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09-9750
CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9750 RESIDENTIAL SWIMMING POOL igzsmay Permit Number: 9750 Address: 6843 STEPHENS PATH xr. Permit Type: SWIMMING POOL RES. ZEPHYRHILLS, FL. Class of Work: SCREEN ENCLOSURE Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 03-26-21-0160-00000-0560 Improv. Cost: 39,000.00 °,e Date Issued: 11/10/2009 Name: MEIKLE DAVID G Total Fees: 400.00 Address: 2135 LOWER DOWDA MILL RD Amount Paid: 400.00 BALL GROUND GA 30107 Date Paid: 11/10/2009 Phone: (770)73 -3771 " or ' esc• 1 1 X 0 • U i• W SC ••/ / RN ENCLOSURE IMA RIVIERA POOLS INC �. BUILDING FEE 330.00 HAWKINS ELECTRIC SERVICE CO PLUMBING FEE 35.00 RIVIERA POOLS INC ELECTRICAL FEE 35.00 @J • r . :;: -c am i,F7 . ", a sv l� POL O STEEL POOL DECK & FOOTER POOL ELECTRIC BOND POOL PLUMBING /PRESSURE FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." to! 1_ 6e0z, fir 44 it, '- 0 TRAC OR PERMIT OFFI v 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 6 i 3 Fax - 813- 780 -0021 Building Department 14'91 `71 J(/ Date Received q 7n 9 D"/ - I Phone Contact for Permitting Owner's Name (tI A t 1 .i€._ _ Owner Phone Number 8 7se- / 1 Owner's Address I661$143 54e1p,S f0. 1 1 Owner Phone Number Fee Simple Titleholder Name 11(A. Owner Phone Number Fee Simple Titleholder Address -- ` n 11/G JOB ADDRESS (2 243 �- cehens ra d� fff Q� • LOT# SUBDIVISION � Gb, • R t PARCEL ID# ©3 2 . 1 4160' D0 - 03619 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED E NEW CONSTR ADD /ALT n SIGN In MOVE n DEMOLISH INSTALL REPAIR PROPOSED USE I 1 SFR n COMM E OTHER _ {fit .SJWjp 1 TYPE OF CONSTRUCTION n BLOCK I FRAME n ' STEEL n OTHER r DESCRIPTION OF WORK / ', , S 11 „ ( yt / _ _ _ sr I )\ (, " ' PCSA t BYIL�ING SIZE 1 V X 30 SQ FOOTAGE l iSD IGHT °� ' W $ 38 t OW. VALUATION OF TOTAL CONSTRUCTION rte." I.-- I ELECTRICAL $ ( AMP SERVICE PROGRESS ENERGY n /W.R.E.C. / n PLUMBING $ / re'lS I / n MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1)�s, ( P('� / n GAS n ROOFING I SPECIALTY n OTHER V { / FINISHED FLOOR ELEVATIONS FLOO VE AREA I In NO ! - 3 b BUILDER &kV; I COMPANY` V [e3 SIGNATURE REGISTERED Y / ms 7 c N I FEE CURRENT I Y 1 N I Address 144 e /V • Mi • AO. /.WIQti ` j License It �� NS 648 ' I ELECTRICIAN -�' COMPANY ,(„(y S Li Ce'i*4MM SIGNATURE �p 1 • / REGISTERED Y / N FEE CURRENT 1 Y / I Address I PO. O-1� iw4' * SI � ri- 334 License# I Er, XL/ I PLUMBER ,j1/4-741/1 I, Y ,D COMPANY 1VIIe�K�'� SIGNATURE r _ REGISTERED Y/ N I FEE CURRENT I Y/ N 1 Address /4L 0 qi N. NebrytM Ave. 7 _ \ $. ii Nikti License# tit-- 145441R' MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I License it OTHER COMPANY SIGNATURE REGISTERED I I Y/ N I F EE CURRENT 1 Y N Address 1 License # I 1 I 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, 1 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 Attomey (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 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 A 0 - EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F. . 1-7. e) jl OWNER OR AGENi CONTRACTOR ' AX Subscribed and too (or rrpgd)r, this Subscribed and sY bpfore.gie J is �{,� 11f � b Al � .el Who Is /are persinally known to me or has /have produced Who Is /are personally known to me or has/have p oduced as Identification. as identification. Notary Public Notary Public 4 JACQUELINE BOGES Commission * Comm' Commission No. r' ^r" JACQUELINE BOGES i�sion DD C29833 " '•`� f* ill - 14 Commission DD 621833 : Expires December 12, 2010 - ��,i • Bonded TM, Troy Fain Inc...". am 309 7019 d► � � + r C Gx Ir mbnr 12, 2010 Name of Notary typed, printed or stamped Name of Notary ty.: ��"f+"`e`* � � Ina"ance 800.386 -7019 813-780 -0020 City of Zep' - iyrY , s -erm: ': Aooca'. "c Building Doliart II -lit Date Received Phone Contact for Permitting i i I r 111 3�f 1�3 tr I I I I I t t�fFl Owner's Name _. Owner Phone Number Owner's Address ( Owner Phone Number I —___ I Fee Simple Titleholder Namel - -- Owner Phone Number Fee Simple Titleholder Address _ JOB ADDRESS _ 1 I I I LOT # I SUBDIVISION I 1 PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR I I ADD /ALT I SIGN 1 I MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR I 1 COMM I I OTHER 1 TYPE OF CONSTRUCTION I I BLOCK I I FRAME I I STEEL I I OTHER I I DESCRIPTION OF WORK I BUILDING SIZE SQ FOOTAGE ( I HEIGHT I BUILDING $ VALUATION OF TOTAL CONST I ELECTRICAL $ AMP SERVICE I P O SS ERGY I I W.R.E.C. I 1 PLUMBING $ MECHANICAL $ d(ALUA 111 OF EC ' NICAL INSTALLATION I GAS I I ROOFIN' I I SPECIAL I I OTHER FINISHED FLOOR ELEVATIONS LOOK ZON. AREA 1 IYES 1 'NO BUILDER , 1 SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y / N I Address License # I ELECTRICIAN COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y / N I Address License # 1 PLUMBER COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # r MECHANICAL COMPANY 1 SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # I OTHER COMPANY 1 SIGNATURE REGISTERED L Y/ N I FEE CURRENT 1 Y/ N I Address License # F RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-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 i l ` City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: l' i/ / era ad- Date Received: //— soq Site: 68t-f3 Ls� 7 hP, :S ig7- Permit Type: 51- po // ' L 66 , Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑ 2007 li //1/ keg ' * dAft(4 41 i' I--4, /lc ,// oe larr. '. v9- /l Jiro i , i44'? Sj,1P J l .iLikr_oz y4.4404' 3) c./ s 4 , s ri This commen;s hall be kept with the permit and/or plans. /ice* Kalvm Switz s Examiner Date ontractor and/or omeowner (Required when comments are present) HILLSBOROUGH COUNTY BUSINESS TAX RENEWAL INSTRUCTIONS Chapter 205.0535 (5) Florida Statutes requires one of the following: FEDERAL EMPLOYER IDENTIFICATION NUMBER - OR SOCIAL SECURITY NUMBER 1. SIGN and return entire form in enclosed envelope, Your validated Business Tax receipt will be returned to you. 2. Eusiness Tax receipts expire midnight, September, 0th. Failure to display a valid Business Tax receipt after Septernber 30th is a violation of HifIsborough County Ordinance 95-4, as amended by 02.5. MAKE CHECK PAYABLE TO: DOUG BELDEN, TAX COLLECTOR P 0 Box 172920 TAMPA, FL 33672 -0920 2009 - 2010 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT _ EXPIRES 9- 30.2090 POLIO NO — 9TAcIle 1'1ESaR MACHINES -- laws— " — LAI I —' - _ 0 0I I ca - 1 I L -- 11 187432 1. UCC CODE EsUSINFSS TYPE H WASTE TAX D90.008 CONTRACTOR - ELECTRICAL SURCw,Rr,E 18.00 - BUSINESS 9260 BAY PLAZA BLVD 504 — '' C. LOCATION TAMPA 3 3619 1- ' 1 "' ■ NAME HAWKINS TROY: BLAJRJDBAJHAWKINS El EC SVC CO INC ''• —i MAILING, PO BOX 89488 ADDRESS TAMPA FL :33689 x - 689 -- 0 C'," G a BUSINESS TAX - :T. < - -- DOUG BELDEN, TAX COLLECTOR .- !IAl NFRGO� P4DA PRIV0.ect• TA%R7FNUgra[ �. :"' r c• „ "" _ IN PVa1NES5 PRQFT ^$IQN CR OCCUPATION PJ'•(•1:4 ILU HEREO THt3 9ECOMES A T Ak R 35 -5200 RECEIPT WHEN VALIDATED. �r .):.. 4106 18743200000 000018002 00000000 _ T'T'd 2t'86LTL2Te :oi 8029I TS +t2t7ST89 00 30I063S SNI)IMdH :wOJd 22 :0T 6002- 0T -riON NOTICE OF 111 COMMENCEMENT . 2009159932 Rcpt:1272164 Rec:20.00 Permit No. DS : 0.00 IT : 0.00 Tax Folio No. h3 - 2�. Zt - Oi6o - 0090_05190 11/05/09 - _.________ Doty Clerk THE UNDERSIGNED hereby gives notice that improvements will 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): l SC Sev/,w,r� 6)e„ S4e, 04 //14,31 7••✓' P. 3/ a) Street (job) Address: C27(13 Ser 4e.is "ct> ,0,, 1 _ /Sf 2.General description of improvements: 5,,,, o • !,- '� s F� 3�S5�z 3.0wner Information a) Name and address: p Ale/A/R C 9y3 .5406,,,, f' {� 4. / ..r 75 L b) Name and address of fee simple titleholder (if other than owner) at c) Interest in property '.Contractor Information • • a) Name and address: X'v,?• G mils • /yYd� - / f /1/s.6ios/Ec` i4vr. Ty ,., a FL 3 b) Telephone No.: Ft /7- le /- 2 .7Sg Fax No. (Opt) 5.Surety Information a) Name and address: /( / /`f PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER b) Amount of Bond: 11/05/09 1 4 1 of 1 c) Telephone No.: Fax No. (Opt.) _ OR BK 8 PG 145 6.Lender a) Name and address: ^/ /jl- 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: rt/ /// 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(I)(b),. Florida Statutes: a) Name and address: /t 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 J013 SITE BEFORE THE FIRST INSPECTION. W YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. SPATE OF FLORIDA�� COUNTY OF 10. ; Signature of Owner or Owners Authorized 0 irector /Partner/Manager Print Name The foregoing instrument was acknowledged before me this 22 " `day of O,. 6.i , 20 0 9; by • as ,Se , (type of authority, e.g. officer, trustee, attorney in fact) for S-� /1 (name of party on behalf of whom instrument was executed). PersonallyKnown OR Produced Identification Notary Signature �� • Type of Identification Produced Name (print) 4 Verification pursuant to Section 92.525, Florida Statutes. Under penal 'es 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.r , noo7 4 4:7.k., TIM BEIANGER i ' • ✓s -.r im : = MY COMMISSION # DD 522368 ignature of Natural Person Si 4 ,1....41 EXPIRES: March 11 2010 Signing (� line # 10.) Aboye •:f os F�°P` Bonded Thin Notary Public Underwriters STATE OF FLORIDA, COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNSS MY HAND AND 0 FICI SEAL THI DAY OF PAULA O'NEIL, CLERK &. OMP ROL ER BY / �/_ _ ' P ' CLERK C�e.'� 7 - 2009 i0:4 AM PROGRESS ENERGY 8137150824 1 ! 1 c E nergy October 27, 2009 Riviera Pools, Inc. 14409 -B N. Nebraska Ave. Tampa, FL 33613 Phone: 813 - 961 -2358 Fax: 813 - 977 -0330 SUBJECT: PROPOSED SWIMMING POOL CONSTRUCTION AT: 6843 Stephens Path, Zephyrhills, Florida Dear Valued Customer: Thank you for notifying us of your proposed swimming pool construction at the above location. We have checked our facilities for this location and there does not appear to be any conflict with the location of the pool. Therefore, we have no objection to the proposed construction. Prior to digging please call Sunshine One at 1 -800- 432 -4770. Florida law requires excavators to call this number so that underground utility equipment can be located before excavation to avoid personal injury and damage to equipment. If you have any questions or require any additional information, please call our office at 727 -372- 5154. Sincerely, PROGRESS ENERGY FLORIDA, INC. . c Darryl Foshee Distribution Engineering D F /atn SOUTHCOAST DIVISION ENGINEERING • 4121 St. Lawrence Drive • New Port Richey • Florida 34653 Telephone (727) 372 -5159 Fax • (727) 372 -5117 PROGRESS ENERGY Pasco County Parcel: 03 -26 -21 -0160- 00000 -0560 001 Page 1 of 2 Search Again Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: II Weekly Archive - Thursday, October 22, 2009 I Parcel ID I 03 26 - 21 - 0160 - 00000 -0560 (Card: 001 of 001) Classification 01 - Single Family Mailing Address Property Value MEIKLE DAVID G Ag Land $0 6843 STEPHENS PATH Land $47,113 ZEPHYRHILLS, FL 335420655 Building $107,046 Physical Address Extra Features 6843 STEPHENS PATH $902 ZEPHYRHILLS, FL 33542 Market Value $155,061 Assessed (Save Our Homes) $155,061 Legal Description (First 4 Lines) Homestead 196.031 tf;�. - $25,000 See Plat for this Subdivision t" Non - School Additional Homestead Exemption - $25,000 STEPHEN'S GLEN AT SILVER OAKS PHASE TWO Non - School Taxable Value $105,061 PB 31 PGS 150-151 School District Taxable Value $130,061 LOT 56 Warning: A significant taxable value increase may occur when sold. Click here for details and info. regarding the posting of exemptions. I Land Detail (Card: 001 of 001) Line I Use IlDescriptionll Zoning II Units II Type II Price 0 Condition II Value I 1 U 0100 11 SFR II OPUD II 6,000.00 11 SF II $7.08 11 1.00 II $42,480 I 2 I 0100 11 SFR II OPUD 11 3,648.00 11 SF 11 $1.27 11 1.00 11 $4,633 Additional Land Information Show Mineral Rights - 5 1 Acres 11 0.22 11 Tax Area II 30ZH I FEMA Code II X IIResidential Codell SIVLGP1 I Building Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1995 Stories 1.0 Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C Central Baths 2.0 1 Line II Description II . Feet 1l Repl. Cost New 1 BAS 1,596 I $101,873 1 1 2 II FSP II 398 I1 $8,872 1 3 80 1I $ 3277 II FGR 4 11 46 11 $ ,915 I Extra Features (Card: 001 of 001) Line I Description I Year it Value I 1 II I s I I DWSWC I 1995 I 611 $902 Sales History Previous Owner 1 SMITH GARY C & JOAN P I Year I Month I Book /Page 0 Type 0 Amount 1 2009 II 09 I 8186 / 1624 1I WD II $181,000 I 2005 1 1 06 1 6443 / 1143 I WD II $194,000 I 2000 l 08 I 4419 / 1378 II WD 11 $ http: / /appraiser.pascogov. com/ search /parcel.aspx ?sec =03 &twn= 26 &rng =21 &sbb= 0160 &... 10/27/2009 Pasco County Property Appraiser - Map Page 1 of 1 Pasco County, Florida Section 03, Township 26, Range 21, 2.0 miles NW of Zephyrhills Prepared by the Office of Mike Wells, Pasco County Property Appraiser. Map Created on 10/27/2009 at 2:15:52 PM. IM I. I ' ! Ira 11 ¢ ' ' iJ c' k ., 1580' ', 4 Isja • r157p; r `s ' ' '4 4 , , ,::, , ¢ 4i fi ..,...e . t ii,. 1 ` l p of f ,.. , :; -,... ,..,. http: // maps. pascogov. com / maps / print. asp ?img= /mapdata/43231515342093 9. jpg &id =U2... 10/27/2009 I-4. HAWKINS SERVICE Co. 1 ' Pool & Spa Specialist A 0 Box 89489 Tampa, FL 33689 -0408 Tampa, FL 813 - 871 -6610 Fax: 81 3-871 -6726 November 4, 2009 City of Zephyrhifls 5335 8 111 St Zcphyrhills, Fl 33542 1, Troy Hawkins, hereby authorize the following person to pull, reinstate, pay for, sign onto, and pick up permits on my behalf for Hawkins Electrical Service Company. Please remove any other persons on file. Jennifer Madison Cindy Talley Chadd Starkey Mark Madison Scott Madison Kevin Shipp Stephan Hugh Joseph label James Moran Larry Angelocei Sandra Mccracken Leslie Rowe Adrian Higgins Henry Hanbur, Dan Kinney Mark Madison Mary 1 chrnam 1 orrairie Engl Eric Haeck Jennifer Madison Ian Dolby Donna Brown Steven Bell SinCerc:l Y • oy 13. Hawkins EC00021.2J State of Florida County of Hillsborough Troy Hawkins who is personally known to me acknowledged the foregoing instrument before me this 2_1 `day of Now rv►b r , ,xocI Notary Signature: 1 6z 4 ,,Q1( I 1,V),C /20,1A,Z , it 1 Notary Public Slide MMNs WW2 Lynn Rose \He Exolret 10/190013 4 b"T•d 2b86LTL €T8 : 8029bTS +1720ST89 OD 23IOa3S SNUIMOH :wOJ. TS:OT 6002- bO -OON STATE OF FLORIDA ti � r DEPARTMENT OF BUSINESS AND PROFESSIONAL REGDLATTON ELECTRICAL C ONTRACTORS LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE: FL 32399 -0783 HAWKINS, TROY 8 HAWKINS SERVICE COMPANY PO BOX 89489 TAMPA FL 33689 a' STATE OF FLORIDA AC# 396220 Congratulations! With this license yoo become one of the 'early one million - . Floridians licensed by the Department of Business and Prcfessional Regulation. _ ' ;" laPR A L RE GUL A T AND PR Our professionals and businesses range from architects to yacht brokers, from "- _� RLCiQI�AREGULATION boxers to barbeque restaurants, and they keep Florida's economy strong. 800002121 08 080058598 Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. . CERTI ,;8iLECTRICAT. CONTRACTOR There you can find more information about our divisions ar d the regulations that RAWEXNS, 'TROY :B' impact you subscribe to department newsletters end learn more about the Department's initiatives. �TK3NS '51310/7 C4 COMPANY Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and oongratulatia�s on your new license! I S CERTIFIED nnaor the previaicne of Ch.499 rf s,mi Gatat ATM 31, 2010 L080829 DETACH HERE S E OFF .ORIDA x:. tORESS� OFFAL 'REGULATION ga I n - .. . -. � T�M1' {e1J . �.. r`: {!- e l'L . = ,�F IiGEN�-INCi BOARD° $EQ#T,U8082904484 DATE BATCH NUMBER 0 b80 • _ 1,2r,„...0::, oZ 1 . " 85'9 9.-ECO ►' '' The ELECTRICAL CONTRACTOR � anµ' `°:,? Named below XS CERT2.P ED'_ ''"`t= 1_ Unde the prov'i ;i�";.0 .,.. + ;,; _ •sions x, r :�S„ ,� Expiration date. AUG 31 2 ? � �..: �.� ... _ $;i f . HAWKINS TROY B :: ..�:. �:;•'� �.. � _ � . • - HAWKINS R. I CGS? : : - ` ; S = 3E V j am , :, , �' :,; =r 926• :_ „+ a BAY. PLAZA BLVD SUIT _ " _ •: {,'. E 504 TAMPA 4 'FL 33 6 "l 9 - CHARLIE CRIST ' 4 s `' . CHARLES W. DRAGO GOVERNOR + • , � ,.. ' !_ �,.. a ,,.. =s , SECRETARY �� = , " ��f1< f�Pt" �id1';4fi:'.R•�i''r149�1:'Y.;i�� I:A1'A!t`: =', '- t7.17 d 21786LTLET8:of 8029t7TS +172.17ST89 00 30I0a3S SNI1Mt1H :woJd TS:0T 6002- t70 -(ON • • ACDRD. CERTIFICATE OF LIABILITY INSURANCE OP ID , OATE(MMiODJYVYI) E -1 11/04/09 PRODUCER THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION Wallace Welch & Willingham Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 300 First Avenue South, 5th: F1 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 33020 ALTER THE COVERAGE AFFORDED BY THE POWCIE8 BELOW. St. Petersburg FL 33733 Phono :727- 522 -7777 Fax:727- 521 -2902 INSURERS AFFORDING COVERAGE NAICIO INSURED INi4URI:HA FCC/ Commercial ins. Co. 33472 Hawkins Electrical Service INSURERS: FCC/ Ins Co. 33472 Company dba Hawkins INsuRERc. Nat ional Trust Ins CO. 9260 PlazaBlvd:4504 Tampa FL 33619 NCUncn INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY HEQUIHEMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUM ANT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED DY TI IC pOLICICS OC;;LTiIIatU I$HkIN IS SUELIh{% 1 1 U ALL I Hk Ik*MS, kXU.0 WUNS ANU CONOITIOPI:; OF SuCI1 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE REF RFRLX:FR RY PAIR CJ AIMS LTR PARE TYPE OF INSURANCE POLICY NUMBER DATE E �IMM PDPD DATE (MT 1 0/W N J LIMIT LIABILITY GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERA! LIARILITY CPP0010315 08/06/09 08/06/10 PRE ISES{E:; $ 300,000 CA:: MADC [ XJ UK:wH MEV ESP (Any one WW1) $ 10,000 __. - .._.. PERSONAL & ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $2,000,000 CCML AGGREGATE LIMIT APFI IFS I+I•F• PRODUCTS - COMP/OP ADG s 2,000,000 POLICY X ` i. n LOC AUTOMOBILE UABILIIY C,nMRINFR SINN F 1 IMIT C X ANYAITo CA0014099 08/06/09 08/06/10 (hiC ', $ 1,000,000 ALL OW NCD Au"! u.s BODILY INJU 4. SCHEDULED AUTOS (Ing person) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (PIA uccidond PROPERTY DAMAGE (Por uccidoni C ^RACE LIABILRY AUTO ONLY - EA ACCIDENT S ANY AUTO � — IITHFR THAN EA AI:O $ AUIUCNLY. .._. ..... —.... _ AGG E7(CESSNMDRELLA LIABILITY EACH OCCURRENCE 82,000,000 A X j occua CLAIMS MADE ;[11480009280 08/06/09 08/06/10 AGGREGATE $2,000,000 _ UtUU(.; IICIL X RETFNTioN g 0 3 WORRIERS COMPENSATION ANO WG 6TA TU- OI H• Emp s• taAalLrtY X (TORY UMITR_ $ ANY PROPRIETOR/PARTNER/RIR': RIVE I001WC09A62322 08/06/09 08/06/10 E.L. EACHACCIDENY $ 800,000 OrrICCR/McHDER EXCLUDED9 R y e s � under F I OISFASF FA FMPI OYFF 8500,000 - _ SPECIAL NFIOVI$IUNH bow, C.L. DISEASE • POLICY LIMIT $ 500, 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSiON9 ADDED 8Y ENDORSEMENT / SPECIAL PROVISIONS 10 days notico applies for:non- payment of premium. A - CERTIFICATE HOLDER . CANCELLATION $UOULO ANY OF1Hk AHQVE OESOHIUAD POLICIES OE OANCEUI,EO IsEpOtni THE $XPWATIQN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 DAYS WRITTEN NOTICE TO THE_ CERTIFICATE HOLDER NA1ED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Sephyrhills 5335 8th Street IMPOSE NO OBUOATIQH OR LIABILITY OF ANT KIND UPON THE INSURER, ITS AGENTS OR zephyrhills FL 33540 REPRESENTATIVES. AUT • ..'RES - , 'i NE ACORD 25 (2001/08) or ®) ACORD CORPORATION 1988 17/2'd 21786LTL €TB : 802917TS+b2bST89 00 39Ind3S SNDIMIJH :WO TS :OT 6002- b0 -('0N : ` <:! :;;' ..a<`. INC. Residential & Commercial Builders To Whom It May Concern, This letter is to inform you I, Tim E. Belanger, qualifier for Riviera Pools Of Tampa, Inc. give permission to obtain permits under my license #CPC1456909 to Kitina A. Bloom DL# B450- 501 - 558730, Steven M. Bell DL# B- 400 - 793 -53- 132 -0, , Adis Diaz DL# D200- 000 -70 -741 -0 and William Molter DL # M 436 - 920 -54- 384 -0. Sincerely, Tim E. Belanger State Of nDraict. County Of 14, llsbbnro h The forgoing instrument was acknowledged before me this 1 day of NDUewtber , 20 D� by T nA 13.€ cy--- , of Riviera Pools of Tampa, Inc. A co . .. 'on, on behalf o e corporation. He / ! - • sersonall kn n to me or has produced as identification. - Notary Public My commission expires; .. ,0: 4 4;; ; . : RAYMOND E. MARTIN : MY COMMISSION # DD920053 o EXPIRES August 26, 2013 (407) 398 -0153 FloridallotarySer ice. corn 14409 -B N. Nebraska Avenue • Tampa, FL 33613 IR (813) 961 -2358 8 (813) 971 -7309 c TA C SO MI • �r 10. . 8..: (1I C 4r ..........:) ' 11 le 4....................• r= 1 Ell = (Tfl ( C2" 0 c.m.r15;p lik 4111110 i /� i ; ' r STANDARD RESIDENTIAL POOL SHAPES I , / / . THESE POOLS MAY BE BUILT W/ CONCAVE OR CONVEX WALLS � _�� \ IF THEY ARE PUILT TO THE DETAILS SHOWN ON THE ATTACHED N: S STANDARD RES. POOL AND /OR SPA DESIGN: DEPTHS MAY RANGE FROM 3 -10'. SAMUEL LIBERATORE, PE 55740 1268 ROGERS ST RIVIERA POOLS (`I FARWATER. FL 33756 Residential Pool/Spa Plan On File Data Sheet Rivieria Pools Tracking #: Date: /Up! p! 1 9 I Reference #: NP024128 Required Per mits (all other info to be filled out b y ap�ljcant) YBuilding � Shotc ete fool YElectrical (Tunite °Spa YPlumbing °Fiberglass C.ither :• 5 O Gas °Other minimum required setbacks to be filled out (or given) by zoning tech / ► °Front: 67 °Rear: ro ° Left Side: 2 5 °Right Side: Z 1 To be filled out by applicant Overall Size: max.length 30 X max. width 1 5 X max. depth G _ Only Est Value: $ 38 WO . Comments: Samuel A. Liberatore, P.E. #55740 Sealed: 3 -20-09 Expire: 3 -20-12 or code change C- To the best of m knowledge all information is correct. ,'/ Y g - - • (Applicant signature) BILL MOLTER MEMBER MEMBER • Cert. #RPO 039761 1 u " u #RPO 066687 • 144098 N Nebraska Ave • Tampa, FL 33613 D ill r • er a ° .olsi NATION (813) 961 -2358 INS POOL INBTI TU T! RESIDENTIAL & COMMERCIAL STANDARD RESIDENTIAL SWIMMING POOL CONTRACT This contract made as of the date of written acceptance by the member builder listed above hereinafter termed "Contractor" and the party name below, hereinafter termed "Purchaser". PURCHASER Dot vid /Me, Ph. HOME T 2 0 / C MAILING ADDRESS x'85'3 S7 A/4 Ph. BUS 9 a 375 9'«/ 4'//x f 3 3SYZ ZIP Contractor agrees to construct a swimming pool and appurtenances thereto as hereinafter provided by the plans, specifications and terms of the contract at: INSTALLATION ADDRESS FOLIO # TERMS Unless specially agreed and set forth herein. Purchaser hereunder agrees to make progress payments based on the total price set forth in the contract, to the Contractor as follows: CONTRACT PRICE $ Eli 00 OC $ //;"17 — F; h� 7 c / o% / /ir Riviera Pools, in an effort to build relations, does not require a deposit. 50% draw includes (permits, layout, dig, steel placement, steel inspection, concrete shell placement) / 7Sd. 0 e 7 30% draw includes (deck grade, plumbing, pressure test, plumb inspection if applicable, waterline tile installed, trim installed if applicable, deck formed if applicable) /.7/4. 06' 20% draw includes (electrical bond, electrical inspection, pour deck or install pavers, apply deck texture if applicable, install screen enclosure if applicable) Pool prepped and ready for interior finish. ? SYD. ■D $300.00 due : fter pool care instruction is given and all items on initial punch out list are completed. Any items concerning punch out after initial list is signed is considered warranty work and will be done immediately following payment in full. Construction progress may be arrested between billing and receipt for each phas construction. This draw schedule has been explained to me and is completely understood. THIS CONTRACT CONSISTS OF FOUR DOCUMENTS: 1. DRAWING SHOWING POOL SPECIFICATIONS 2. PLOT PLAN 3. SAFETY ACT ADDENDUM 4. COLOR SELECTION SHEET NOTICE TO PURCHASER DO NOT SIGN THIS CONTRACT BEFORE YOU READ IT OR IF PERTINENT INFORMATION IS MISSING FROM BLANK SPACES This is a home solicitation sale. If you do not want the goods or services contracted for, you may cancel this agreement by mailing a notice to the seller. This notice must indicate that you do not want the goods and services and must be postmarked by midnight the third day after you signed the agreement. This contract shall be deemed an offer to the Contractor and shall be null and void unless accepted by a duly authorized officer of the Contractor within fifteen days of the date and year noted above the Purchaser's signatures. The salesman has no authority to bind the Contractor. All agreements and understandings are contained in this contract and the Purchaser warrants that there are no agreements or understandings other than are set forth in this document. Acceptance of the terms of this contract by Contractor is to be communicated to the Purchaser by transmitting a copy of this contract to them showing acceptance by the sellers by the execution of a duly authorized officer of the Contractor or by • ing constructs. . w 1 DATE /D — S' d 7 PURCHASER - OWNE ` •' r 'Date D 0 SUBMITTED BY DATE OF BIRTH PURCHASER - OWNER Date ACCEPTED BY Date DATE OF BIRTH If purchasers are husband and wife, both must sign. If owner is different from purchaser, owner must sign. PURCHASER(S), BY SIGNING ABOVE, ACKNOWLEDGES AND AGREES TO ALL THE TERMS AND CONDITIONS ON ALL PAGES OF THIS AGREEMENT EVEN THOUGH SPACE LIMITATIONS REQUIRE THAT SOME ARE PRINTED IN SMALLER TYPE. WARRANTY OF POOL AND /OR EQUIPMENT IS NULL AND VOID UNTIL FINAL PAYMENT HAS BEEN SATISFIFn • • RESIDENTIAL SWIMMING POOL, SPA AND /OR HOT TUB SAFETY ACT NOTICE OF REQUIREMENTS I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at dYS .1Y-y hr,, j Ps "( Lop 4 4 ,•//s, F t, , and hereby affirm that on of the following (Please Print Street Address) methods will be used to meet the requirements of Chapter 515, Florida Statutes: (Please Initial the methodtss) to be used for your pool) The pool will be isolated from access to the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29; The pool will be equipped with an approved safety pool cover that complies with ASTM F1346 -91 (Standard Performance Specifications for Safely Covers for Swimming Pools, Spas and Hot Tubs); ■ ' All doors and windows providing direct access From the home to the pool and located within the enclosure /fence required by the Pasco County Land Development Code, Section 530.4(D), will be equipped with an exit alarm that has a minimum sound pressure rating of 85 decibels al 10 feet; M doors providing direct access from the home to the pool and located within the enclosure /fence required by the Pasco County Land Development Code, Section 530.4(D), will be equipped with self - closing, self - latching devices with release mechanisms placed no lower than 54" above the floor or deck; I UNDERSTAND AND AGREE THAT NOT HAVING AT LEAST ONE OF THE ABOVE INSTALLED AT THE TIME OF FINAL INSPECTION, OR WHEN THE POOL IS COMPLETED FOR CONTRACT PURPOSES, WILL CONSTITUTE A VIOLATION OF CHAPTER 515, F.S. AND WILL BE CONSIDERED AS COMMITTING A MISDEMEANOR OF THE SECOND DEGREE, PUNISHABLE BY FINES UP TO $500 AND /OR UP TO 60 DAYS IN JAIL AS ESTABLISHED IN CHAPTER 775, F.S. I FURTHER UNDERSTAND AND AGREE THAT THE OWNER AND /OR CONTRACTOR WILL COMPLY WITH THE FOLLOWING REGULATIONS CONCERNING SWIMMING POOL, SPA AND /OR HOT TUB ENCLOSURES, IMMEDIATELY UPON COMPLETION OF THE SWIMMING POOL, SPA OR HOT TUB, IN COMPLIANCE WITH SECTION 530.4(D), PASCO COUNTY LAND DEVELOPMENT CODE: 1. Construct around the swimming pool, spa or hot tub a MINIMUM FOUR FOOT HIGH. FENCE with self - closing, self- latching gates. The fence must not have any gaps, openings, indentations, protrusions, or structural components that could allow a young child to crawl under, squeeze through, or climb over the fence. Gates must open outward away from pool area. The releasing mechanism of the latching device must be located on the poolside of the gate and so placed that it cannot be reached by a young child over the top or through any opening or gap. No opening in the fence may be large enough to admit a four -inch sphere. 2. Construct a screen enclosure around the swimming pool, spa or hot tub with self - closing, self - latching screen doors. Latches on exterior screen doors must be minimum 54 inches from the exterior access standing surface. All screen enclosures require Building Permits, 3. Provide and utilize an approved safety swimming pool, spa or hot tub cover that complies with ASTM F1346 - (Standard Performance Specifications for Safety Covers for Swimming Pools, Spas and Hot Tubs). Such cover must be capable of being securely fastened over the swimming pool, spa or hot tub when not in use. 1 FURTHER UNDERSTAND AND AGREE THAT one of the enclosures described above will be completed prior to final inspection of the pool, spa or hot tub. ADDITIONALLY, I FURTHER UNDERSTAND AND AGREE THAT the owner will require his /her pool contractor and his/her screen enclosure contractor (if applicable) to request and successfully pass a final inspection immediately following the completion/installation of the swimming pool, spa or hot tub. IF THE SIGNATURE of the Contractor, acting as agent for owner, appears below, the Contractor promises in good faith to make the Owner aware of the above - described requirements and penalties before commencing construction. SWORN AND SUBSCRIBED BEFORE ME THIS Zz �� , DAY OF "edge/ , 20 O9' � OWNER ONTRACTOR SIGNATURE PUBLIC L/ l) ' /14 � � /e PLEASE TYPE OR PRINT N ABOVE s ? 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I I N. 01 STATE OF FLORIDA DEPARTMENT BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET "��"� TALLAHASSEE FL 32399 -0783 BELANGER, TIM E RIVIERA POOLS OF TAMPA INC 14409 B N NEBRASKA AVENUE TAMPA FL 33613 f AC# 3868683 s'e STATE OF FLORIDA Congratulations! With this license you become one of the nearly one million ` ^S" DEPARTMIENT OF BUSINESS'' AND Floridians licensed by the Department of Business and Professional Regulation. ' Our professionals and businesses range from architects to yacht brokers, from ION PROFESSIONAL REGULAT boxers to barbeque restaurants, and they keep Florida's economy strong. CPC1456909 07/22/08 088009769 Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. CERT COMMERICAL POOL /SPA CONTR There you can find more information about our divisions and the regulations that BELANGER, TIM E impact you, subscribe to department newsletters and learn more about the RIVIERA POOLS OF TAMPA INC Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! IS CERTIFIED under the provisions of ch.489 8s Expiration date: AUG 31,- 2010 L08072201249 DETACH HERE AC# 3868683 - S7ATE Of FLORIDA DEPARTMENT OP IN PROFESSIONAL REGULATION CONS TR LICENSING BOARD SEO # LO8a 72aoi249 f 'T4 Named ` ,Ts'‘ � �t IFIE Under t se pr'ov'isions of Chapt a fi Expiration date: AUG 31,,2010„,,,,,,i.„.„7,31,4. BELAN# TIN E 11' RI 7I 2A OOL :F T om 14409 B N NEBRASKA'''AV.E u' ' TAMPA FL 3 3613 CH ,'RLIE GRIST CH .TCK DRAGO GOVERNOR Ilf INTERIM SECRETARY SPI AY AS REOUIRED'SY LAW Hillsborough County Business, Tax Information • The Hillsborough County Business Tax Receipt only represents payment of a business tax for the privilege of operating a business in Hillsborough County and does not constitute competency. It does not permit the business to violate any existing regulatory or zoning laws of the state, county or cities, nor does it exempt the business from any other taxes, licenses or permits that may be required by law. • Business tax receipts expire midnight, September 30th. Failure to display a valid business tax receipt after September 30th is a violation of Hillsborough County Ordinance 95-4, as amended by 02 -5. • Payment of a Hillsborough County Business Tax is non - refundable unless the payment to be refunded was the result of a duplicate tax payment. 2009 - 2010 Hillsborough County Business Tax Receipt Valid Thru 9/30/10 Folio Number Rooms Seats Employees Facilities/Machines 21363 0 0 1 0 Occ Code Business Type H Waste Surcharge Tax 090.000 CONTRACTOR - COMMERCIAL SWIMMING POOLS 40,00 18.00 Business 14409 N NEBRASKA AVE B Location TAMPA 33613 Name BELANGER TIM E DBA/RIVIERA POOLS OF TAMPA INC Mailing 14409 N NEBRASKA AVE #B Address TAMPA FL 33613 -2201 BUSINESS TAX Has hereby paid a privilege tax to engage in the business, profession, or occupation specified hereon. This becomes a tax receipt when validated. Doug Belden, Hillsborough County Tax Collector 1 813.635.5200 • • Occupational Information Page 1 of 2 , _ - 11‘ , .' IA\ ,,„,„,,,„ • £- Home About Us Locations,„ Contact Us, Link Business Tax Information for Folio 21363 H ome Site Map Disclaimer Mission Statement The following information is provided as a convenience by the Hillsborough Offices County Tax Collector's office, which is not responsible for any errors or Property Taxes omissions. Motor Vehicles Vessels Folio Number 121363 Parking Permits Fiscal Year 10 . D river Licenses H unting &Fishing B usiness Taxes Owner Information Tourist Devekopment Year 2010 (Folio 121363 I Store# F inancial Reports BELANGER TIM E DBA/RIVIERA POOLS OF TAMPA Renew Motor Vehicle Business INC Registrations Address 14409 N NEBRASKA AVE #B Pay Property Taxes V r,,a . , .:»I City TAMPA !State I FL 'Zip 1336132226 J am 11111 Business Location *Credit cards are accepted online Address 14409 N NEBRASKA AVE only Suite B I City I TAMPA I Zip 133613 Temp Bus ness N Check Transfer N Spec. Half Year N Supplement N Handling Exempt 0.00 Law 0.00 Haz Fee 40.00 Amt. Library Due Created 01/06/1995 Modified 07/09/2001 3:56:47 PM 1 1 1 1 1 1 I 1 1 http:// www. hillstax. org/ occweb /occupational_information.asp ?FolioNumber =213 63 &Fis... 10/28/2009 A/R Information Page 1 of 1 di 171r r v Home About Us,, Locations„ Contact Us,. Linl Business Tax A/R Information H ome Site Map Disclaimer Mission Statement The following information is provided as a convenience by the Hillsborough Cou Offices office, which is not responsible for any errors or omissions. Property Taxes Motor Vehicles Vessels Receipt Register Receipt Post Transaction Amount License I Parldng Per its Number Number Date Date Code Paid Amt A Daver Licenses 854 85 07/08/2009 07/08/2009 4206 $58.00 $18.00 $ Hunting &Fishing Exempt Over Under Refund Refund Hazardous Source F Business Taxes Amt Amt Amt Amt ChkAmt WasteAmt Z $0.00 $0.00 $0.00 $0.00 $0.00 $40.00 BT C Tourist Development Penalty Created Modified Financial Reports Code On On Renew Motor Vehicle 07/08/2009 07/08/2009 Registrations K 12:05:45 12:05:45 Pay Property Taxes PM PM VISA 41];rt. . 11 Business Tax E -Mail: businesstax @hillstax.org Telephone: (813) 635 -5200, Fax: (813)612 -6707 *Credit cards are accepted online only Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released i, request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. Updated: January 02, 2007 Page URL: http://www.hillstax.org/occweb/Occupational_ar_information.asp http:// www. hillstax .org /occweb /Occupationalar information.asp ?Licenseld= 853822 10/28/2009 Occupational Information Page 2 of 2 Occ. Ord. Tax Haz. Type Stamp Qty Description Supplemf Code Number Due Waste Code Num. CONTRACTOR 090.000 26.01 18.00 Y 4 1 COMMERCIAL N SWIMMING POOLS Type Price Based On Code 1 Flat rate for professionals, excluding attorneys Base rate of $15 plus $3 for each five persons employed, maximum of 2 $150 3 Seats 4 Employees 5 Flat rate plus law library for attorneys 6 Shows of all kinds (circuses, exhibitions, carnivals) $225 per day with maximum payment being six times the daily fee ($1350) 7 Facilities or machines 8 Facilities or machines 9 Rooms 10 Device Note a hazardous waste fee may be applied, depending on the type of business. Click Here for A/R Information Business Tax E -Mail: businesstax(a hillstax.org Telephone: (813) 635 -5200, Fax: (813)612 -6707 Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released i, response to a public- records request, do not send electronic mail to this entity. Instead, contact this office phone or in writing. Updated: January 02, 2007 Page URL: http: / /www.hillstax. org / occweb /occupational_information.asp http: / /www.hillstax. org / occweb /occupational_information.asp ?FolioNumber =21363 &Fis... 10/28/2009 From: Jean Reynolds At: Ins By Ken Brown.inc FaxID: To: Riviera Pools Of Tampa Inc Date: 10/28/2009 12:21 PM Page: 1 of 2 DATE(MM /DD/YYYY) 111 CERTIFICATE OF LIABILITY INSURANCE RIVIE-3 10/28/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance By Ken Brown , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 948117 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Maitland FL 32794 -8117 Phone:321- 397 -3870 Fax:321- 397 -3888 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Amerisure Mutual Ins. Co 23396 INSURER B Amerisure Ins Company 19488 Riviera Pools Of Tampa Inc INSURERC 14409 -B North Nebraska Ave INSURERD Tampa FL 33613 INSURER E • COVERAGES THE POLICIES OF INSURANCE LISTED FH . H- vE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR COI .I ONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFF0RL ED Er THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHC WII b,ta1 Nt-.'. E BEEN REDUCED BY PAID CLAIMS. AULIL LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YYYY) DATE (MM /DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 UHNW A X COMMERCIAL GEfIE= A__I -LIU�- GL205488801 01/01/09 01 /01 /10 PR EMISes(EaE V RoLN a, enr -e) $ 100,000 CLAIMS MADE I X F MED EXP (Any one person) $ 5,000 X Contractual Liab PERSONAL a ADV INTLIPV $ 1,000,000 X Per Project GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT AFF I PE= PRODUCTS- COMP /OP AG $ 2,000,000 POLICY 2__ L- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO CA20548901 01/01/09 01 /01 /10 (Ea accident) ALL OWNED ALIT,:'a BODILY INJURY SCHEDULED AUTOO (Per person) X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY ALIT) OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE OCCUR LV.IIL L ./ L E AGGREGATE $ DEDUCTIBLE $ RETENTION $ :$ WORKERS COMPENSATION X TORY LIMITS 0 ER AND EMPLOYERS' LIABILITY Y I N B ANYPROPRIETOR /PAPTNER/F.F WC200609208 01/01/09 01 /01 /10 E L E A C H A C C P D E N T $ 1000000 OFFICER/MEMBER E%CLIJDED' (Mandatory in NH) E L DISEASE - EA EMPLOYEE $ 1000000 If yes, $escnbe under SPECIAL PROVISIONS below E L DISEASE - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS i VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS fax 813 - 780 -0021 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ZEPHYRH 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 Building Department REPRESENTATIVES. 5335 8th Street Zephyrhills FL 34248 AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From: Jean Reynolds At: Ins By Ken Brown :Inc FaxID: To Riviera Pools Of Tampa Inc Date: 10/28/2009 12:21 PM Page: 2 of 2 I MPORTANT 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). If 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 lieu 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 (2009/01)