HomeMy WebLinkAbout08-8084 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8084
BUILDING PERMIT
Permit Number: 8084 Address: 7839 GALL BLVD
Permit Type: SIGN ZEPHYRHILLS, FL.
Class of Work: FREE STANDING SIGN Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost: 6,730.00 ,
Date Issued: 7/18/2008 Name: MICROTEL/JAMM HOTELS,LLC
Total Fees: 132.50 Address: 7839 GALL BLVD
Amount Paid: 132.50 ZEPHYRHILLS, FL. 33542
Date Paid: 7/18/2008 Phone:
Work Desc: REMOVE CHANGABLE COPY FACE AND REPLACE WITH EMC/LED
j1 _1 _JJII__AJc
SPEARS CONSTRUCTION AND CONSULT SIGN 97.50 ELECTRICAL FEE 35.00
FARLEY ELECTRIC SERVICE
FOOTER
ELECTRICAL ROUGH
FINAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when extra inspection
trips are necessary due to any one of the following reasons: a)wrong address b)condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
CONT TOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/H omeowner: L Y 6M'
SK J
Date Received: 2 Z D yU
Site: 7J3 9 (',q ff
Permit Type: e
Approved w/no comments:❑ Approved w/the below comments: ❑ Denied w/the below commen2jts:
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This comment sheet shall be kept with the permit and/or plans.
Kal Switzer—Pl Xaminer Date Contractor omen er
(Required when comments are present)
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021.
Building Department it
Date ReceivedI.
Phone Contact for Permittin t/tOwner's Name 341P,1_ oTE LS),�L-L-C- Owner Phone Number7 '7 3-
Owners Address 'd�I S7 l i K �A/ C.
Owner Phone Number ____
Fee Simple Titleholder Name „//i r vll 1 7� 'L_l— Owner Phone
eeJNNummbfer
Fee Simple Titleholder Addresa `r', / r�Y/LG /` hd2 /T'-�'/ F -31451
JOB ADDRESS x18.39 j,4/.J BLVd ZPhVR/�iLLS FL3335VI LOT# I
`'/�
SUBDIVISION PARCEL ID# 5'/-2S Z/ !M/6-O,7 -e/O
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEWCONSTR B ADD/ALT SIGN = MOVE = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION BLOCK /��L Pl'C/�FRAME Q STEEL Q OTHER
DESCRIPTION OF WORK I�-��/ll�G é/'r .+ C.B - i4e,- wt 'n C L1ED
BUILDING SIZE I I SQ FOOTAGE HEIGHT
BUILDING $
ALUATION OF TOTAL CONSTRUCTION
ELECTRICAL AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
PLUMBING $ l
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION l�C
= GAS = ROOFING = SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS I
FLOOD ZONE AREA =YES =NO
BUILDER COMPANY f2�y:yL/`-✓ C-Q1JSC.A�t;Y� ! l. S 4-/�I�C"'
SIGNATURE t_ _.� REGISTERED TE Y/ N FEE CURRENT �►Y/N
+4 Address V (//r �tst�7GI"lz License# I e4e
ELECTRICIAN COMPANY �� - �l `
SIGNATURE I ()� /REGISTERED' Y/ N FEE CURRENT Y/N N
6 ,J
Address G � 51 License# I 22 3
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address I License#
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address 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)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.
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" 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 ID-OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOT.1bF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRALTO
Subscribed and sworn to(or affirmed)before me this sworn r f d) t
by
Who is/are personally known to me or has/have produced 's/are personally known o me or has/have pr duced
as identification. as identification.
Notary Public Notary Public
Commission No. Co ion No.
,.�,vimr C BENNM
Name of Notary typed,printed or stamped Name of Notary typed,printed or st ptll �•�v1'K DD533183
vecrr,0r EXIPIRES:Aug.30,20W
(107)396-O133 Florida Notary Service coo
STATE OF FLORIDA 1111111111111111111111(lIIIIII1111111HIIIIIII1111111111111
COUNTY OF PASCO 2008092193
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE Rcpt:1187832 Rec: 10.00
OR OF PUBLIC RECORD IN THIS OFFI TNESS MY DS: 0.00 IT: 0.00
HAND AND OFFICIAL SEAL THIS DAY OF 06/20/08 Dpty Clerk
2
JTTPN,C OF UIT URT JED PITTMpN, PRSCO COUNTY CLERK
B PUTY CLERK NOTICE OF COMMENCEMENT 06/20/08 12:18pm 1 of 1
OR BK 7866 PG 678
Permit No.
Property Identification No. 3 2s s2/ i)D ID O/70' "" 9O/0 e 2)' 00/0
0/O F O Z
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.
Fi.esrlf u''L3 L# b3 P81P({S nau77i7
I.Description of property(legal /i<1/LS oiJyGb).N DC-SG /+'1 A't"Af WT
a)Street Address: Tb'� P�L
2.General description of improvements
3.Owner Information
a)Name and address: ?K1MM IHoeL5 (.ee. 3/x181 &Sf (aka IRd. Ilea. 1 Im Herber. FL 3'Uo$5
b)Name and address of fee simple Mrlehold.�a(if other than owner)
c)Interest in property ou..te.r
4.Contractor Information
a)Name and address:4V •5 h 5T/,yR L FL-
b)Telephone No.: [.3325III—Od)94 Fax No.(Opt)h: c2) 3F' 7 /321.51
5.Surety Information
a)Name and address: N/A
b)Amount of Bond:
c)Telephone No.: Fax No.(Opt)
6.I.ender
a)Name and adds ss: Co I o&I t ,.( BAA (. N A t t,r�O Ner'tt. $IVA West Lees b tare FL 3W7'
-b
Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a)Name and address: iMar a NeL,1 '�4O l Quill C1 hP4lm ith rlovrr FL. 3 W/o SS
b)Telephone No.: '7V7 4 S. 2LII Fax No.(Opt) ,Z7 el 34-'2 a Z
8.In addition to himself owner designates the following person to receive a copy of the Lienor's Notice as provided to Section
713.13(1)(b),Florida Stables:
a)Name and address:
b)Telephone No.: Fax No.(Opt)
9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date is
specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,
FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF shoos
Signature o Owner or or Owner',Autha.ized OlCieer /PartnedManager
Mara er ee 1. N1.n a IV
TiPfgregoing ins neq wawiedge4. efçre me this aday of XW_ _2O ,by
(type of authority,a-g.o ,trustee,attorney
in fact)fo (name of party on behalf of m
Personally Known_OR Produced Identification,L Notary Signature
Type of Identification Produced C. Name(print) C�
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
Signature of NlI4Psrao.1 Signing Above
,Y r.,.. MA.RC D.LAWRENCE
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JACK 33570,FLOR
PH IDA
.ICENSE NO.
ONE NO.352.787.6161
715 BAI—MORAL CIRCLE
s r FS13URG,FL 34748 f
NEW LED CHANGEABLE COPY SIGN TO REPLACE EXISTING
MANUAL CHANGEABLE COPY SIGN. EXISTING SIGN 32 SF
IN AREA, NEW SIGN TO BE 39" X I 15", 31 . 15 SF.
NO CHANGE IN TURNING MOMENT 5O ENTIRE SIGN REMAINS
IN ACCORDANCE WITH 2004 FL BLDG CODE Wit-IT 2000 REVISI NS ApR 22
AT I JO MPh WIND LOAD
,,,MID-FLORIDA SAL :3/8- _ ► -o-
SIGN & GRAPHICS PROPOSED MICROTEL INN LED 3602 Parkway Blvd Leesburg,FL 34748
352-787-3882.352-787-9427(F ) SIGN - Z P I-i YRI1 I LLS
0408- 1
■dhayes@mdiflsigns.com
6
Pasco County Parcel: 34-25-21-0010-01700-0010 001 http://appraiser.pascogov.com/search/parcel.aspx?sec=34&twn=25&r...
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 10, 2008
Parcel ID 34-25-21-0010-01700-0010 (Card: 001 of 002)
Classification 39 Hotels, Motels
Mailing Address Assessment (totals)
JAMM HOTELS LLC Ag Land $0
36181 EAST LAKE RD #102 Land $464,246'''
PALM HARBOR, FL 346853142 Building $1,796,498
Physical Address Extra Features $78,867
7839 GALL BLVD
ZEPHYRHILLS, FL 33541-4317 Total Assessment $2,339,611
Legal Description (First 4 Lines) Save Our Homes $0
ZEPHYRHILLS COLONY COMPANY
LANDS PB 1 PG 55 PORTION TR 17 Taxable Value $2,339,611
DESC AS COM AT NELY COR LOT 1
ZEPHYRHILLS SUPERCENTER PB 42
Land Detail (Card: 001 of 002)
Line Use Description 1 Zoning Units Type Price Condition Value
1 3900 HOTELMOTEL I 00C2 11,000.00 SF $10.00 1.00 $110,000
2 3900 HOTELMOTEL 00C2 39,000.00 SF $9.00 1.00 $351,000
3 3900 HOTELMOTEL ', 00C2 2,497 00 SF $1.30 1.00 $3,246
Additional Land Information
Acres 1.21 Tax Area 30ZH FEMA Code - Commerical Code OPAR2AC
Building Information - Use 39 - Hotels Motels (Card: 001 of 002)
Year Built 2004 Stories 3.0
Exterior Wall 1 Above Average Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Carpet Flooring 2 None
Fuel Electric Heat Forced Air- Ducted
A/C Window Unit Baths 24.0
Line Description Sq. Feet Repl. Cost New
1 BAS 26,674 $1,863,179
2 UST 72 $2,026
3 CAN 293 $6,147
Extra Features (Card: 001 of 002)
Line Description Year Units Value
1 PAV ASP 2004 18,760 $12,663
2 SWC 2004 1,950 $2,925
3 POOLCON 2004 352 $11,264
4 COOL DK 2004 1,312 $4,487
5 PVCF LF 2004 168 $553
6 LIGHTSM 2004 2 $3,655
7 LIGHTDM 2004 5 $10,320
8 ELEVATR 2004 1 $33,000
I of 2 5/13/2008 1:29 PM
Pasco County Parcel: 34-25-21-0010-01700-0010 001 http://appraiser.pascogov.com/search/parcel.aspx?sec=34&twn=25&r...
Sales History
Previous Owner BINGHAM JAMES H & KURLANDER R
Year Month Book/Page Type Amount
2003 11 5656/ 1062 WD $380,000
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
2 of2 5/13/2008 1:29 PM
Map-Pasco County Property Appraiser http://maps.pascogov.com/maps/showmap.asp?Name=PascoMap_N...
Pasco County, Florida '2.7 miles of Zephyrhills
25 21 0010 00100 001
When I click on the map: 1 ,, 441 00/0 00100 00110
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Image Size / Quality:
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Links of Interest:
Recent Sales in this area N
Search for property in Pasco 900 Feet
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MapID# 2826605
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I of 1 5/13/2008 1:32 PM
04/10/2008 17:03 7279398852 HOSPITALITY PLUS PAGE @1101
//AMID-FLORIDA
SIGN & GRAPHICS
3602352-787-3862Pq 352-787-9427 (FAX) PROPOSAL
April 8, 2008
Marian Goodman
SKY Hospitality, LLC
36181 East Lake Rd.#102
Palm Harbor, FL 34685
PROJECT: MICROTEL INN&SUITES—ZEPYHRHILLS, FLORIDA
Mid-Florida Signs&Graphics proposes to perform the work listed below for the price of SIX
THOUSAND FOUR HUNDRED EIGHTY AND NO11 00 DOLLARS($6,480.00):
A. FURNISH AND INSTALL one(1) used double sided RED LED Electronic
Message Center. Message Center to be 39"x 115", slightly smaller than the
existing manual changeable message center. Remove existing sign, install LED
sign and hook up to existing electrical. Provide new communication pigtail wiring
connection system so that LED sign can be changed with a laptop computer at
site. A person will have to manually hook up the computer to the sign to unload
and change messages when required.The LED sign has its own internal
computer for continuous operation. Install a photocell on main ID sign to
electrically separate the ID sign from LED sign. The LED sign must be
energized at all times for cooling fans,etc,and operationally controlled by the
computer. This sign should be allowed by the City as it is smaller than what is
existing. No Permit anticipated, if one required then cost to be added as
applicable.
TERMS: 50% DEPOSIT, Balance Due UPON COMPLETION; Sales Tax INCLUDED
Mid-Florida Signs&Graphics is a full-service electrical and architectural sign company providing
service around Central Florida. We are a UL-listed company, and perform all work In accordance
with the 2004 FBC with revisions and supplements and to the NEC(2008 ed.).
Thank you for the opportunity to present this proposal. We look forward to working with you in the
near future.
Signed _ Accepted/By
Todd Hayes,Vice Presiders Named
Date O� )6 17666 Date-1 —(o-4
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BILL HOLT INSURANCE 382 826 8627 06/12/08 04:4Spm P. 002
CERTIFICATE OF INSURANCE
The company indicated below certifies that the insurance afforded by the policy or policies numbered and
described below is in force as of the effective date of this certificate. This Certificate of Insurance
does not amend, extend, or otherwise alter the Terms and Conditions of Insurance coverage contained in any
policy numbered and described below.
CERTIFICATE HOLDER: INSURED:
CITY OF ZEPHYRHILLS RONALD D FARLEY
BUILDING DEPT DBA<FARLEY ELECTRIC SERVICE
5335 8TH STREET P.O. BOX 490633
ZEPHYRHILLS, FL 33542 LEESBURG, FL 34749-0633
I 1 POLICY NUMBER I POLICY I POLICY I LIMITS OF LIABILITY I
TYPE OF INSURANCE I & ISSUING CO. IEFF. DATE IEXP. DATE I (*LIMITS AT INCEPTION) I
LIABILITY 177-AC-661832-0001 05-01-08 05-01-09 1 I
[X] Liability and NATIONWIDE I I Any One Occurrence........ $ 1,000,000
Medical Expense J MUTUAL FIRE I 1 I I
[X7 Personal and I INSURANCE CO. I I I Any One Person/Org ....... $ 1,000,000
Advertising Injuryl I I I I
[X] Medical Expenses I I I ANY ONE PERSON $ 5,000 I
[X] Fire Legal I I I Any One Fire or Explosion $ 100,000
Liability 1 I I I
I 1 I I General Aggregate* ....... $ 2,000,000
I I I J Prod/Comp Ops Aggregate* . $ 1,000,000
J C 1 Other Liability I I I I
I I
AUTOMOBILE LIABILITY I I
I [ :1 BUSINESS AUTO I J I Bodily Injury
I I I I I (Each Person) .......... $
] Owned I I I (Each Accident) ........ $
[ 1 Hired 1 I I Property Damage I
I f. ] Non-Owned I J 1 (Each Accident) ........ $
I I I I I Combined Single Limit ..__ $
I I
EXCESS LIABILITY i I I Each Occurrence .......... $
I I Prod/Comp Ops/Disease
I I Umbrella Form I I Aggregate* ............. $ I
I 04-01-08 04-01-09 STATUTORY LIMITS
[X] Workers' I FU BA A I BODILY INJURY/ACCIDENT ... $ 1,000,000
Compensation 11 0634863 I I Bodily Injury by Disease I
and I I EACH EMPLOYEE .......... $ 1,000,000 I
[X] Employers' I I Bodily Injury by Disease
I Liability I I I POLICY LIMIT ........... $ 500,000
Should any of the above described policies be cancelled before the DESCRIPTION OF OPERATIONS/LOCATIONS
expiration date, the insurance company will endeavor to mail VEHICLES/RESTRICTIONS/SPECIAL ITEMS
written notice to the above named certificate holder, but failure to
mail such notice shall impose no obligation or liability upon the
company, its agents, or representatives.
Effective Date of Certificate: 05-01-2008 Authorized Representative: Bill HOLT INS A122247
Date Certificate Issued: 06-12-2008 Countersigned at: 32703 RADIO ROAD
LEESBURG, FL 34788-3908
FARLEY
ELECTRIC
w SERVICE
Letter of Authorization
To Whom It May Concern:
I, Ronald D. Farley, owner and license holder for Farley Electrical Service grant authority to Tim
Wainscott to apply for, sign for, and pick up permits for me from the City of Zephyrhills, Florida.
Rona rD�,..FF e
Farley Electric Service
State Lic No. EC0002293
P.O. Box 490633
Leesburg, Fl 34748
Office (352) 787 5960
Mobile (352) 636 8585
Contractor
r� �, Subs ri d worn to rmed) e t
Who ts/ ersonally kno to me or has/have produced
�/�—^ ^ as identi cation.
t I
N ��` 1 JANISE C BENNETT
MY COMMISSION#DD555183
Commission No t Oe EXPIRES:Aug.30,2010
(407)398-07 53 Florida Notary SWCe.Com
Name of Notary typed,printed or stamped
Stamp
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
`°a TALLAHASSEE FL 32399-0783
SPEARS, ALLEN WAYNE
SPEARS CONSTRUCTION AND CONSULTING LLC
3815 CHRISTINA TERRACE
LADY LAKE FL 32159
- r
STATE OF FLORIDA AC# 32' 22 8 1 L4
D-SFARTMLN.T.OF BUSINESS AND
PROFESSIONAL REGULATION
CGC1513G60 05/23/07 060720950
CERTIFIED: GENERAL CONTRACTOR
SPEARS, ALLEN WAYNE
SPEARS CONSTRUCTION AND CONSULTI
IS CERTIFIED wader the provisions of Ch.489 rs
srzpirstion deb AUK 31 2008 L07 05 2 3 0 0116
DETACH HERE
AC# 3228142 STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING-BOARD SEQ#L0705230011E
.. - LICENSE' NBR
105/23/20071060720950 CGCI513-TG6O
The GENERAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2008
SPEARS, ALLEN WAYNE
SPEARS CONSTRUCTION AND CONSULTING LLC
3815 CHRISTINA TERRACE
LADY LAKE FL 32159
CHARLIE CRIST HOLLY, BENSON
GOVERNOR DISPLAY AS REQUIRED BY LAW -SECRETARY
SF FJ'i
June 12, 2008
City of Zephyrhills—Building Department
5335 8th Street
Zephyrhills, Florida 33542
Re: Authorization Letter for Tim Wainscott
To Whom It May Concern:
This letter is to provide authorization for Tim Wainscott to have all powers to sign
documents and pick up permits for any purpose as they apply to the Microtel Inn and
Suites located at 7839 Gall Blvd, Zephyrhills, Florida 33541-4317.
The critical information for my License is as follows;
License Holder: Allen W. Spears
License Number: CGC 1513660
Qualified Business: Spears Construction and Consulting, LLC
Qualified Business Number: QB55217
Signed,
Allen W. Spears
President/CEO of Spears Construction and Consulting, LLC.
State of:
County of:
to (or ffirm and subscribed before me this I v day o , 20k, by
(name of person making state ent)
Fti�rok ?:'llr dr FsENNIrTT
s M t D WMISSION#DD555183
GI to EXPIRES:Aug.30,2010
(407)ns-0153 Florida N0WY Servic&Com na re of Notary u lic-State of
ary e
(Name of Notary;Typed,Printed of Stamped)
Personally Know rx�or Produced Identification
Type of Identification Produced
5II)TRS C0USTRUCTI0IT 6 C00SULTIITG.LLC • 3002 Fri KWP1T D0ULIVfRD SUITI 1 LIISDURG.ILORIDii 31140 • TILIIl10fl (332)314-0000 IiTCSII1ILI(332)314-0001
06/12/200809:07 CONSTRUCTION INSURANCE CORP - 13523140097 NO.432 101
Client#:325g7 SP@ARcONST
ACORDrM CERTIFICATE OF LIABILITY INSURANCE I
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Construction Insurance Corp ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2110 Herschel Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
Jacksonville,FL 32204 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
904 388-1988 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER k Amerlsure Insurance Co
Spears Construction 8 Consulting LLC
3602 Parkway Building,Suite I INSURER B:
Leesburg,FL 34748 INsuRERC:
INSURER O:
INSURER E:
COVERAGE$
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 DESCR19ED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER LILY EFPEC POLICY
M LIMITS
A GENERAL LIABILITY GL2044997 05102/0$ 05/02/09 EACH OCCURRENCE $1000000
X COµMERCIALGENERII��ALLIABILITY AMAGET R O s30Q000
(:[.AIMS MADE CE OCCUR MED EXP(Any one Person) 610 000
k1 BIk!Additional Ins PERSONAL A ASV INJURY $1,000,000
kj Blkt Waiver of Sub GENERAL AGGREGATE s2,000,000
GENT AGGREGATE LIMIT APPLIES PER; PRODUCTS OOMPIOP AGO $2,000,000
POLICY K P O LOC
A AUTOMOBILE LIABILITY CA2044998 05/02/08 05/02/09
COMBINED SINGLE LIMIT
X ANVAUYa (Eaoccdant) i,000,000
ALL OWNED AUTOS
SCHEOULED AUTOS BODILY INJURY $
(Per Oil—)
X HIREDAUTOS
X NON-OWNED AUTOS BODILY INJURY
(Per ecdd�lll)
(PerracW_,�DAMAGE M
GARAGE LIABILITY
AUTO ONLY-EA ACCIDENT S
ANY AUTO
OTHER THAN EA ACC S
AUTO ONLY: ADO S
A EXCLSSJUMBRELLA UABIUTT CU2044995 05102/08 05/02109 EACH OCCURRENCE s5,000,00o
X OCCUR c:JCLAIMSMADE ADOREOATE $10.000,000
DEDUCTIBLE S
RETENTION $
S
A WORXER8 COMPFNSAI1CN AND S
WC2044994 05102108 05/02/09 K WC sTATu. aTH-
EMPLOYERS LIABILITY
ANY PAOPRIETOR)PARTNERIE%ECUTIVI: E.L,EACH ACCIDENT $1,000,000
OFFICEyMEMBER E>ICLUDEDT
I(yysee,0escnbo untl7l E,L.DISEASE•FA EMPLOYEE$1 000 000
SPECIAL PROD ION66elow E.L.DISEASE-POLICY LIMIT a1,D0D DQQ OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS,VEI'IICLBS!EXCLUSIONS ADOFA BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OP THE ABOVE DS$CRIBED POLICIES BE CANCELLID BEFORE THE EXPIRATION
City Zephyr Hills OATat THEREOF,THE ISSUING INSURER WILL ENDEAVOR T4 MAIL
5335 8th Street �0_ DAYS WRrrMW
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Zephyr Hills,FL IMPOSE NO OBLIGATION OR LJABWTV OF ANY IONp UPON THE INSURER,R5 AGENTS OR
RffikkRRIUIENTATIVEL ^� s,
Al♦M ftft?a
ACORP 25(2081!06)1 of 2 #S72207/M63486
50010 ® ACORO CORPORATION 1988
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