Loading...
HomeMy WebLinkAbout09-9025 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9025 BUILDING PERMIT Permit � Number: 9025 Address: 5741 YORKSHIRE DR Permit Type: RE -ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: WEDGEWOOD MANOR Est. Value: Parcel Number: 10- 26 -21- 0120 - 00000 -0830 Improv. Cost: 6,300.00 t _ Date Issued: 4/15/2009 Name: SMITH, PATRICIA Total Fees: 65.00 Address: 5741 YORKSHIRE DR Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/15/2009 Phone: (813)715 -0360 Work Desc: REROOF SHINGLE THE SKYLIGHTERS REROOF RESIDENTIAL 65.00 4 „ V .�� ` - DRY IN ROOF INSP TAPE JOINTS ROOF INSP 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 re recording your notice of commencement." ' 4/ 5 -L� -_ CONTRACTOR SIGNATURE PERMIT OFFI prR 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 j 6U � Fax-813-780-0021 Building Department Date Received 4 S O 1 Phone Contact for Permitting -- '''N Owner Phone Number . i -' /(S CO Owner's Name ; cx . f i is r I Owner's Address I5- Z ( A I Owner Phone Number Fee Simple Titleholder Namel ( Owner Phone Number Fee Simple Titleholder Address I I JOB ADDRESS 7 L7 l VG ic K S' A ; r °t.._ sa I LOT # l I SUBDIVISION PARCELID# fb 2'`_2'1 „ l.( 2 -0 -V"dO 0"3o (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED 1 NEW CONSTR I I ADD /ALT 1 1 SIGN 1 1 MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE SFR I I COMM n OTHER I TYPE OF CONSTRUCTION I I BLOCK 11 FRAME I I STEEL I I OTHER I DESCRIPTION OF WORK c\ e____S / k., ) P ICiv c e- rin vs P /e.ec-c,c)c-:- BUILDING SIZE SQ FOOTAGE HEIGHT I BUILDING $ 6 ..30v VALUATION OF TOTAL CONSTRUCTION I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY 1 I W.R.E.C. I I PLUMBING $ I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS ROOFING 1 1 SPECIALTY 11 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES LINO . Ill R - __. 0( BUILDER COMPANY SIGNATURE 0 s• Q REGISTERED I Y / N I FEE CURRENT ` I Y/ N I O ddress 19 SOS M3-20<A ��-" ` I )e0g�.N 33.5 V 0 , ( License # s'""— 4`3a 760 y eS'�Y� ELECTRICIAN COMPANY "I l/ � C SIGNATURE REGISTERED Y N I FEE C ENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address License # 1 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" 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 LEN •• ER OR AN ATTORNEY BEFORE RECORDING Y (1/4 NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. ' " 7.0 OWNER OR AGE ► 7 2��O CONTRAC • _a.. "ice Su scnb ed and swprn r e bef me this Subscribed an. savor : ,•r�:ffirmed) before me this Cfr 01 by0 7to 1/4-' 11S�� 4,( Subscribed 9 b "A's personally known o me o as/have produced Who is /are personally known o me . has /have produced as identification. (..; Lt- as identification. w J , , t:�j• I( Notary Public Notary Public �^� f■ o omission � • �a � . •��:��•- . , � A' . CO NE BOGES • Com i - ? �. ExeiresDecember 1 , 2010 Commis No n� CommiSaiun DD 621633 ' Bo'ded Troy Inwru¢e:Tem • A: Expires December 12, 2010 ° R " F "'t mru Tro r h,hvwmrne 6W-365-7019 Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped Apr 15 09 01:21p THE SKYLIGHTERS 8136434510 p.1 TODD INGANAMORT DBA THE SKYLIGHTERS 2903 BELL SHOALS ROAD BRANDON, FL 33511 PHONE #: 813 - 690 -7663 FAX #: 813 - 643 -4510 CCC1327604 STATE CERTIFIED ROOFING CONTRACTOR SUBMIT TO: DATE: 3/2612009 PAT SMITH 5741 YORKSHIRE DR ESTIMATE ZEPHYRHILLS FL 33542 813 715 0360 ACCEPTANCE UNIT j QUANTITY 1 DESCRIPTION I PRICE I TOTAL 1.00 INSTALL A NEW 30 YEAR ROOFING SYSTEM $6,300.00 $6,300.00 $0.00 $0.00 WORK TO INCLUDE: $ 1)TEAR OFF ROOF TO SMOOTH SURFACE $0.00 2) INSPECT AND REPLACE ALL BAD WOOD(EXTRA) $0.00 3)INSTALL A UNDERLAYMENT $ 4)REPLACE ALL FLASHINGS NEW AND DRIP EDGE $0.00 5)1NSTALL A NEW 30YR DIMENSIONAL ROOF $0.00 6)INSTALL NEW RIDGE VENTS ON ROOF $0.00 7)SUPPLY ALL PERMITS $0.00 8)CLEAN UP AND HAUL AWAY ALL DEBRIS $0.00 9)RENAIL ENTIRE ROOF DECK $0.00 10)INCLUDE 10" TUBULAR SKYLIGHT WITH 4' TUBE $0. 00 ADDrONAL TUBING Ifg$30 PER FOOT $0.00 $0.00 PLYWOOD IS $50 PER SHEET $0.00 FACIA AND BOARD FEET $4.00 PER FOOT $0.00 $0.00 $0.o0 THANK YOU FOR YOUR BUSINESS 1 TOTAL' :6,300.00 To: City of 2ephyrhills Building From: Amanda Phone: 991 9 -08 -09 11:39am p. 2 of 2 L 4/8/2009 Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Alliance Insurance Solutions LLC THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 1777 INSURERS AFFORDING COVERAGE St Petersburg, FL 33731 INSURER SUNZ Insurance Company A 727-497-1247 INSURER www.ins4biz.com Insured INSURER TXRECO, Inc. d /b /a Pinnacle C Employee Leasing INSURER Suite 121 D 115 West Olympia Ave INSURER Punta Gorda FL 33950 E THE POLICIES OF INSURANCE LISTE BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I 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. POLICY POLICY INSR EFFECTIVE EXPIRATION ATE LTR TYPE OF INSURANCE POLICY NUMBER M D AT E M D AT YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIAB FIRE DAMAGE (Any one fire) $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEPI'L AGG LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 1POUCY F1PROJECT f LOC $ AUTOMOBILE LIABILITY _ ANY AUTO COMBINED SINGLE LIMIT $ _ 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 $ JANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ ]OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A EMPLOYERS' LIABILITY TION WCPE0000000803 6/15/2008 6/15/2009 ✓ 'STATUTORY ACCIDENT NT TIT I ✓IDTHER $ � A ACCIN $ 1000000 EL DISEASE • EA EMPLOYEE $ 1000000 EL DISEASE • POLICY OMIT $ 1000000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVtSI6NS Coverage provided for all leased employees but not subcontractors of: Skylighting, LLC dba The Skylighters Client Effective Date: 08/13/2007 State of Florida Coverage Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL . 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE City of Zephyrhills Building LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION Phone 813- 780 -0020 OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- Fax 813- 780 -0021 SENTATIVES. ' 10 Days for Non - Payment of Premium. 5335 8th St AUTHORIZED Zephyrhills FL 33542 REPRESENTATIVE ({ //off -t Douglas Lilak �gi y MJI4 S CERT NC 4759848 CLIENT CODE. PEL 'Amanda Phone: 941- 833 -2065 4/6/2009 11:29:43 AM Page 1 of 1 RPR 17:18 Watts, Dawson & Associates (FAX)813 685 Od2d P.001/002 . . COM110.3vatt.t. CERTL-111.LATE OPINSITRANCERAMST Qe tkit130re5.r.t • vkv1 LIZ r gz- 642-45ir wso L. 1. Mar t I ; a . 1.1 4 n // 5 DOES • r. :4 If (- • SOLDER NEW TO HS NAV= AS AN ADDITIONAL I t :AD • . NO 4 MASON B.13. AMINO AB ADDELIONAL SPECIAL MM VOIDING MR gig ADDITIONAL /U? . 1512aliE A.SPE=CICSSMR DliaVERYnentUtrna VAX TC413" MAL 416111k ANYQ506130blaq.BASECCICUU:r jori. T AT818.9811010 PLEASENWEDMITONAOUNTROER 877-.821.6462 • -.„ - • Due to bighvoinme zegoestp **item to be faxed,Wait‘Dawocon AisidatettAtte. has a Ohm tszot mond poky ono wade. Me AMA drot for your:leggist taboanibtoadtoropated lay oor proceo-god fps mammy, andthen anted as Instzucted. We poxes ourwodtitt t oredoneetdved coda lobo/dr to alio/ our:gaits. you Iwo tbze•iafer.or 31tuafion, plum lekos latovrand wawa do =best to accoctonodateyou, ?bosky= faz your ori'doskunding. . . _ no s".4"1.4lps n LW= Lacs', 1 N.sc MU 1 /0.1 "Wt cu., Ow APR- 08- 2009(WED) 17: 18 Watts, Dawson & Associates (FAX)813 685 04Ed P. 002/002 ACQFID, CERTIFICATE OF LIABILITY INSURANCE OP ID LH DATEIMMIDDMVYY) EM ELT 04/08/09 , PRODUCER ' THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION Watts Dawson 5 Aasoaiatas, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE IHeme Office HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 3.3008 N. 56th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa FL 33617 Phone: 813 -985 -0349 Pax: 813- 989 -3284 INSURERS AFFORDING COVERAGE NAIL 0 ammo INSURER A: ATLANTA CASUALTY INS CO INSURER B; ) RCURT CASUALTY INS CO. • JJ� SKYLIGHTERB INSURER C: HE'LL S a ! ROAD INSURER D; BRANDON INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TD THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDIITON OF ANY CONTRACT OR OTHER DOCUMENT wrrH 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 LIMrre SHOwN MAY HAVE BEEN REDUCED BY PAID CLAIMS, T LTR N �� POLICY NUMBER DA I MM'�) - POLICY (MID orrn L LIMITS TR IBRt TY'! or aSURANCi GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �AINAGIF rvHeNieu $ 50 000 A X COMMERCIAL GENERAL LIABILITY L083004204 -1 07/30/08 07/30/09 PREMIBES(Ee000urawo , CLAIMS MADE © OCCUR MED EXP (Any one penmen) $ 5 ( 000 PERSONAL S ADV INJURY $ 1/000,000 GENERAL AGOREGATE 12,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP /OP AGO $ 2,000,000 l POLICYn Tsi nLOC AUTOMDSLLi LIABILITY MIIINa SINGLE LIMIT 1 500,000 ANY AUTO ALL OWNED AUTOS BODILY INJURY H X SCHEDULED FLC7009270 -4 02/24/09 02/24/10 (Perperaon) $ X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) 1 PROPERTY OAMAGE 9 ^— (Par occident) GARAGE LABILITY AUTO ONLY • EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ — AUTO ONLY: AGO $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE S OCCUR E CLAIMS MADE AGGREGATE $ $ - H DEDUCTIBLE 1 RETENTION $ $ WORKERS COMPENSATION AND ITORV LIMITS I I ER SMPLOY!RN LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFF ICERIMEMBER EXCLUDED? E.L, DISEASE • EA EMPLOYEE S N yyea eeUlbe under 6PE�IA PROVISION! below E.L, DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OP OPERATIONS I LOCATIONS / VEHICLES /'EXCLUSIONS AMMO BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITYZEp SHOULD ANY OP THE ABOVE DESCRIBED POLICIES B! CANC'ELLSO BOOR! THE EXPIRATION OATS TH'ER'EOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS wRITT01 NOTICE TO TAR C'ERTIFICAT'E HOLM NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL CITY OF 2$FIT►L6 IMPOSE NO OBLIGATION OR LUIS � OF ANY IMO UPON THE INSURER, IT$ AGENT$ OR 533 8TH STREET REPRESENTATIVES. ZZPHYRHILLB FL 33542 AUTHORIZED REPRESENTATIVE ,ii BRANDON OFFICE c •:Ma ACORD 25 (2001 106) 0 AC • - I • ' r - PORATION 1988 To: City of 2ephyrhills Building From: Amanda Phone: 941 4 -08 -09 11:34am p. 1 of 2 • • From: • Alliance Insurance Solutions LLC So Box "" FAX DOCUMENT St Petersburg, FL 33731 • • Certificate of Insurance Delivery by ecertsonline '" 727 -497 -1247 www.ins4biz.com • From: Amanda Phone: 941- 833 -2065 T0: • Subject: Certificate of Liability: TXRECO, Inc. d /b /a Pinnacle • City of Zephyrhills Building • Phone 813-780-0020 Date: 4/8/2009 Fax 813- 780 -0021 5335 8th St Delivery Via: FAX 18137800021 ZEPHYRHILLS FL 33542 No. of Pages: 2 Attached please find your requested Certificate of Liability Insurance issued by Alliance Insurance Solutions on behalf of SUNZ Insurance Company. THIS NSSAGE IS INTENDED FCR THE USE OF TI-E INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND WY CCNTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXENPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE NSSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBYNOTIFIED THAT ANY DISSEMNATION, DISTRIBUTION OR COPYING OF THIS COMMJNICATICN IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED TM COMMJNICATI0N IN ERROR, PLEASE NOTIFY VS INEDIATELY BYTELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO U5 AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. © 2002 Certificate of Insurance Delivered by ecertsonline TM Insurance Visions, Inc. All rights reserved. i el3 7130- 001_ f K City 1,of Zephyrhills BUILDING DEPARTMENT 9/17/07 RE: Permit # 10 Ins pection �fidavit I ; n A - o N w A cc -i— ,licensed as a(n) Contractor* /Engineer /Architect, (please print nanii and circle Lic. Type) FS 468 Building Inspector* License #; CC ('J o 1-1 7 (oa On or about 5 , I did personally inspect the roof (Date & time) deck nailing and /or secondary water barrier work at _ 5 - 7 Yore-AA, j7r ' (circle one) (Job Site Address) Based upon that examination I have determined the installation was done according to the mac. ; - 'ligation Retrofit Manual (Based on 553.844 F.S.) 1 /10111*- *nature STATE OF FLORIDA COUNTY OF Sworn to and subscribed before me this day of /4 1 . By U�.(� /l�n� Notary Public, State of Florida Non om n $emon f Florida tJog.1 J1 ttabx - -_ i a 00130888520 bt4I , 1� Ex pir C es 0 3ommission /1 112 (Print, type e or stamp nalne) Ex Commission No.: l�'i> Rto 8 5 Personally known Produced Identification Type of identification produced. * General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the . deck for each inspection. • STATE OF FLORICA, COUNTY OF PASCQ -. 20 IIIili l lllllillilllllllillllllllllllilllll ll llllllllllll 20 THIS IS IC.; CERTIFY THAT THE FOREG • IN ?ISA ',- TRUE AND CORRECT COPY OF THE D¢UMENT Ms ON FILE OR OF PUBLIC RECORD IN THIS OFFIG + Rcpt: 1237957 Rec: 10.00 . DS: 0.00 IT: 0.00 VuiTNESS MY HAND A OFFICIAL SEAL THIS , a. 04/15/09 Dpty Clerk /c5 DAY OF 4 2 Oo - ,: , / PAULA S . O ' N EIL, CLE K & OMPTROLLER r`- 04/1 $ 5 % 0 9 } (O a cm N PggCO IA OR B K A 1 CLE of 1 MPrROLLeR SY' �i1�� �..ii. j� sEPUT"fiCLERK V GC PG 1332 NOTICE OF COMMENCEMENT Permit No. 90a Property Identification No. ! d ( .11 0 O 40000 0 $30 THE UNDERSIGNED hereby gives notice that improvements wilI 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. 1. Description of property (legal description :) , , Vk1, . „ f , - a fi . ' - , , , 144 4 N a) Street Address: 57 ,/ ) eh, rL Or . /1, // 6' A r 1 f f 3 r -- 3 S` 2. General description of improvements: Re R f / 3. Owner Information a) Name and address: 1, _ .. - , ' b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4. Contractor Information VI a) Name and address .. , , , . , , , . -1" - , . , . - , . , b) Telephone No.: N /.3 - ( / - 7G 43 Fax No. (Opt.) 2/3 - 6 4 /3 - 4 C c 5. Surety Information a) Name and address: 4/ /4 b) Amount of Bond: c) Telephone No.: Fax No. (Opt) 6. Lender a) Name and address: .✓ //r 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: 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: b) Telephone No.: Fax No. (Opt.) 9. Expiration dare 0f Notice' of C,.," r. :ce:nent (the exph" iron iLue 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 PASCO 71.4.._ of Owner or Owner's Authorized dO Officer /Direct Print Name The ro instrument was acknowledged before me this 47 day of 14pfa C. ,20 t , by P�/ , Li r.. :),11 b . ti 14, as (5 T (type of authority, e.g. officer, trustee, attorney in fact) for . jw J (name of party on behalf of whom instrument was execu Personally Known OR Produced Identification Notary Signature � j /61 Type of Identification Produced F- L .�a 44,2. /LJLrVaine (print) M1Me ! /.Sgt L (,C.. 1 (J:.- V 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 ber S L FORMS /IBC �,,,� MELISSA L WOOD Signature of Natural Person Signing Above fly �t Notary Public - State of Florida j 1. 0 1 • My C Expires Oct 22, 2009 � 1 ' Commission 1 0D 443216 I mo ' ° '' �,` Bonded By Nations Notary Assn.