HomeMy WebLinkAbout09-9121 CITY OF ZEPHYRHILLS
5335 -8th Street
(813)780 -0020 9121
ELECTRICAL PERMIT
Permit Number: 9121 Address: 6930 GALL BLVD
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEMENT Township: Range:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Contractor: OAR ELECTRIC INC Book: Page:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02- 26 -21- 0010 - 00800 -0050
Improv. Cost: 2,409.00,. ' 1J! ° 771 z : - , ; 7-.NW o
Date Issued: 5/13/2009 Name: COMMUNITY NATIONAL BANK
Total Fees: 45.00 Address: 6930 GALL BLVD
Amount Paid: 45.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/13/2009 Phone: (813)783 -8122
Work Desc: REMOVE & REPLACE MAIN SERVICE PANEL — uL0 rem (eon • •
ti ld Ada , s - 9y 0 .a
E LECTRICAL FEE 45.00
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ROUGH ELECTRIC
CONSTRUCTION POLE
PR - METER. - --
NAL.. d U �5 ---
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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 inspection 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."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be
performed in accordance with City Codes and Ordinances.
1-e,A.4`'--- 4l 1,
CONTRACTOR PERMIT OFFI PR
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813 -780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021
Building Department #9/ (
Date Received 5 131 CDR Phone Contact for Permitting 8` 476 -- 880 l
Owner's Name Ct..}tr ar ".J -4..4. nY-• Owner Phone Number 313-'783 - 8 1 L 2.
Owner's Address to 1 3 0 61 /0.., I 1 ?\ V d, Owner Phone Number
Fee Simple Titleholder Name ZLek%i W,,, \ \5 I F L 3354t Owner Phone Number
Fee Simple Titleholder Address
JOB (p
JOB ADDRESS ?so 6r'at t- t d- 2't.p L` c 4.1 Lkl, FL- 335 2 LOT #
SUBDIVISION PARCEL ID# 0 1 -1-1. -00 10 - 0 0 800 - 00 50
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR p ADD /ALT I 1 SIGN I I MOVE 11 DEMOLISH
INSTALL REPAIR
PROPOSED USE I I SFR I I COMM I I OTHER 1 I
TYPE OF CONSTRUCTION I I BLOCK I 1 FRAME 1 1 STEEL 11 OTHER I I
DESCRIPTION OF WORK RlwhwO• A. 4- �tQ \"te. M..% v, Ste 4.c.d. — ?"`
BUILDING SIZE SQ FOOTAGE X/C X P /A1 — tiuxia
I 1 BUILDING $ VALUATION OF TO 2x, di ii
ELECTRICAL $ AMP SERVICE /.R.E.C.
24 / . p0 6QD j 930 61,21 F1-��
1 1 PLUMBING $ /s (O
.z/ _ LtP J2
I 1 MECHANICAL $ VALUATION OF ME
ND 1� w D/9� �,(� 7---'
I I GAS 1 ROOFING 1 1 SPECIALTY [ 70;ge
(:7 — 8 �O j
FINISHED FLOOR ELEVATIONS FLOOD ZONE J / O /
I
BUILDER COMPAN
SIGNATURE REGISTERE
Address License #
ELECTRICIAN 1 COMPANY t- g. 1 �ec - 'fie : c --^t -
SIGNATURE II �--.1 �� REGISTERED I Y/ N I FEE CURRE I Y/ N l
Address 190 6 S?is.ty" AA. 6 AS S PL License # It' 1 30 1 2 9 52.
PLUMBER COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y / N I
Address I License # (-
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y / N 1
Address License # l
OTHER COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1
Address 1 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. 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to (or affirmed) before me this Subecribed nd swojato (or affirmed) before me this
by S by KCcAward S. 1406,r
Who is /are personally known to me or has /have produced Who is /are personally known to me or has /have produced
as identification. 1- c -' as identification.
i1'(
Notary Public '*.m ::- � :rse. _ _ Notary Public
w . : *_ om iI s io n DD 621833
Commissi. • o. ' � °` Exp DPCember 12 ^
Commission No. ..Ntk; Bonded Thru Trey Fai Insurance 8p 855 -
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
From:Lisa Johnson FaxID:863- 967 -7592 Page 2 of 3 Date:05 /13/09 09:52 AM Page:2 of 3
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID LS
OARS -01 DATE (MM/DD/YY1Y)
05/13/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Mulling Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P 0 Box 308 208 E Park Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Auburndale FL 33823 -0308
Phone:863- 967 - 4454 Fax:863 -967 -7592 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A. Old Dominion Insurance Co 40231
INSURER B. Florida Citrus Business c Ind
Oar Electric, Inc. INSURER C
Richard Hoar
920 East St. INSURER D
Lake Wales FL 33853
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.
Wort NSRC TYPE OF INSURANWort gaol POLICY NUMBER DATE (MM/DDM')E POLICY (MM /DD/Y1')N
LT LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
U IU(EaKt
A X COMMERCIAL GENERAL LIABILITY MPG87292 04/01/09 04/01/10 PREMISE Soccurence) NItU $ 500000
CLAIMS MADE I X 1 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
7 POLICY n 5E 8 n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
A X ANY AUTO B1G87292 04/01/09 04/01/10 (Ea accident) $ 300000
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 CLAIMS MADE AGGREGATE $
_ $
DEDUCTIBLE $
RETENTION $ $
WC SiAIU-
WORKERS COMPENSATION AND X TORY LIMITS I () El
EMPLOYERS' LIABILITY
B ANY PROPRIETOR/PARTNER/EXECUTIVE 10640653 04/01/09 04/01/10 E . EACH ACCIDENT $ 100000
OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 100000
If yes. describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500000
OTHER
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
electrical work - within buildings
CERTIFICATE HOLDER CANCELLATION
CITYOZE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Zephyrhills IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
5335 8th Street REPRESENTATIVES.
Zephyrhills FL 33540 AUTHORIZED ESENT
ACORD 25 (2001/08) CD ACORD CORPORATION 1988
.13- MAY, -2009 09:09 From:CFE 8636769458 To:813 780 0021 P.1/1
ACV 3 9 5:15:6 '- 1 $: ATE! OE FLORIDA _' ,
azp I C PROP SIGNAL REGIDT. ATION
1.. ORS LICENSING 130ARD
SEC# Ii06CIO2103079 • DATE- nalcl, f4t LI'CEN E-A1831 ' , ' 1 E34 r 4 .: . ;-'5
08/27/1008 ` O.13O45062:: ^ Mild 3:29 :.. -=IF 0 `f a - •
The .,ELECTRICAL CONTRhiC roR' :`- , ^ (
( 1� /yp 1-- 0' 1 - • '
. Named _below 411 REGISTERED _ 4.
4�. f:fi - ;t T,. ,- \ Tr
Under t b►e provisions ::- aLCbin 'ti $. T'$ a- . a.; 4 _
Exp'irati deixe c .AUG - 3 1: :2 4 • . 5 a L1
- (` NDIVIDUAL - :MUST` MEET *.t - 710 ..C]CNB•INi ../,' °., , i - '
RB,QUIRBMENTS PRIOR. :Id `CON RACT t -. _ AREA)'-• -
8OAR ' P.I'C REi JT LB8 `^° -. *- '. `° . --.-7,:r::=,, i
OAR ELECTRIC- INC:: ' . x ��," � , : fi i+ Q'• .
37:33. BUCKBOAR TRArL . �I , , ». ,, r '" 1
:LA10E WALES * P 3399.8 -) -~ , , - -
... cr a , V nA`•! - /G f ,•X"� kff. r r r _
Y' =�• a 'r: , �r .,1 : • Cg?1 LE3 W. DRAOO
• Ct'iARLIB CR+ksI , y«.'.�: _ : . '� � e ,. ^ i e.>•' { � r i .. • • ^' - GOVERNOR s; „;:+.; `.. - SECRETARY -
.., ,,, ...:..._..... . . .. ,t . , . DISPLAY ?AS;TREOUIRED LAW
'�" ;;., IMPERIAL P COUNTY LOCAL BUSINESS TAX RECEIPT
,s�.�.- RECEIPT / ACCT r 99 700113 2 0 Cl/US � �
"� ' L�, 9zo EA sr EXPIRES: 9/30/2009 ,�►
\ � .: ",
13 • LAKE WALES - NOT IN CITY ��
O WNER HOAR, RICHARD JULES
230 CONTAAQTOR. ELECTRICAL:UNLIMITE
OAR ELECTRIC INC
920 EAST ST ,
LAKEWALES FL 33853
BUS TM TYPE RENEWAL
BASE TAX 55.00 AOOL FCC PENALTIES. TOTAL. 55.00
1:. 20:,0G3G (G) rp.ifos MN owner Booty 6w.nq N.M*e•
I
JOE G. TEDDER, TAX COLLECTOR 1_J t ^,i ^ J :,, • ru CL); :Ulu • (s4h I vf,' t L .11u2. tC a f tL ,o G1 1 5! a . 7 11 • www Pv kT,txv> w
THIS POLK COUNTY LOCAL BUSINESS TAX RECEIPT MUST BE CONSPICUOUSLY DISPLAYED AT THE BUSINESS LOCATION
0000005500 0000005500 0000000000063280 1001 0 .
Municipal. Board of E, aminers Inc. of Polk County FOLK COUNTY BUILDING DIVISION CERTIFICATE OF COMPETENCY P 0 BOX 9005, 5, ORWR C302, BARTOW. FL 33031 -9005
CERTIFICATE OF COMPETENCY
NUMBER: LTC #:1648- ELECTRICAL REGISTERED
EC 03
ISSUED: 09/08/2004 EXPIRES: 09 /30/2009
NAME: RICHARD HOAR NAME: RICHARD HOAR
ADDRESS: P .0. 80>< DBA: OAR ELECTRIC INC
CITY ADDRESS: 920 EAST ST
4 .
(*Wee, f 1 33838 WALES, FL 33853 -
CLASSIFICATION: UM CONTRACTOR CoNTR IDR: 208
GENERAL CHAIRMAN: KiD Aldridge e
Y $
APPLICANT: REGa :ER13012952
EXPIRES: 09/30/09 ISSUED 09/1//07