building Performance Method for Commercial Buildings
Effective December 8, 2006
PROJECT SUMMARY
Short Desc: Dazzlin Donuts Description: Dazzlin Donuts
Owner:
Addressl: 5131 Gall Blvd. City: Zephyrills
Address2: State: Florida
Zip: 33542
Type: Dining: Cafeteria/Fast Food Class: Renovation to existing buildi
Jurisdiction: ZEPHYRHILLS, PASCO COUNTY, FL(611600)
Cond Area: 3870 SF Cond&UnCond Area: 3870 SF
No of Storeys: I Area entered from Plans 3870 SF
Permit No:' 79�// Max Tonnage 5
If different,write in:
5/19/2008 EnergyGauge FLA/COM 2004 v3.00
Compliance Summary
Component Design Criteria Result
Gross Energy Use 5,862.8 5,888.9 PASSES
LIGHTING CONTROLS PASSES
EXTERNAL LIGHTING None Entered
HVAC SYSTEM PASSES
PLANT None Entered
WATER HEATING SYSTEMS None Entered
PIPING SYSTEMS None Entered
Met all required compliance from Check List? Yes/No/NA
IMPORTANT NOTE: An input report of this design building must be submitted
along with this Compliance Report.
5/19/2008 EnergyGauge FLA/COM 2004 v3.00 2
CERTIFICATIONS
I hereby certify that the plans sp cific . s cover d by this calculation are in compliance wi the
Florida Energy Code
Prepared Building Official: //f "
Date 5 C' Date:
I certify that this building is in compliance with the FLorida Energy Efficiency Code
Owner Agent: Date:
If Required by Florida law, I hereby certify(*)that the system design is in compliance with the FLorida
Energy Efficiency Code
Architect: Reg No:
Electrical Designer: Reg No:
Lighting Designer: Reg No:
�1 c+ CA- o Sg7j?j
Mechanical Designer: cl �r Reg No:
Plumbing Designer: Reg No:
(*) Signature is required where Florida Law requires design to be performed by registered design
professionals. Typed names and registration numbers may be used where all relevant information is
contained on signed/sealed plans.
5/19/2008 EnergyGauge FLA/COM 2004 v3.00 3
Project: Dazzlin Donuts
Title: Dazzlin Donuts
Type: Dining: Cafeteria/Fast Food
(WEA File: Tampa.tmy)
Whole Building Compliance
Design Reference
Total 99.33 100.00
$5,863 $5,889
ELECTRICITY(MBtu/k 99.33 100.00
Wh/$) 116789 117543
$5,863 $5,889
AREA LIGHTS 11.66 9.07
13720 10665
$689 $534
MISC EQUIPMT 0.97 0.97
1134 1134
$57 $57
PUMPS&MISC 0.05 0.05
52 52
$3 $3
SPACE COOL 40.17 37.60
47226 44200
$2,371 $2,214
VENT FANS 46.47 52.31
54657 61492
$2,744 $3,081
Credits & Penalties (if any): Modified Points: = 99.33 I PASSES I
External Lighting Compliance
Description Category Allowance Area or Length ELPA CLP
(W/Unit) or No.of Units (W) (W)
(Sqft or ft)
None
5/19/2008 EnergyGauge FLA/COM 2004 v3.00 4
Project: Dazzlin Donuts
Title: Dazzlin Donuts
Type: Dining: Cafeteria/Fast Food
(.WEA File: Tampa.tmy)
Lighting Controls Compliance
Acronym Ashrae Description Area No. of Design Min Compli-
ID (sq.ft) Tasks CP CP ance
PrOZoISp1 8 Food Service-Leisure Dining 1,679 1 1 1 PASSES
Pr0Zo2Sp1 8 Food Service-Leisure Dining 2,191 1 1 1 PASSES
PASSES
Project: Dazzlin Donuts
Title: Dazzlin Donuts
Type: Dining: Cafeteria/Fast Food
(WEA File: Tampa.tmy)
System Report Compliance
PrOSyl System 1 Constant Volume Air Cooled No. of Units
Single Package System< 1
65000 B /hr
Component Category Capacity Design Eff Design IPLV Comp-
Eff Criteria IPLV Criteria liance
Cooling System Air Cooled<65000 Btu/h 13.00 13.00 8.00 PASSES
Cooling Capacity
Air Handling Air Handler(Supply)- 0.80 0.90 PASSES
System-Supply Constant Volume
Pr0Sy2 System 2 Constant Volume Air Cooled No.of Units
Single Package System < 3
65000 Btu/hr
Component Category Capacity Design Eff Design IPLV Comp-
Eff Criteria IPLV Criteria liance
Cooling System Air Cooled<65000 Btu/h 13.00 13.00 8.00 PASSES
Cooling Capacity
Air Handling Air Handler(Supply)- 0.80 0.90 PASSES
System-Supply Constant Volume
PASSES
5/19/2008 EnergyGauge FLA/COM 2004 v3.00 5
Plant Compliance
Description Installed Size Design Min Design Min Category Comp
No Eff Eff IPLV IPLV Hance
I None
Water Heater Compliance
Description Type Category Design Min Design Max Comp
Eff Eff Loss Loss Hance
None
Piping System Compliance
Category Pipe Dia Is Operating Ins Cond Ins Req Ins Compliance
]inches] Runout? Temp [Btu-in/hr Thick [in] Thick [in]
[F] .SF.FJ
I None I
5/19/2008 EnergyGauge FLA/COM 2004 v3.00 6
Project: Dazzlin Donuts
Title: Dazzlin Donuts
Type: Dining: Cafeteria/Fast Food
(WEA File: Tampa.tmy)
Other Required Compliance
Category Section Requirement(write N/A in box if not applicable) Check
Infiltration 406.1 Infiltration Criteria have been met
System 407.1 HVAC Load sizing has been performed
Ventilation 409.1 Ventilation criteria have been met EJ
ADS 410.1 Duct sizing and Design have been performed
T&B 410.1 Testing and Balancing will be performed
Motors 414.1 Motor efficiency criteria have been met
Lighting 415.1 Lighting criteria have been met LJ
O&M 102.1 Operation/maintenance manual will be provided to owner
Roof/Ceil 404.1 R-19 for Roof Deck with supply plenums beneath it EJ
Report 101 Input Report Print-Out from EnergyGauge FlaCom attached?
5/19/2008 EnergyGauge FLA/COM 2004 v3.00 7
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SOUTHEAST DESIGN INT. INC-PRMT#7841-REMODEL INTERIOR-5131
GALL BLVD
SQ. FEET PRICE
MAIN OR LIVING: 3,900 $ 55.79
OTHER AREA UNDER ROOF: - $ 91.00
OTHER: - $ -
VALUATION $ 217,581.00
FEE SHEET $ 834.00
ADDRESS
DRIVEWAY
BUILDING: $ 850.68
ELECTRICAL: $ 187.65
PLUMBING: $ 125.10
MECHANICAL: $ 87.57
SUB-TOTAL $ 1,251.00
RADON: $ 39.00
TOTAL $ 1,290.00
SEWER: $ -
WATER: $ -
IRRIGATION: $ -
TOTAL: $ - N/A
WATER METER: $ - N/A
IRRIGATION METER[$ - N/A
FIRE DEPARTMENT FEES
PLANS TOTAL: $ 232.20 denial 1st review fee
PLANS TOTAL: $ 464.40 approved 2nd review fee
INSPECTION TOTAL: $ 30.00
PERMIT TOTAL
TOTAL: $ 726.60
PUBLIC SAFETY IMPACT FEES
POLICE $ -
FIRE $ -
5% $ -
TOTAL: $ - N/A
SUB-TOTAL $ 2,016.60
PARK IMPACT FEES $ - N/A
SIF'S: $ -
100.0% $ -
1.0% $ -
TOTAL: $ - N/A
TIF'S : $ - N/A
99% $ -
1% $ -
TOTAL: $ 2,016.60
SQ. FEET PRICE
MAIN OR LIVING 3,900 $55.79
OTHER AREA UNDER ROOF - $94.00
OTHER - $-
VALUATIO $217,581.00
FEE SHE $834.00
ADDRES
DRIVEWA
BUILDING' $850.68
ELECTRICAL $187.65
PLUMBING $125.10
MECHANICAL: $87.57
SUB-TOTAl $1,251.00
RADON: $39.00
TOTAl $1290.00
SEWER $- Il ll rr, I"
WATER $-
V �
IRRIGATION $-
TOTAL. $-
WATER METER: $-
IRRIGATION METE - 1`
FIRE DEPARTMENT FEES
PLANS TOTAL
INSPECTION TOTAL
PERMIT TOTALI
TOTAL:
PUBLIC SAFETY IMPACT FEES
POLICE $-
FIR $-
5% $-
TOTAL. $-
SUB-TOTAL $1,290.00
PARK IMPACT FEES
SIF'S $-
100.00/ $
1.00/ $
TOTAL $-
T I F'S 5-
990/ $
10/ $
TOTAL: $1.290.00
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.: Zti Contractor. .Say - /
Business Name: L tt bO(J .4S Billing Address: 2j cI J
Business Address: C i3 . C la
Business Phone No.: Billing Phone No.:
Business Fax No.: Billing Fax No.: 0f2Z__
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
ite Plan Annual N/C Sprinkler $50 1st Alarm N/C
Mufti-Family/Commercia .06 sf 1st Re-inspection N/C Standpipes $50 2nd Alarm N/C
(Minimum Charge$ . 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C
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
0-25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150
26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- perank $50
STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100
Per Riser $50 Hydrostatic Test $65 per system Fire Works $500
FIRE PUMP Acceptance Test $45 per system Camp Fire $25
Per Pump $100 Hydrant Flow $75 Controlled Bum $100
FIRE ALARM SYSTEM Hood/Duct $50
8 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 Waste Tire Storage $50 Annual
Dry $50 Fire WallSmoke Wall $15 perwall Generator<KW $100
CO2 $50 LP Gas $25 per tank 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 a Exhaust Hood/Duct $30
Natural Gas Installation $50 Re-inspection DBL
(Per System) (other than annual)
Spray Booth $50 Inspection scheduled DBL
and cancelled less than
24 hours
Construction Insp. N/C
Emergency Vehicle Act $50 FALSE ALARM
PLANS TOTAL j INSPECTION TOTAL! PERMIT TOTAL!____ TOTAL
2JZ GRAND TOTAL /+ I 14
Comments: 4 Ii 5ll/h Zee-x-. //jet AG ��-SG.Sr�•Cs�
Date:__________
Insrctor: ?' d14Aø14_,I
05/28/2008 12:00 3526285619 INSURANCE DEN PAGE 01/02
ACORD CERTIFICATE OF LIABILITY INSURANCE DAT2(MMIDpIYYYY)
05/28/2008
°°erg`Insurance Dan,Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
5447 S oakridge Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5447 S ssa FL 34446 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Phone:352-628-2331 Fax:352-828-5819 INSURERS AFFORDING COVERAGE NAIC#
INSURED _...... ...._. ..�
Rumore's Electrical Services, Inc. INsuRER&BANKERS
Vinny Rumore INSURERS; -
3829 Biscay Place INSURER C:
LAND O LAKES FL 34639 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 PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
— — POLK:YEFECTIVE POUCYEXPIRATION --
PDLXwNUMBER PATE( Irn LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000
X COMMERCIAL GENERAL LIABILITYDAMAGE TO
PREMISES1Es�aocNOMA�_ $
A CLnIM3MADE OCCUR MBDEXP(/�anpnraonl 9 5,000
_... .. -, ...... 09-00005326704-3-01 05/09/7.008 05/09/2009 PERSONAL A ADv INJURY $ 1,000,000
GENERALA@OREGATE $ 2,000,000
GEN'LAGGREGAT'E UN PLIES PER: "
•. PRODUCTS-COMMOPAGG 3 1,000,000
X POLICY j PRO Ti L°C -._...-.
FIre Demaga 100.000
AUTOMOBILE LIARII,ITV
COMBINED SINGLE LIMIT
ANYAVTO (EnaorJdnnl)
ALLOWNED AUTOS -'""'"
BODSCHEDULED AUTOS (Per
el ft) 3
HIRED AUTOS -
NON-OWNED AUTOSBODILYINJURY
(PerncckMM)
-- PROPERTY DAMAGE
(Parammen1)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
:R ANY AUTO
OTHER THAN EA ACC 3
AUTO ONLY: AGG S
RRCESSIVMBRELLALIABILITY EACH OCCURRENCE S
OCCUR Li CLAIMS MADE AGGREGATE $
DEDUCTIBLE -- $
RETENTION S
WORKERSCOMPSIONAND WCSTATU- OTH•
EMPLOYERS'LIABILITY QS E __
ANY PROPRIETOWPARTN91RI"ECI.rTIVE E.L.EACHACCIDENT
OFFICERIMEMDCR EXCLUDED?
IF e,donailbe Mlder E.L.DISEASE•EA EMPLOYEE S
9 EC AL PROVISIONS below El.DISEASE-POLICY UNIT E
OTNfiR
DESCRIPTION OP OPERATIONS!LOCATIONS I VEHICLE'S/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
AS RESPECTS OPERATIONS OF INSURED
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OP THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1U DAYS WRITTEN
South East Design
813-780-0021 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.OUT PALURE TO DO SO SHALL
1 I v L IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESSINTATIAM.
AUTOO REPRESENTATIVE
ACORD 25(2001/08) ACORD CORPORATION 1988
May 28 08 09:38a PARESH PATEL 4078779515 p.1
SPI MECHANICAL
762 HOMEGROVE DRIVE
WINTER GARDEN FL 34787
407 - 383 -4669 (PHONE)
407 - 877 - 9515 ( FAX )
FACSIMILE TRANSMITTAL SHEET
TO: FROM: PARESH PATEL
COMPANY: - L` DATE: i% _� P 2
FAX NO: ; ` _ TOTAL PAGES W/COVER:
PHONE NO: - L' -i ATT:
NOTES/ COMMENTS:
May 28 08 09:38a PARESH PATEL 4078779515 p.3
Earl K. Wood, Tax Collector Local Business Tax Receipt Orange County, Florid;
'his local business tax receipt is in addition to and not in lieu of any other tax required by law or municipal ordinance.Businesses are subject to regulation ofzoning,health and othi
awful authorities.This receipt is valid from October bO through September 30 of receipt ear.Delinquent penalty is added October 1.
ORIGINAL** EXPIRES ►3012008 5O00-0541865
5000 BUSINESS OFFICE 530.00 1 EMPLOYEE 1804 CERT MECHANICALCONTRACTOI $30.00 1 EMPLOYEE
PATEL PARESH R QUALIFIER
TOTAL TAX SE0.00
PREVIOUSLY PAID $60.00
TOTAL DUE 50.00
JAY JAGDAMBA CORPORATION
PATEL PARESH R
762 HOMEGROVE DR
WINTER GARDEN 34787-6501
762 HOMEGROVE DR (MOBILE)
U-WINTER GARDEN,34787
PAID: 560.00 98-340573 8/6/2007
This receipt is official when validated by the Tax Collector.
City of Winter Garden
110 Henderson Street,Winter Garden,Florida 34787
Occupational License
LICENSE MUST BE POSTED IN CONSPICUOUS PLACE AT ALL TIMES
Business Name: SP1 MECHANICAL Location: 762 HOME GROVE OR
License No: 07-00003751 Class: #IECHANICAUMVAC CONTRACTOR
Issue Date: August 14,2006 Expires: September 30,2007
License/Add'tl Tax: 86.00 0.00 Penalty: 0.00
Total: 0.00 Restrictions: MUST COWLYNRH NONE OCCUPAl10N REOUREYENTS
Comments:
SPI MECHANICAL
JAY JAGDAMBA CORPORATION(DBA)
762 HOME GROVE DR LOT 9
WINTER GARDEN FL 34787
Authorized Signature
May 28 08 09:39a PARESH PATEL 4078779515 p.4
03-21-2007
ALEX SINK STATE OF FLORIDA
cmEFF MCIALOFFII DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' CONDENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 08/31(2006 EXPIRATION DATE 08130/2008
PERSON: PATEL PARESH R
FEIN: 061653630
BUSINESS NAME AND ADDRESS:
JAY JAtt>iDAMBA CORPORATION
DBA SPI MECHANICAL
762 HOME GROVE DRIVE
WINTER GARDEN FL 34787
SCOPES OF BUSINESS OR TRADE
1- MECHANICAL CONTRACT 2- HEATING & AIR CONDITIONING
IMPORTANT: Pursuant to Chapter 440 . 05114). F.S., am officer of a carporatioe who elects exemption trod this chapter by filing a canilicete of election ender this
section may oat recover benefits or comptosetioa Bader this chapter. Purseal to Chapter 440.06112). F.S., Certificates of election to he exempt.., apply only within the
scope of the business or trade listed an the notice of election to be exempt. pursuant to Chapter 440.05(151, F.S., Notices of election to be exempt end certificates of
election to be exempt shall be subject to revocation if. at any Lime alter the filiep of the notice or the issuance of the certificate, the person eased on the entice or
certificate No longer seats the regeiremems of this section for issuance of a certificate. The department shall revoke a certificate at any time tar tailere of Ike person
named an the certificate to Well the reoairesents of this sectloa. QUESTIONS? (850) 413-1609
OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA IMPORTANT
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION O Pursuant to Chapter 440.051141. F.S., an officer of a corporation who
CONSTRUCTION INDUSTRY elects exemption from this chapter by filing a certificate of election
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA L under this section may not recover benefits or compensation under this
WORKERS'COMPENSATION LAW D chapter.
EFFECTIVE: 08/31/2006 EXPIRATION DATE: 08/30/2008 Pursuant to Chapter 44(105(12), F.S, Certificates of election to be
PERSON: PARESH R PATEL H exempt. apply only within the scope of the business or trade listed on
FEIN: 061653630 R the notice of election to be exempt
BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 44205(13). F.S., Notices of election to be exempt
JAY JAGDAMBA CORPORATION and certificates of election to be exempt shall be subject to revocation
OBA SPI MECHANICAL if, at any time after the filing of the notice or the issuance of the
762 NOME GROVE DRIVE certificate, the person named on the notice or certificate no longer meets
WINTER GARDEN, FL 34787 the requirements of this section for issuance of a certificate. The
department shall revoke a certificate at any time for failure of the
SCOPE OF BUSINESS OR TRADE person Railed on the certificate to meet the requirements of this
I- MECHANICAL CONTRACT 2- HEATING & AIN CONDrTtONING Section.
QUESTIONS? (850) 413-1609
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
DWC-252 CERTIFICATE OF ELECTION TO 13E EXEMPT REVISED 09-06
May 28 08 09:38a PARESH PATEL 4078779515 p.2
STATE OF FLORIDA
DEPARTMENT OP BUSINESST ND piôFssIomi REGULATION.
CDNST tUC1`SON;INE3IISTRY iICSNSING BOARD -SEQ#L0,60611A0044`,`
•. LICENSE NBR
06/11/2006 1058092113 CMC1249308
The MECHANICAL CONTRACTOR_' =_
Named below IS CERTIFIED
Under the provisions of Chapter 489 Ps.
Expiration. date: AUG 31, 2008
PATEL, VARESE R
JAY .JAGDANBA CORPORATION
762 HOME GROVE DRIVE
. . . .WINTER GARDEN FL:=•34787,
JEB BUSH SIMONE MARSTILLER
GOVERNOR SECRETARY
DISPLAY AS REQUIRED BY LAW
May 28 08 09:39a PARESH PATEL 4078779515 p.5
ACORQ. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDM/)
11 13/2007
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
OVIEDO INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
120 N. CENTRAL AVE. STE. E HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
OVIEDO FL 32765 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
407-971-9090
INSURERS AFFORDING COVERAGE
INSURED SPI Mechanical NSURERA Progressive Insurance Co n
y
Jay Jagdamba Corporation dba INSURERS: Old Republic Surety Coepany
762 Nome Grove Drive INSURERc: American Vehicle Insurance C
any
Winter Garden FL 34787 INSURER D:
407-383-4669
INS JRER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN.THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IHSR I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY EACH CCCUF4 ENCE $ 1.000,000
X COMMERCIAL GENERAL UABILITY FIRE DAMAGE(Ivry cne fre) $ 100,000
CLABAS MADE OCCUR MED EXP(Any one person) $ 5,000
C 510511045276-1 11/26/2007 11/26/2008 PERSONAL&ADVINJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GERV L IW^GREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
X POLICY PRO LOO
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO (Ea aooidenq S
ALL OWNED AUTOS
X SCHEDULEDAL'TOS BODILY INJURY S
(Per person) 50,000
8 HIRED AUTOS 02328179-3 10/03/2007 10/03/2008
NON-OWNED AUTOS BODILY:NJURY
(Per accident) 100,000
er cR accident) S DAMAGE 50,000
GARAGE LIABILITY
AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC S
AUTOONLY: AGG $
EXCESS LIABILITY
EACH OCCURRENCE S
OCCUR CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE
$
R=TENTICN S
$
WORKERS COMPENSATION AND T Y LIMA O
EMPLOYERiS,LIABILITY I
E.L.EACH ACCIDENT S
E.L.DISEASE.EA EMPLOYE
OTHER
E.L.DISEASE-POLICY LIMITS
USINESS SERVICES BOND LIMIT 5,000
B OFL-0551569 07/28/2007 07/28/2008
DESCRIPTION OF OPERATIONS/LOCATION5/VEHICLE5 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Heating/Air-conditioning/Refrigeration Sales, Services and
Installation
CERTIFICATE HOLDER f I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOWDANY OF TIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Ci Of Z DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
53 5 8th SStt T11 l NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL
Zepltyrhi l is FL 33542 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR
Fax: 813-780-0024 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25-S(7/97) ID CORD CORPORATION 1988
May 24 08 11:08a p.3
10!08/2007 13:56 3526295619 INSURAN- Ut_n
oe
ACORD„ CERTIFICATE OF LIABILITY INSURANCE 10 oo7
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFO TIRMAON
PRooucEnlnsuranee Den,Inc ONIY AND CONFERS NO IEGNTa UPON THE CERTIFICATE
DrivICLOEL THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
5447 S OakrlLge 446 THE c GE AFFORD®BY THE POLICIES BELOW.
fjO�BSgO FL 34446
INSURERS AFFORDING COVERGOE NAILS y
Phone:352.62&2331 F10c 352-828-5819 1 D 5ANICER3
tNIURED Rumore's Electrical Services. lnc_
INgURPJ1JC
Vinny Rumore INS<1R RG
3829�5 Biscay Place aruRSRa --
LAI� O LAKES FL 34639 INstMERE:
COVERAGES _
THE POLICIES OP INBURMNC!UBTED BELOW HAVE!EE'I ISSUED TO THE INSURED NAMED ABOVE FOR TW POLICY PERICf R�IGATED.NOTWITMSTANDANY R EMENT,TERM OR CONOI11ON OF ANY CONTRACT MJ
MAY PERTAIN TI18 INSURANCE ORDER B THE POLICES D OESCRISBO DOCUMENT
l4BREIiL IS SUBJECT TO 011 TM!RMS,EXC USION8 AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LOST?SHOVNJ MAY HAVE BEENRBDUCEO$Y DAB_y CLAIMS w
w _ POLICY 1.OOD.600
6ACNOCCURRENCL
at ER .ITT
X CaMUMMALGENERN.LMOITIv dip M>•ttelianl ��
!�OLAM/AMAAE OCWR P ` AADYINJURY S .•._. 1 00D.000
09.00005326704-3-01 0510912 7 5!09!2006 ALAOC t 2 0 0
.COMPIatAss i 1,060,000
GENT.AGCRECAT4_LlM(Y AM"A*PER' dire D9 OO 000
X POLICY PAo-
AUrOMODILEuAWLITY M SIHQlEL11MT'
0NYAVToOOll. .••.-
ALL CWNWAM03 Y
(Pttl TllSI1 —..... s... -..�
LiC11E0W.6a AUTOG
BODILY WUAY
NOTED AUTOn {p/*/CetdsTli ;
NOKOWNEC AUTOS
PROPER Y DAMAGE
.- IP.►oan+Mu
GARAOEWMLRY AUTO OILY-EAACCIDJOIT S
ANY AurD EAACC S
OTFERTNAN
AUTD ONl.Y. AGG
EACHOCCURR6VCE S
DJ OVA"IMLALYWII.IIY
DCCUR EJ CLAMP.SNir,A AC+@R0!.lt
i
OQfUCTIHI.E —
i
ETA'TIDN $ we ATU• OTM-
EM worn A*Q$MKIIJ1V 1 AND 0$Y
EMPLOYERS'10%'Al
E.LEACHACGnR S
ANY PR CAR IE'IONPARTNERA'ytWAMYC E1.DISEASE-BAPaMLOY5E S
OPFICERMIeIIDER EXCWOED7 ---"" "
U ,diicr*ot td N^ E1.DlSEICIE.peuc'rLXNIf b
OTHiR
atS.A'1IDN OP OPtTItATIONS I LOCAnWIS I VENCLES f EJtGl.U1ION*ARSE BY aOORSOI[NT rSP ECWL IMDVtSl0NB
AS RESPECTS TO WORK PERFORMED BY INSURED.
CLVtTIFICATE HOLDER CANCELLATION
/N00{,O AMT OFT11E R601IBDE$CRlt≥DPOLICI05 t>E CAR�7JJL0 F6wgi T1Iq iXPIRAT+ON
OATS TNEREOP.THE"WOPMLi M IIIER WILL EMO"v0R TO MAIL 10 CAYB OYRRIEII
NONCE TO TNR CIyl I CATS NOLOWI N1MPb To TIE LEFT.DUI'PAILURO TO D0 SO%BAIJ.
IMPOSE ND OBNOATWN ER UAIRJIY OP ANY KU)UPON TKE JE$JIl61.ITS 101111$OR
REPRE$EMTATNI.
AOTNOROED114RE9QRTATIYQ (y/��_/- ^
ACORD 25(2001108) C ACORD CORPORATION 1958
May 24 08 11:07a p.1
STATE OF FLORIDA
-DEPARTMENT OF BtlSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395
1940 NOR= MONROE STREET
TT;a ►e3ggg FL 32399-0783
RUMORS, YINNXB D
RUMORES ELECTRICAL SERVICES INC
3829 BISCAY PL
LAND 0' LAKES FL 34639
------........ ... . ._.. _ ... _ •_ STATE ra oRin+►. AC# 2 7 -
DEPARTMENT OF.BUSINESS :END
PROF83OMAL 12RLATION
ER13013579 08f17/06 050809474
BBCi. ELECTRICAL. CONTRACTOR'
,iLUMORE, VIED.:
• BIIIiORES:ELECTRICAL SERVICES INC. .
(INDIVIDUAL MUST MEET ALL LOCAL
• LICEESXMG REQUIREMENTS PRIOR
•,TO" CONTRACTING IN ANY :,AREA):.
$AS RZGXSTERED'ue.r the prov a3oms of;:Ch 489
ipLrati :e.ee::AUG:31, .2008 LOGOOi. SO2.3O
DETACH HERE
STATE OF FLORIDA`'
DEPARTMENT O BUSINESS AND PROFESSIONAL REGULATION
E CTRT ',i, CONTRACTORS LICENSING 80 SELo6a81 0oi3o:
- L2C�ifS$ r3�B8
70717Z1006 050809474 lERi3O .3579
The ELECTRICAL CONTRACTOR -
Named below HAS REGI BRED ..
Under the provisions of Chapter 489 PS.
8xp .rat Ofl dale•, AUG 37 2 1 ::
3 t
(INDIVIDIIAL==MUST:::MEEfi AFL thCAL. IrIC i3ING
REQUIREMENTS PRIOR TO CONrBACTING,'IN 1Q7C ARRA)
RUMOR$,. VINNIE.D" r' .
RUMORES ELECTRICAL SERVICES INC
3829 BISCAY PL. _
LAND O' ' LAKES -FLr 34639
.... JEB 'BUS
NiR3TILI:ER
GOVERNOR SECRETARY.
. t]tSPLAYA3 REQUIRED BY LAW
May 24 08 11:07a p.2
t -- UEvR.OPM EW LK .ING DT
OFFICE DSPLAY GAA�
CEll1RC.A7E OF COMPETBVCY DEVELOPMENT REVIEW SERVICES DEPT
CONTRACTOR LICENSING
cc CERTIFICATE OF COMPETENCY
ID:# G 5rr r^� E R —OSS79
V D RUMOR E � t?sS�i►r22 F_R —O S8i79
C.C_
ELECTR I 3NTRACT OR Be it known that
HAVING METIHE COIuPE'T@ICY REQU EM FQR ; ELECTR I t r A
THE LICENSETEf M EXPIRING. 9/30/09 '
i
LA FL 4 -9
--------------------------------- -
[T SHALL BE THE RESPONS1BiUTY OF THE UNDER SE C._18 PA�SCO COUNTY CODE HAS(u,Ei THE
LICENSEI`To KEEP ALL INSURANCE,SONDS, P EON •OR A CERTIFICATE OF COMPETENCY
ADDRESSES AND PHONE NUMBERS CURRENT'
PO940740h1J .:
3e c'. b'-c ^rl`.}.t`S : f-" - iF- J FBI- z x!S& 'rCP C' 33110',G..e i.TVf�..tl .J:u['C9.'!'
-...'.IylfT:O I=' 31j'':^=?�Si uE r- ..r_x. t fit r,�_:Y' b isi
a i
ACCOUNT NO 66507 _ . TYPE OF BUSINESS--
SIC CODE= 1731.x,2 ELECTRICAL CONTRACTOR
LOCATION ADDRESS:
3829 BISCAY PLACE
LAND .0 LAKES
RUKORES ELECTRICAL SERVICES. IN
3829 BISCAY PLACE DATE RECEIPT A4lOUNT..
LAUD 0 LAKES FL 34639-4801.
0.7/27/07 527514 31.25:
L:q..t,.LIL.w16LL.dnlaititl* ..dhu:1.tt,i..,..t u
May 24 08 11:08a p.4
05-12-2008
ALEX,SINK STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers Compensation law.
EFFECTIVE DATE: 05/12/2008 EXPIRATION DATE: 05/12/2010
PERSON: RUMORE VICENZINO
FEIN: 204771258
BUSINESS NAME AND ADDRESS:
RUMORE'S ELECTRICAL, SERVICES INC
3829 BISCAY PLACE
LAND 0' LAKES FL 34099
SCOPES OF BUSINESS OR TRADE:
1- REGISTERED ELECTRICAL CONTRACT
IMPORTANIT. Panacea to Cbapler 440 . e51t41, F.S., se otflar al a rvrponl(a■ who olaets sampUau from Ibis caplet by IOitg ■ undlkats of eIeclioa uedet this
sectfml may not rotator Mnalits er taroponmioq a■der this chapter. Pursuant to Chapter 440.05(121. F.S., Cenilledoe of sledmn N be exempt... apply only vithia the
scope al the haziness or wade listed an no Mtta at elettloa Ic be exempt. Putnam la Cbtptar 440.0511* F.S., PolIces of election to he exempt and carliticates of
election I■ be exempt shelf be subject ea mvaatiau it, ar soy tlma titer the filly of the aetia II tko Issuance at the attitkate, the parse■ aanad our the aatiee or
eerlittcale our laa,er meets the reaulraNas at alz sectias tar iszu■oc2 of a cedificate. The department shell revoke a cerlelcme at arty hue tar failure of the person
named an the certlftcNe to meet the regeirpmats of ms seettaa.
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 QUESTIONS? 18501 413-1609
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCML SERVIC AI .. F IMPORTANT
DIVISION
ON INDUSTRY S Cs O Pwsotett to Chapter 440.05114), F.5, an officer of a corporation who
C ELECriON TO BE E7t19W+r FROM FLORIDA L elects exemption from this chapter by filing a certificate of election
WORKERS'COMPENSATION LAW under this section may not recover benefits or compensation under this
D chapter.
EFFECTIVE 06/12/2008 EXPIRATION DATE: 05/12/2010 Pursuant to
PERSON VICENZINIO RUMORE H Chapter within the, F.S., ftificates of election to to be
exempt.. apply only within the scope of the business or trade listed on
FEIN: 204771258 E the notice of election to be exempt
BUSINESS NAME AND ADIJRESS E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt
3829RVMORES
BIS ELECTRICAL SERVICES InIC and certificates of election to be exempt shell be subject to revocation
3829 aISCAV PLACE if, at any time after the filing of the notice or the issuance of 'the
certificate, the person vaned an the notice or certificate no longer meets
the requirements of this section for issuance of a certificate. The
department shall revoke a certificate at any time for failure of the
SCOPE OF BUSINESS OR TRADE person named on the certificate to meet the requirements of this
I- REGISTERED ELECTRICAL CONTRACT section.
QUESTIONS? 1850) 413-1609
CUT HERE
Carry bottom portion on the Job, keep upper portion for your records.
OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
3829 Biscay Place
Land O'Lakes, FL 34639
Phone (813) 996-7217
Fax(813) 996-7092
Cell(813) 695-5733
Lic. #ER-13013579
May 27, 2008
To whom it may concern,
Vinnie Rumore is the only authorized person to pull permits for Rumore's
Electrical Services, Inc..
Vinni Rumore
STATE OF FL RlUi
COUNTY OF t(.C'!
The foregoing instrument was acknowledged bef
me this&t day of 2O
by �( 1 personally known to
me or who has cad as
identifica
fjitNotary Public,State of Florida
Commission#DD 550507
My comm.expires May 14,2010
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus (813) 780-0041
Kerry Barnett Fax (813) 780-0044
May 8, 2008
Plan Review Comments
I have reviewed and disapproved the plan for an interior remodel located at 5131 Gall
Blvd Dr due to the following reasons. My comments have been placed below. Please
contact me if you have any questions with regards to my comments.
1. 2 hour fire separation shall be installed between the upper level storage and the
lower level assembly area. A UL listing shall be used. 1 hour rating will be
allowed if upper level has a sprinkler system in accordance with NFPA 13, 2007
edition. NFPA 101, Table 6.1.14.4.1
2. Panic hardware required on side exits.
3. Address front of building, 6" minimum.
4. Install smoke detectors in all storage related rooms and un-used areas. Detectors
shall be hardwired with battery backup and tied together.
5. No storage is allowed in unused area or in utility room.
6. Certified fire extinguisher Class K required in kitchen area. Certified ABC
extinguisher required to be in the unit.
7. 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'.
8. Door 2 shall have an exit light. Door 3 shall have a combination exit/emergency
light. Main door shall have a combination exit/emergency light. Exit lights
outside and inside the storage room and utility room need to be removed. Can not
exit through these rooms.
9. Seating capacity per NFPA 101 Table 7.3.1.2 limits this area to approximately 15
14-15 people with tables and chairs.
10. Trash compartment gates/doors shall be of a non-combustible material.
11. Ventilation/heat removal hood(non-grease) shall be installed over convection
oven and proof box oven. Plans and permit required from contractor installing
units. This shall include all details, cut sheets, etc.
12. Install emergency lights in front handicap bathrooms.
13. Plans and permit required from contractor for installation commercial
grease/exhaust hood over fryers. This shall include all details, specs, cut sheets,
etc.
2
-14. Plans and permit required from contractor install suppression system for
grease/exhaust hood. All calcs, details, specs, cut sheets, etc. required with plan
submittal.
15. Access shall be provided in all un-used space both on ground level and upper
level.
16. Stairs for upper level shall be compliant to the code.
17. GFI's shall be located anywhere within 6' of water.
18. Electrical panel shall not be obstructed. 36" required to sides and front.
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.: S f
Plan No.: Contractor ��T �
Business Name: t i' Billing Address: 2- CD+4((S L_a�S
Business Address: (3\ t + S
Business Phone No.: Billing Phone No.: * .?--4'—
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
8 Site Plan N/C Annual N/C Sprinkler $50 1st Alarm N/C
Multi-Family/Commercial .06 sf 1st Re-inspection N/C Standpipes $50 2nd Alarm N/C
3V6 (Minimum Charge$25.00 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C
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
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 per system Camp Fire $25
fl Per Pump $100 Hydrant Flow $75 Controlled Bum $100
FIRE ALARM SYSTEM Hood/Duct . $50
8 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 , Waste Tire Storage $50 Annual
Dry $50 Fire Wall/Smoke Wall $15 per wall 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 10'x10'or greater $15 per tent Torch Pot/Applied $50
OTHER Fire Pump $45 Haz.Materials $100 Annual
LP Installation per tank $50 Fire Suppression $30
Fuel Tank Installation $50 System Acceptance
❑ (Per Tank) $50 Exhaust Hood/Duct $30
Natural Gas Installation $50 Re-inspection DBL
(Per System) (other than annual)
Spray Booth $50 Inspection scheduled DBL
and cancelled less than
24 hours
___ RConstruction Insp. N/C
Emergency Vehicle Aoi $50 FALSE ALARM
PLANS TOTAL____L� /(� INSPECTION TOTAL I_34:)— PERMIT TOTAL TOTAL
GRAND TOTAL
Comments:
Date: S __
Inspgctor: / -r'7
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus (813) 780-0041
Kerry Barnett Fax(813) 780-0044
May 21, 2008
Plan Review Comments
I have reviewed and approved the revised plan for an interior remodel located at 5131
Gall Blvd Dr due to the following reasons. My comments have been placed below.
Please contact me if you have any questions with regards to my comments.
1. 2 hour fire separation shall be installed between the upper level storage and the
lower level assembly area. A UL listing shall be used. 1 hour rating will be
allowed if upper level has a sprinkler system in accordance with NFPA 13, 2007
edition. NFPA 101, Table 6.1.14.4.1. The process submitted shall show it meets a
2 hour rating in accordance with the UL listing.
2. Door 2 shall have an exit light.
3. Ventilation/heat removal hood(non-grease) shall be installed over convection
oven and proof box oven. Plans and permit required from contractor installing
units. This shall include all details, cut sheets, etc.
4. Stairs for upper level shall be compliant to the code. Stairs shall maintain the 2
hour rating between lower level and above ceiling.
Inspections Required:
1. Fire rating/Fire walls( screw inspections and finals required—if using suspended
tiles cut sheet showing they are rated shall be supplied to the fire marshal at time
of inspection—also all material used with suspended ceiling shall also have cut
sheets that shows they are rated)
2. Separate inspections based on separate permits (hood and suppression)
3. Building Final
TRANSACTION REPORT P . 01/01
MAY/ 13/MAY/ 13/2007/SUN 01 : 27 PM
FAX (TX) U
# DATE START T. RECEIVER COM.TIME PAGE TYPE/NOTE FILE
01 MAY/13 01: 26PM 818636446507 0:00:47 2 OK ECM 6814
ti
Zephyrhills Fire Rescue
6907 Dairy Road,Zephyrhills, FL 33542
Fire Marshal Bus(813)780-0041
Kerry Barnett Fax(813)780-0044
mays, 2008
Plan Review Comments
I have reviewed and disapproved.the plan for an interior remodel located bet 5131 low. Please
l
Blvd Dr due to the following reasons. My comments have been placed
contact me if you have any questions with regards to my comments:
1. 2 hour fire separation shall be installed between the upper level storage and the
lower level assembly area. A UL.listing shall be used. 1 hour rating will be
allowed if upper level has a sprinkler system in accordance with NFPA 13, 2007
edition.NFPA 101, Table 6.1.14.4.1
2. Panic hardware required on side exits.
3. Address front of building, 6"minimum.
4. Install smoke detectors in all storage related rooms and unused areas.Detectors
shall be hardwired with battery backup and tied together.
5. No storage is allowed in unused area or in utility room.
6. Certified fire extinguisher Class K required in kitchen area. Certified ABC
extinguisher required to be in the unit.
7. 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'.
8. Door.2 shall have an exit light.Door 3 shall have a combination exit/emergency
light.Main door shall have a combination exit/emergency light.Exit lights
outside and inside the storage room and utility room need to be removed. Can not
exit through these rooms. roximatel 15
9. Seating capacity per NFPA 101 Table 7.3.1.2 limits this area to app y.
14-15 people with tables and chairs.
10. Trash compartment
installed removal
hobf material.
11.Ventilation/heat od(non-grease) shall be stall d over convection
oven and proof box oven. Plans and permit required from contractor installing
units. This shall include all details, cut sheets, etc.
12. Install emergency lights in front handicap bathrooms.
13.Plans and permit required from contractor for installation commercial
grease/exhaust hood over fryers. This shall include all details, specs, cut sheets,
etc.
May-22.2008 02:08 PM Air West A/C Inc 7272397918 4/4
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M" CERTIFICATE OF LIABILITY INSURANCE I5/512000
COUCPIR I THMS CET ATh d t6SuED AS A MATTER OF INFORMA1i1ON
INSL13tl+,>!i^CJ r OILY ANO MO RIIaHT3 UPON THE CERTIFICATE
>i§
364 Ehrlich Rd #78 s HOLDER. CERI1FI�CATE DOES NOT ,AMEND, EXTEND OR
'2►mpeL, ALTER THE TH GE AFFORDED B' E P0U "EE BELOW.
FTa 33524
(813)855-9BB8 INS!lRERS AR ORODIG CO WE IMAM
;URFD .i81.irw st IL/C, Ina *IIJ1ERA
INSURER U;
23.13. SuTrnyda.1 Blvd. #3 INSTIR_R a
C.3aax�oat-tar, PL 33765 IN&RRER 0:
721-725-5052 1I SURER E:
VERA rE
THE POLICIES OFF INSURA.NCB LISTED 6i`+LOIRr HAVE BEEN 1S U TOTHE rt1SUR T P4fDABOVl OR THE POIJCY PERIOD INDICATEa tNOTWRH3TANDlNG
aNY 1i•EUUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER 13000MENT WITN IWT TO WHICH TN6 C RTfl 1CATT MAY BE ISSUED OR
WAY PERTAIN,711E IWSURA)1OEAFFDRp@p BY THC POLXS UE=IBED t•IEREM1a SUBJECT TO L THE TERMS.I?XCLU51ON5 AWCI COIV(>fTi0NB OP•BUGH
POUO1ES.AGAP.EGATSLIMITSSHOV114 MYMAVEBEEMREDUCEDBYPAIDCLAIMS.
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XI corAmaRam aerre u,Lm L87Y njuem ray oee�r.nee s 100,000
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Lakeland, Fl 33813 NQTIC TA THti Cf flROATE H0Lbeee N'tw s-THE l EFT.BUT FA*JJRE To DO Bo SliaL
Sax 863-644-0257 IMPOSE NO 0BU IOW OR LIABQITY OP)tMY KIND UPON T+1R II 1L trs AMTS OR
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AUTHORIZED
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1bRt]Z5(3DII1I08) ; 8ACOPO OORPORATION 1280
b/Z 8i6L6£ZLZL 3UI 3/V ;SOM JLV Wd LO:ZO 80OZ-ZZ-' W
FROM :THE CAMPBELL AGENCY FAX NO. 8502343505 May. @5 2008 @9:31AM P2
ACO CERTIFICATE OF LIABILITY INSURANCE 5/55i 008
PRDDueeR THIS CER FICATE IS ISSUED AS A MATTER OF INFORMATION
Wbrkcomyp 8 ecialists ONLY AN CONPIR6 NO RIGHTS UPON THE CERTIFICATE
P 0 BOX 9495 HOLDER, IS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER TH COVERAGE AFFORDED 8Y THE POLICIES BELOW.
Panama City Beach, FL 32417
(800) 508-9126 INGURERB A FORDING COVERAGE NAICS
INSURED AIR WEST A/C, INC. INSURER A: A .-.
INBUP,SR D
2111 8UZ4NYDALE BLVD, STE 8 INsuaER c
CLEAIPATER, FL 3765 INSURER 0 —
(727) 725-5052 INSURER COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW NAVE RUEN 188UBO TO THE INSURED NAMID ABC E FOR THE POUCY PERIOD INDICATED.NOTWTHSTANDING
ANY REQUIREMENT,TERM OR CONDITION CF ANY CONTRACT OR OTHER DOCUMENT WITH R ISPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT I ALL THE TERMS,EXCWSION9 AND CONDITION&OP SUCH
POLICIES,AGORE:BATE LIMITS BHONM MAY HAVE SEEN REDUCED BY PAID CIAI MS.
POLICY NUMBER OATS D OdYlCTh6 UMITS
GENERAL LIAEILITY EACH OCCURRENCE 8
OOMMMCIALGINORALLIABILITY ippI
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POLICY PRO- LOC
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A ICOIAO ER BroOiuee�oiMaurn�
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OESCRIPTIONOFOPERATIONS(LOCATIONS!VEHIOL.lS!!XCI,UIICNIADOEOBY'!I.100RSEMGNTIBPECIALPROVIS S
CERTIFICATE HOLDER CANCELLATIO
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1256 STRAYTON DRIVE DATE THEREOF. IEISSUING INEUROR N1LL GNCMAVOR TO MAL^DAYS WRITTEN
LAIND, FL 33813 N1O4 TO THB 0.RflPI0ATE HOLDUR NAMED TO THE LEST,BUl MANJJR!TO DO Bo SHAD_
IMPOSE NO 09111 AT1ON OR LIABILITY OP ANY KIND UPON THE INSURER ITS AOENTB OR
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FAX COVER SHEET
TO: Patel Construction OM: Pino Mastrota
FAX# (813) 780-0021 AGES 4 cumnva co
PHONE #: ATE: 05/22/08
Documentation for Ze hyrhills job.
X_URGENT--FOR REVIEW -PLEASE COMMENT _PLE SE REPLY -PLEASE RECYCLE
Here is the paperwork you asked for.
Respectfully,
Pino Mastrota Cell#727-543-4272
Senior Bid Estimator
2111 Sunnydale Blvd. Suite B, Clearwater, Fl 33765 Pho a (727) 725x5052 Fax (727) 239-7918
State License CAC05 1739
b/T 8t6L6£ZLZL OuI 3/d ISOM v Wd L0:Z0 800Z-ZZ-' W
NOTICE OF COlYIlVIENCEMENT I
IIIIIVIIIVIIIVIII(Ili)VIII(III)VIIIIIIIIVIIIIIIIIIII
2008077229
Permit No.
Property Identification No. ( I �' (� '" Z Oo @ — I 0O-oo 3o
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 Statutes,the following information is provided in this NOTICE OF COMMENCEMENT_ vF Z,Ee i -Ji.us f f3 1 F - 5.t+ 1. -rs -6 i NcL B(oak
I.Description of property(legal description:) Ic OIZ ?7$6 6- 7
a)•Street Address: fl 3I. L f3 Lv7 •• y t tL
2.General description of improvements: yTcyZi
3.Owner Information r —
a)Name and address: v J.YI V�3taL1 ?{-01, N b)Name and address of fee simple titleholder(if other than owner)
• c)Interest in property
•4.Contractor Information r��� '1.5 I �. .t a w
a)Name and address: �C h Uk 1- �_ i/ icon i�l C • e 1 1 3'3 a'1 j
b)Telephone No.: R i;,cxt_ (li J Fax No. t.
5.Surety Information
a)Name and address: j_'14-
b)Amount of Bond:
c)Telephone No.: Fax No.(Opt.) Rcpt: 1182130 Rec: 10.00
6.Lender i DS: 0.00 I T: 0.00
a)Name and address: 05/22/08 Dpty Clerk
Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be
a)Name and address: Sa.- A c-I . S y ,�,;k6 1.l C. n.Is" served: 1' ' y
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: _ �Q► .s %1 l ;� �o
-b)Telephone No.: ��, tfT�3.� .Fax No.(Opt.) _ tp N-0
9.Expiration date of Notice of Commencement(the expiratioih date is one year from the date of recording unless a different date is Z m�
specified): QD/y�oo3
• ZZ
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,. a o
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. - F,
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST M c
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE.OF COMMENCEMENT. �° —4
STATE OF FLO auw ANGEL L. MEPIDOZA (� ( ►�c,
COUNTY OF P CCU Y P u��� N*. d Fwwel0l
Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager X
Commhatlon Expiroa Oct 24,2010
�. Col mialm 8 DD 606523 1 FI �T�" _ ��
„it. BaldedTtm0Nef WNofe_ PnatName .
The foregoing instrument was acknowledged before me this J2 day of _ ' _,20th ,by hfi,`(i I e l'
as 0 Ui (type of authority,e.g.officer,trustee,attorney
in fact)for ' �oa✓l�,t-f'q_ , (name of party on behalf of whom' e t was executed).
Personally Known OR Produced Identification ✓ Notary Signature
Type of Identification Produced (1a+nc�Ct Do7JE'�'1 1"i5 Name(print) \. L /6c �ZCi..
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.
1. .yvv } 1 fti(G'k`T
Signature of Natural Person Signing Above
FORMSINOC,rvsd2007
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT ON Flit
OR OF PUBLIC RECORD IN THIS OFFICE.WITNESS MY
HAND AND OFFICIAL SEAL THI DAY OF
2
JED PITTMAN ERK OF CIRCUIT COURT
BY DEPUTY CLERK
Pasco County Parcel: 11-26-21-0010-18500-0030 001 Page 1 of 2
Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Questions
Other Parcel Cards: 1 1 2
Other Agency Data: Tax Collector School Board Supervisor of Elections
Data Current as Of: Weekly Archive - Saturday, May 03, 2008
Parcel ID 11-26-21-0010-18500-0030 (Card: 001 of 002)
Classification 11 - Retail Stores, One Story, All Types
Mailing Address Assessment (totals)
BBHARTI INVESTMENTS INC Ag Land $0
2151 SOUTHERN OAKS LN Land $54,180
LAKELAND, FL 338133197 Building $65,479
Physical Address Extra Features $1,572
5131 GALL BLVD
ZEPHYRHILLS, FL 33542-4963 Total Assessment $121,231
Legal Description (First 4 Lines) Save Our Homes $0
CITY OF ZEPHYRHILLS PB 1 PG 54
LOTS 3-6 INCL BLOCK 185 Taxable Value $121,231
OR 7786 PG 974
Land Detail (Card: 001 of 002)
Line Use IlDescriptionhi Zoning Units Type IL Price Condition Value
1 1100 IISTORE 1FLRII 00C2 7,000.00 II SF II $6.24 II 1.00 fi $43,680
2 1100 IISTORE 1FLRII 00C2 7,000.00 I $1.50 Q 1.00 $10,500
Additional Land Information
Acres 0.32 Q Tax Area 30ZH FEMA Code IJ X IlCommerical Code M3012AS
Building Information - Use 11 - Retail Stores (One Story) (Card: 001 of 002)
Year Built 1948 Stories 1.0
Exterior Wall 1 Corrugated Metal Exterior Wall 2 None
Roof Structure Steel Frame or Truss Roof Cover Min Roof(Corr. or Sh M)
Interior Wall 1 Masonary or Minimum Interior Wall 2 None
Flooring 1 Finished Concrete Flooring 2 None
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 2.0
Line II Description I Sq. Feet I Repl. Cost New
1 FST I 1,680 $61,404
2 II SDA 720 $52,632
Extra Features (Card: 001 of 002)
Line Description Year Units Value
1 PAV ASP 1948 833 $169
2 CLFENCE 1948 ii 1,000 $353
3 UDU-M 1996 1 $1,050
Sales History
Previous Owner BUTTERFIELD WAYNE COOPER
Year Month Book/Page Type Amount
2008 03 7786 / 0974 WD $235,000
2006 10 7252/0639 WD $128,700
2001 10 4749/_1099 WD $0
Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Questions
http://appraiser.pascogov.com/search/parcel.aspx?sec=11&twn=26&rng=21&sbb=0010&bl... 5/7/2008
SOUTHEAST DESIGN INTERNATIONAL INC.
2151 SOUTHERN OAKS LANE, LAKELAND, FL- 33813
TEL:(863)409-6422 FAX:(863) 644-6507
DATE: 27 JULY 2008.
To,
Fire Marshall,
City of Zephyrhills,
Florida.
Ref: Dazzlin' Donuts 5131 Gall Blvd. Zephyrhills, Florida.
Dear Sir,
As per our site meeting, we would like to make following adjustments to our
approved plans as under:
1. The owners agree to use the space above the restaurant only as attic
space and not storage. It will be used only to access any repairs to
mechanical equipments and its ducts. The owner also agrees to label the
access door to the attic area so that the attic will never be used as
storage area.
2. The attic area will be sealed tight to prevent any smoke or fire entering
into it from kitchen area and shall be available for inspection prior to final
occupancy.
3. The sketch and detail for storage room and its UL number rating is also
attached per your request for review and information.
If you have any question please call Bipin Patel at 863-409-6422.
Thanking You,
, Sincerely Yours,
BI PATEL.
BBHARTI
INVESTMENTS INC .
"A DAZZLIN' DONUTS ENTERPRISE"
2151 Southern Oaks lane, Lakeland Florida 33813.
Date: 27 July 2008.
To,
The
Fire Marchall,
City of Zephyrhills,
Zephyrhills, Florida.
Ref: Use of attic space at Dazzlin' Donuts, 5131 Gall Blvd in Zephyrhills. .'7 SLf I
Dear Sir,
We as owners of the dazzling donuts agree to use the space above restaurant
only as attic space and will label the area so that it can never be used as any
storage space.
Thanking You,
Sincerely Yours,
Bharti Patel
BBharti Investments Inc.
m
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Jacqueline Boges
From: Kerry Barnett
Sent: Wednesday, May 27, 2009 10:42 AM
To: Jacqueline Boges
Subject: RE: dazzling donuts
If the Bldg Dept will is charging then we will charge,otherwise I believe a letter stating that no changes are being made
from original plan review would be fine.
Kerry Barnett
Fire Marshal
Zephyrhills Fire Rescue
Zephyrhills, Fl 33542
813-780-0041
(c)813-714-6326
kbarnett(a fire.zephyrhills.fl.us
From: Jacqueline Boges
Sent: Wednesday, May 27, 2009 8:37 AM
To: Bill Burgess; Kerry Barnett - f j -2�
Subject: dazzling donuts ) I
Lm
Dazzling Donuts permit will expire on June 15th 784 Gall blvd the contractor wants to know would he have to resubmit
new plans to finish job once he get the finance o it?
Jackie Boges
Code Support Specialist
ext. 3513
1
Jacqueline Boges
From: ' Bill Burgess
Sent: Monday, June 01, 2009 9:40 AM
To: Jacqueline Boges; Kerry Barnett
Subject: RE: dazzling donuts
We would not need an update due to the fact that all phases of construction have been installed and inspected under
the 2004 code. Kerry may require a set on the installation of the kitchen equipment and fire suppression systems if
applicable.
From: Jacqueline Boges
Sent: Wednesday, May 27, 2009 8:37 AM
To: Bill Burgess; Kerry Barnett
Subject: dazzling donuts
Dazzling Donuts permit will expire on June 15th 7841 Gall blvd the contractor wants to know would he have to resubmit
new plans to finish job once he get the finance to do it?
Jackie Boges
Code Support Specialist
ext. 3513
1
CITY OF / / / / BUILDING
ZEPHYRHILLS DEPARTMENT
OF ADDITION OR CORRECTION
ADDRESS DAT PERMIT,,
cT7I L5 2v5 L " l1
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
will be accepted.
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' i Dri - &t4rS j ( r
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 780-0020 FOR RE-INSPECTION
or other material,until the proper inspector has had ample time to approve
the installation.
OFFICE HOURS 7:30 AM-4:30 PM MON.-FRI. INSPECTOR
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