The URL can be used to link to this page

Home My WebLink About09-8940 CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 8940 BUILDING PERMIT Permit Number: 8940 Address: 5911 9TH ST Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: NC CHANGEOUT Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11- 26 -21- 0010 - 01400 -0010 Improv. Cost: 4,000.00 Date Issued: 3/19/2009 Name: MCGLONE, DENISE C Total Fees: 50.00 Address: 6636 WOODSMAN DR Amount Paid: 50.00 WESLEY CHAPEL FL 33544 Date Paid: 3/19/2009 Phone: (813)713 -5559 Work Desc: CHANGE OUT 2 1/2 TON ALL SEASON AIR CONDITION AND HEA A/C CHANGEOUT 50.00 pa--r 4-0 & Lm �•s �� a ..:.. �a R•" g`: _ , „O%' � a" P.� ,mss' � . - L.d,.aa +�� f x ... , ., .. ,. :... 1 ._ .. -, : �° a . , �? : •. : DUCTS INSTALLED DUCTS INSULATED 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." CONTRACTOR SIGNATURE PERMIT OFFI �R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Pasco County Parcel: 11- 26 -21- 0010- 01400 -0010 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: I Weekly Archive - Saturday, March 14, 2009 Parcel ID 1 11- 26 -21- 0010 - 01400 -0010 (Card: 001 of 001) I Classification 11 01 - Single Family Mailing Address Property Value MCGLONE DENISE C Ag Land $0 6636 WOODSMAN DR Land $26,502 WESLEY CHAPEL, FL 335443127 Building $34,645 Physical Address Extra Features $854 5911 9TH ST ZEPHYRHILLS, FL 33542 -3514 Market Value $62,001 Legal Description (First 4 Lines) Assessed (Save Our Homes) $0 CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 1-3 INCL Taxable Value $57,001 BLOCK 14 OR 3736 PG 727 Land Detail (Card: 001 of 001) Line II Use 1 Descriptionll Zoning 11 Units II Type II Price II Condition II Value 1 II 0100 11 SFR II 00R2 II 8,400.00 II SF 11 $3.06 II 1.00 0 $25,704 ( 2 II 0100 (1 SFR II 00R2 I1 2,100.00 II SF 11 $0.38 II 1.00 II $798 Additional Land Information Acres 11 0.24 II Tax Area II 30ZH II FEMA Code') X IlResidential Codell ZHLHLP2 Building Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1965 Stories 1.0 Exterior Wall 1 Concrete or Cinder Block 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 Terrazzo Monolithic Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C Central Baths 2.0 Line 11 Description (1 Sq. Feet 11 Repl. Cost New 1 11 BAS II 1,064 11 $44,050 2 11 FOP 11 100 11 $1,035 3 11 FCP II 240 11 $2,484 4 11 UST 11 96 11 $1,573 Extra Features (Card: 001 of 001) Line 11 Description 1 Year 11 Units 11 Value 1 11 DWSWC I 1977 11 222 11 $233 2 11 UDU -M 1 1994 11 1 11 $465 3 11 UDU -M I 1977 11 1 11 $156 Sales History Previous Owner 1 JOHNSON ED Year 11 Month 1 Book /Page 11 Type 11 Amount 1997 11 04 1 3736 / 0727 II W D II $57,000 1996 II 08 I 3623 / 0560 II W II $40,000 1992 II 02 I 3003 / 0440 11 WD II $ http: // appraiser. pascogov.com /search/parcel,aspx ?sec =11 &twn= 26 &rng=21 &sbb= 0010 &b... 3/19/2009 . , PROPOSAL ALL SEASON AIR CONDITIONING ,'x 7 J- z 7 Z 5 & HEATING, INC. Work Telephone 3659 Lake Breeze Drive • Land 0' Lakes, Florida 34639 • (813) 875 -0794 License #CAC046905 Fax (813) 929 -9424 Home Telephone "Ce'hne... QOe r7ecy Customer Name is t4 Y A ll' e!) n e ereir Date J "" 0 Address j // 9 / rt - C7 2 ,- r M Zip J3Lry Z Description O • nri1 a Z 1 t7-1 /J rcz'c X 7 /6/ /44 Gm S' Pte. 11) 4� ry /'7at,.-1 r 0 Y1 , Zoek /A G� ® P ✓' A /v C C f G 7 f .l C- u t kl 6v %h S ✓4L / Cd . 6 fri ...S7 eic ri "K 17 4 I r 7; • ex...5 7// 6,,, ' T .n. rJ / 1 r ( / ( _ MCY /2 is ii- ( / i ,.f J`" 4 RO A 7" --f k/ i 71 c / r h-, ; T �`CY/ zt 6- b a I ,Ac J J /C/ 7c, ✓ h4 Y' Ye, -, 4 /< / Y s., .5 **--- ye' i., ..,-- :: y 7 y Payment Schedule Subtotal Deposit: Balance Due: «o d - Z 9- a 7 Date Completed: Tax r 9 Z C 0 proval $ job Tot?‘" 000.. O h r //y/ (- Ls 7 — 0a Zd _r33,5 . .i- f L .51 Customer Signature Technician Name Technician Signature �f ?<' 7 O-- DL, L 1 Beeper /Phone# / r) DEFAULT BY PURCHASER - If the said purchaser fails to perform the ( PAYMENT - Any part of a payment that is not paid will be charged the covenants herein contained, All Season Air Conditioning & Heating, highest allowable interest rate by law commencing the first day the job Inc. shall be entitled to recover any and all costs incurred, including starts until final payment. / 1 / 1 r . 813 - 780 -0020 City of Zephyrhills Permit Application . 1 ' r t Building Department _ U Date Received ' ii -O G Phone Contact for Permitting -- IIIltlltll11111 /� _ 9' Owner's Name yi. N eo n r / N< r Owner Phone Number 45 / / 7-171 / Owner Phone Number Owner's Address _.5 Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address J (� JOB ADDRESS J / a Q 1 / 7 7/ / ,f 7 LOT # SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR I I ADD /ALT I I SIGN 1 1 MOVE 1 1 DEMOLISH ��, INSTALL REPAIR PROPOSED USE SFR 1 1 COMM I I OTHER I I TYPE OF CONSTRUCTION 1 1 BLOCK 1 I FRAME ' I I STEEL I I OTHER I I C OF WORK hA 151. T a 1 , 2 Z ' 3" `"/ `f 7 BUILDING SIZE 1 SQ FOOTAGE HEIGHT I I BUILDING $ VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY I I W.R.E.C. I I PLUMBING $ MECHANICAL $ (/ /t,(/V/v�/�� a � C � ) VALUATION OF MECHANICAL INSTALLATION t f I I GAS 1 1 ROOFING I 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES IINO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y / N 1 Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # MECHANICAL Z___ l COMPANY LL J P. i.,fp''1 SIGNATURE REGISTERED Y/ N I FEE CURRENT Y / N I Address 3_ .S? A ,& /! Yoc Ze. iek Lod / 34 License # I II4 C O '/C 7 o .5 OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I 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 NC 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. 1 also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection- Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency- Asbestos abatement. Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOT - E OF • MM CEMENT FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and sworn to (or affirmed) before me this Sub 9iOed and s m to affirmed ore me is by jf 7 -09 by \C t/ ! h Who is /are personally known to me or has /have produced Who is /are p rsonally known to me o has/ ve produced as identification. L Ck xO as identification. Notary Public I� ..,:.r _ !iC Notary Public S Comnjis.lon N• tri *= Commission 621833 Commission No. °;: J =miter 12, 2010 ' • ; 5To Bonded Mtn troy Fein InIJrando MO-385-7019 Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped Il Lown , ULM 1 II-11;A I L OF LIABILITY INSURANCE DATC(MWO 03/19/2009 PRODUCER (800)524-7024 FAX (800) 524 -4013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Automatic Data Processing Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1 ADP Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Roseland, N3 07068 INSURERS AFFORDING COVERAGE NAIC # INSURED ALL SEASON AIR CONDITIONING AND HEATING, INC. INSURERA: Twin City Fire Insurance Co 29459 3659 LAKE BREEZE DRIVE INSURER 6: LAND 0 LAKES, FL 34639 INSURER C: (813)929 -9424 INSURER 0: 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 UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. o FaOD L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POUCY EXPIRATION DATF IMNIMD/YYI DA1etMM/DWYYI LIMITS GENERAL LIAB1UTY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILm DAMAGE TO RENTED S PRFMI.RPR /Pa nrnuwnre I CLAIMS MADE n OCCUR MED EXP (Any one Denton) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ OF_N'L AGGREGATE LIMIT APPLIES PER: PRO PRODUCTS - COMP /OF AGG $ POLICY n JECT - n LOC -" AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (ES Aoelelant) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS IPer person) HIRED AUTOS BODILY INJURY NON - OWNED AUTOS {Par aacklgM) PROPERTY DAMAGE $ (Per accident) GARAGE UABILITY AUTO ONLY - EA ACCIDENT $ - R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY; AGG $ EXCE85 /UMBRELLA UABILITY EACH OCCURRENCE $ OCCUR n CLAIMS MADE AGGREGATE _ S S DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 76WEGH09042 03/21/2008 03/21/2009 X WC STATU TOTH- EMPLOYERS' UABILITY MIT4 I l AR A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE • EA EMPLOYEE $ 100,000 n Dyeed UtAL PR Oa VISIO under NS below E.L. DISEASE - POLICY LIMIT $ 500,000 SPECL PR OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. City of Zephyr Hills BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILITY 5335 8th Street OF ANY KINO UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. Zephyr Hills. FL 33542 AUTHORIZED REPRESENTATIVE Rudy Pena /Bird- Waldron ACORD 25 (2001/08) FAX: (813) 780 -0021 OACORD CORPORATION 1988 § \ y «\ It^ 2y \y& k 4 P= » 0 M CLIC < GZ u o � §4 \ k s y.;f4ta : 2 ` /2< .« O _#_ \: \\$ \1 < <kk2 f ; \ • From: Eileen To CITY OF ZEPHYRHILLS Date: 3/19/2009 Time: 1:12:24 PM Page 1 of 1 ACORD • CERTIFICATE OF LIABILITY INSURANCE OP ID EN DATE(MM/DD/WW) ALLSE -1 03/19/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MORROW INSURANCE GROUP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LENORA C. OLNEY /A196064 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 16606 NORTH DALE MABRY HIGHWAY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CARROLLWOOD FL 33618 Phone: 813 963 - 1669 Fax: 813 961 - 3743 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: OLD DOMINION INSURANCE CO 40231 INSURER B ALL SEASON AIR CONDITIONING INSURER C & HEATING, INC. 3659 LAKE BREEZE DRIVE INSURER D. LAND 0 LAKES FL 34639 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. iNSH AUU L - POLICY EFFECTIVE POLICY EXPIRATION LTR NSRO TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD/YY) DATE (MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY MPG78589 04/30/08 04/30/09 PREMISES (Ea ccuence) $ 500000 CLAIMS MADE I X OCCUR MED EXP (Any one person) $ 10000 PERSONAL &ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2000000 POLICY n JECT n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 1 1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WCSIAIU- OIH- WORKERS COMPENSATION AND TORY LIMITS I ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes. describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITYZEP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF ZEPHYRHILLS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL CONTRACTOR LICENSING BOARD IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FAX 813 780 0021 5335 8TH ST. REPRESENTATIVES. ZEPHYRHILLS FL 33540 Aur ° Q P' 'M E !1 ® ACORD 25 (2001/08) �, (�' C (� � ACORD CORPORATION 1988 ADP 3/19/2009 12:11 PM PAGE 2/003 Fax Server • ACORA CERTIFICATE OF LIABILITY INSURANCE DATE � � 2 �) PRODUCER (800) 524 -7024 FAX (800) 524 -4013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Automatic Data Processing Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1 ADP Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUC BELOW. Roseland, NJ 07068 INSURERS AFFORDING COVERAGE NAIC # INSURED ALL SEASON AIR CONDITIONING AND HEATING, INC. INSURERA Twin City Fire Insurance Co 29459 3659 LAKE BREEZE DRIVE INSURER B: LAND 0 LAKES, FL 34639 INSURER C: 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 ADM. T YPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POUCY EXPIRATION LIMITS I TR N - R R1 q DATE RAM01YY1 DATE IMM/OIVYYI GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PRFMISFS (Fa neruranrnl _ CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ PERSONA. 8AOV INJURY $ _ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $ n POLICY n PR n LOG AUTOMOBILE LIABILITY COMBINED SINGLE LNWT - ANY AUTO (Ea accident) f , ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR n CLAIMS MADE AGGREGATE $ f DEDUCTIBLE $ RETENTION $ - $ WORKERS COMPENSATION AND 76WEGH09042 03/21/2009 03/21/2010 1 TOGRY I MRS I IOFR EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000 A ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 100,000 If EAL describe 500,000 SPECIAL PR IAL PROVISIOISIO NS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL j,Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Zephyrhi 11 s BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5335 8th Street OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhill s, FL 33542 AUTHORIZED REPRESENTATIVE Rudy Pena/WILDER ACORD 25 (2001108) FAX: (813) 780 -0021 ACORD CORPORATION 1988 FROM : ALL SEASON AIR CONDITIONING FAX NO. Mar. 19 2009 03:56PM P1 � 1 .. ' . CoT . ' 1 1 .1'1 " s 7 �7 • RECE • 200 09 Issued pursu a nI : an d ' s ubject'to Florida' a Pasco County Ordin Iss d not certify compliance with • • zoning or other,la Th►sJi must ,.be place of.business. Expires September 30- : i iv►c n .::04176.5 T'1 ' COLLEC . ... Tr N • S I` G CDD,:.,. .1,7 31'' _ A ,. , CONIII,T , .- L INO. • .. .. .. Y'ASCO JN F,• • -. Y) • -' , . ': L :.- • ; _ - C Li1 SS .. • • -- "u T ' 'LOCATION. ADDRESS ! • : �r ,. i 36.59 .1.AKE BREEZE DRIVE • ALL.:SEA.SON, AC .AND.HEAtI I NC rev o LA 0 LAKES 36'39. _LAKE. BR EEZE ',DR V.E :LAND ''.0. LA °FL .34639 6 6 '; 0 2 . . :•'.. ; : . . . ;. , M ... 0 - - DATE .. RECEIPT AMOUNT • 6 3I 25 ..1:: i,J II....n,t,f ;JIrai,.I• ;' . U�Iti1 taJ . 52 2 • • ' . ..._ ,r .� ,:. .'/` ..... .� .. � i. > ,.. - µ - ms - p . - v � 200$ -0 • ' s -and = a .bcda ances:.I P7741t ic e hoe s. riot. ity_ comp li a n c e'wl$i __ _ _- _ ° JssraI?W�Stia�ataiii- satj�E�:��'F!d$d� 8s�co: . ,:• t _ ' s .��. gust- !�•%posE€.d.�on , ; , 7 4 '•. eK - .ii:�� >' � / ' J . - C f ' � -' '� �!. � S:Ji:f'' .l -+ :r' �.+ . r / .1 y'II � •f\ .emu ay \ 'Y _ -ACCOu _ fi ' . LL i R r p D . :BUSINES ONERS ,5':T 1 :. . 5 7 " 22 06 R A3C -A lft CDND ASC ' CCJ JN i Y ' F1�OtIDA. - . • M 4' S - - � . - \. rR .-- �,L( , • • r' , e 3659 1l1 'B DRIVE ALL_:�S£AS Ac A'• -HEA "I.NO I -NC , ; �:"r LAND 11 - LAKES: 36.59 ` LAKE: BREEZ V E a • LAND 1I'. L'AKES E. Z . 6602 o • . DATE RECEIPT: A MOUNT 08/1 - `552325.: 50.0 'leak 11401111141..114:. .II I1,..11 hIlE {Errk+ l.I.b �;l El� /'( ),1, ,. 1/ \ 4 5 Z .,.,......„.„,..