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Home My WebLink About09-9569 CITY OF ZEPHYRHILLS 5335 - 8Th STREET • (813)780 -0020 9569 BUILDING PERMIT Permit Num . er: 9 Address: '3 AVE Permit Type: DEMOLITION ZEPHYRHILLS, FL. Class of Work: 636- DEMOLITION Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14- 26 -21- 0270 - 00000 -00B0 Improv. Cost: „ Date Issued: 9/23/2009 Name: EDGEWOOD ENTERPRISES LLC Total Fees: - EIS i A. , 1 Address: 4531 GALL BLVD Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: r Q rriv r'o ,f Phone: Work Desc: DEMO STRUCTURE- FEE WAIVED PER GB ;1, ' . € o u E , T E , :, spa per, 4._..,y4 _• • •N - VI .I i t 3 _. � w a mss �s ' , #'-: 6 4' ,I r. "a INAL V - •' 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 improv - 1 e, •• • ur property. If you intend to obtain financing, consult with your lender or an attorney • - • - • �• • rding y • r notice of commencement." - ' 1 / 4 , <- CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Pasco County Parcel: 14- 26 -21- 0270 - 00000 -00B0 001 Page 1 of 2 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: II Weekly Archive - Saturday, September 19, 2009 7 Parcel ID 14- 26 -21- 0270 - 00000 -0080 (Card: 001 of 001) Classification II 28 - Rental MH /RV Park I Mailing Address Property Value EDGEWOOD ENTERPRISES LLC Ag Land $0 4531 GALL BLVD Land $235,169 ZEPHYRHILLS, FL 335426236 Building $12,378 Physical Address - See All 32 addresses (First Shown) Extra Features $1,680 38214 C AVE ZEPHYRHILLS, FL 33542 -5706 Market Value $249,227 Legal Description (First 4 Lines) Assessed (Save Our Homes) $0 EDGEWOOD NO 1 UNREC PCL B COM Taxable Value $249,227 SW COR NW1 /4 NOODG 49 53"E 665.36FT N89DG 52'03 "E 1155.28 FT NOODG 35'44 "E 407FT POB N00 Land Detail (Card: 001 of 001) Line II Use IlDescriptionll Zoning II Units II Type II Price II Condition II Value 1 II 0220 I RV PARK Il 00M2 II 33.00 0 UT II $4,447.00 II 1.50 II $220,127 2 II 0220 II RV PARK II 00M2 II 6,000.00 II SF II $1.52 II 1.00 II $9,120 3 II 0220 II RV PARK II 00M2 II 14,100.00 II SF II $0.42 II 1.00 II $5,922 Additional Land Information -- Acres 1.94 Area 30ZH Code Residential Code RRVPCL1 Commerical Code RRVPCL1 Building Information - Use 02 - Mobile Home (Card: 001 of 001) Year Built 1972 Stories 1.0 Exterior Wall 1 Pre - Finished Metal Exterior Wall 2 None Roof Structure Flat Roof Cover Min Roof(Corr. or Sh M) Interior Wall 1 Plywood Panel Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Gas Heat Forced Air - Ducted A/C None Baths 1.5 I Line II Description Q Sq. Feet II Repl. Cost New l 1 0 BAS II 564 II $17,360 3 II FEA II 528 II $13 820 4 II 288 II $1,785 Extra Features (Card: 001 of 001) Line II Description II Year II Units I Vlue 1 II UDU II 1974 II 480 $1,080 2 II UDU II 1974 II 240 II $540 3 II A /C -2 II 1974 0 1 U $60 Sales History Previous Owner II PASCO RENTALS INC Year II Month II Book /Page II Type II Amount 2006 II 06 II 7048 / 0092 I WD II $700,000 11 I I 11 0 http: / /appraiser.pascogov. com/ search /parcel.aspx ?sec= 14 &twn= 26 &rng =21 &sbb= 0270 &b... 9/23/2009 Pasco County Parcel: 14- 26 -21- 0270 - 00000 -00B0 001 Page 2 of 2 2004 11 12 0 6167 / 0714 I 2c I $72,200 2001 II 01 U 4516 / 0366 II WD II $80,000 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections http: / /appraiser.pascogov. com/ search /parcel. aspx ?sec= 14 &twn= 26 &rng=21 &sbb= 0270 &b... 9/23 /2009 Fax- 813 -M - uun City of Zephyrhills Permit Application y, 0 5 o 81 780 0020 Building Department _( 7 • 1 _ Mg: ___ ............. MEM Phone Contact for Permitting __ _____ R eceived • ............ _:___••• -• Owner's Name S- 1—(C Owner Phone Number Owner Phone Number C Owner's Address ' Owner Phone Number Fee Simple Titleholder Name p Fee Sim le Titleholder Address LOT # • 3 Ff2 (Cl /J =1 JOB ADDRESS .04:70 . 0•/I • .0 � IIIIIII IIIIIIIIIIII PARCEL ID# L ( - 2 0 SUBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) D EMOLISH NEW CONSTR e ADD /ALT SIGN Q MOVE WORK PROPOSED e 0 INSTALL REPAIR PROPOSED USE ED SFR =i1 COMM FRAME Q STEEL [ �] OTHER � TYPE OF CONSTRUCTION Q BLOCK .mo o Sir v Gtr/ e- e DESCRIPTION OF WORK � HEIGHT BUILD SIZE 1=== SQ FOOTAGE ................................................................................................. ............................... • ..................................................................................................................................... BUILDING VALUATION OF TOTAL CONSTRUCTIO Q W.R.E.C. 1111M 11111111 AMP SERVICE D PROGRESS ENERGY ELECTRICAL PLUMBING 111.11111111111 VALUATION OF MECHANICAL INSTALLATION MECHANICAL ROOFING ED SPECIALTY Q OTHER GAS =I FLOOD ZONE AREA YES [_]NO FINISHED FLOOR ELEVATIONS COMPANY ® FEE CURRENT Y / N BUILDER REGISTERED _ SIGNATURE License # Address COMPANY ® Y!N ELECTRICIAN REGISTERED FEE CURRENT SIGNATURE License # Address 111111111111111111111111 COMPANY 1110/31 YIN SLUMBER REGISTERED FEE CURRENT SIGNATURE License # Address COMPANY MECHANI REGISTERED Y / N FEE CURRENT Y / N SIGNATURE License # Address _ Ut G CS ,�s t S"G✓ Y / N OTHER COMPANY Cross Q REGISTERED Y / N FEE CURRENT SIGNATURE C /55 76 License # C Address � RESIDENTIAL Attach m teno(0aworkiing Building date. Required onsite, Construction tr e Plans, Stormwater Plans w/ Silt Fence installed, Minimum ( ) I Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large lrgs P of Energy Forms. R O W Permit for new construction. COMMERCIAL Attach m complete sets of days Plans as a Life Safety Page; ( ) Minimum tac (tie days * Ste Work Permi fo alt new pr All commercial requir StOrmwater Plans meet compliance SIGN Sanitary Facilities & 1 dumpster. SIGN PERMIT Attach ROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. application, notarized Owner & Contractor sign back of app upgrades over $5000) If over $2500, a Notice of Commencement is required. (A/C ** 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 I I NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictionf which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with ar 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 ap72 -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 - WeIIs, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. US Environmental Protection Agency- Asbestos abatement. Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO , ICE OF C ..:.,,,a:th MENT. FLORIDA JURAT (F.S. 117.03) LL OWNER OR AGENT CONTRACTOR f� Subscribed and sworn to (or affirmed) before me this S}�,. -cri• -d and swo .t• (or affirm s; - .re me this Who is /are personally known to me or has/have produced Who -isf. e'•ersonally k • o me or has /have pro. Aced as identification. as identification. Notary Public (' Notary Public Commission No. Commission t q�. ` µv P. Wendy Brueningsen Name of Notary typed, printed or stamped Name of Notary typed, printed or stamp � �OF r :•c commission # DD595266 1 F4�� °' Expires September 14, 2010 hn Bonaeo rro Fain in surance , n. 30n 385- ,-r.,: S2P/22/2008/MON 04:21 PM ZEPHYAHILLS BUILDING FAX No, 813-780-0021 P. 002 • • • • — PURCHASE 'ORDER :City' 01.Z p`h rhjlls • • No. 00006599 VENDOR: Ste' TO: BILL TO: Cross Construction Services hl City Ball City of Zephyrhills 25221 Wesley Chapel Blvd 5335 8th St 5335 8th St. • Lutz, FL 33559- Zephyrhills, FL 33542 - .Zephyrhills, FL 33542 . • • • VENDOR NO. VENDOR PHONE NUMBER TERMS DATE REQUIRED DELIVERY DATE CCS (813) 907 -1013 0 09/09/2009 SmpPING INSTRUCTIONS (none) • ITEM QTY U/M DESCRIPTION / TASK PRD CODE ACCOUNT ' UNIT PRICE • AMOUNT 1 0.00 Demo -38214 C Ave - See 001- 2400 - 524 -5260 4,485.0000 4,485.00 • Notes • • • SUBTOTAL: 4,485.00 TAX: 0 -00 • SHIPPING: 0.00 • • TOTAL: '4,485.00 • TAXABLE: No • CONFIRMING: No • 4,,f52 4). "- - ' AUTHORIZED SIGNATURE • SPECIAL INSTRUCTIONS: • • • • • • IMPORTANT: OUR ORDER NUMBER MUST APPEAR ON EVERY INVOICE AND PACKAGE This order is given upon the representation and guaranty of the manufacturer or seller that no breach of any State or Federal Law or Regulation has occurred in connection with the manufacturing, processing, branding, labeling or transportation of the•merchandise herein mentioned. If such breach occurs or is charged by any legally constituted State or Federal authority, the buyer shall be entitled to rescind the order and return the unused merchandise and shall also be held harmless by the manufacturer or seller against any penalty incurred and /or the cost of defense of any proceeding designed to penalize the buyer therefor. ACORD ' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/1fY1fY) 9/22/2009 PRODUCER Phone: 813- 226 -1300 Fax: 813- 226 -1313 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Tampa ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 15519 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa FL 33684 -5519 INSURERS AFFORDING COVERAGE HAIL* INSURED INSURERkZurich American Insurance Co. 16535 Cross Construction Company Inc (%ERmSteadfast Insurance Co. 26387 Cross Construction Services Inc 25221 Wesley Chapel Blvd INSURER C: Lutz FL 33559 -7201 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. INSR ADD'L POLICY EFFECTIVE POUCY EXPIRATION LTR IN$RD TYPE OF INSURANCE POLILVNUMBER DATE (MWU YYI DATE (IMIDOIYYI LIMITS A GEN ERALLIABIUTY GL0586754904 3/1/2009 3/1/2010 EACH OCCURRENCE $ 1, 000, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Eaoccurence) $150,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL 3ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000, 0 0 0 POLICY I A f JECT LOC A AUTOMOBILELIABRITY BAP586754604 3/1/2009 3/1/2010 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Peraccidenl) GARAGE UABIUTY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTOONLY: AGG $ g EXCESS/UMBRELLAUABI.m SE0586754804 3/1/2009 3/1/2010 EACH OCCURRENCE $5,000,000 X OCCUR CLAIMS MADE AGGREGATE $5,000,000 $ DEDUCTIBLE $ X RETENTION $10,000 $ A WORKERS COMPENSATION AND WC586755104 3/1/2009 3/1/2010 X TORY STATU 10TH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1 , 0 00 , 0 00 If yes, describe under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ 1,000,000 B OTHER PEC586754304 3/1/2009 3/1/2010 i'ach Claim $1,000,000 Pollution (Lead Asbestos) , ggregate $2,000,000 Liability DESCRIPTION OFOPERATTONS/ LOCATIOMS VEHICLES /EXCLUSIONS ADDED BYENDORSENIENT /SPECIAL PROVISIONS See Cross Construction Inc, Cross Construction Services Inc - Certificate Attachment dated 3 -1 -09 attached *Except for 10 days non payment of premium RE: CERTIFICATE HOLDER - ETHAN T. LILLIBRIDGE CGC1505176 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED CITY OF ZEPHYRHIT,T.0 BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE 5335 8T1 STREET CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO ZEPHYRHILLS FL 33542 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES - AUTHORD'J=D REPRESENTATWE ACORD 25 (2001108) '. r s1 - '"' "•p A D C RATION 1988 CROSS CONSTRUCTION COMPANY INC CROSS CONSTRUCTION SERVICES INC. CERTIFICATE ATTACHMENT Coverage Form General Liability coverage form CG0001 applies. Additional Insured Certificate Holder is a General Liability Additional Insured and an Auto Liability Designated Insured, when required by written contract. Primary / Non - Contributory Additional Insured Primary and non - contributory General Liability Additional Insured provision applies, when required by written contract. Per Project General Aggregate General Liability Per Project General Aggregate applies when required by written contract Contractual Liability General Liability and Auto Liability Insured Contract contractual liability provisions apply. Separation of Insureds General Liability and Auto Liability Separation of Insureds provisions apply. Waiver of Subrogation Waiver of Transfer Of Rights Of Recovery Against Others To Us provision as respects General Liability, Auto Liability, and Workers Compensation applies in favor of Certificate Holder, when required by written contract. Excess Liability Underlying Insurance Excess Liability schedule of underlying insurance includes General Liability, Auto Liability, and Workers Compensation Employers Liability. 3 -1 -09 IMPORTANT if the certificate holder is an ADDITIONAL INSURED, the po icy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in Neu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the poicy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) ( 4 44 1E>00., CO TRUCTIO1i 5- 25221 Wesley Chapel Blvd. Lutz, Florida 33559 Phone: (813) 907 -1013 • Fax: (813) 907 -0297 CITY OF ZEPHYRHILLS TO WHOM IT MAY CONCERN, PLEASE BE ADVISED RICK POLLESCH (DRIVERS LICENSE (#P420- 732 -62- 410-0) IS GRANTED THE AUTHORITY OF ACTING AGENT FOR RUSSELL E. ARNEY (LICENSE #CBCO59838) "OR" ETHAN T. LILLIBRIDGE (LICENSE #CGC1505176), AND CROSS CONSTRUCTION IN MATTERS INVOLVING PERMITTING. SINCERELY, ''I*' RIDGE – VICE PRESIDENT ' - OSS CONSTRUCTION SWORN TO AND SUBSCRIBED BEFORE ME THIS 23th OF SEPTEMBER, 2009. •,.. # 14 44 10 MY COMMISSION EXPIRES: 8/24/2010 TAMARA JAM ,• ` d '� C Tamara James ? �•� h •'tC NOTARY PUBLIC, STATE OF FLORIDA, PASCO COUNTY -•: f,;, :•- Commission # DD574915 X PERSONALLY KNOWN TO ME. Expires August 24, 2010 ' • t rip- 1.06.1 T1OV M6in 144 . 60040.4014 NRH ei ,,e''''/ \cr ,Qrt 'q_\.C' /l ' ° v .,.., City of Zephyrhills:7 Building Department / t �� V 1 Phone: (813)- 780 -0020 bvif Fax: (813)- 780 -0021 ..., \1 1 TO: Rick FROM: Gene € € FAX #: 813- 907 -0297 FAX #: DATE: 9-22-09 # OF PAGES including cover sheet: 2 ! € € € ! MESSAGE: ! Rick attached you will find a purchase order for the demo work to be done . € € ! I € € Thanks ! € Gene € ! ! € ! € € CroS s C 1G € € ! ! € I € € € € € { € ! ! i ! € d , .! PURCHASE ORDER City Of :Z eprh : rhills "" i No. 00006599 � 0 1' �1. VENDOR: SHIP TO: BILL TO: Cross Construction Services In City Hall City of Zephyrhills 25221 Wesley Chapel Blvd 5335 8th St 5335 8th St. Lutz, FL 33559- Zephyrhills, FL 33542- Zephyrhills, FL 33542 VENDOR NO. VENDOR PHONE NUMBER TERMS DATE REQUIRED DELIVERY DATE CCS (813) 907 -1013 0 09/09/2009 SHIPPING INSTRUCTIONS (none) ITEM QTY U/M DESCRIPTION / TASK PRD CODE ACCOUNT UNIT PRICE AMOUNT 1 0.00 Demo -38214 C Ave - See 001- 2400 -524 -5260 4,485.0000 4,485.00 Notes SUBTOTAL: 4,485.00 TAX: 0.00 SHIPPING: 0.00 TOTAL: 4,485.00 TAXABLE: No CONFIRMING: No ....5 L' AUTHORIZED SIGNATURE SPECIAL INSTRUCTIONS: IMPORTANT: OUR ORDER NUMBER MUST APPEAR ON EVERY INVOICE AND PACKAGE This order is given upon the representation and guaranty of the manufacturer or seller that no breach of any State or Federal Law or Regulation has occurred in connection with the manufacturing, processing, branding, labeling or transportation of the merchandise herein mentioned. If such breach occurs or is charged by any legally constituted State or Federal authority, the buyer shall be entitled to rescind the order and return the unused merchandise and shall also be held harmless by the manufacturer or seller against any penalty incurred and /or the cost of defense of any proceeding designed to penalize the buyer therefor. P. 01 /01 TRANSACTION REPORT SEP /22/2008/MON 04:21 PM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE /NOTE FILE 01 SEP /22 04:20PM 99070297 0:00:31 2 OK SG3 9355 • ... , City -of Zephyrhills: •..., � �,� ,� "� �:. Building Department J ^i X l y , iLa i y .q:y�ti. W ' 'r O: T • Phone: (813) -780 -0020 `' Fax:. (813)- 780 -0021 5 •�l TO: Rick • FROM: Gene FAX #: 813-907-0297. • FAX #: DATE: 9 -22 -09 # OF PAGES including cover sheet: 2 MESSAGE: Rick attached you will find a purchase order for the demo work to be done . • Thanks Gene • • � 1 __.. ,