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HomeMy WebLinkAbout10-10421 CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 10421 FENCE PERMIT Za » -. a = 1IE E b d E o.. Permit Number: 10421 Address: 5336 16TH ST Permit Type: FENCE ZEPHYRHILLS, FL. Class of Work: FENCE /NEW Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11- 26 -21- 0010 - 17200 -0210 Improv. Cost: 3,987.00 Date Issued: 4/30/2010 Name: BIRMINGHAM, MATTHEW Total Fees: 70.00 Address: 3847 OAKHURST LN Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/30/2010 Phone: (813)447 -1651 Work Desc: INSTALL 174' X6 WOOD FENCE W/ 1 WALK GATE/ 1 DD GATE SUPERIOR FENCE RAIL INC (727)536 -1905 F & FENCE 40.00 CONTRACTOR CERTIFICATE 30.00 E" sa a a y : ,g ._ .. a' a ; P y I a€, i 1 14 •• ,r..n,• ; �s. •. �.> .. .,,, ?��., r .. : . ..__ .. r�. ... - -a ��,� � FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances A g n - 6 20 /t- CONTRACTOR PERMIT OFF! PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER APR -30 -2010 01:26 FROM: 727 585 8500 TO:18137800021 P.2/7 813_7e0 -0020 City of Zephyrhills Permit Application Fax - 913.790.0021 Building Department Dab ROCeNed Phone Contact for Permhtl Owners Nome (Ylack-4- ? • rmi n q to m Owner Phone Number RI 3 IWT L0 5 Owner's Address ! 533(p 1(0 +\ j� ( Owner Phone Number l Fee Simple TIUeholdor Name! Owner Phone Number I Fee Simple Titleholder Addrose r I JOB ADDRESS 15 . S(49 1 U + h S+ 1 MM LOT * f 20 SUBDIVISION I 1 PARCEL !Del 11-26- W 2I - Io - ii ag o - o a ( 0 (OBTAINED FROM PROPERTY TAx NOTICE) WORK PROPOSED e NEW CONSTR Fi ADD /ALT 0 SIGN O MOVE O DEMOLISH INSTALL REPAIR PROPOSED USE O SFR In COMM O OTHER ■• ..„7 ,�M• TYPE OF CONSTRUCTION O BLOCK MN FRAMES Q STEEL 1 /' OTHER r DESCRIPTION OF WORK A •a 174 to: hi.h p C - J(6 X` k r nce (of I LS) • ! 4 1 as 9a{e- 8UILDING 8I - S0 FOOTAG - , HEIGHT BUILDING IS, 0 VALUATION OF TOTAL CONSTRUCTION O ELECTRICAL IS I AMP SERVICE 0 PROGRESS ENERGY O W.R.E.C. 6(airt.4.. O UMBING �t ( (n O MECHANICAL IS VALUATION OF MECHANICAL INSTALLATION Q n GAS � - . : • -• ME PE(1ALTY Q OTHER O FINISHED F • - ELEVATIONS ' F OOD ZONE AREA OYES NO 1 - UILDER COMPANY I I GNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I A... el I Licenses I ELECTRICIAN COMPANY SIGNATURE NkurSTEr1EO I Y / N I FEE CURRENT I Y/ N I Address I License I I PLUMBER COMPANY SIGNATURE REGISTERED I I Y / N I FEE CURRENT I Y/ N I Address 1 License e l MECHANICAL COMPANY [ SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N I Address I 1 License M OTHER COMPANY ! SIGNATURE REGISTERED I Y/ N I PEE CUMENT I Y / N J Address I ( IDEA License e ie RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plana; (1) set of Energy Forme; R -O-W Permit ter new construction, Minimum ten (10) working days after Oubmittal date. Required oneite. Construction Plans, Stormwater Plana w/ SIN Fens, installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisinnanarge projects COMMERCIAL Attach (3) complete ssls 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 submiltal date. Required oneite, Construction Plans, Slormwater Plans w/ Silt Fence installed, Sanitary Facllkles & 1 dumpeter. She WOW Permit for an new propels. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. • •PROPERTY SURVEY required for MI NEW construction. ,, Fill out applicatIon completely. Owner & Contractor sign back of application, notarized H over 82500, a Notice of Commencement Is required. (A/C upgrades over $6000) •- Agent (tor the coMrekxor) 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) Remote Sewers Service Upgrades A/C Fences (PIct/Survoy/Footage) DrIvaways -Not Ober Courtier if on public roadweys..needs ROW APR -30 -2010 01:26 FROM: 727 585 8500 TO:1E137800021 P.3'7 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 uncenein es to whet licensing roquiromonts 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 end 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 protect 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 52,500.00 or moro, I certify that I, the applicant, have been provided with a copy of the 'Florida Construction Lion Law — Homeowner's Protection Guide' prepared by tho Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than tho "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. 1 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/WastewaterTreatment. - 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 Tots 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 pemtit 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 WITH YOUR LENDE OR AN ATTO EY BEFORE RECORDING YOU CE OF COM ENCEMENT. FLORIDA JURAT (F.S. 117. 9) OWNER OR AGENT ' G CONTRACTOR i Subacnb d and swam 10 a bgroro ine this E �llj Subscribed and swo o r rmed) before me this 1A O r\ 1 by M i 11 0 - C' ( P'f — apri t by et - .& a '+''.• INare personally known ,o me or hes/haue produced (Mw isiaro person known to mo or h - avo produced - - es C �/Y �� 1 esiden _ h fl flceden. e �.. E Li � Aku uunE otary Pudic S t 0 �� ..* V o rir 1 Q, S,A�Nota,y Public Commission No. D b) g 3t, j a / L � 40 Commission No. 1� D 0 n I O. •ephaniE. t . m12+eng an E P. ina.riens Name or Notary typed, panted or stamped Name Notary typed, printed or stamped :' STEPHANIE R MARTENS '. it, - STEPHANIE R MARTENS MY COMMISSION 5 00830125 i MY COMMISSION 0 00830125 4}4kir EXPIRES October 09, 20 2 EXPIRES October 09. 2012 . 1407) 350.0703 FaaaNasrve arks awn uo713960iss Menowek ryesnw.m,n Pasco County Parcel: 11 -26 -21 -0010- 17200 -0210 001 Page 1 of 1 Data Current as Of: II Weekly Archive - Saturday, April 24, 2010 Parcel ID I 11- 26 -21- 0010 - 17200 -0210 (Card: 001 of 001) I Classification 11 01 - Single Family Mailing Address Final 2009 Value BIRMINGHAM MATTHEW M Ag Land $0 3847 OAKHURST LN Land $26,023 ZEPHYRHILLS FL 33541 -6425 Building $27,423 Physical Address Extra Features $0 5336 16TH ST ZEPHYRHILLS FL 33542 -5060 Market Value $53,446 Legal Description (First 4 Lines) Assessed (Non School Amendment 1) $53,446 See Plat for this Subdivision . Taxable Value $53,446 TOWN OF ZEPHYRHILLS AKA CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 21 & 22 & NORTH 6.00 FT OF LOT 20 BLOCK 172 Land Detail (Card: 001 of 001) Line II Use I °DescriptionII Zoning 0 Units II Type II Price II Condition II Value I 1 II 0100 II SFR II 00R2 II 8,400.00 II SF II $3.06 II 1.00 II $25,704 I 2 II 0100 II SFR 0 00R2 II 840.00 II SF II $0.38 II 1.00 L $319 I Additional Land Information I Acres a 0.19 II Tax Area II 3OZH II FEMA Code II -- ( °Residential CodeIj ZHLHLP2 I Building Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1956 Stories 1.0 Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Plywood Panel Interior Wall 2 None Flooring 1 Asphalt Tile Flooring 2 None Fuel Electric Heat Forced Air - Ducted A/C Central Baths 1.0 Line I I Description II Sq. Feet II Repi. Cost New I 1 II BAS II 936 II $34,445 2 U UOP II 180 II $994 I 3 I I UDG I 312 11 $3,459 I Extra Features (Card: 001 of 001) I Line II Description 11 Year 11 Units II Value I No Extra Features I Sales History I Previous Owner II GOLDNER DANIEL A I Year II Month II B ook /Page II Type II Amount I 2010 II 01 II 8252 / 0845 II WD II $65,000 2009 I� 03 II 8043 / 1343 11 2c 11 $ I 2009 II 03 II 8043 / 1344 II 2 II $ I http: // appraiser. pascogov .com /search/parcel.aspx ?sec =11 &twn= 26 &rng=21 &sbb= 0010 &b... 4/30/2010 APR -30 -2010 01:28 FROM: 727 585 8500 TO:18137800021 P. 6'7 PASCO COUNTY BUSINESS TAX RECEIPT 2009 -10 Issued pursuant and subject to Florida Statutes and Pasco County Ordinances. Iseuence does not certify compliance with zoning or other laws. This receipt must bo posted conspicuously in place of business. Expires September 30. Mike Olson ACCOUNT NO' 079596 TAX TYPE OF BUSINESS' SIC CODE' 1799.05 PASCO COUNTY Tx.ORIDA FENCE INSTALLATION d' "'`r +►�''•_ LOCATION ADDRESS= ;'�.``�, �' 1385 STARKEY RD LARGO SUPERIOR SUPERIOR FENCE & RAIL INC : 3• � 1.385 STARKEY RD LARGO FL 33771 -3111 •�.�: DATE RECEIPT AMOUNT 08/11/09 572072 53.75 I I I...I I.I...I I...I...I I..I I....I I..1 (.,.111..1.,1.1.11...1 • ••r . 1? :is rt ; .. • . • • APR -30 -2010 01:28 FROM: 727 585 8500 T0:18137800021 P.7/7 DAM (MM W IOD/YY{ / �/, .r UP R CERTIFICATE OF LIABILITY INSURANCE SE 6 i 04/30/10 PRODUCE THI5 IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Jean Arthur Associates , Znc , HOLDER. THI5 CERTIFICATE DOES NOT AMEND, EXTEND OR 5626 Red Bug Lake Ad ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. winter springs TL 32709 Phono:407- 699 -9930 Fax:407- 699 -5626 INSURERS AFFORDING COVERAGE NAIL* INSURED INSURER A Orsnito sate Insurance Colman — 23809 INSURER B. 'nu OAe.n1t Mumma. Company .,, �C Sups ox Fenn & Rail of INSIkiu c St Paul Fire & Marine Pinellas County, Inc. 3400 Stark Road N ISURIER 0 sr. Lola Largo FL 33771 EepLex.r. IAa Co 10701 1 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED UELOW NAVE DEER IGGUED TO THE INb1NGb NAMED ADOVC FCII THE POLICY PERIOD INDICATED. NOI W11 M IN UINCi ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER 0OCUMENr WITH RESPECT TO WHICH MIS CERTIMCAIE MAY SE ISSUED C4 MAY PERTAIN, TFIC INSUR,NCG N BY 1HE POLICIES DESCRIBED HEREIN is SLOJECTTO ALL THE TERMS. OCCLUSIONS AND CONDITIONS OF SUCH POLICIES AGOROGAT6 LIMITS SHOWN MAY HAVF IIFpN RFD cal By PAID CLAIM weft muLT1. LTA NO TYPE OF INSURANCE POLICY NUMBER SAWMPA D LIMBS GENERAL u*O1LIry EACH OCCURRENCE $1,000,000 A X mum c uu. c,F_Nemed. LIASILITY 02 LX 00293 -0 07/01/09 06/25/10 PRc` `Ma n c 8x.00,000 _ CLAIMS MAOF ©Cx.0.IR APED Ex» (Any ono parson) _ 3.0,000 PERSONAL a ADV INJU RY 5 1, 000 , 0 00 _ GENI!RAL Arr,REGATE T $ 2,000,00 0 1 –... GENt AGGREGATE LIMIT APPLIES PER PROnhjCTa. couRaa Aso 5 2 , 000 , 000 7 POLICY 1^ 1 fT n LOC AUTOMOBILE LIABILITY — 5 X ANY AUTO 8A7266NO22095EL 06/25/09 06/25/10 fE'' LmaT $ 1000000 f Q euiuerN) — ALL OWNED AUTOS UODILY INJURY 5 _ SI)IEDULED ALTTOS (Per person) B X HIRGDAUTOS BODILY INJURY $ B X NON"OWNEDAUTOS 1Por ocol00n1) .. .... .. _... PROPERTY DAMAGE $ Per accident) GARAGE LIABILITY - - -M– AUTO ONLY - EA ACCIDENT 5 — ANY AUTO OTHF THAN EAACC $ AUTO ONLY AGO 5 EXCESS / UMBRELLA LIA8ILITY EACH OCCURRENCE $ 2 , 000 , 000 C � OCCLR 7 CLAIMS MADC 8905521928 07/01/09 06/25/10 AGGPCGATC $2,000,000 — _' DEDUCTIBLE — X RETENTION $3,0,000 $ WOI$cr.R: COMPENSATION WG Irmo AND EMPLOYERS' LLABILITY Y I N X (TORY LIMITS 1 X III RI 0 ANYPRawHIE NrwEXECUrIVE ❑ 0930 -42425 06/25/09 06/25/10 EL EAEHACCIOENT $ 500000 OFFICER/MEMBER E)CLUDED I (M.nd.I.ry m NN) E.L. DISEASE- EA EMPLOYEE 5500000 6F1EC er. I A L PRO d. P VIS5I0 I NS N O N E L DIS ASE- POLICY LIMIT $ 5000 IO OTHER A Property Section 02 -LX- 00183388 -0 07/01/09 06/25/10 89P -Out 40,000 A Commercial Appii 02 -LX- 00183988 -0 07/01/09 06/25/10 Contents 5000 DESCRIPTION OF OPERATIONS / LOCA`noNE / VEHICLES 1 R9Yfa. USI(wds AD060 9y ENDORSI_MtNY/ EPdCUIL PAMAOIONO License holder Christopher Johnson M C■1043.8, Fence Erection Specialty Contractor CERTIFICATE HOLDER CANCELLATION WOULD ANY OP TWO MOVE DOOCROOD POLICIES/ BO CANCELLED OEroAE THE ExpaixnoN CITYOFB DATE THEREOF. THE MILANO INSURER WILL ENDEAVOR TO MAL 10 , OATS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, SLIT FAILURE To DO SO SHALL City of Sephyrhi 3.1s me0E8 NO OEUOATON OR LIABILITY OF ANY KIND UPON T►q INSURER. ITS AGIONTS oR Building Dept. ROMIE68NTATIV6$ Fax:813 -780 -0021 5335 8th Street A REPRpsENraTlve IZeDRYrhiils FL 33542 ACORD 25 (2009/01) ACORD CORPORATION. AN rights reserved. The ACORD name and Togo aro registered marks of ACORD APR -30 -2010 01:27 FROM: 727 585 8500 TO:18137800021 P.4'7 SUPERIOR FUNCE&RAIL.INc ti/here Quality fMattel's! 1400 Starkey Rd Largo Fl 33771 (Tel) 727 - 536 -1905 (Fax )727 -S85 -8500 Date: 4 1 30 I C7 RE: LETTER OF AUTHORIZATION 1, Christopher Johnson, holder of a PCCLB number C-10418, do hereby authorize the following to act as my agent(s) in submitting permit applications and obtaining permits as well as make changes to permits and plans, initial changes made by the building dept and/or sign applications for the qualifier: Authorized Agents: rn u .l _l hr_l 11104_ CraSb r . 1 i' C P Dorman 1 unders , • I at I, as the li sed qualifier, am responsible for any application submitted by my agent(s). C •phcrJa n Contractor Si ure State of Flom�a, Cottn of CJ k.S sworn to (or affirmed) and subscribed hefore me this aayof_ ri , 2010 Notary Seal: Notary: R Qjr 1,D Signatu of Notary Public -State of Florida ' STEPHANIE R MARTENS ea -' : � , ; "- MY COMMISSION # DD830120 ') ,Mark S . EXPIRES October 09. 2012 Print G Nanie of Notary Public (407) BBB -0157 FIMWUNelrryaervececo n Personally KnownWOR Produced TD [ 1 Type of Identification Produced APR -30 -2010 01:27 FROM: 727 585 8500 TO:18137800021 P.5'7 • L 1 B PIN 'LEA S C s I N b LICF?NSING UAItD COMPETENCY CARD • THIS CERTIFIES THAT Christopher L Johnson DSA Superior Fence & ItnilrOr Pinellas County: inc HAS:ME?T ALL THE REQUIREMkiN'!'S FORT1OL1JtNO A _ COUNTY WIDE.CERTIF?ICATE OF COMPETENCY NO. C:1041a AND IS' DULY C &R11FIFD. Fence itrectiun:Spedaity tontr IN 9000 STANDING UNTIL Septennber30,2010 C -10418 DATE UN ISSUANCE . esimrtooy Johnson, . Christopher 1. * Please cut out license along lines 4421 Calnt Water Couri Orlando, PL 328J 7 • APR -30 -2010 01:26 FROM: 727 585 8500 TO:18137800021 P.1'7 To: City Of Zephyrhflis FA)C Fax number: 813- 780 -0021 From: Mike Crosby Fax number: 727 -585 -8500 Superior Fence & Rail of Pinellas 1400 Starkey Rd. Largo, FL 33771 Telephone Number: 727 -536 -1905 Date: 4/30/10 Regarding: �.—.4 licensing / Permit DDD - Phone number for follow -up: 727-536-190S 000 000 Comments: From:Malinda Torres FaxID:407- 695 -0212 Page 2 of 3 Date:4/30/2010 01:18 PM Page:2 of 3 DATE (MM/DD/YYYY) co CERTIFICATE OF LIABILITY INSURANCE SUPER 6 04/30/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Jean Arthur Associates , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5626 - Red Bug Lake Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Winter Springs FL 32708 Phone:407- 699 -9930 Fax:407- 699 -5626 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Granite State Insurance Compan 23809 INSURER B: The Phoenix Insurance Company 25623 Superior Fence & Rail. of Pinellas County, Inc. INSURER C St Paul Fire & Marine 24767 1400 Stark Road INSURER D: Bridgefield Employers Ins co 10701 Margo FL 33771 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 CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSK NUU L POLICY EFFEC 1IVE - POLICY EXPIRATION LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD/TYW) DATE (MMIDDM'YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 /VNFK A X COMMERCIAL GENERAL LIABILITY 02 -LX- 00183388 -0 07/01/09 06/25/10 P I U S (Ea Nt NItU occurence) $100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1 , 000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 — 1 POLICY R7 jEC+ n LOC — — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 B X ANY AUTO BA7266NO2209SEL 06/25/09 06/25/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY 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 EA ACC $ OTHER THAN AUTO ONLY. AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $2,000,000 C OCCUR I CLAIMS MADE SP05521928 07/01/09 06/25/10 AGGREGATE $ 2,000,000 $ DEDUCTIBLE $ X RETENTION $ 10 , 000 $ WORKERS COMPENSATION X ITO L IMITS X ER AND EMPLOYERS' LIABILITY D ANYIPROPRIETOREXCLNER /EXECUTIVE YIN 0830 -42425 06/25/09 06/25/10 E. L. EACH ACCIDENT $ 500000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500000 If yes. describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500000 OTHER A Property Section 02 -LX- 00183388 -0 07/01/09 06/25/10 BPP -Out 40,000 A Commercial Appli 02 -LX- 00183388 -0 07/01/09 06/25/10_ Contents 5000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS License holder Christopher Johnson # C- 10418. Fence Erection Specialty Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYOFZ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Zephyrhills IMPOSE NO OBLIGATION OR LIABILfY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Building Dept. REPRESENTATIVES. Fax:813- 780 -0021 5335 8th Street A D REPRESENTATIVE lZephyrhills FL 33542 ACORD 25 (2009/01) 1988 -20 9 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 813 - 780 -002Q City of Zephyrhills Permit Application Fax -813- 780 -0021 Building Department Date Received Phone Contact for Permitting -- mattaamatmatamitor ' Owner's Name •T 'B� r m � n 1 Owner Phone Number I R !' �Q L q 7 I 5 Owner's Address 5 "' r, 1(0 + Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address f - �- \ JOB ADDRESS .Jl� 1 + m 0 LOT # 2 SUBDIVISION PARCEL ID# II- 21.Q - 21 - CO to - 11 ac,C 0 a t v (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH INSTALL REPAIR PROPOSED USE n SFR 1 1 COMM = OTHER I EPn hns+ia fl kkim cm I TYPE OF CONSTRUCTION n BLOCK n FRAME n STEEL n OTHER I I . (� ' woLjIK Ct DESCRIPTION OF WORK in al-cot 11 t' 0-C ( i h 1 ` C1 b b l e ( ce nc w 1 I BUILDING SIZE SQ FOOTAGE HEIGHT Eltk fltEEl •.:.:. '.. :111. ... _ 1.1 . 11'1.11:11 :•:.... 1' 111'111 ...... I�IttEIL In BUILDING $ 3 9 5,7: vv VALUATION OF TOTAL CONSTRUCTION I 1 ELECTRICAL $ AMP SERVICE n PROGRESS ENERGY n W.R.E.C. - I 1 PLUMBING $ I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS n ROOFING I 1 SPECIALTY I 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES nNO BUILDER COMPAN v3 ' /� -j'1 e SIGNATURE � � / REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I / / Address ` Z Da ff� zy. gw License # ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N I Address License # ..1. •:.1...,.,.., 1 .:, ........,••rlia:i?il 1:1::.1:: V ..1:La:.•::: cal le3 l ....1' °ri'::::r: :... ...., ^h 3: 11 Er4IfiffiElfgEtt 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. 11........... •• .. _.._. , y- aferi ""rsnxmu' €ggRE€ ICE€ €€ff€ P EEIE € € €€i'g'gurcrffEFFE IH I ITN € €illIIiIII€ c . •.' 11 . •1.11....1 Y.... Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division— Licensing Section at 727 -847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89 -07 and 90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. ' CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection- Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency- Asbestos abatement. - Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone "V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A ". in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDS OR AN ATTOR EY BEFORE RECORDING YOUR 0T CE OF COM ENCEMENT. FLORIDA JURAT (F.S. 117. 3) OWNER OR AGENT CONTRACTOR 1 Subscribed and sworn to r a Ir before me this3Feal,t '1< Subscribed and swo 'o ' irmed) before me this O y O 1 __( —by 'M \' V 2 • C. .� 11 � P-pY"\ 1 by CYN T'\ C7e.1kc - ..)on S()'""• Wh is /are personally known to me or has /have produced Who is /are personally known_to me or has /have produced as identification. = as identification. \_�L r . - 1 111 . / Pi ota ry Public =w1_,A, _! Ci 00_,,k • Notary Public Commission No. DP 83C) 1 oZ (.= Commission No. D 1 %?-,C) 1 Ol c S) R. ir1ar2 }-e)nS aephani E R, marknS Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped u« +''ti STEPHANIE R MARTENS �► '•' ' r ' o ' t STEPHANIE R MARTENS " MY CO # DD830126 " - MY COMMISSION # DD830126 • viirdie ss EXPIRES October 09, 2012 „ f, EXPIRES October 09, 2012 (407) 398 -0153 FlondallotarySery ice .com (407) 398 -0153 FloridallotaryService.com S 8 ` S Home Improvement Agreement: Proposal for Fencing Installation p 1 A h. 1 4 140.-1 (In l P?2 5 /- / /f' /f Z Customer's Last Name, First Nam Store (� Store No. Order No. 7 / 6 I-41 J r Date J 1 ..1 7 /2e. Service Address 7 e f I Y A i.,1 L ` PRICE IS VALID FOR 30 DAYS FROM L 7 Js Z DATE OF PROPOSAL City State Zip X1 1 — y Y 7- /61" / Customer's Daytime Phone No. Customer's Evening Phone No. Customer's E -mail Address P/ 3 — Z/ y 7 -/6 rj Nearest Cross Street PERMIT /INSPECTION I R ION Permit required? es o Homeowner to obtain permit nstallation professional Plot plan or ey available? (Installation Professional requires copy of permit before installation) to obtain permit es I] No APPROXIMATE LAYOUT Selection $ FENCE FOOTAGE CONTAINED IN THIS PROPOSAL I .)' `- •XIMATE BASED ON FIELD MEASUREMENT. FINAL PRICE WILL BE ADJUSTED BASED ON ACTUAL FENCE F J f Ie' USED, AS SET FORTH IN TERMS AND CONDITIONS, L) ADDITIONAL COST OPTIONS .■111M■e1 Mile J ADD THE PRICES IN THIS COLUMN TO THE SELECTION ri_ - -lIIVilar TAKE DOWN AND HAUL 1111•111311111111111111111 1 AWAY OLD FENCE $ 10'1■■.ippli.�11■ allIMMIIIIIIIIMPAMIN 41 2111 WI III tf T ' a. , rll111u•iu1 1 1 1 1 1 1 1 1 1 = r 6 1 1 1 1 . 1 5 /Z ( it A.)'_ / '- FENCE INSTALLATION RELATED TO GRAD - EASE INITIAL ONE SUB TOTAL $ PLEASING TO THE EYE OLLOWING FLOW STEPPED INSTALLATION DEPOSIT $ w 1 ; BALANCE DUE /A' 7 F ENCE TO BE LEVEL WITH HIGHEST GRADE SLIGHTLY UNEVEN GRADE WITH FENCE STEEP SLOPE WHERE FENCE CANNOT•RACM (UPON COMPLETION) $ �/ / (CU TO FILL IN GAPS FOLLOWING FLOW OF GROUND STEPPE CUE FOLLOW TO F N GAPS GRADE AND GAPS ( ) I _ FENCE WILL BE UNEVEN AT TOP FENCE- CUSTOMEIfl LARGE UNDER Product W 0 0 v + Product Product Style: t Height: (`, j Style: Height: Style: Height: _. _ . ------• r -11L- _l L< _ c.aa a D o t Footage: If Gates: Footage: If Gates: Post Cap: Color: Post Cap: Color: Post Cap: Color: Map of Survey r Completion Date: Field Work Date: 2/24/2009 Revision History: Oev 0 2/26/2009) (ev 0 2/26/2039) / FL 0902- I 068 ...' BOUNDARY SURVEY PASCO COUNTY . . • : . • . . . . .. . . . . • • • i--- • • .. • • . AL! L"WAY • • - . .. . . . . . • . . • . . . .oz • . . . • . . 6 .: . . . - , . • 5 89 E 1 40.00(P) • • .' . .• • • - .- . .• . . . • • . 5 89 E 1 40.04'(M) • . - ' -- lb . • END. IR 1/2" Eft C> C. I 2.3 END. IR 1/2 • t\i 9.4' — , t• - 26.0' \ / — ONCN" • 50.G' . .._ 0 b d \/ .. LOT 22 ..0 0 LD i STORY RES 0 1<u I 2.3' 3' CONC DRIVE 0 #533G b/ \ ci k..0 if) tj &) - ° 8 (.,*, BLI<", I 72 i u-lo - C O ......, 6 . , .i.gi_ ___ _L._ t..ii 'S 422 \ — ___ _____ .- 0 a < N" 87. . . • U 6) U LOT 21 ILI (IL ro Lc' I 2.3' - - 1— • 1 0 0 BLK I 72 ,. o 111 z b 12.4' 82.8' CZ o . 31.2' j --, I if) AC 1 ] in N 1 6 1---- z / _ (I) • 4' WOOD FENCE ,/ / •„ .., / ,, /, 7/ /.. ■ // .. • FND. IR 1/2" END. IR 1/2" _ 3' —.0 LB. #3555 i N 89 W 1 39.9T(M) LB. #3555 4 • -4---N 30.0' WEST 1 40.00(P) (...D • • • - DIRT — LO: • -i I 2 I .0' I I 6 ,ri ASPHALT (..0 in FND. IR LB. #3555 @ 5E CORNER Of LOT 1 I 8 • c) I hereby c_it.!fy II.. 4.0%.:.,-kz.r . • "-`11r . of the hereon ' ■ 0.. l % 'I ) f! r''., ., describeJ pr.]: ty 6 .-. true : corr.. t epresentation of I L.) f ri ic. .2 , • a surrey 1 c ncier my ?i , •.611on and t .t aid survey meet the in ■•1 t i 4 hw - el 5 t1r.d ar , t ourth by the Fla da . F i_ s1 91 16;5 OA d c e o .., pursuant to to 30 ninnimmlnum1 15 30 Sec.tion 4 - . tf.i • r.i° t ,t , 5 and tpter G l Ci-1,/-Ci i&icla Ai.lininistLscior, i....o.f.te. , her, this doc.oinc.;it is .v.iN tronica310iiylt.1 an.), .1.?I' d persuant 411 Section .472) ." '' of he Fiol .da izta : . and Chapter GRAPr1IC SCALE (In feet) ' *P.* GIG- ' 7- . • Alik ritAil 4 ; : i g ration Code. I inch = 30' ft. State of qorida Pr.gfes7ft SilthR- . Mapper License no. 6571 -.... EXACTA LAND SURVEYORS, INC- TAMPA OFFICE LB. 7337 601 CLEVELAND ST, SUITE 501 CLEARWATER, FL 33755 FL0902 1068d Page Two of Three (this page not valid without all three pages) Map of Survey H SUPERIOR t:NCE RAIL ric, Where Qualit% l'ilatters! 1400 Starkey Rd Largo Fl 33771 (Tel) 727 -536 -1905 (Fax )727 -585 -8500 Date: L4 , ` 01 1 RE: LETTER OF AUTHORIZATION I, Christopher Johnson, holder of a PCCLB number C- 10418, do hereby authorize the following to act as my agent(s) in submitting permit applications and obtaining permits as well as make changes to permits and plans, initial changes made by the building dept and/or sign applications for the qualifier: Authorized Agents: 11 1 uaW bnd fx 1 CroSb el i p liurmal 1 unders . • at I, as the li sed qualifier, am responsible for any application submitted by my agent(s). G C topher Ja2rn Contractor SiF' ure State of Flori4a, Coun of 0-e 1 `Q sworn to (or affirmed) and subscribed before me this 3pfi ay of 1 , 2040 Notary Seal: Notary: Signatu of Notary Public -State of Florida : STEPHANIE R MARTENS MY COMMISSION # DD830126 `< r r `3 EXPIRES October 09, 2012 Print Commissioned Name of Notary Public (407) 398 -0153 FloridallotaryService.com Personally KnownWOR Produced ID [ ] Type of Identification Produced • PINELLAS COUNTY CONSTRUCTION` LICENSING BOARD COMPETENCY CARD THIS CERTIFIES. THAT . Christopher L Johnson DBA Superior Eence & RaItOf Pinellas:County Inc HA S, MET- ALL THEREQUIREMEN` S.FOR HOLDINGA COUNTYVI/IDE'CERTIFICATE COA C =1041$ AND IS DULY ; CERTIFIED,AS Fence Erection‘Specialty Contr IN GOOD STANDING UNTIL September:30, 2010 C-10418 DATE OF ISSUANCE 06!22!2009 Johnson, Christopher L * Please cut out license along lines 4421 Calm Water Court Orlando, FL 32817 • • • 11 PASCO COUNTY BUSINESS TAX RECEIPT 2009 -10 Issued pursuant and subject to Florida Statutes and Pasco County Ordinances. Issuance does not certify compliance with zoning or other laws. This receipt must be posted conspicuously in place of business. Expires September 30. Mike Olson ACCOUNT NO: 079596 TAX COLLECTOR TYPE OF BUSINESS: SIC CODE: 1799.05 PASCO COUNTY FLORIDA FENCE INSTALLATION ' "E, r '' ' LOCATION ADDRESS: • ewe 1385 STARKEY RD SUPERIOR FENCE & RAIL INC -�`� LARGO 1385 STARKEY RD ".)-111 LARGO FL 33771 -3111 DATE RECEIPT AMOUNT 08/11/09 572072 53.75 1 n.1,,, 11,,,1111 11„11,,,,11,,, u ,,, a 1 11,1 • • R CERTIFICATE OF LIABILITY INSURANCE OP ID MT DATE(MMIDD/YYYY) SUPER -6 04/30/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Jean Arthur Associates, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5626 Red Bug Lake Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Winter Springs FL 32708 Phone:407- 699 -9930 Fax:407- 699 -5626 INSURERS AFFORDING COVERAGE NAIC INSURED INSURER A. 23809 Granite Slate Insurance Campan INSURER B: The phoenix insurance company 25623 Superior Fence & Rail of Pinellas County, Inc. . INSURERC St Paul Fire & Marine 24767 1400 Stark Road INSURER D Brid .field Employers ins co Largo FL 33771 4 p 10701 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 CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. irv�rt AUU'L POLICY Efh ±L 1 IVE - POLICY EXNIRAI1ON LTR INSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYYYY) DATE (MMIDDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY 02 - LX- 00183388 -0 07/01/09 06/25/10 PREMISES ccuence) $ 100,000 CLAIMS MADE X OCCUR MED EXP Any one person) $10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 — 1 POLICY X PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 B X ANY AUTO BA7266NO2209SEL 06/25/09 06/25/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) B X HIRED AUTOS B X NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE $2,000,000 C X OCCUR CLAIMS MADE SP05521928 07/01/09 06/25/10 AGGREGATE $2,000,000 $ DEDUCTIBLE X RETENTION $10,000 $ WORKERS COMPENSATION WC SIA OI AND EMPLOYERS' LIABILITY Y / N X TORY LIMITS X ER D ANY PROPRIETOR /PARTNER/EXECUTIVE 0830 -42425 06/25/09 06/25/10 E . EACH ACCIDENT $500000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E. L. DISEASE - EA EMPLOYEE $500000 If yes, describe under SPECIAL PROVISIONS below E L. DISEASE - POLICY LIMIT $ 500000 OTHER A Property Section 02 - LX- 00183388 -0 07/01/09 06/25/10 BPP -Out 40,000 A Commercial Appli 02 - LX - 00183388 -0 07/01/09 06/25/10 Contents 5000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS License holder Christopher Johnson # C- 10418. Fence Erection Specialty Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYOFZ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3.0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Zephyrhills IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Building Dept. Fax: 813 - 7 8 0 - 0 021 REPRESENTATIVES. 5335 8th Street A • 4 D REPRESENTATI ( Zephyrhills FL 33542 4111P,- ACORD 25 (2009/01) 1988 -20 9 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • To: City Of Zephyrhills F IA)( Fax number: 813 - 780 -0021 From: Mike Crosby Superior Fence & Rail of Pinellas Fax number: 727 - 585 -8500 1400 Starkey Rd. Largo, FL 33771 Telephone Number: 727 - 536 -1905 Date: 4/30/10 Regarding: Licensing / Permit Phone number for follow -up: 727 - 536 -1905 Comments: / " IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 201 0060777 III Rcpt:1302720 Rec: 10.00 DS: 0.00 IT: 0.00 Key No. 04 /30/10 K. Garci Dpk Permit No. . NOTICE OF COMMENCEMENT PAULA S. O'NEIL, PASCO CLERK & ty COMPTROLLER Cler 0430B10 PG O 1 THE UNDERSIGNED hereby gives notice that improvement will be made O O 8322 R BK m Of 495 to certain real property, and in accordance with Chapter 713, Florida State Statutes, the following information is provided in this Notice of �/ Commencement: this space reserved for recorder . 1 Description. of Property: Parcel o. 1 I — zcu — 21 0 0 1 0 — 3.00 c) 1 C5 G,r� t"Z�,�y�, � - n i/S Pit f '�i Sy ! "S�-/ a-422 42-4,1" ;-74.36. a m 51 t ' e , . x t /S (Legal description of the property and street address if available) G ' A- 4 / /irfi / 72 2. General Description of Improvement P P VefY`t2 1 nS�Qi It n-4-i on • 3. Information: Infoation: Name la • } Address � . r �.� Interest in Pro ert� "' ay i1�9�1L1i1■�L Name of Fee Simple titleholder (It other than owner): tat- �_ P to r Address City Zip 4. Contractor: Name p State Address: L �. • M 1 r • Phone No. .�)�;t�L • ax o. �19'i���� • fate h :'k: "S � P $' 5. Surety: Name • Address Amount of Bond: $ Phone No. City State Zip Fax No. 6. Lender: Name Address Phone No. City State _ Zip Fax No. • 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 7 13.13(1)(a)(7), Florida Statutes: Name Address • Phone No. Fax No. City State • 8. In addition to himself or herself,.Owner designates of to receive a copy of the Lienor s Notice as provided in Section 7 Phone No. of person or entity designated by owner. on. a utes. 9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording unless a different date is specified.) • WARNING TO OWNER: ANY PAYMENTS • DE BY THE OWNER AFTER THE EXPIRATION-OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713 PART 1 • C 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF CO ENCEMENT MUST B - ECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSUJ WIT •UR LEND - Ortt AN • ORNEY BEFORE COMMENCING WORK OR RECORIING YOU r NOTICE OF COMMENCEMENT. •n. ereo own- or•,Pers •ut ortze. • 'icer Director/ "artner Manager � ,�� �`L►� * Signature Re • .red by same below by 'X' mark '"' ignatory s r i -' * ', e STATE OF F L o ° J A COUNTY OF f 0 S c The foregoing instrument was acknowledged before me this a1 day of t\ n (\. C(., e. . 20 V, b as Y (Type of authorit • for .Name •of Person) g., office, trustee, attorney in fact) (Name of a "F";', who! ' ''f" " ' ' e" +!q r r P �;r Y , • rat M Y COMMISSION # DD 79 A. ature r -� "�` • �#` _ U v �c. 0; EXPIRES:Juty14,2012 • Print, y i , m Personally Known OR Pro. uced Identification Type of Identification Produced: ` L Q du 5 L Verification pursuant to tin s .525, Florida Statutes: under penalties of perjury, 1 declare that I have read the foregoing and that the facts stated in it are ue to the bes •f m �• le. :e and belief. ' -'.nature o at al " erson ignmg • .ove ""3" '0 PATR MULHOLLAND . •° 1 ,. MY COMMISSION # DD 799121 2..r�' EXP IRES: July 14, 2012 '; c' Bonded Thru Notary Peelle Underwriters a ■rrr. _a u-„, • STATE OF F LOSICA, COUNTY OF PASCO THIS IS TC CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DL7CUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNESS MY HAND AN OFFICIAL SEAL THIS 2 0 PAULA S O DAY OF COMPTROLLER BY J� _564 .� DEPUTY CLFRI~ _" 9