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HomeMy WebLinkAbout09-9188 CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 9188 BUILDING PERMIT • 7 "7 : F . , t ' E 11 , i77 3 ...:'. ' ti. x�R ,h „< ..¢, ' '.. , a' E : ..,.. .... ..a we X: � Permit Number: 9188 Address: 7204 OMEGA CT Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: ALPHA VILLAGE Est. Value: Parcel Number: 35- 25 -21- 0050 - 00000 -0750 Improv. Cost: 3,500.00 F; Date Issued: Name: JONES, DOLORES Total Fees: 75.00 Address: 7204 OMEGA CT Amount Paid: 75.00 ZEPHYRHILLS, FL. 33540 Date Paid: 6/11/2009 Phone: (813)715 -1745 YIBBEFT111:", *Mkt Work Desc: INSTALL PATIO COVER 12 X 22 BAHR, RANDY KEITH BUILDING FEE 75.00 ( ■ .� �, I.:a a •..a.: ;��...:: ,�... ;:.._: _ ;.., °_. :.dad s s #. .? _ , o a ,g: ". ..s v • FOOTER 2ND ROUGH PLUMB ''SC 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." C CONTRACTOR SIGNATURE PERMIT OFFI rR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9188 BUILDING PERMIT Permit Number: 9188 Address: 7204 OMEGA CT Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: ALPHA VILLAGE Est. Value: Parcel Number: 35- 25 -21- 0050 - 00000 -0750 Improv. Cost: 3,500.00 Date Issued: Name: JONES, DOLORES Total Fees: 75.00 Address: 7204 OMEGA CT Amount Paid: ZEPHYRHILLS, FL. 33540 Date Paid: Phone: (813)715 -1745 Work Desc: INSTALL PATIO COVER 12 X 22 <�`' �. S � ,.. fl rs. 4�g';t €� p . ". .., D � ; t„`:y v '� ���• _,`.,.i.P '"'S, �.. BAHR, RANDY KEIT BUILDING FEE 75.00 apirej LM. , 4.op ( <tM 6 lb -D` f t FOOTE 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" arf 41 /I CONTRACTOR SIGNATURE PERMIT OFFI 'R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER d • • • 1111111 11111 1111 11111 11111 111111111111111111111111111111111 2009077006 Rcpt:1246381 Rec: 10.00 DS: 0.00 IT: 0.00 NOTICE OF COMMENCEMENT 06/03/09 _ Dpty Clerk Permit No. LA 5 0' N PPSCO CLERK &of 1 PTROLLER 06OORR3PAU6K9 8 EIL 7 FG 1676 Property Identification No. 3S - 0 7 -(5 - -d-/— O X3 V Od WO- 0 7Sd THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and m accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal descriptign :) t'/! /l E eats. PA-/ Pd /9 ,6 - a 14 7J - 6/42 ‘7AP a) Street Address: 7 DI U1)1 IT f 7 Ara() 2.General description of improvements; P J0 C.-14 /L ' )C 07-o- 3.Owner Information a) Name and address: 1 o /ex ✓ Q,!' 70L-17 y d 2 j t. aa-ij- 2 hJ J , • 31W d b) Name and address of fee simple titleholder (if other than owner) c) Interest in property y,° 4.Contractor Information a a) Name and address: 86-AP ( ,f 1 .SAC . acgd J �-f L t j Ze. . /1 F/. 21.17,41-- b) Telephone No.: Fax No. (Opt.) 5.Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6.Lender a) Name and address: 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 date of Notice of Commencement (the expiration date 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 'agt 0 ' bth/Y.1 a0 J Print Name The foregoing instrument was acknowledged before me this d -� day of TLt.Ae , 20 el, , by u r am/ as devit2/` (type of authority, e.g. officer, trustee, attorney in fact) for 1L e/ (name of party on behalf of whom ins ent was executed). Personally Known/ OR Produced Identification Notary Signature 1 Type of Identification Produced Name (print) v Y C /e T Verification 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 belief. FORMS /NOC,rvsd2007 NOTARY PUBLIC - STATE OF FLORIDA Stacie Hartwig , Commission #DD652189 •'�• ,° Expires: OCT. 16, 2009 BONDED THRU ATLANTIC BONDING CO., INC. STATE OF FLORIDA, COtiNTl'OT ii ' THIS IS TO CERTIFY THAT - I HE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNESS MY HAND A,'► 1►FFICIAL SEAL THIS ` _— DAY OF �F , 2 1 PAULA S O'NEL ,A` K S C QMPTROLLGR BY ! s DEPUTY CLERK 06/.10/2009 15:00 3525679638 PASCO FARM BUREAU PAGE 01 .a►c r� CERTIFICATE OF 114 Newa LS C E R TIFICATE IS ISSUED A MATTER OF INFORMATION L {ABI>. E [ 06/0912009 4........--- PROW= Axe ONLY AND CONFERS NO RI UPON THE CERTIFICATE EXTEND OR Allen Altman Agency Pasco Co Farm Bureau ALTER T E CERTIFICATE COVERAG AFF DE ED BY TH O BELOW. 12445 US 3 Dade City, FL 33525 INSURERS AFFORDING CO } E NAM 0 MlVREEO FA.. FL MARL INSURERS: FFVA 1 Behr Aluminum, Inc. INSURER D: 6440 Fort King Rd INSURER C; Zephyfiills, FL 33541 .. INSuRERD: _ . 1.. . I ER INSUR e: 1 COVERAGES THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AOOVE FOR THE POLICY P REOD INDICATED. NOPAMISTANDING ANY REOUIROMENT. TERM OR CONDmON OF ANY OONTRACT OR OTHER DOCUMENT WIN RESPECT TO WHIM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUGIES DESCRIBID HEREIN IS SUBJECT TO AU. The TERMS. CLUSIONS AND cONDmoNS OF SUCH POUCIES. AGGREGATE UNITS SHOWN MAY HAVE DEIN REDUCED BY PASO CLAIMS. t PD � Y ir rl oo mNi 1 1 LIANIS PAN OWL POLICY NURSER DAT, nmoDOI+'Y10'+ DATP T! um MR f NNIIYANCE EACNOCCURREsNGE S GENERAL LUDIUTY DA b'S TO gCwTFA COMMERCIAL GIBIERAL LIABLW PR iTI ISES IFS aea_�p10.NL_ s Mascoow ) S ` CHINS MADE Q OCCUR p@ 6ADVMAY S GE?1 AL _ AGGREGATE LIMIT APPLIES PIM p PRODUCTS • COWAN. A811 $ - t POUCV n •t ri LOG - I AUrcesoBI! UABlUT callow' SINGLE LIMIT $ ANY AUTO Tea Alxident) ALL MS= AUTOS l SIN JURY t SCHEDULEOAUTOS '^ DO YINJURY f — MIRED AUTOS (Per NON•OWNED AUTOS PR RTY DAMAGE s elf areNw _ AUTO ONLY - EA ACCIDENT S GARAGE LIABILITY AGC S ANY AUTO gulp ONLY: AGG = EAC _ iXCE.SSfI)AIDREW UABILITY AGORCGATE: _ OCCUR El CLAIMS MADE 1 - 1 = RETENTION i W CSTATU - ar r COMPENSATOR 1 L I L N• m � urs lei MID °P LOYelrLAe TTY V f w e.L.IeACH ACCIDewT $ 500,400 8 IINYPROP RIE70R�PIIR © wc840- 0021343 -20 01/01109 01/01/10 � ,se• a,,,, s500.000 Niondstery IInN E9ICWDED7 It .desolR. DISEASE- POLICY NIT 1 500 000 - •lCILLPR• �. � . OM ER DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES 'EXCLUSIONS ADGEro R Y ENDOIfS T 7 snow- PROVI$IORS - SHEET METAL WORK CER11F1CATE•HOLDFR Fad • *Phone. CANCELI-ATION womb ANY OP ABOVE P $BCRE!DPOUCIUEER!CANCEU.EDI ORETEREXPIRATION CITY of ZEPHYRHILLS DATE THEREOF, THE ISSUING INSURER YELL ENDEAVOR TO MAIL 1Q_ DAYS TfRII TEN 5335 8th Street Room TOTER: common MOMS! NAEED TO THE I.1iT. RUT PMLURE To 00 SO SH ►LL Zephyrhills, FL 33541 EMPOSD No OBuOA urinary C F ANT IONP UPON TN 8J N. TTE AGENTS OR fax/4113 -78 021 T" �' / ACfI P A I ACORD 25 (2009107) 980.2009 ACOR D CORPORATION. All rights reserved. The ACORO name and logo rsObre d ,narks of ACORD T'd h66E88 s .J4e8 dbtP :EO 60 OT unr 06/10/2009 14:52 3525679638 PASCO FARM BUREAU PAGE 03 77q CERTIFICATE OF INSURANCE /f ... v �� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES LISTED BELOW. COMPANIES AFFORDING COVERAGES: FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 Company Letter A: GAINESVILLE, FLORIDA 32614 -7030 Florida Farm Bureau General Ins. Co. NAME AND ADDRESS OF INSURED: Company RAM t S ALUMINUM INC •- Letter B: 6440 FORT KING RA ZEPHYRHILLS FL 033542 Florida Farm Bureau Casualty Ins. Co. The po ides of insurance listed below have been issued to the Insured named above and are in force at Ih , time. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this oertilioale may be Issued or may penaln, the insurance afforded by the poNcles described herein Is subject to all the terns, exclusions and conditions of such polities. CO. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION LIMITS IN mumps LTR (MMIDD/YY) DATE (MM OD/Yr Germ' Aggregate $ 1000 General Liability: Proauas•canrareee General uadMlly operat amps $ 1000 fxcommerclal (Occurrence Form) . orm) 04 / 15 / l 0 Persand &" Mjury $ 500 A r1 Owner's &Caht►actors CPP 9527..690 04/15/09 Each Occurrence $ 500 ProtettivE' Fire Damage (Ay one lira) $ 50 ; D Fir's Personal Liability Medial Exp a (Any one person) $ 5 Automobile UabMIy: / Combined Single Unit $ IMyBub Bodily Injury 1 All owned autos (Per Person) $ 0 Scheduled autos Bodily Injury ❑ Hired autos (Per Acddont) $ f 1 Non -owned autos Property $ Damage Excess Lability: Each Aggregate Occurrence ❑ Umbrella Form ❑ Other than Umbrella form $ $ Employers LIabIHty: $ ❑ Farm Employer's LIabety (Ennocur nee) C� Farm Employee's Meth $ l $ Other. I ... _ - $ DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES: SHEET METAL WORK CANCELLATION: Should any of the above described policies be cancelled before the explration date thereof. the Issuing company will endeavor to mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY CODE 51 DATE ISSUED 0 6 / 0 3 / 09 CITY OF ZEPHYRHILLS PASCO County Farm Bureau 5335 8TH STREET Serviced by ZEPHYRHILLS, FL33541 JOHN W GRANT, IV AUTHORIZED REPRESENTATIVE 93.7.692 (Rev. 9193) 06/10/2009 14:52 3525679638 PASCO FARM BUREAU PAGE 01 A ® C ERTIFICATE OF LIABILITY INSURANCE 1 DATE MIDDm 06/09/2009 PRODUCER Pax, PAPPAS THIS CERTIFICATE IS IS AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Allen Altman Agency Pasco Co Farm Bureau ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. 12445 US 301, Dade City, FL 33525 FL INSURERS AFFORDING COVERAGE NAIC # INSURED Roll Phonon INSURER A: F FVA Bahr' Aluminum, Inc. IN9URERa: 6440 Fort King Rd INSURER C: Zephyrhills, FL 33541 INSURER D: �• J INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY AY PERTAIN, THE REQUIREMENT, CE AFFORDED BY THE POLICIES DESCRIIBED HEREIN I DOCUMENT B ECT TO ALL THE TERMS, EXCLUSIONS AND CON I11ONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WEIR AOD•L POLICY EFFECTrvE POLICY DIPIRATION LIMITS isI• . _ . POLICY NUMBER w BI rID BITaI RXr /MMe]DPr0:L EACH OCCURRENCE S GENERAL LIABILITY EACH TO RbNTED COMMERCIAL GENERAL LIABILITY PREMISES (F t>LcurinQq) $ 1 CLAIMS MADE E OCCUR , MED EXP (Any one person) $ PERSONAL & ADV INJURY _. $ GENERAL AGGREGATE $ GEN 'L AGGREGATE L!M(T APPLIES PER PRODUCTS • COMPIOP AGG $ _, POLICY PR ti • ■ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ee neolnent) ANY AUTO — ALL OWNED AUTOS BODILY INJURY S (Perpnraon) _ SCHEDULED AUTOS BODILY INJURY (Pet occident) $ -r NON •OWNED AUTOS ' — PROPERTY DAMAGE $ (Per aedtlenl) AUTO ONLY • EA ACCIDENT S GARAGE LIABILITY - OTHER THAN EA ACC S ANY AUTO AUTO ONLY AGG S EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE - $ E OCCUR E CLAIMS MADE AGGREGATE S S R_ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION 1 TORY TATU I J AND EMPLOYERS' LIABILITY Y I N E L EACH ACCIDENT $ 500,000 a ANY PROPRIETOR IVARTNER�EXECW1VE 0 Wc840- 0021343 -2009A 01/01/09 /09 01 /01 /10 (mammon NH) I7rCLUDlD? EL, • EA EMPLOYEE $ 500,000 (Man In NH) SPE ye CIAL tleePROVI,riID un der NS below E.L. DISEASE • POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS SHEET METAL WORK CERTIFICATE HOLDER Fax# Phone# CANCELLATION SHOULD ANY OF THE AnOV! DESCRIBED POLICIES BE CANCELLED BEFORE TEE EXPIRATION CITY OF ZEPHYRHILLS DATE THEREOF, 7145 ISSUING INSURER WILL ENDEAVOR TO MAIL _IQ_ DAYS WRITTEN 5335 8th Street NOTICE 10 THE CERTIFSCATE HOLDER NAMED TO TN! LEFT, BUT FAILURE TO DO SO SHALL Zephyrhills, FL 33541 IMPOSE No OBLIGA •� 0 LIABILITY OF ANY KIND UPON TN USURER; ITS AGENTS OR fax#813 -780 -0021 t(;�P - ATIVES• 1 / A • -•,• REP - 0' • f! , ACORD 25 (2009/01) 988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo , e registered marks of ACORD 06/10/2009 14:52 3525679638 PASCO FARM BUREAU PAGE 02 IMPORTANT .If. the certificate • holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ff SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon_ • ACORD 25 (2009101) 06/04/2009 15:30 3525679638 PASCO FARM BUREAU PAGE 01 CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION � ONLY AFFORDED BY THE UPON THE CERTIFICATE BELOW. HOLDER. CONFERS NO RIGHTS THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER COMPANIES AFFORDING COVERAGES: FLORIDA FARM BUREAU INSURANCE COMPANIES Company P.O. BOX 147030 Letter A: GAINESVILLE, FLORIDA 32614 F1oe Farm Bureau General Ins. Co. NAME AND ADDRESS OF INSURED: Company BAHR ' S ALUMINUM INC Letter B: 6440 FORT KING RD Florida Farm Bureau Casualty Ins. Co. ZEPHYRHILLS FL 033542 The policies of Insurance sated below have been issued to the Insured named above and are in lore at this time. 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, ALL LIMITS IN THOUSANDS CO. POLICY EFFECTIVE DATE POUCY EXPIRATION TYPE OF INSURANCE P OLICY NUMBER D D DATE (MCvtIDD)YY) �1"R General ApgrepAM $ 10 0 0 General Uabillty: a fade $ 3 ( Cornrnrndet General Liability operations 6 Advonless *Ty $ 500 _ (OcoummceForm) CPP 9522690 04/15/09 04/x5/7.0 A ch 0a ,enco $ 5 0 0 Cl L7 Owner's Contractor's Rae Dames (Ary one fire) $ 50 0 Farmer's Personal Liability Medical Esparto (Any one person) $ 5 Combined Automobile LlaWllty: Single Unit $ 0 Any auto . BodOy Injury 0 All owned autos (Per Person) $ 0 Schedurrd autos Bodily Injury (Per Accident) ❑ Hired autos Property Cl Non•avvned autos Damage $ Fxcesq Llablllly: Occurrence � 0 Umbrella Form $ 0 Other than Umbrella loon $ $ $ _ Employers Liability: onxeel El Ferro Employers Lto Nry -'' `\� $ ` Mach wpm* o Farm Ertrployon'e Medical \, Other: WC840-0021343-2009 Workers Com•en - ation .i.• 01 01 2009 500 '000 $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES: / SHEET METAL WORK / J` '" . CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the Issuing company will endeavor to m 7.0 days written notice to the below named certificate holder, but failure to mall such notice shall impose no obligation or liability of any kind upon the co mpa n y. - 0 6 0 3 0 9 ADDRESS OF CERTIFICATE HOLDER: COUNTY CODE 51 DATE ISSUED / CI NAME AND OF ZEPH YRHILLS Serviced by, PASCO Court Farm Bureau 5335 I3TH STREET ZE»HVRHI LTA , FL335 JOHN W GRANT, I V AUTHORIZED REPRESENTATIVE 93.7492 (Rev. 5/93) 06/04/2009 14: 47 3525679638 PASCO FARM BUREAU PAGE 01 CERTIFICATE OF INSURANCE N THE THIS CERTIFICATE IS ISSUED AS A MATTER OF IO ALTER O THE COVERACEAAF ORDER BY THE OOCI S LISTED B HOER NFERS NO RIGHTS THIS CERTIFICATE DOES NOT AMEND, EXTEND OR COMPANIES AFFORDING COVERAGES: FLORIDA FARM BUREAU INSURANCE COMPANIES corny P.O. BOX 147030 Letter A: GAINESVILLE, FLORIDA 32614 - 7030 Florida Farm Bureau General Ins. Co, NAME AND ADDRESS OF INSURED: Company BAHR' S ALUMINUM INC Letter B: 6440 FORT KING RD Florida Farm Bureau Casualty Ins. Co. ZEPHyRHILLS FL 033542 The po des of Insurance fisted below have been issued to the insured named above and are In force at this time. ',standing any requirement, term or condition of any contract or other document with respect to which the certificate may be Issued or may pertain, the insurance afforded by the policies described herein Is subject to all the terms, exclusions and trorrt$O. pole POLICY EFFECTIVE DATE POLICY EXPIRATION ALL LIMITS IN I� CO. TYPE OF INSURANCE POLICY NUMBER ( �p,NDopry) DATE (MMIDD/YY) LTR General Aggregate $ 10 0 0 General Liability: operatlora agg Pio°"��COI" regate $ 10 0 0 OCommoniel General Liability 0 b /15/10 Personal A Advanleing blur). $ 5 0 0 A (Occurrence Form) CPP 9522690 04/15/ $ 500 A ❑ Owner's a Contractor's FIm Damage IAN one Ike) $ 5 0 P►otactNe 51 Farmer's Personal Liabagy • Medeal Warn Vol aw Person) $ 5 Combined Automobile Liability: Single Unit $ CJ Any auto . Sadly Injury $ 7 All owned autos (Per Person) C� Scheduled autos Bodily Injury $ • (Per Acxldent) [] Hired autos Property Non•Owned auras Damage $ Each Ettcess LIablHly: Occurrence Aggregate O Umbralla Form $ $ U Other then Umbrelm form $ Employers uabfPty: 1E80 Name D Farm Employer's Uaagry L $ Farm Employee's Medical $ Emlorne) Outer. — $ DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES: SHEET METAL WORK CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the Issuing company will endeavor to man 10 days written notice to the below named certificate holder, but failure to mall such notice shall Impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY CODE 51 DATE ISSUED 06/ 03 / 09 CITY OF ZEPHYRHILLS Serviced by PASCO County Farm Bureau 5335 8TH STREET ZEPHYRFIILLS, FL33541 JOHN W GRANT, IV AUTHORIZED REPRESENTATIVE 93 -7.892 (Rov, 5/99) • :. City of Zephyr BUILDING PLAN REVIEw COMMENTS 41, / �Ll Contracto omeowner= Date Received: Site: u Permit `Type: Denied -w/the below comments= ❑ Approved w /the below comments' ❑ Approved -wino commence • This comment sheet shall be kept with the permit and/or plans. and/or Homeowner Date Contractor present) Kalvin Switzer — Tans Examiner Date (Regwred when comments are p Building Department -- q( 6 b Date Received / 0 9 Phone Contact for Permitting Q/3 70 -- S ,3 U / red -T Own er Phone Number ' 0 /3 7 /s - / 7 J ` f Owner's Name 1 9' d,')/ 2 L 7 Owner Phone Number Owner's Address Fee Simple Titleholder Namel I Owner Phone Number I I I Fee Simple Titleholder Address // �J �- I JOB ADDRE 7 e�-d ]� d /Pep- CO ` I LOT # I 7`r �O 1 9 _ a � s Q I SUBDIVISION rili% Ji I PARCEL I#I (..X-41 d dTd _ b (/41/.2L& C � (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED l NEW CONSTR I I ADD /ALT I I SIGN I I MOVE 1 1 DEMOLISH INSTALL REPAIR PROPOSED USE 1 1 SFR I I COMM I I OTHER 1 TYPE OF CONSTRUCTION 1 I BLOCK I I FRAME 1 I STEEL I I OTHER 1 I DESCRIPTION OF WORK 1 A ld COM r 4- f xo2.d -/ I BUILDING SIZE I /0 ` X 6 I SQ FOOTAGE I b2- 1 Y I HEIGHT I I BUILDING $ 3, SVO (1) VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY Li W.R.E.C. PERMIT E. VICE I PLUMBING I$ I .813) 7(18-53141. I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS 1 1 ROOFING 1 I SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I 'YES I 1 N • 1 ir �+ BUILDER / COMPANY Cr f FEE CURRENT , -/`C N SIGNATURE XICt11-41/ REGISTERED � Y / N Address C I V W For/ / L C A S Ad 2 /rF7- JJ42- License # ELECTRICIAN COMPANY 1 SIGNATURE I REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I Address License # 1 PLUMBER COMPANY 1 SIGNATURE REGISTERED I Y / N I FEE CURRENT 1 Y/ N I Address License # MECHANICAL COMPANY 1 SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # 1 OTHER COMPANY 1 SIGNATURE REGISTERED L Y/ N 1 FEE CURRENT I 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) 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 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. (AIC 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 TWICE PAYING LENDER OR AN ATTORN ATTORNEY BEFORE FINANCING, CONSULT FORE RECORDING YOUR NOTICE O COMMENCEMENT. WITH YOUR FLORIDA JURAT (F.S. 117.03) ��� OWNER OR AGENT t- - /0-414 CONTRACTOR ca_ 104_34/.6- Subscribed and sworn to or affirme befo me � e this / J _ _S . bscribed and sworn tq �?r affirmed efor me this /Jr 72� di by f t f C' if T 4.4c e9 by clY -t Who is /are personally known to me or has /have produced Who is /are personally kno�a.uw -oi-ha // s e tiff aced. as identification. / e)GZ,Notary Public /` 4 Notary Public Commis in No �Ti [ i. A �� � Commission o. NOTARY PUBLIC- ,:?, F, r� . R TTT Name of Notary typed, p ?fir st d Name of Notary typed, prm tsl ped . • i //://.11 -7 - 1 -- ---4----- 1 i I i 1 I QD 1 1 c›. N.) 1 , , 1 parE,,O j,). ° , , A 6,a i } P412 00o M e--- 020 , t /6,00 i - 1 , 0 1 P .. i 15-.00 i f / , Co ' 1 _ ,v .„ ,00 , 1 1 I .. ' ' - '. ' L-, W. , .,‘,'. ,. , :; ' : - . .. . -: .7 : -- ,. *. • . ; - 7 b.2_ 0 REVIE‘Al DATE 01 -' 7 7.EP!—IYRH IL_ PL/-::-,:, _ . _. , i „: :Ni ALL WORK SHALL COMPLY wiTH ALL . 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