HomeMy WebLinkAbout09-9184 CITY OF ZEPHYRHILLS
• 5335 - 8TFI STREET
(813)780 -0020 9184
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
Permit #:9184 Issued: 6/02/2009 Address: 6104 ST
Permit Type: GENERAL BUILDING PERMIT ZEPHYRHILLS, FL.
Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 2,278.00 Total Fees: 45.00 Subdivision: PARK HILL
Amount Paid: 45.00 Date Paid: 6/02/2009 Parcel Number: 02- 26 -21- 0180 - 00000 -0550
Name: WEST COAST ALUMINUM & SCREEN INC Name: NOONAN, ROBERT & CONSTANCE MARIE
Addr: 1451 ALAMEDA DR Address: 6104 17TH ST
SPRING HILL FL 34609 ZEPHYRHILLS, FL. 33542
Phone: (352)684 -3721 Lic: Phone:
Work Desc: GENERAL REPAIR TO SMALL FIRE DAMAGE ALUMINUM ROOM AREA
BUILDING FEE 45.00
P
° 9
00 . p b 4 s2 €C1ffi•= 4 ,7 _ ... . 404 a. �. � ,.,.. "'
FOOTER 2ND ROUGH PLUMB MISC� INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE -SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
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."
CONTRACTORS SIGNATURE PERMIT OFFI I -
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813- 780 -0020 City of Zephyrhills Permit Application C� Fax -813- 780 -0021
Building Department '( / -7
Date Received l -- %, jt Phone Contact for Permitting --
Owner's Name g d / ,f •' b €P j�.l ace b1.A" / Owner Phone Number
Owner's Address o/ 0 V t 7 f/ Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 0 /o / �/
/7 IL c LOT # 7 I
SUBDIVISION Par K u "`M PARCEL ID# o a 6 at of 90 OGOO a O. r.r
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED I I NEW CONSTR ADD /ALT 1 1 SIGN I-1 MOVE I 1 DEMOLISH
INSTALL REPAIR
PROPOSED USE [1 SFR 1 COMM n OTHER I 1
TYPE OF CONSTRUCTION 11 BLOCK 1 1 FRAME 1 1 STEEL n OTHER I //4M n 4, #v)
DESCRIPTION OF WORK & Yv, / /I !! c '/'
BUILDING SIZE SQ FOOTAGE HEIGHT
BUILDING $ 2_2._ 6 �3 /� VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY n W.R.E.0
1 PLUMBING $
1 I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
1 1 GAS 1 1 ROOFING I 1 SPECIALTY n OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES 1 NO
BUILDER 7"... COMPANY LIJ65 T GO q f AW al S
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
V5
Address 1 �/ /Ill /*/ 6J4 h' f/%4.,' /id/ License # I �CG O , �6 7 ,S r
790
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address I License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address 1 License #
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1
Address 1 License #
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1
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. (NC 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.0
OWNER OR AGENTY CONTRACTORq(
Subscribed and s t (of b re me this Subscribed and sworn to (or affirmed) befoFe me i �� / 7P,
- -c)G} by Jr' /7. 4 - 1 t Cl�q.-,d /P/ 6 -2 -0ci by' , C./� 4-' `�: G+ d
Who is/are personally known to me or has/have produced Who ersonally known to me or has /have produced
(,,, Cg ¢ as Identification. L c € S-< as identification.
3
D�i� M. 10%.*---
Notary Public
i k Notary Public x .; Yom, JACQUELI elk:—
DD 3
Co rn sio _ 62183 Commissi No. �/ , o�:� ,, JACQUELINE DOGES ': t,: ; n € Exp Deco � .. L E Co DO 2010
December 12 DD 621833
• � ! a arnNTnvrbmmaN+ F S
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Name of Notated, printed or stamped Name of Notary typed%; - O Fain I nsurance 80
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• Acrylic Rooms WEST COAST 1451 Alameda Dr.
• Pool Enclosures Spring Hill, FL 34609
• Screen Rooms ALUMINUM AND SCREEN INC.
• Car Ports Phone: 727 - 856 -4999
• Glass Rooms www.westcoastalum.com Phone: 352 684 - 3721
• Entry Ways - Toll Free: 1- 877 - 789 -3721
• Vinyl Rooms Fax: 352 -556 -2584
• Aluminum Roofs
• Concrete
FREE EST MA TES • STATE CERTIFIED LICENSE #SCCO56755 • BONDED & INSURED
Purchaser (4(4/ / 0a✓�.f e/"0 )6 ti Subdivision
Address 7 q yy g 74' /e 4 CA Directions
City it/f°4. State PL Zip 7 W sf
PH: (H) ?.27 - v - PH (W) IC*. 2.2 9 , 6 41f
Job Address N o4.1v, a. 6 l oy n " s. ❑ Estimate ❑ Contract
WEST COAST ALUMINUM AND SCREEN INC. agrees to furnish labor and materials and estimates good
for 30 days for the improvements on the above real property according to the following specifications:
Type 1Jk /// ("it k v Wall Hgt. 'h Doors ( Spouts
Color ? Riser Wall Elite --- "'• t, Kick Plate '�
Roof Style - Dbl. Chair Rail Y Pans of Fla. Glass
End Wall --- Gutter i Fan Beams Posts
Carrier Beams
Permit Information:4Yes ❑ No Approx. Sq. Ft. Roof Approx. Sq. Ft. Walls
Description of work:
go / c e .
k, S e- li e, el Vt' y/ W , ws
5c,,,f c
Contract Price: 2 7 S
' Deposit: Zo
R b
9 '
P4
Balance Due: 2a 79. 4.
A survey sheet r a p lot plan and complete legal description is required on all pool and patio enclosures.
PERMIT MUST REMAIN POSTED UNTIL FINAL INSPECTION.
TERMS OF CONTRACT
It is agreed by and between the parties hereto that upon default of any payment or breach of any of the covenants herein, the entire unpaid
balance shall become due and payable immediately, and thereupon seller and his assigns may collect any unpaid balance due under said
contract together with a reasonable attorney's fee and take such other action as seller may elect to pursue to collect any unpaid balance
due hereunder. If it becomes necessary to employ an attorney in exercising any one of the foregoing remedies, seller and his assigns shall
collect a reasonable attorney's lee In addition to the remedy aforesaid from the Purchaser. It is also agreed that the said goods shall
remain the property of WEST COAST ALUMINUM AND SCREEN, INC. until fully paid for In cash, no matter what manner or whatever degree
it may be attached to the realty. Purchaser agrees to keep said property in good condition and working order until said property has been
paid In full. No verbal or written agreement on the part of anyone other than contained herein Is valid or binding on the company and shall
not be accepted by the Purchaser. Purchaser agrees to pay Interest at one and one half percent (1.5%) per month from completion date.
This contract and terms therein will constitute any provision for a notice to the Purchaser as are provided or may be provided under the
laws of the State of Florida relating to the work lien law or any other Ilen provisions under the laws of the State of Florida. Guarantees are
void if other installations are added in any way to work done by WEST COAST ALUMINUM AND SCREEN, INC. 1 hereby acknowledge receipt
of a copy of this contract. Since these goods are custom made, this order Is not subject to cancellation.
Standard Warranty Period 1 - Year for workmanship /materials unless specified other. No warrantee on concrete.
By Signing this estimate he purchaser agrees to enter a binding contract with West Coast Aluminum and Screen Inc.
%? . = 9 -�1
SALESMAN PURCHASER
# 3 9 9 4 7 7' 7 STATE OF , FLORIDA
DEPARTIYIENT
. CONS OF BITSINESS RJ � N LBOARD ATIO S L08091102"372
DATE BATCH NUMBER
09 11 2008 08010914 ; SCCO5675-5
The SPECIALTY STRUCTURE CONTRA .OR: ; #
Named below IS CERTIFIED
Under the provis3.ons of Chaps 'S
Expiration date: AUG 31, 2010 .,.
1
CHANDLER 07ILLIAM EUGENE
WEST COAST ALUMINUM & SCREEN..INC' .�. 4
1451 ALIEDA DR
34609 SPRING HILL FL 3
CHARLES �7 D1�
CHARLIE E� Sf'LR A #T C!UIRED .B SECRE
RNOR 'Y LAW
PASCO 0 .I' BUSINESS TAX RECEIPT 2008 -09
Issued pursuant the This license must bee and o Pasco c County sly In place of bus business. Expire tmr compliance with
Mike 01soe
ACCOUNT' N0: 074446 TAX COLLECTOR SPECIOFTBUSINESS:
SIC CODE 1741.05 PASCO COUNTY .FLORIDA CONTRACTOR
..*".011"E srq >F •. LOCATION ADDRESS:
°^ • 18807 OLD SHADY HILLS RD
• ,a :I
ti o ..;
SPRING HILL
WEST COAST ALUMINUM & SCREEN I ; Si 2
18807 . 0LD SHADY HILLS .; RD • DATE RECEIPT AMOUNT
SPRING HILL FL 34610-6735 "co
07/24/08 549396 31.25
I r, �1lr ,lurlullnlrl�llnrlrr�lirr
•
if 6/2/2009 11:50 L ion Insurance Lion Insurance Company -►CITY OF ZEPHYRHILLS 1/1
Date
CERTIFICATE OF LIABILITY INSURANCE 1 6/2/2009
Producer: . Lion Insurance Company This Certificate is issued as a matter of information only and confers no rights
2739 U.S. Highway 19 N. upon the Certificate Holder. This Certificate does not amend, extend or alter
Holiday, FL 34691 the coverage afforded by the policies below.
727 - 938 - 5562 Insurers Affording Coverage NAIC •
Insured: South East Personnel Leasing, Inc. Insurer A: Lion Insurance Company 11075
2739 U.S. Highway 19 N. Insurers:
Holiday, FL 34691 Insurer C:
Insurer 0:
Insurer E:
Coverages
The policies of insurance listed below have been issued to the insured named above for the polity period indicated. Notwithstanding any requirement, term or condition of arty contract or other document with respect to which
this certificate may be issued or may pertain. the insurance afforded by the policies descnbed herein is subject to all the terms, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by
pad claims.
INSR ADDL Policy Effective Policy Expiration Date Limits
LTR INSRD Type of Insurance Policy Number Date
(MM/DD/YY) ( MM/DD/YY)
GENERAL LIABILITY Each Occurrence $
Commercial General Liability
Damage to rented premises (EA
Claims Made Occur occurrence) $
Med Exp $
Personal Adv Injury $
General aggregate limit applies per: —
General Aggregate $
D Polity 0 Project a LOC
Products - Comp /Op Agg $
AUTOMOBILE LIABILITY Combined Single Limit
(EA Accident) $
Any Auto Bodily Injury
NMI
All Owned Autos
(Per Person) $
Scheduled Autos
r— Bodi y Injury
Hired Autos
Non -Owned Autos (Per Accident) $
Property Damage
(Per Accident) $
EXCESS /UMBRELLA LIABILITY Each Occurrence
R
Occur a Claims Made Aggregate
Deductible
■
A Workers Compensation and WC 71949 01/01/2009 01/01/2010 X I Cory Limits I I ER
Employers' Liability
Any proprietor/partner/executive officer /member E.L. Each Accident $1.000900
excluded?
E.L. Disease - Ea Employee $1.000,000
If Yes, describe under special provisions below.
E.L. Disease - Policy Limits $1000 000
Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616
Descriptions of Operations /LocationsNehicleslExclusions added by Endorsement /Special Provisions: Client ID: 29. 44-021
Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to and working for the following "Client Company":
West Coast Aluminum and Screen Inc.
Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. active employee(s) , while working in Florida.
Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity.
A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562.
FAX: 352 -556 -2584 & 813 - 780 -0021 / ISSUE 06 -02 -09 (TD)
Begin Date 9/17/2007
CERTIFICATE HOLDER CANCELLATION
CITY OF ZEPHYRHI LLS 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. but failure to do so shall impose no
obligation or liability of ary kind upon the insurer. its agents or representatives.
5335 8TH STREET
ZEPHYRHILLS FL 33542 e.....4.1
06/02/2009 12:19 FAX 3526862891 WHITING AGENCY 8002 /002
CERTIFICATE OF INSURANCE
The company indicated below certifies that the insurance afforded by the policy or policies numbered and
described below is in force as of the effective date of this certificate. This Certificate of Insurance
does not amend, extend. or otherwise alter the Terms and Conditions of Insurance coverage contained in any
policy numbered and described below.
CERTIFICATE HOLDER: INSURED:
CITY OF ZEPHRYHILLS BUILDING WEST COAST ALUMINIUM AND
DEPT SCREEN INC
5335 8TH ST 1451 ALAMEDA DR
ZEPHRYHILLS, FL 33542 SPRING HILL, FL 34609 -5712
POLICY NUMBER POLICY POLICY LIMITS OF LIABILITY
TYPE OF INSURANCE & ISSUING CO. EFF. DATE EXP. DATE ( *LIMITS AT INCEPTION)
LIABILITY 77 -AC- 732952 -3001 10 -22 -08 10 -22 -09
[X] Liability and NATIONWIDE Any One Occurrence $ 300,000
Medical Expense MUTUAL
[X] Personal and INSURANCE CO. Any Dne Person /Org $ 300,000
Advertising Injury
[X] Medical Expenses ANY ONE PERSON S 5,000
fxl Fire Legal Any One Fire or Explosion $ 100,000
Liability
General Aggregate* $ 600,000
Prod /Comp Ops Aggregate* _ $ 300,000
[ ] Other Liability
AUTOMOBILE LIABILITY
f 1 BUSINESS AUTO Bodily Injury
(Each Person) E
r 1 Owned (Each Accident) 3
[ ] Hired Property Damage
r 1 Non-Owned (Each Accident) S
Combined Single Limit $
EXCESS LIABILITY Each Occurrence
Prod /Comp Ops /Disease
[ 1 Umbrella Form Aggregate*
STATUTORY LIMITS
[ ] Workers' BODILY INJURY /ACCIDENT ._ $
Compensation Bodily Injury by Disease
and EACH EMPLOYEE S
[ 1 Employers' Bodily Injury by Disease
Liability POLICY LIMIT S
Should any of the above described policies be cancelled before the DESCRIPTION OF OPERATIONS /LOCATIONS
expiration date. the insurance company will endeavor to mail 10 days VEHICLES /RESTRICTIONS /SPECIAL ITEMS
written notice to the above named certificate holder, but failure to
mail such notice shall Impose no obligation or liability upon the
company, its agents, or representatives.
Effective Date of Certificate: 10-22-2008 Authorised Representative: Whiting Agency Inc.
Date Certificate Issued: 06-0Z-2009 Countersigned at: 11270 Spring Hill Drive
Spring Hill, FL 34609
06/02/2009 12:19 FAX 3526862891 WHITING AGENCY 11001 /002
WHITING AGENCY, INC
11270 SPRING HILL DRIVF.
SPRING HILL, FL. 34609
352.686 -2891
352 -686 -2894 FAX
FACSIMILE TRANSMITTAL SHEET
'I't): vaOM;
Licensing Lyndy Bianculli
COMPANY: DATE:
City of Zephrybills 6/2/2009
I AX NO: NO 171+ l'ACRS:
813- 780 -0021 2
I7IIC)NI! NUMI11ill• al(NDI;It'S RI {I %I %I(I(NCI+ N(JM11RR:
RI ^ YOIIR RL l'ERIINCls NUM1MR:
West Coast Aluminum
❑ URGENT ❑ FOR RRVTI ?W ❑ PLEASE COMMENT ❑ 1'I,I ?ASI; REPLY ❑ PI.EAS1 +, RI +,( :YC;1.1,
NUTES /C:OMMENTS
Certl6cate of insurance
Thank you,
Lyndy Bianculli
•
1!MAII. ADDRItNS LYNDY@Wlll'I'IN(:INS.( :UM
Confidentiality Nonce-This Facsimile Contains confidential information which may also be legally privileged and which is intended for the use of
the addreaaec(a) named above. if you have retA_ivt d this facsimile in error, phase notify us in'uncdiately by telephone and shred the entire
facsimile.