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HomeMy WebLinkAbout09-9949 CITY OF ZEPHYRHILLS 5335 - 8Th STREET (813)780 -0020 9949 ■ BUILDING PERMIT • Permit Number: 9949 Address: 7810 GALL BLVD Permit Type: SIGN ZEPHYRHILLS, FL. Class of Work: WALL SIGN Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35- 25 -21- 0010 - 00700 -0000 Improv. Cost: 2,000.00 �11 7. - 7, 7 t>• _ Date Issued: 1/06/2010 Name: PRIM RIMERICA GROUP ONE Total Fees: 60.00 Address: 3629 MADACA LANE Amount Paid: 60.00 TAMPA FL 33618 Date Paid: 1/06/2010 Phone: (813)933 -0629 Work Desc: INSTALL (2) WALL SIGN WEST & SOUTH 20 X 60 X 11'2 - EXIST ELEC UPS STORE I •N .-°N ITYS•LUTI•N SIGN 60.00 ICON IDENTITY SOLUTIONS f :-"1/1 OOT i. E R a C b' X42 3 k r * * E.. - ,--f �' } . uired 3E:� ..., �". i ,, ,, „ '..'. • . . k � F E LEINAL CT R94 ROUG1) 0 F itt '' 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." i C hail % 01, i 44,.,, A CONTRACTOR SIG TURE PERMIT OFFI rR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 44, ,q q it y sumac= , City of Zephyrhills Permit Application Fasela-710m1 , RAM Detanmeel Oats Rsayarsd - - • Phone Ganisat for Roma IIIIII - ' Oafter a Num i i Mer • a C _ ) CI . 1 - owner nano Numast 813 C. • 04 ' K 206 eamer•AMInale 1 3 41 a.9 fl actaca. Lao e.7 Omer flama *lumbar I FAA Simple TAIDINNWr Niguel I 4 Gaserlohass Number I Far AMA TARIM* JOIN MUM 1 Siva -Ze_phrb)11S, FL 33542.1 LOTS SUNINVINION I Zap turridiun PARCEL MI 135 25-21- 013o - 0000 0 - 0 I Ail) Icarmaaro POOMINIONNIITI Mt NONON WOPIKP 1113POSID Ei3 PM MOM .ccaLy 71 sew 1171 WOVE ED CEIMOUSN INSTML NOM PROPOUIDIM ED 9FR cow 1=1 ODER 1 7 mew convmuunots EZI atm 1=1 mate 1=1 arm ED MIER 1 i, ojtS2QA 0 arepgrwas, cw wpm -rriSiGIM, si v,..3 1.44=5:7 - 12. na Socrfil Eie...va41 ern_ . _ .. _... r -----, 1 sultana ars 1 ;20' X 400 1 SQ FOOTAGE 200 1 'MOW I " I n GO MALMO I, 20 . 1 VALUATION Of TOTAL CONSTRUC110,1 1:::1 ELT. ii ------------ 1 AMP SERVICE C:j PROGRESS MR3 CD W.R.E.C. 1=] PUG ri_________I 0 es co...4/ w A ,..,- 124/8,,, CZI MMISICAL 1 --------1 uurom or meal/NC& termilenoti GAS El ROOFING r1 81 CO on ER CG. (OTC V" , 4 smispeDFLooRezvAroto 1 ----- 1 FL000 ZONEA REA [Dyes o N0 6 ci . A.. __ 1 1 r___ \ :1 --' P 441.1116Silki% OMER i SEWER . 1 YTM J ray mew 1 1 f 1 ti 1 I -1 maws I Lamm* f , ... / euzlium, 0,, _ 41111M01 ' coivAsy 1 X m s RISINIAll in At „...,„&ril RENS I V/ N I asy ammo L Y/ al 1 Miens 1 t Wain 0 14. ,A 0 07 AZ 2 I ..... . . .... ... ... .. .... .... ... PLUMBER COMPANY r . 1 mac Immo L Y a Is i NM UMW/ I i : N Addams j I mama I I MECONCAL COMPAIda 1 MOILATURE , admen 1 Y a N 1 FIE cuaamar 1 Y / al Moss I_ 1 users** I 1 OR 1 COMPANY I S I M P I A T U R E j m y s i s i m m o j Y# N i a r E c r s a l s r a r 1 Y I N 1 _ Mama 1 1 Lissom! I 7 RONOSNUAL RNA PI Rd Run (2)asladlhollag PI Mud al enegmlrom laGSVPswilar saw aonekadlon. Miabraaalss PO) walks] dam allua =WM data. Required MA. CossIsmalan Rant 9twamosswRants• SR Fame *Med Smarmy Foals' 11 Outwear: NUNN* ranottreasasomarge MAW COMMUNAL MIKA (3) swomplos us of Nalem Run Mos AIM Satarmftmg it) re et Emmy RMS. RrOJN Pallet*, raw ermaitglien. Maims sin (110.0oUss days ANN ammo on.. Rasutebasals. ONRInadon Awe. eftespastsPlarat tag UT Amos issiabd, SWAM FRAM IICI Minim Mb Wad Ponittorall m papas. PA cvainervial ramiamnbinunmeorullwast - MN PERMIT MO IN)alsaftogasssad rum . "'PROPIRTT MINTY lacNiAN lora NNAtconoveast, ' ONANIYAVV me mAsookoponamokai owner &Caisadaralms Watt* apolkullan. acirtasd W am IMAM. a Make of Cowsmasesinsat is raqmkod. 4AIC appaulesssar MOD) •• Awed Mx ma sysdrador) or Pow 10 moray tba be avow) mid Is scomo sea raNdasd *sr Iran awe, WARM Ms vast ins COMER mum. Most ciARMIORIR ORM ARM Sam Sento Upgrades ast Ram (FloalurwARroAsaa} Odunwaysale4 am Odisibrien ARIA roodsays nods Mt 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 fora 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 contractors) 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 pemmit 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: 1 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, WaterlWastewater 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, 1 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. 111 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 a Y• ; __. , ' - ORANA •; BEF•,E R O - •1 Y• - •11 E •F OM ENCEMENT. FLORIDA JURAT ( -_- � • OWNER R .... —de t 1 !' . • ACTOR � I 7i I ./ - � S /2 'f 27 Z. $u • sarorry10 before ` - Subs bed • worn to (a affirmed) before' me this / Z � by L. c by Ch f ct'- r M c W is/are PPB known to me or has/have produced ,s/a personalty known to me or has Kaye p(kduced as identification. : 2' � L _ mo as identification. OFFICIAL SEAL • — Notary Pudic Notary Public Of Illinois / 9 / t t -- Com sion No. � ' My Comm .1. ,. 21,2013 N. Name of Notary typed A >. • - • or stamped Name of Not ry typed. printed or stamped ` ,�P`�::•' ANDREW B. fJUER rt * MY COAWSSIOtt t DO 919525 ✓ EXPIRES: August 24,2013 e fit oF A b r Bonded llmrfialpi Wart $snk•t II City of Zephyrlulls BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: Date Received: / 2 - 2-2 -09 Site: .7 6/0 C48 l' /6 1 v 1 �p ' a s / Permit Type: 2 //oaf] S/ S GAS 7 �� , S � c Approved w /no comments. 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If ..., ... ;.„ -4 1 i :,. r t f f p : . .7 .. . 1 - ; 1.. '! ! ip-10,.::•,; lilL 1 rE-0 1 9 3 i =r, I ...• t, i. ie44, m .. . ,_ . ..... 6.--___ .•'= ,.... 74. - -i- 'c', a - rif c0 I, ! lial ro: 0 2 I .. 1 i L/3 1 • , ...- re, tra 1 ... = g .... 5-.., er..: 11.1 L3 ' 1. 1 • ' '' CI CI g 1 ... .... .1,,,,,.::. . .4 , t,‘ r' r '.., • ' I 0) ........ ; ...a < , 3 ! ,' 3 , . ' 'i q!Z 'IR' 1 di yr c ,.._ . .... , ..... ._ ., , . 1 -,--4 0 : .,_ .' '...j ‘,., 1 .1. ■ ff: 40 8 ,.., EnCon Services, Inc. Sign Design Calculations Job Description PREPARED BY: EnCon Services, Inc. UPS #910 2272 Jaudon Road 7838 Gall Blvd. Dover, FL 33527 Zephyrhills, Florida 813 - 655 -3373 l' -1" x 10' -6 7/16" raceway F 813 - 655 -9814 Design per 2007 Florida Building Code, 2009 supplement, Section 16 Wind Load ASCE 7 -05 Aaron Biedenbach, P.E. Design Specifications FL PE #52949, FL EB 9394 Importance Factor 1 OH PE 60756, OC #01893 Kzt 1 KY PE #20281, P #2463 Exposure Factor B IN PE #PE 19600322 Kd 1 FL CBC #060535, QB #22527 Kz 0.7 V 120 (mph) GCp -GCpi 1.28 Zone 4, H < 60 Feet Wind Pressure 33.0 (psf) Sign Information 1 f f r / iIPp Width 10.53 (ft) ` A IA Q• p , Thickness 1.00 (ft) ®� 0..N.; �‘C E N Distance grade to top 30 (ft) o • e No 52941i Wind Sheer Force 35.67 (Ib) e -0 d Weight of Sign 114 (Ib) ' , STATE O'- 0 Total Sheer Force = 119.19 (Ib) ='� • 4 •�. • 0 ' �'► Total Tension Force = 375.63 (Ib) � � � fl �`, 1 1 i � . Required Provided Fastener size (Nominal) 3/8 3/8 Minimum number of fasteners 8 8 Sheer Force per fastener (Ib) 14.9 280 Tension Force per fastener (Ib) 47.0 352 Combination Tension and 0.19 <1 O.K. Sheer ratio THREADED ROD THROUGH WALL IS PREFERRED IN ALL INSTANCES. IF IT IS NOT POSSIBLE TO USE THREADED ROD, SEE CHART BELOW FOR APPROPRIATE ANCHOR SELECTION. SIZE AND NUMBER REQUIRED ARE NOTED IN THE CHART ABOVE. WALL STRUCTURE ANCHOR TYPE WOOD BLOCKING LAG BOLT (3' EMBEDMENT) THROUGH BLOCKING 518' PLYWOOD OVER STUD FRAMED WALL LIBERTY TOGGLE BOLT HOLLOW CONCRETE BLOCK SLEEVE ANCHOR (1 -112" EMBEDMENT) ALL ANCHORS SHALL BE CHOSEN AND PLACED IN ACCORDANCE WITH MANUFACTURERS INSTALLATION INSTRUCTIONS 12/8/2009 UPS 910 Zephyrhills 1 -1 x 10 -6 RW — — t.....' ■ X J .4 1 Z re' ...I '47 b ••• •• , t.3 •••• r) ...... L:-„, zEs .t — , 1 4 - ;:.., g .... r: igft „„ g 3,10 Og R „3 ti:e t: I s 't .. 1 .> ...... .-... ., „ > ▪ en = • c, N g --'''' k i‘IN g;M Rfig L iv) Cil 4 7 1 ,:. :_-_, , 1 , co ...• 0 i _ • 4 t Cen) E (-.X 1 1 rir7 4 - 3 - . 1 • VI* i c- • L .. II t 1 = X , r, • — 1 :..., ;L. . ' -.. • t . t ' CO . ..c, #. 11 :L .-" /E9111 ..- 1 r ......- ', •---1, , .., .4 c3 i■ t ‘) .-• I ...3 =aoaseecee.a..„, .j - --.---.---,.. 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W Q en a U' 1...„ 0 NO a W "' z a ( 1— C 0 0 0 = L�J in _I ha U H Q 1 C I 6 J N o J a 2 U W 9 Ix t/1 ce co .a .d lial fYfOD • s .'‘,) 1 -s 4�� „ IN A/ ��w'� a g`.9 iu i go r _\ \ . • �r • ee e. s 0 e° / /1s1 CO Q m r1 6:1 _ _ EnCon Services, Inc. Sign Design Calculations Job Description PREPARED BY: EnCon Services, Inc. 2272 Jaudon Road UPS #910 Dover, FL 33527 7838 Gaall ll Blvd. 3373 Zephyrhills, Florida F 813- 6 816 55 -55 - l' -1" x 10' -6 7/16" raceway Design per 2007 Florida Building Code, 2009 supplement, Section 16 Wind Load ASCE 7 -05 Aaron Biedenbach, P.E. I Design Specifications I FL PE #52949, FL EB 9394 Importance Factor 1 OH PE 60756, OC #01893 Kzt 1 KY PE #20281, P #2463 Exposure Factor B IN PE #PE 19600322 Kd 1 FL CBC #060535, QB #22527 Kz 0.7 V 120 (mph) GCp -GCpi 1.28 Zone 4, H < 60 Feet Wind Pressure 33.0 (psf) Sign Information Height Width ,1 t `y / I 1 i� ® ® � ' 10.53 (ft) ® ® Q' B I ED , '� Thickness 1.00 (ft) �� � \ G ESQ « g D istance grade to to 30 (ft) Z Q' o a o ° No 5294.9 � ; " ,_ -� Wind Sheer Force 35.67 (Ib) * • * • : `ty a Weight of Sign 114 (Ib) s STATE OF ti Total Sheer Force = 119.19 (Ib) ` O - ` o ` : �',� r, • Total Tension Force = 375.63 (Ib) � ,1 , 0 idiillil 1,0' Required Provided Fastener size (Nominal) 3/8 3/8 Minimum number of fasteners 8 8 Sheer Force per fastener (Ib) 14.9 280 Tension Force per fastener (Ib) 47.0 352 Combination Tension and 0.19 <1 O.K. Sheer ratio THREADED ROD THROUGH WALL IS PREFERRED IN ALL INSTANCES. IF IT IS NOT POSSIBLE TO USE THREADED ROD, SEE CHART BELOW FOR APPROPRIATE ANCHOR SELECTION. SIZE AND NUMBER REQUIRED ARE NOTED IN THE CHART ABOVE. WALL STRUCTURE ANCHOR TYPE WOOD BLOCKING LAG BOLT (3' EMBEDMENT) THROUGH BLOCKING 518" PLYWOOD OVER STUD FRAMED WALL LIBERTY TOGGLE BOLT HOLLOW CONCRETE BLOCK SLEEVE ANCHOR (1 -1/2' EMBEDMENT) ALL ANCHORS SHALL BE CHOSEN AND PLACED IN ACCORDANCE WITH MANUFACTURERS INSTALLATION INSTRUCTIONS 12/8/2009 UPS 910 Zephyrhills 1 -1 x 10 -6 RW . I a 0 • > ~ M N l� 0 W Z Q O � %F m SC 2 M O 0 O� 1-O W J O< o a I- a 7 � 7 N < W 3 cn li c 3 zaaX �m a ll (Qp(7� Z � 6 �p l Z Zp J O O M O Y 0 W S 0 > J 0 '� Y F O n U In m W 2 � J , j o (r 6 z `"i" o 3 , a w Z-' 0 Q d- / � in ▪ U J � y t O O WW ( * 0 S 6 1 m N a N X 41 % 8 CO L CC Q Q J W d I J F 4 . O) J '- J d W 4. 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Q ro 0 a' 0= Z g = W M i j Sao 0 0 F 0 H N K LJ Q L 2 U W N a' OM 11 cr'710D \ � \ is p X a" —k, N y aJ! P p il_ o \ i. e•a deg f �A v M AA® 1,1 W Q m ... rn .. f l FA7i. DATE: December 2, 2009 TO: City ofZepherhills FAX# 813 -780 -0021 FROM: Fran Eggleston for Icon Identity Solutions PHONE: 813-477-3987 FAX: 888 -809 -5296 PAGES: 7 This is the Contractor Certificate requirements as discussed that were needed to register the sign company with the city and to be able to pick up the permits. Please contact me as discussed when all is approved and I will return for the pick up. Will follow up and make sure these attached is everything needed. • • icon Corporate Headquarters Icon Identity Solutions Identity 6ol urlone 1418 Elmhu,xr Road elk Grove Village. IL 60007 Tel: 847.364,2250 Fax: 847.364. 1517 December 28, 2009 ' "` °" le° " C0 � City of Zepherhills City Hall — Building Department Zepherhills, FL To Whom It May Concern: This letter authorizes Frances Eggleston with Carolina Permits to sign and pick up permits for the following location, The UPS Store 7838 Gall Road Zepherhills, FL By: IMS (The Icon Companies) - r. r 0444 1 / ' / ��yy / y NAME , U STATE OF TlUS1CAS COUNTY OF by \ The forgoin in t ument was acknowledged before me thislZ . 2009, A\2-1. . / r( IIL�en , who is j� • = sonally know to me, or Produced d rre t drivers se as identification. .........„ V A i,‘ i 11. P. I. 1 IlL .....:. - .." . mipr. fil coi - e of Notary OFFICIAL SEA(. y ' commission expires: _ JANE A CONSALyQ C • mmission Number: NOTARY PUBLIC , STATE OF ILLINOIS MY COMMISSION EXPI S'08/03/13 8 - C Chicago • Columbia • Dothan - Houston • Ontario • Philadelphia - Tampa 1 I11S/ 4t, STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 1 ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET (850) 487-1395 • .d' TALLAHASSEE FL 32399 -0783 MCGUIRE GRANT BURTON MR ICON IDENTITY SOLUTIONS INC 2200 TALL PINES DR STE 106 LARGO FL 33771 STATE OF FLORIDA AC# 4410845 Congratulations! With this license you become one of the nearly one million - DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation_ ` ` • PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers. from ' w-- boxers to barbeque restaurants. and they keep Florida's economy strong, E312000722 05/21/09 080416995 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 . SPECIALTY ELECTRICAL CONTR There you can find more information about our divisions and the regulations that MCGUIRE, GRANT BURTON MR impact you, subscribe to department newsletters and learn more about the ICON IDENTITY SOLUTIONS INC Department's initiatives. CERTIFIED AS: SIGN ELECTRICAL SPECIALIST Our mission at the Department is: License Efficiently, Regulate Fairly_ We constantly strive to serve you better so that you can serve your customers. Is CERTIFIED wider r no Thank you for doing business in Florida. and congratulations on your new licensei pzovAsions of Ch. 489 rs ft:Amt. dace,. A.UG 31, 2010 L09052100252 DETACH HERE AC# 4 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSINGG BOARD SECS L090S2109252 DATE BATCH NUMBER LICENSE NBR 05/21/2009 080416995 ES12000722 The SPECIALTY ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2010 AS A SIGN ELECTRICAL SPECIALIST MCGUIRE, GRANT BURTON MR ICON IDENTITY SOLUTIONS INC 2200 TALL PINES DR LARGO FL 33771 CHARLIE CRIST GOVERNOR CHARLES W. DRAW DISPLAY AS REQUIRED BY LAW SECRETARY _ ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/09/yyYYl 12/15/09 PRODUCER 1- 630 -773 -3800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher Risk Management Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR Two Piero* Place ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Itasca , IL 60143 - 3141 Morgan Dudsik 630 - 285 - 4439 INSURERS AFFORDING COVERAGE NAIC# — INSURED NSURERA: LM INS CORP 33600 - Ieon identity Solutions Inc ABA as Imagecare Maintenance Services INSURER B:LXBERTY INS CORP 42404 1418 &lmhurat Road INSURERC:BT PAUL FIRE & MARINE INS CO 24767 Elk Orovo Village, IL 60007 INSURER D:LIBERTY MOT FIRE 108 CO 23035 INSURERS PIR8k' NE FUND IND CORP 11380 COVERAGES THt POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EPfCCTrve POLICY EXxPIRATION 17F1 IN9RO TYPE nF INSI IRANer POUCY NUMBER DA IM DAT8 rnWfODn'YI Lean A GENERAL T85141336181039 03/28/09 03/28/10 EAOHOCCURRCNCE 91,000,000 DAMAGE it) KILN t X COMMERCIAL GENERAL LIABILITY PREMISES (Es oteurence) 5500,000 AL CLAIMS MADE I OCCUR MED RAP (Any one person) $ 10, 000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 , GEN 'LAGGREGG LIMIT AFFUEE5 PRODUCTS- COMP /OPAGG 52,000, P O L I C YT A 1 1 ° LOG �H AUTOMOBILEUABILITY AS7141436181029 03/28/09 03/28/10 COMBINED SINGLE LIMIT © ANYAUTO (E. acaden) $1,000,000 • ■ ALL OWNED AUTOS BODILY INJURY SCHEDULED - (Par person) 9 X HIRED AUTOS BODILY INJURY X I NON - OWNED AUTOS (Par accident) • PROPERTY DAMAGE (Per accident) GARAGE LIABILITY — AUTO ONLY -EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY; AGO 9 C I EXCESSIUMBRELLALIABILIty Q106803107 03/28/09 03/28/10 EACHOCCURRENCE $ 25,000,000 X OCCUR 7 CLAIMS MADE AGGREGATE $ 25,000,000 8 - DEDUCTIBLE RETENTION $ 10,000 D WORKERS COMPENSATION APO MC2141436181019 03/28/09 03/28/10 X I WCSTATU OTn. EMPLOYERS' LIABILITY TORYUMITS FR ANY PROPRIETOR /PARTNER/EXECUTIVE E.L EACH ACCIDENT 91,000,000 OI PICER/MEMSEREXCLUDED? lives. oeecnbe EL DISEASE - EA EMPLOYEE 91,000,000 SPECIAL PROVISIONS below DISEASE - POLICY LIMIT $1,000,000 OTHER E Sxceas Liability 98100082184110 03/28/09 03/28/10 Occ /Agg 10MNx25M DE8CRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES / 5XCLUBIONE ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS *See Attached for Additional Insured Informations CERTIFICATE HOLDER CANCELLATION 10 Days Notice of Cancellation for NonPayment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION city of Zephyrhills, FL GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS wanTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 714E LEFT, BUT FAILURE TO DO SO SHALL 5335 8th street IMPOSE NO OBLIGATION OR UABIUTY OP ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATNES. Zephyrhille, FL 33542 AI/THORI2 DREPREBENTATIVE — U8A ACORD 25 (2001/08) j heath m `e4 -..*.. V. .4.^ 13836951 ACORD CORPORATION 1988 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). 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 The Certificate of Insurance on the reverse side of this form 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 (2001/08) SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 5/09 NAME OF INSURED: Icon Identity Solutions Inc DBA me Imagecare Maintenance Services Additional DescrlOtion of Operations/Remarks from Pane 1 Additional I nforrn 5tion GENERAL LIAHILITTI *Additional Insured with primary wording where required by written contract per Form No. LG31800907 *waiver of Subrogation where required by written contract per Form No. L031200907 AUTOMOBILE LIARILTIYi *Additional Insured and Lose Payee wording where required by written contract per Form No AX12230303 *waiver of Subrogation where required by written contract per Form No. AX12100205 WORKERS' COMPENSATION: *waiver of Subrogation as required by written contract per Form No- MC000313 (4- 1_1994) SUPP (05/04) PRIICA GROUP ONE, INC_ December 9, 2009 City of Zephyrhills 5335 Eighth Street Zephyrhills, FL 33542 RE: ZEPHYR COMMONS, LLC /ZEPHYR COMMONS SHOPPING CENTER FLATROCICSERVICES, INC. DBA THE UPS STORE 7810 GALL BLVD., ZEPHX,RFJILLS, FL, 33541; FOLIO #35-25-21-0130-00000-0140 To Whom It May Concern: As agent for the subject property, I hereby authorize Icon Identity Solutions or their authorized Arent to secure a sign permit for our tenant, "The UPS Store ". Thank you for your assistance, Sincer c-K Scott G. Russel As Agent for Zephyr Commons, LLC State of Florida County of Hillsborough Sworn and subscribed to me this nth day of December, 2009 by Scott G. Russel who is personally known to me. rr oo�wa I. &ECG I Signature of Notary Public = " , , M ���pp- sta�a a �� eonaa Tnrougn N atioeal nduy :ask Richard L. Trzcinski Managing Partner 3629 Madaca Lane, Tampa, FL 33618 -2048 • Phone: 813.933.0629 • Fax: 813.935.3420 www.primericagroupone.com 1 BUSINESS TAX RECEIPT City of Largo 2009 - 2010 FILE # 2010001067 DBA' ICON IDENTITY SOLUTIONS, INC. Business Name & Mailing Address Physical Address, Owner, Phone ICON IDENTITY SOLUTIONS, INC. 2200 TALL PINES DR #106 2200 TALL PINES DR 0104 LARGO, EL 33771 LARGO, FL 33771 -5318 KEVIN L WASHINGTON 727 - 536 -8646 ELECTRICAL SIGN CONTRACTOR Classification NAICS No. Qty. Amount Electrical Work Contractors 1731 100 $100.00 PCCLB: REG 9/30/2009 STATE: ES0000425 8/31/2020 Certificate Number: 22800 Engaging in any business occupation is subject to zoning restrictions. The collection of this Business Tax/Administrative Service Charge does not authorize the holder to operate in violation of any City ordinance, law or regulation. Each holder is solely responsible for notifying the Community Development Department, in writing, of any change in status, location or ownership. Renewal notices will be sent to the last known address and owner of record. Issuance is in no way intended as an approval or disapproval of the holders competence or skill. This Business Tax Receipt expires 30 September 2010. Penalties are provided by F.S. 205 if not renewed before 1 October 2010. Additional penalites of up to $250 may apply if not renewed by 31 December 2010. THIS IS NOT A BILL NO REWUNDS POST IN A CONSPICUOUS PLACE CDPR3026.RPT FAX DATE: January 6, 2010 TO: City of Zepherhills FAX# 813- 780 -0021 FROM: Fran Eggleston for Icon IIdenity Solutions PHONE: 813477 -3987 FAX: 888- 809 -5296 PAGES: 2