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09-9363
CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9363 BUILDING PERMIT Permit Number: 9363 Address: 39044 5TH AVE 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: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 12- 26 -21- 0030 - 00300 -0040 Improv. Cost: 1,595.00 h� 1:1 _:Ma. F Date Issued: 7/21/2009 Name: BOTTICELLI, CAMELLIA Total Fees: 60.00 Address: 39044 5TH AVE Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542 Date Paid: 7/21/2009 Phone: (954)609 -6772 Work Desc: SCREEN ROOM 10'8 X 13'4 ON EXISTING SLAB :?F e a �� � s - ke`H..#� 'x.�,. i , � ${ 1t :�>x �S :r e_ r.. T , s $ �",+ nw. 6 `x w4�s5W V 3 t * � � p s � . .... STEPHEN AND WOOD ALUMINUM INC BUILDI FEE 60.00 0 LC (6 rl -0 9 1 / al„ 't 4 ' o'F t l . ti �� T �d , . o ,. ; : , , , y ' `._ r„. 'r n � ,i: r' ,� RI �' 6 a g'� f4 .R �.3e, ;i: ��` � =v . � 1. .�..< e _ = u� .... x �< . .a �'� � s;a�2 -^ a „�„ � '� „� s � s� s FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE -SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." • CO RACT I G N ATURE PERMIT OFFI 'R PE I T EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: S6-d '( a) - 17)d /4/(/-//1 Date Received: �' / Site: 3 . 9 d Permit Type: /d' 8 X /3 y ` eeri /41-► Approved w /no comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑ pp PP This comment sheet shall be kept with the permit and/or plans. fNi - � Y B urg ss Building Official Date Contractor and/or Homeowner (Required when comments are present) Bennett Engineering Group, Inc. Lawrence E. Bennett, P.E. 315 Herbert Street Port Orange, FL 32129 386 fax: 386 January 1, 2009 TO ALL BUILDING DEPARTMENTS Re: Master File Engineering "ALUMINUM STRUCTURES DESIGN MANUAL" 2004 Florida Building Code with 2006 Supplements Dear Building Official /Plans Examiner: This is to certify that the following contractor /company is hereby authorized to use my "ALUMINUM STRUCTURES DESIGN MANUAL" during the year 2009. Authorization is on a January to January basis regardless of the edition of the manual. This authorization also applies to contractor master file drawings, "ONE PERMIT ONLY" drawings or any "site specific" drawings that I may furnish the contractor. The following contractor /company is hereby added to my 2009 MASTERFILE LIST: Steve Green Stephens & Wood Aluminum, Inc 9718 E. US Hwy 92 Tampa, FL 33610 SCCO56671 Should you have any questions, please contact me at your convenience. Sincerely, o il 4 1M lbw, if- i 1 - _ {iCf1 - - . . ' . q i" 1.I 1 V, i1 N.t Lawrence E. 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C e i •� r H �� n 0 w - n7 I i l ig c : m.m eat: �o b ° e � , s,,, a 5 ° CO N �$ ° ° �3a� m- Vi QQ Q :% G — o m • 1a• '3 o r §giielq 'a oaok� oNMI - , pR 'y, n T 2 I y �� r m - r - z a! A §4X2c1R- KA !rv�r.izrb 5s11 m.8 .._m 'cg 813 LJlly UI L_Cp11yulIIII r /11.JIJIItiauull • ^ - ._ • -- ---• Building Department fq __ 3003 Date Received Phone Contact for Permitting 8 7.3l as o0 Owner's Name , / I Owner Phone Number ?3/- 1009- (077? Owner's Address 3 9 01 / 1 i � .- Owner Phone Number Fee Simple Titleholder Name (f /� �' Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 39d'Ty ' - - LOT # SUBDIVISION �, PARCEL ID# /07 of /— 0 6 ) 36 -00306 - 004b (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN 1 1 MOVE 1 I DEMOLISH INSTALL REPAIR PROPOSED USE I SFR 1 1 COMM n OTHER TYPE OF CONSTRUCTION n BLOCK [] FRAME 1 1 STEEL n OTHER ( I DESCRIPTION OF WORK /C ? t_ 1 1 BUILDING SIZE 4 _ ._��,.`�- a6 E 1 3 V HEIGHT BUILDING $ 1 _r 5 VALUATION OF TOTAL CONSTRUCTION .-.0 �� 1 ELECTRICAL AMP SERVICE 1 1 PROGRESS ENERGY l W.R.E.C. 1 1 PLUMBING $ .1 I .p/(� s ��. ; I" I V f , r, MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIA h ,;; j u / GAS 1 1 ROOFING [] SPECIALTY ] OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA nYES [] NO , 0 1 BUILDER C OMPANY 9 Gl)d'et L'c' SIGNATURE / ��� 111■..,_ REGISTERED I ri N 1 FEE CURRENT I Y/ N 1 Address - U s 9o2, 33 License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N . 1 FEE CURRENT I Y / N Address 1 License # PLUMBER COMPANY SIGNATURE REGISTERED 1 Y/ N . 1 FEE CURRENT 1 Y/ N 1 Address License # MECHANICAL COMPANY , SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N Address License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division — Licensing Section at 727 -847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89 -07 and 90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. US Environmental Protection Agency- Asbestos abatement. Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the 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 OBT FINANCING, CONSULT WITH YOUR LENDER 0 : AN ATT • R Y BEFORE RECORDING YOUR N • ICE OF CO ENCEMENT. FLORIDA JURAT (F.S. 117.0 , ; /r.�l� C ONTRACTOR . - OWNER OR AGENT J / ( Subscribed ands :m to (or a' rmed) b;for a this Subsp bed and swor affirms• .re Is to Qr by aJI f ; Who is /are ersona)ly known to me or has/have produced Wh s /are ersonally known to me or has -ve produced as identification. identification. (i(1)l d � ,/, Notary Public 10. Notary Public Commission No. Commission No. rww, C of NWitkJ r - CAROL A. SMITH � v c(1M1A1v11ssio # DOM6O •• • • Name of Notary ty ped, ry tyP printed "t iXP1[ � aabern,X40 ' Name of Notary ty. . 15#1§EP 27.2010 , rinted or st r-awaa+ornRY n Noitiry seiPa Fl. Dime* AIM, CO. IJg11F3- N(YfARY Y ,. .0 ew ■ 'TEPHENS & WOOD "LUMINUM INC. CUSTOM POOL ENCLOSURES & PATIO SCREEN ROOMS 9508 EAST M. L. KING, JR. BLVD. TAMPA, FL 33610 A PHONE (813) 621 -2200 FAX (813) 621 -8300 www.stephensandwood.com ^-� RX0029836 Date �.1 Lit' ZZ , ZaM. 07 Sold to CAM t L -tt1 C C Cam} ,� 1301 t �-L-i Job Number `•'"' O 7 Street .31044- 5 A V a Municipality PA. w Crb..1, N rr Cit A&A «`S State Ft- Zip 334 Instructions Phone (H) % C oq "(bill- ( W) Job Address PE s gi SUN ROOM " r 1 ❑ AL OOF • ?LA 4 t.) C3)L mot-, o t� ❑ ATE ROOF .DD .heyt- . N%- MrTaft: - b 04 & COLOR FRAME: "• C Y t k i ■ tN,VS V 'e i;OM. C t 1 folk kko■Sk uy,T. tINM Bronze ^ El 16" Kickplate ( a �4.FtJ `yE-LO� C &l& ki1L. Ch Rat NUMBER OF DOORS: One Two ee . l j Gl` s��l�i U ALUMINUM ROOF: ,_I Ft. 1)c*1$l.Osa Coloi < ( oRS so q GUTTER: i.iiiklACC 1-C Ft. r Color �� ROOF TYPE : v El G ,� �, ' tea, ❑ an sa . � ' N 41( l , �'�p (Z ❑ Other: ki joy i � ti t 4 4 R OPTIONS: . El Concrete tot $ �t ( �,�: w� Ptc;.; {;� ❑ ki CI nd s Railing WSA MasterCard; Height: Balance due upon completion ■ TOTAL / (� OWNER'S RESPONSIBILITY: The owner agrees to assume responsibility for job location being ORDER $ / V , within his property lines and not in violation of setbacks or other restrictions. The owner will provide t adequate access to job site. Contractor has assumed electric current will be supplied by owner from DOWN C existing outlet. MATERIALS: The owners hereby covenant and agree that the title to the materials PAYMENT $ 5/ ©. 3 24 fumished which comprises a part of the subject matter of this contract shall remain in Stephens & Wood Aluminum, Inc., until the contract price and any extras are paid in full. The owners further BALANCE covenant and agree that said material shall be deemed to be considered personal property although DUE $ ' �. the said material may in some manner be affixed or attached to the real property within which the herein said material may be freely severed from the premises as any other personalty by Stephens & Wood Aluminum, Inc., their successors and assigns. DEFAULT: In the event the owner shall fail to make any payment when the same is due, or any part thereof, or fail to perform fully and promptly any covenant or agreement herein set forth, they will pay to Stephens & WoodAluminum, Inc., its successors or assigns, all costs and expense the said Stephens & Wood Aluminum, Inc., or its successors or assigns may thereby be put to, including a reasonable attorney fee. If the owners shall become bankrupt or be put into receivership, or fail to make any payment when due, or fail to perform any covenant herein contained, all sums then unpaid shall become due and payable immediate without notice. THIS AGREEMENT shall be binding upon the heirs, administrators, executors, successors and assigns of the owners. WARRANTY: Stephens & Wood Aluminum, Inc., warrants that all materials used in completing installation, contracted for herein will be of high quality and new, and that all work will be done in a workmanlike manner. Any breach therein, causing any substantial defects, shall be remedied without charge, providing written notice is given Stephens & Wood Aluminum, Inc., within one year of completion. It is agreed however, that no claim may be filed under this warranty and no obligations to make adjustment thereunder, will accrue until full indebtedness of the owner to Stephens & Wood Aluminum, Inc., is paid. The above shall be null and void unless accepted within thirty days following date submitted. It is agreed by the owner that any claim either under this contract or under the warranty herein above set forth, shall be brought only in the appropriate court in Hillsborough County, Florida. Notice to Buyer: (a) Do not sign this before you read it or if it contains any blank spaces. (b) You are entitled to an exact copy of which was delivered to and receipt is hereby acknowledged by buyer. 1 q This �' day of 1 ! Accepted b .. A/1 , te. � a. ...ii (-ar � � � o! Submitted By AC1/4,-4.- 4,....,.... 1 wner Approved By o zott, Owner Stephens & Wood Aluminum, Inc. Tv el i; T BBB 07/15/2009 10:29 9413515298 SUNTECH DOORS 4 , PAGE 01/01 ste. '7 weoc • SuntechDoors " "c 1N sun#echdoors .,com C O t P O i�A E in ri r\), Screen Door Installation Instructions Tools Needed 1) The left & right z -bars are notched for ease of • Measuring Tape installation. Measure the Inside of each side of • Hack Saw or Chop Saw the opening,then mark the bottom of the z - bars , z, • Screw Gun measuring from where notched (fig.1) and cut • �' • Cordless Drill off. Fasten in place leaving 1/16 " space for ' " � - • # 2 Philips screw driver bit header with two (2) # 8 x 1" screws in each for • 1/4" drill bit the present. (you may need to adjust them �:;:; ''' '` � �; n • 1/8" drill bit later.) Fig. 1 � �. Components 2) Measure from z - bar to z - bar, cut header and • Screen Door then fasten in place. • Left & Right Z -Bars 83 " each 3) Measure from header to floor on hinge side. Deduct 2 ¶4 ", then cut hinge off • Header Z -Bar 42" at the bottom. (2 1 " will allow the bug channel to fit up under the hinge so • Piano Hinge & Channel 82 y. " the bug channel will fit from z -bar to z -bar.) • Bug Channel 38 1 " Fasten the hinge 1/8 "- 3/16 " down from the I ,"e'r~'■•%. • 18 # 8 x 1" Philips self tapping screws header - approximately 3/16 "from the felt. �� ° ~"RI Heft • 18 # 8 x i/ " Philips self tapping screws Use slotted holes at top and bottom, then ; '.y �; f m a� •m " ►, • • Hydraulic closure tube & Handel kit adjust hinge to close against the felt without . �; i . ..■ HEADER binding. Fasten off rest of hinge screws. (fig.2) " ' 1 gg �';� "" . .. ' ., `' ' 4) Fit door into the hinge channel (Screen to Inside 4 . °i 1 ` on all Suntech Doors) (fig.3) position door in ��r „i�I an L li , R place d ust u” " el ���" ` "': li, I ! along header and sid gl e j amb. Screw 3/16 a #8 x �/ Fig.2 E i . F j G screw near the adj top and bottom 1/8 of the r hinge vea __ � :, : , , __ MINIM INIM I= M MI MN. MN � i � , T channel. Recheck the reveal (it may be Z j i necessary to adjust z -bar, header or door if the =., � 1 ; z door frame of the house is out -of- square.) .; B i ii i � �' I 1 i : fasten off hinge and z -bars. ; m. A i ` r • 8 5 With the door closed measure from '`'"Al F IiEa ∎ �� i. 5) m the edge of i. j' F the door to the z -baron the hinge side. Cut ;r • ,, b ug channel, and then slide onto the bottom mor al _: i _ of the door. (fig.3) lift up to meet the hinge = ;r ,�,�_ channel and adjust other end. Fasten to door. •� ? 1' ' .' 4 s4 6) Install the hardware, locate the latch where it will ' not interfere with the door knob, dead -bolt, Fig.3 `�� spreader bar, etc. Using template (fig.4) drill 3 - Hinge Z Z.Ear '/4 " holes thru door frame on the center rib, assemble latch (fig.5) & mount Channel Bug Channel on door. Line up & attach keeper on jamb adjust to firmly engage latch. Locate a position on the spreader bar, kick bar or door frame to mount closure tube. Line up jamb bracket with open side towards z -bar on house jamb, fasten with screws provided. ,' (fig.6) place hold open clip on shaft against lugs to set closure with correct tension for installation, insert shaft into jamb bracket with pin. Attach door bracket on other end, ; ,� position on door & screw bracket to door. Release hold open dip. Check for closing speed & j rotate barrel to adjust if necessary. Y enR � , � F ig.5 ,� \ N. re q HOLD OPEN CLIP p + 0 i 70 ADJUST SPEEC - TURN TUBE u Fig.6 Fig.4 LINST A /7. STATE OF FLORIDA . DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ;' ,1 ' CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 „' 1940 NORTH TALLAHASSEE MONROE STRFLT32399 -0783 GREEN, STEVEN D STEPHENS & WOOD ALUMINUM INC 19218 SEA MIST LN LUTZ FL 33588 g .. STATE OF FLORIDA AC# 3 9 6 14 9 Congratulations. With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. DEPARTMENT OF BUSINESS AND Our professionals and businesses range from architects to yacht brokers, from PROFESSIONAL REGULATION boxers to barbeque restaurants, and they keep Florida's economy strong. SCCO56671 09/09/08 070538131 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. CERTIFIED SPECIALTY CONTRACTOR There you can find more information about our divisions and the regulations that GREEN, STEVEN D impact you, subscribe to department newsletters and learn more about the STEPHENS & WOOD ALUMINUM 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. is CERTIFIED under the Thank you for doing business in Florida, and congratulations on your new license! provisions L08090902442 of Ch.489 FS Expiration data: AUG 31, 2010 8090902442 • DETACH HERE AC# O STATE OF FLORIDA kd DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L08090902442 DATE BATCH NUMBER LICENSE INiBF - 09/09/2008 070538131 SCCO56671 The SPECIALTY STRUCTURE CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS_ Expiration date: AUG 31, 2010 - GREEN, STEVEN D STEPHENS & WOOD ALUMINUM INC 19218 SEA MIST LN LUTZ FL 33588 CHARLIE CRIST CHARLES W. DRAGO GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW STEPHENS AND WOOD ALUMINUM, INC. 9718 E. U.S. HIGHWAY 92 TAMPA, FL 33610 813 -621 -2200 813 - 621 -8300 (Fax) AUTHORIZATION LETTER I, Steven D. Green, contractor license number SCCO56671, hereby authorize the following individual to act as an agent in obtaining permits for Stephens and Wood Aluminum, Inc., in the • of e hyr "IIs, Florida: William R. Gootee, Jr. This authorization is to remain in effe ' definitely, unless cancelled by me in writing. Steven D. Green Sworn to an subscribed to befor- e this 13th day of July 2009 by Steven D. Green, who is personally known to me. Notary Public: ! y MYCOMMISSION WEBS: rr,�o 20a Carol A. Smith Commission expires: 9/27/2010 LTtVlly LVV.7 1V;1! H17 YHIa.. L /VVL r .x our v CY' Certificate of Insurance 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 polides described herein. Named Insured(s): TriNet HR Corp.; Gevity HR, Inc; Gevity HR, LP; Gevity HR II, LP; Gevity HR III, LP; Gevity HR IV, LP; Gevity HR V, LP; Gevity HR VI, LP; Gevity HR VII, LP; Gevity HR VIII, LP; Gevity HR IX, LP; Gevity HR X, LP; Gevity HR XI, LLC; Gevity HR XII Corp; Gevity XIV, LLC. 9000 Town Center Parkwy Insurer Affording Coverage Bradenton, FL 34202 (A) Commerce & industry insurance Company Coverages: (B) New Hampshire insurance Company The polides of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condtion 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 condtions of such policies Aggregate limits shown may have been reduced by paid claims Type of Insurance Certificate Exp. Policy Number * Limits Date Employers Liability Workers' (A) 23259191 7 -1 -2010 Bodly Injury By Accident Compensation ( B ) 23259215 $2,000,000 Each Accident Bodly Injury By Disease $2,000,000 Policy Limit Bodly Injury By Disease $2,000,000 Each Person Other: Employees Leased To: Effective Date : 01 -JUL - 2009 53101. Stephens and Wood Aluminum Inc The above referenced workers' compensation policies provide statutory benefits only to the employees of the Named Insured(s) on such polides, not to the employees of any other employer. Cancellation: Should any of the above described polides be cancelled before the expiration date thereof, the insurer affording coverage will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. *Policy numbers may vary depending on jurisdiction. Certificate Holder: ;*fit > 4 SeTedetv Itreagealt, Toe, City of Zephyrhills Building Department AON Risk Services Northeast, Inc 5335 8th St (866)443 -8489 09-JUL-2009 Zephyrhills, FL 33542 Phone Date Issued ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID PS DATE IMM'DO'YYYY) STEPWOO 07/09/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Roe Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New Port Richey FL 34655 Phone: 727 - 376 -0030 Fax: 727 - 376 -2262 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A. State Auto Mutual Ins. Co. 25135 INSURERS: Owners Insurance Company 09386 Stephens S Woods Aluminum, Inc Design Aluminum Exchange, Inc. INSURER c 9718 US Hwy 92 E. 1 INSURER D : Tampa FL 33610 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND 008517ION5 OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR 400'L POUCY EFFECTIVE POLICY EXPIRATION I LTR NSRD I TYPE OP INSURANCE POLICY NUMBER DATE H ,yDNy) DATE y) UNITS GENERAL LIABNTY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY PBP1013733 02/28/09 02/28/10 PREMISES (EA =won./ $ 100,000 CLAIMS MADE X I OCCUR MED EXP /Any on• pPnon) S 5,000 PERSONALS ADV INJURY 15 1,000,000 GENERAL AGGREGATE F 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER i ' PRODUCTS - COMP,OPAGG $ 2,000,000 POLICY I JECT LOC AUTOMOBILE UABILITY COMBINED SINGLE LIMB 2 1,000,000 B X ANY AUTO 4747950600 11/26/08 11/26/09 10055 I ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per pawn) X H)RED AUTOS { r - � BODILY INJURY X NON -OWNED AUTOS (Par ecuEernl PROPERTY DAMAGE IPeracddeNl S GARAGE LIABIUtt AUTO ONLY - EA ACCIDENT 5 ANY AUTO EA ACC S OTHER THAN AUTO ONLY: qGG 5 EXCESS/UMBRELLA LIABILITY i EACH OCCURRENCE q OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE ! s RETENTION 5 IS WORKERS COMPENSATION AND Y1C STAT(I- 1 050. EMPLOYERS' LIABILITY TORY OMITS ER ANY PROPRIETOR /PARTNER /EXECUTIVE EL EACH ACCIDENT I S OFFICER /MEMBER EXCLUDED? E DISEASE EA EMPLOYEE b If yea. tleaclibe under SPECIAL PROVISIONS below E DISEASE • POLICY LIMIT $ OTHER A Property Section PBP1013733 j 02/28/09 02/28/10 Property $30,000 A Equipment Floate PBP1013733 02/28/09 02/28/10 DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES / EXCLUSIONS ADDED 8V ENDORSEMENT /SPECIAL PROVISIONS *30 DAYS NOTICE OF CANCELLATION EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON - PAYMENT OF PREMIUM CERTIFICATE HOLDER CANCELLATION CITYZEP SHOULD ANY OF THE ABOVE DE5CR1BEO POLICIES BE CANCELLED BEFORE THE EXPIRATION THE CITY OF ZEPHYRHILLS DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MALL * DAYS WRITTEN CITY HALL, BLDG DEPT, NOTICE TO THE CERTIFICATE HOLDER AMMO TO THE LEFT, BUT FAILURE TO DO SO SHAD. FAX# 813 - 780 -0021 IMPOSE NO OBLIGATION OR LMB., OF ANY KIND UPON THE INSURER, ITS AGENTS OR 5335 EIGHTH STREET ZEPHYRHILLS FL 33542 REPRESENTATIVES. RUTH. I EPRESENT- E O ACORD 25 (2001/08) © ACORD CORPORATION 1988 • 21308 -2009 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9 - - 2009 FOLIO NO FACILITIES OR MACHINES ROOMS SEATS EMPLOYEES 0 0 0 0 RENEWAL 11502.0000 OCC. CODE BUSINESS TYPE H. WASTE TAX SURCHARGE 330.001 RETAIL STORE 30.00 BUSINESS 9508 E DR MARTIN L KING JR BLVD LOCATION TAMPA 33619 NAME STEPHENS & WOOD ALUMINUM INC MAILING 9508 E DR MARTIN L KING JR BLVD ADDRESS TAMPA FL 33610 BUSINESS TAX RECEIPT DOUG BELDEN, TAX COLLECTOR PAID - 43541 - 6 HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813-635 -5200 07/25/2008 30.00 IN BUSINESS, PROFESSION, OR OCCUPATION SPECIFIED HEREON. THIS BECOMES A TAX RECEIPT WHEN VALIDATED. • 1