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HomeMy WebLinkAbout10-10337 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10337 BUILDING PERMIT low - :Er :7 Permit Number: 10337 Address: 5920 NEWBERRY CT Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: WEDGEWOOD MANOR Est. Value: Parcel Number: 10- 26 -21- 0120 - 00000 -0270 Improv. Cost: 599.00 Date Issued: 4/08/2010 Name: DORAZIO, ADAM & HELEN Total Fees: 52.50 Address: 5920 NEWBERRY CT Amount Paid: 52.50 ZEPHYRHILLS, FL. 33542 Date Paid: 4/08/2010 Phone: (813)783 -1937 Work Desc: REPLACE 9 X7 GARAGE DOOR ilPf7 717 •UALI A ARA • • • - - IN BUIL•IN 52.5s F) /1,- • • - 2 • R• U H - LUM: MI ° IN ULA • ILIN 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 our Re l. - rty. If you intend to obtain financing, consult with your lender or an attorney before reco -/ ; , u AST" ice of commencement." fOr /'i - CONTRACTOR SIGNATURE PERMIT OFFI �R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER -N-Vi 1-. tiri , P""." - 1 1'4 ■ 1 '. City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor /Homeowner: 4LI(a G Ao d LS' d --7.-A. - Date Received: 4' 6 Site: 5 20 11 tdber CT Permit Type: El 7 /:/ a o 9vvj boog., Approved w /no comments: Approved w /the below comments: El Denied w /the below comments: ❑ This comme t sheet s' . 1 re kept with the permit and /or plans. if Kalvin 1 7 : - ' s Examiner Date Contractor and/or Homeowner (Required when comments are present) ''`` "' 11 -20 -2009 • ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 11/20/2009 EXPIRATION DATE: 11/20/2011 PERSON: PIERCE MITCHELL 0 FEIN: 593664637 BUSINESS NAME AND ADDRESS: QUALITY GARAGE DOOR SERVICES INC 116 SOUTH PARK AVE 30/-26.9- h 3 G I ' 9 TITUSVILLE FL 32796 jz /— z (,q7-7Y SCOPES OF BUSINESS OR TRADE: 1- REPAIR SERVICE 2- CERTIFIED RESIDENTIAL CONTRACT 3 - GARAGE DOOR INSTALLATION IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05113), F.S.; Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES ►'' DIVISION OF WORKERS' COMPENSATION 0 w t F to Chapter 440.05(14), F.S., an officer of a corporation who CONSTRUCTION INDUSTRY � . O elects exemption from this chapter by filing a certificate of election � CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA . • • ` � e� L under this section may not recover benefits or compensation under this WORKERS' COMPENSATION LAW �^ D chapter, EFFECTIVE: 11/20/2009 EXPIRATION DATE: 11/20/2011 Pursuant to Chapter 440.05(12), F.S., Certificates of election to be PERSON: MITCHELL 0 PIERCE H exempt.. apply only within the scope of the business or trade listed on FEIN: 593664637 R the notice of election to be exempt BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt QUALITY GARAGE DOOR SERVICES INC e exem P and certificates of election to be exempt shall be subject to revocation J � 116 SOUTH PARK AVE if, at any time after the filing of the notice or the issuance of the TITUSVILLE, FL 32796 certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the SCOPE OF BUSINESS OR TRADE: person named on the certificate to meet the requirements of this 1- REPAIR SERVICE 2- CERTIFIED RESIDENTIAL CONTRACT section. 3- GARAGE DOOR INSTALLATION QUESTIONS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 Ylorida Building Code Online Page 1 of 6 • G �cii r ri L m �un ity Affairs wiffirmazir MS Homo Lou In User Registration i Hot Topics Submit Surcharge i Slats & Faces ■ i Publications II le 74k : Still ! BCIS SIDS Hap ! unb Search . fr.r f; Product Approval d USER: Public User cn_ ranog T Att,;ir•; PIWKLAPPELVAI IMI > fSdusCOC. ADzikatloasea sb > A - ROJ.ISatloaltst > aPVrkstlon wow • CCfl MuNiTY PLJ•N.YNC FL10474 Application Type New c7r: VEL •p•;,Nr Code Version 2007 EMERGENC Application Status ,AN,C,L Comments Approved • F;CE OF ThE Archived SECRETARY - Product Manufacturer C.H.I. Overhead Doors Address/Phone/Emall 1485 Sunrise Drive Arthur, IL 61911 AT, L t It 4, I LL COMPLY COMPLY WITHAL. , (217) 543 -2135 Ext 427 (' jcampbel r VA i1.J \ COD ; FLORIDA LUILD1 .' Authorized signature CODE, 'ti�=T1O,1 FL CTttIC CODE A:v'•_, Jim Campbell OF ZLPITYR HILES n i 'ICI` ANCES )campbellOchiohd.com • Technical Representative Patrick J. Hunter Address/Phone/Email PO Box 260 1485 Sunrise Drive, IL 61911 (217) 543-2762 phunter©chlohd.com VIEW DATE '11-6 1-/°) Quality Assurance Representative Shawn Yurkovlch j � � �� �HYRHI�LS Address /Phone/Emall 1485 Sunrise Drive s Arthur, IL 61911 MINER'_ i` (217) 543-2135 Ext 4264 syurkovich©Chiohd.com Category Exterior Doors Subcategory Sectional Exterior Door Assemblies Compliance Method Evaluation Report from a Florida Registered Architect or a Ucensed Florida Professional Engineer F Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who • John E. Scates developed the Evaluation Report Florida Ucense PE -51737 Quality Assurance Entity Architectural Testing, Inc - Certification Services Quality Assurance Contract Expiration Date 12/31/2012 Validated By Gordon Thomas, P.E. F Validation Checklist - Hardcopy Received Certificate of Independence Fb1474 RO nr --� _cQd_Qf Ind o ndepce Scate5_2QQ$off Referenced Standard and Year (of Standard) wa YAW ANSI/DASMA 108 2002 ANSI/DASMA 108 2002 ASTM E330 2005 2002 http : / /www.floridabuilding.org/pr /pr app_ dtl. aspx ?param= wGEVXQ q bg16I48zTr... 3/1/2010 Limits of Use Installation Instructions Approved for use in HVHZ: No FL10474_RO IIBJA- 00x- 03Jamb Attachm_ ents.pdf Approved for use outside HVHZ: Yes FL10474RO II Z3- 1004 - pan 051608s.pdf I Impact Resistant: No Verifled By: John E. Scates FL 51737 Design Pressure: +19.5/ -22.0 Created by Independent Third Party: No Other: C.H.I. drawing Z3- 1007 - 01300; 10' -0" Evaluation Reports maximum width; The optional glazing available DOES FL10474 _RO_AE Evaluation Report s.pdf meet the wind Toad requirements of the building code but FL10474_RO AEZ3- 1007- 01300s.pdf DOES NOT meet the Impact resistant requirements for Created by Independent Third Party: Yes windbome debris regions. This product without glazing DOES comply with the impact resistant requirements for windbome debris areas. (ref FBC 1609.1.4) SA 4 12250, 2251, 2240, 2241 Steel Pan (25 gauge min.) hollow or laid in place polystyrene insulation Limits of Use Installation Instructions Approved for use in HVHZ: No FL 00x -03 JambAttachments.pdf Approved for use outside HVHZ: Yes FL10474 R0 _II Z4 -10045 pan 051608s.pdf Impact Resistant: No Verifled By: John E. Scates FL 51737 Design Pressure: +23.2/ -26.2 Created by Independent Third Party: No Other: C.N.I. drawing Z4- 1007 - 01300; 10' -0" Evaluation Reports maximum width; The optional glazing available DOES meet the wind Toad requirements of the building code but . ; DOES NOT meet the impact resistant requirements for '. "". by ldepende Yhfrtf �. windbome debris regions. This product without glazing Petty Y es DOES comply with the impact resistant requirements for windbome debris areas. (ref FBC 1609.1.4) 10474.5 12250, 2251, 2240, 2241 Steel Pan (25 gauge min.) hollow or laid in place Limits of Use polystyrene insulation Approved for use In HVHZ: No Installation Instructions FL10474_RO II BJA- 00x -03 JambAttachments.pdf Approved for use outside HVHZ: Yes FL10474 RO II Z5- 10045 - pan- 051608s_pdf Impact Resistant: No Verified By: John E. Scates FL 51737 Design Pressure: +27.3/ -30.8 Created by Independent Third Party: • Other: C.N.I. drawing Z5 1007 - 01300; 10' -0" Evaluation Reports No maximum width; The optional glazing available DOES FL10474_RO AE Evaluation Report s.p_df ' meet the wind load requirements of the building code but FL10474 ROAE Z5- 1007- 01300s.pdf DOES NOT meet the impact resistant requirements for Created by Independent Third Party: Yes windbome debris regions. This product without glazing DOES comply with the impact resistant requirements for windbome debris areas. (ref FBC 1609.1.4) 10474.6 12250, 2251, 2240, 2241 Steel Pan (25 gauge min.) hollow or laid in place Limits of Use polystyrene insulation Approved for use in HVHZ: No Installation Instructions FL10474 RO II BJA - 00x03 JambAttachments.pdf i Approved for use outside HVHZ: Yes FL10474 RO II Z6 1 pan- 051608s.pdf Impact Resistant: No Verified By: John E. Scates FL 51737 Design Pressure: +31.4/ -35.5 Created by Independent Third Party: Other: C.H.I. drawing Z6- 1007 - 01300; 10' -0" Evaluation Reports No maximum width; The optional glazing available DOES FL10474 RO AE EvaluationReport_s.pdf meet the wind Toad requirements of the building code but FL10474 RO AE Z6 -1007 01300s.pdf DOES NOT meet the impact resistant requirements for Created by Independent Third Party: Yes windbome debris regions. This product without glazing DOES comply with the Impact resistant requirements for windbome debris areas. (ref FBC 1609.1.4) 10474.7 12250, 2251, 2240, 2241 Steel Pan (25 gauge min.) hollow or laid in place Limits of Use polystyrene insulation Approved for use in HVHZ: No Installation Instructions FL10474 R0 II_ BJA- 00x- 03 Jamb Attachments.pdf Approved for use outside HVHZ: Yes FL10474 ROIIZ7- 10045- pan- 051608s.pdf Impact Resistant: No Verified By: John E. Scates FL 51737 Design Pressure: +36.0/ -40.6 Created by Independent Third Party: Other: C.H.I. drawing Z7- 1007 - 01300; 10' -0" Evaluation Reports No maximum width; The optional glazing available DOES FL10474 Evaluation Report s,pdf meet the wind load requirements of the building code but FL10474 AEZ7- 1007- 01300s.pdf DOES NOT meet the impact resistant requirements for Created by Independent Third Party: Yes windbome debris regions. This product without glazing DOES comply with the impact resistant requirements for indbome debris areas. (ref FBC 1609.1.4) 10474.8 12250, 2251, 2240, 2241 Steel Pan (25 gauge min.) hollow or laid in place Limits of use polystyrene insulation Approved for use in HVHZ: No Installation Instructions F1.10 RO IIBJA- 00x -03 Jamb Attachments.pdf Approved for use outside HVHZ: Yes. FL10474 ROIIZ8- 10045- pan- 051608s.pdf Impact Resistant: No Verified By: John E. Scates FL 51737 Design Pressure: +38.3/ -43.5 Created by Independent Third Pa Other: C.H.I. drawing Z8 1007 - 01300; 10' -0" Evaluation Reports No maximum width; The optional glazing available DOES FL10474_RO AE Evaluation Report s.pdf meet the wind load requirements of the building code but FL10474 — R0 AE Z8 1 007- 01300s.pdf DOES NOT meet the impact resistant requirements for Created by Independent Third Party: Yes windbome debris regions. This product without glazing DOES comply with the impact resistant requirements for windbome debris areas. (ref FBC 1609.1.4) 1 to ♦ c) I o t 3 x b J 1 t - - -5 b . x c . ) . a. m §52 a y 1$ e $ ^ Ow z p ig 8 b mN § 1 br A a iI g. §mo bo NO r e _c am „ 40 F r 1 A N A f1 �O q A t i — " i sumo! r • g A SS W 2 , N. o X 0 . I sr! - L !i 1 s si \ b ' ' II , , J O •11 a . e 1 01 a es w a s i , . W oo , ! , I , s i 1 11 W LI 1 0 OHO Q. . n = Z N O .4 m y 0 X 0 . s s s s s s w 1 q 1 b u el 1 c er. . - ,.'- Qp 1 section u N - 81 0, \ � ., 4 G so �I Q to to A Quantity N •r.l NY QQQ N . Sty F. q OA to a w w N per side Q, . _ 'nl P. TPS .. Voll o cz4 2 a o il i 1.0 f W. w a , E. a ,: k _ a E — tug - s r he [___, r. 4 . _ 5 r, E e v�'� i7 5 g U . b i b : Q g 1 a 1 00 ♦ 0 1 0 • a • g S Y O N a< 5. '� x R V sr v F A )4 = 8. Q N _ > N N Ov O• -. A C. O Y N ^ x q F 2 • A . flf f a O. 3 ro g o "'3 e. S 'w o' o n I S o v n E x� a; am 5. 4 • a n 1 < ` - 9. °- W. " x < A 7i y A _t__ .^. 7 x 4. _ ���� a E. g -- :=1,1 /4 w — w = its, pEa NON oN ? ^ O x w w ,_ a O f1 x g a< 1.%'0.1 8 - I g; w� x 1 E g Noe a S g �1 = 5' ii Y j lib 9 .4 Q -L--- ro S 3 H o 2 ° o a $ E c II 4' F Na a R 5 < a g' w - ' ^ S 0° R ' i0 n Oo �. _ N , i R g § & .' A A w g °a II �. o� iu 7 A N , � c r . �' '- i N1.1 E N Iitl sg a ri N 7 e .9'.`t • E' ' E � , Go � � Q cr - E ^�i Q ae 4 m S p q g u �� e� D. S n O e� n g O „ "•3 < J 22i ^SSS a a g Oe O � ' \ e ^ tt t.r g• y — E = Fi e G n a6� � , � 1 c 'l q D � 2i «a' 5 $ E 3 E s iii SO N 0. Q. r r % N ,i ! i �� r IL rrr N.��N _ _� u-g - u p - N ` N w ■ O 0ei i i i CD a to A 0 4/5/2010 2:49 PM FROM: JW Edens J. W. Edens _Co., Inc. TO: 18137800005 PAGE: 002 OF 003 ACORP CERTIFICATE OF LIABILITY INSURANCE DATE i� o PRODUCER (321)383 -4554 FAX (321)383 -4523 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3.W. Edens & Company, Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P P. 0. Box 278 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Titusville, FL 32781 -0278 Kimberl y Bacon INSURERS AFFORDING COVERAGE NAIC # INSURED Quality Garage Door Services, Inc. INSURER Southern Owners Insurance Co. 10190 116 S. Park Ave. INSURERB • Progressive Titusville, FL 32780 INSURERC INSURER D 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 CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AMYL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR� DATE WMI00M/1 DATE ~DEWY) GENERAL LIABILITY 72697829 07/21/2009 07/21/2010 EACH OCCURRENCE $ 500, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50 000 PRFMISFS (Fa °mu - Anne) CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 A PERSONAL & ADV INJURY $ 500, 000 GENERAL AGGREGATE $ 1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMP /OP AGG $ 1,000,000 POLICY PEa LOC AUTOMOBILE LIABILITY 026076415 04/12/2009 04/12/2010 COMBINED SINGLE LIMIT ANY AUTO (Ee accident) $ S00,000 ALL OWNED AUTOS BODILY INJURY $ B X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ .. $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- DTI+ TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT OFFICER /MEMBER EXCLUDED E L. DISEASE - EA EMPLOYEE $ If yes. describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES /EXCLUSIONS ADDED BV ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Zephyrh i 11 s BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5335 8th St . OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhi l l s, FL 33542 AUTHORIZED REPRESENTATIVE _3. Wayne Edens /KIM _- U ACORD 25 (2001/08) FAX: (813) 780 -0005 MACORD CORPORATION 1988 ; . , t , ' . . , - . . , • ;1 • • i • • 4 .. • • i % ' '■ • I.. • „ • • • • . • 4 • • I • • • I . • • . ii • • . • ,. . • • 4 • ) .• • ".• 4 1 .... ■• . •''''' - '■'` A ‘2 . ‘" 4 " A "'' ' , .•-, .',,•. I 1 „ oi ,.._ ' ', t`,..• , r,..,;,'4•,. 7 1i .r •.0%,- ti ; ` •..,/ '. ' ' .. r • I ;,:7".. 1 ''. • ,i, ,',.. '' ' . ' 7,,,,' ,.. ,,, ,..„i-, 1 v • 1-.- ,--r. ..'i`\,..c.,..e.(t-r-?:, 1' :1/ ''''''''k \,-,"L".•/,',.',''.4,/tr*Ie'7Vrfle• " '- ''. - I( ''.3 0-41P- Jr"1 • r" 4-1 ..,.' ^•... , -7,,r. ..r. 7 • •-,?' ',) , I -1 ° , ■ , „.._,V...:=-,.,„4-4 . , , , „ r IA j , ' t., - .., ; ,....,„_=.. .,x _ t . ,.._. ..,,,.. g.;•.■ 4. ,-',. A .., --11,....,....t_ ., , I , ., I A / , i W•;1 - , . . 1 "?: / (i"' 7.. . 1 m . ' / '.. . \ !, rer...t, ',:,).! '\... , • - . 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SUBJECT TO COUNTY ZONING RESTRICTIONS 200110022 • 2009 -• 2010 TAX RECEIPT SHOULD BE DISPLAYED ON PREMISES THE PERSON(S), OR ENTITY BELOW: BUSINESS PERIOD: OCTOBER 1, 2009 ■ SEPTEMBER 30, 2010 EXPIRES: SEPTEMBER 30, 2010 QUALITY GARAGE DOOR SERVICES INC ISSUED PURSUANT AND SUBJECT TO FLORIDA STATUTES AND BREVARD COUNTY CODE ISSUANCE DOES NOT CERTIFY COMPLIANCE WITH ZONING OR OTHER LAWS. 116 S PARK AV BUSINESS TAX RECEIPT IS SUBJECT TO REVOCATION FOR ZONING VIOLATIONS, AND / OR FAILURE TITUSVILLE FL 32796 TO MAINTAIN REGULATORY PRE - REQUISITES AS REQUIRED FOR BUSINESS CLASSIFICATION(S), OR SUBSEQUENT ACTNTTIES. NOTIFY TAX COLLECTOR UPON CLOSING OF BUSINESS. A PERMIT IS REQUIRED TO ADVERTISE (Inducing with signage) 'GOING OUT OF BUSINESS'. LISA CULLEN, CFC, Brevard County Tax Collector LOCATION: P 0 Box 2500, Titusville, Florida 32781 -2500 (321) 264-6910 116 S PARK AV UPON A CHANGE OF OWNERSHIP OR LOCATION, CITY OF TITUSVILLE, FL 32796 BUSINESS TAX RECEIPT SHOULD BE TRANSFERRED WITHIN 30 DAYS. OWNED BY: QUALITY GARAGE DOOR SERVICES INC GR 6 MITCHELL 0 PIERCE, QUAL. • BUSINESS CLASSIFICATIONS, DISCLAIMERS, AND RELATED FEES: EXEMPTIONS: NON EXEMPT PENALTY $5.55 300301 GARAGE DOOR CONTRACTOR NEW • 470535 REPAIR SERVICE 820005 2009 - 2010 RECEIPT AMT $37.00 // 4::; �j 4'` llcJ I ,% /_ �� r:L: -.+• �,+ {l "' PAID I t ,d • e. �, 'ii s <ct. ,01 ∎� � z 4•.55 .../ amiNilif Le. 0 . IgLt � , k.k.f , i e _, or L PSEN A. 4 -4Rla BRANCH OFFICES:. Merritt Island Office, 1450 N. Courtenay Pkwy, Merritt Island, FL 32953 (321) 455 -1413 . Melbourne Office, 1515 Samo Road, Melbourne, FL 32935 (321) 255 -4453 Palm Bay Office, 450 Cogan Dr. SE, Palm Bay, FL 32909 (321) 952 -6325 MAIN OFFICE: 400 South St., 6th Floor, Titusville, FL 32780 (321) 264-6910, (321) 633 -2199, ext. 46910 • TXIRCPTDeIH QUALTY GARAGE 1300K SEKV 1CL ,, .. ..� .. 116 SOUTH PARK AVENUE TITUSVILLE, FL 32796 ; `. c n 3 "SERVING CENTRAL FLORIDA FROM COAST TO COAST" ur►anuu vsuti e9y -0022 ovc►du (407) 977 -7474 IG:s11i.M.aee (407) 022.4sfn ct nand (407) R91 -9880 Lake Mary (407) 273 -0479 Sanford (407) 333 -3444 Snfrd/Lk Mary (407) 333 -1343 Winter Park ....(407) 207 -6373 Winter Park ....(407) 971-9887 Wntr Springs (407) 275 -2994 Clermont (352) 243 -6791 Deland (386) 738-1688 Orange Cty......(386) 775-3667 Daytona ..........(386) 226 -2120 New Smyrna ..(386) 423 -7373 Palm Coast (386) 447-1969 Cocoa/M.1 (321) 633 -7584 Mlbrn/Plm Bay (321) 728 -9202 Brevard Beaches(321) 633 -7548 Titusville (321) 264 -6399 Gainesville (352) 336 -3667 Ocala (352) 369 -0569 Lady Lake (352) 259 -7667 Polk County....(863) 533 -3993 Lakeland (863) 680 -1900 Winter Haven (863) 297 -3667 Lake Wales (863) 802 -3667 Sebring (863) 314 -9348 Tampa (813) 226.8866 St. Petersburg..(727) 898 -8711 Clearwater ......(727) 943 -9455 Tarpon Sptings..(727) 466 -9611 Brandon (813) 643 -3484 Spring Hill (352) 686 -1375 Tanis Palms ..(813) 977-0776 Dade City (352) 518-0111 Service Technician: r? A or K IDatc :1 4. — 14, 1 Misc: Custom�:1� d /f� /744 Z)Lne Phone: Cell Phone: Other: _ S eet: / 20 Cit . _ IP: Quantity Description Unit Price Extended Price 1 Service Call ($19.95) & Trip Charge ($15.00) ) J 9x /nd�./ X0110' 6 y 19 y r c, '7/ /f // i 1 7,r7/ /AA.' ' e w ; s 5 r /71 ,t/d'a/ f✓�it, t 4 r� ..DOsX -Ix/if //(1 7/r,/ OP • -- 1A't D 72 /1AX Olp'aye--'0,e ,sef 4kiZ14� 64/ i a o.k 1: A/7 Warranties void if no service ticket presented, Customer or other Company has performed work, or the Quality sticker has been rcmovcd. Warranties DO NOT cover power surges, or Acts of God, e.g. Hurricanes, Tornadoes, Lightning, etc. Warranties also do not cover "disengaged trollies" or `misaligned" sakty sensors. Warranty work will be performed only Monday thmugh Friday between 9:O0am & 3 :OO.pm. Manufacturer's warranties ONLY apply to all ckctricklectmnic assem- blies or parts. Only the first warn my Service Call is free on recurring problems. 1 acknowledge receipt of goods and servic- es in the amounts indicated above. I authorize my credit card issuer to pay the amount indicated above as the "Total ". All pricing on goods and services on this Invoice were explained to me and I gave my approval for the work to be performed. I understand and agree that all parts and services are non - refundable and non - returnable and that all wrap and used parts were removed unless I specifically requested them to be retained. All deposits arc Non - Refundable. Payment Method: Check: Cash: Crcdit Card: MC VISA Discovcr AMEX Expiration: / Card #: Make Checks Payable To; Qtaality Garage Door Services, Inc. Check Return Fee is 555.00 - `\ Signed & Accepted TOT )--"' 4/Z d Z66Z WE iZ£ « Z0:0110-40-010? 813 - 780 -0020 City of Zephyrhills Permit Application Fax- 813 - 780 -0021 Building Department Date Received - - / Q ( 0 Phone Contact for Permitting 32- ( 1 a6 -- t03q e t Owner's Name \V\ \ - Oa-tit= Owner Phone Number f (3 - 183 - %q11 Owner's Address S9 an Nat.) Bell/ C..1 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS Sal az) NI 6 C. ( 1 LOT # a1 SUBDIVISION listens (dpop tA00000 PARCEL ID# 10 - 26-A t - 01110 - O0oo0 - 0410 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR l ADD /ALT n SIGN I I MOVE DEMOLISH INSTALL REPAIR PROPOSED USE F SFR 1 1 COMM I I OTHER 1 TYPE OF CONSTRUCTION BLOCK I 1 FRAME I I STEEL 1 1 OTHER 1 I DESCRIPTION OF WORK '► Wee q*1 C Qeo BUILDING SIZE SQ FOOTAGE HEIGHT , 134 BUILDING $ .kG 511 VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY 1 I W.R. .C. I l PLUMBING $ 0 V e I S I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � •- �yZ,�'C l � I+ I I GAS I 1 ROOFING I I SPECIALTY I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES I / / // uacv i BUILDER V ��� /' CO MPANY Q /A�c �[.4>�46(3 coat �S4Gltl,'CS, _1 1 SIGNATURE /� REGISTERED l Y/ N I FEE CURRENT I Y/ N I Address 1 (b 5 ?m,,v, ( t O3Vt + f[_. 32 License# 0.0_,(3J41/ 83 ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED 1 Y / N I FEE CURRENT l Y / N I Address License # I MECHANICAL COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I 'MI I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N L FEE CURRENT I Y/ N 1 Address License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. H - 1 - H - H I11I1I1II11111111tIII1I1I11 Directions: I 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 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 an() Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89 -07 and 90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers- Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency- Asbestos abatement. - Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone "V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR F • (LURE TO RECORD A NOTICE OF COMMENC MENT 0 • Y RESULT IN YOUR PAYING TWICE FOR IMPR • ,y NT TO YOUR PROPERTY. IF YOU INTEND A• : T INANCING, CONSULT WITH YOUR LENDER ' • Jr fi:r Y BEFORE RECORDING YOUR •TI 1 r -/ 'I� EN CEMENT FLORIDA JURAT (F.S. 117 , ,f 7 , ,4r / OWNER OR AGENT`✓' ///// CONTRACTOR '� Al S scribed and swo n to (or affirmed) befor a this Subscribed and sworn to (or ffl ed) before a this S- by sworn o , t i c y� /c) by c�( /�+� E l� a }motet vh o Is /are personally known to me or has /have produced Who is /are personally known to me or has /have produced L f C e",52 as identification. (• �.t.S -_ as identification. L ��`' l I S Notary Public • " ./) 1 Notary Public v '' y,, ,UELINE BO Co a .. i, :r{,J =' ommiSSlon DU 621833 Commission Ale:'; ^ ' JACQUELINE BOGES !`; : Exp res : a•: ' ° X19 -+ . .R t 11 Commission DD 621833 .a;•. eooaes 41 i ri ay e ^ bon ded ThN Troy Fain IMUr a ,7 .� �= Expires December 12, 9p1 Q Name of Notary typed, printed or stamped Name of Notary ty e13, •rinteitr" jpeckfnw,rPoceoaoaeeao+a