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HomeMy WebLinkAbout10-10701 CITY OF.ZEPHYRHILLS ,..'.._,. l/ 5335 - 8TH STREET - . • (813)780 -0020 10701 BUILDING PERMIT Permit Number: 10701 Address: 6331 MAISIE RD #20 LOT 194 Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: TOWNHOMES Lot(s): Block: Section: Square Feet: Subdivision: EILAND PARK TOWNHOMES Est. Value: Parcel Number: 03- 26 -21- 0230 - 00000 -1940 Improv. Cost: 43,660.00 g' -' =...£t . ,, § , - '- 4 Date Issued: 7/22/2010 Name: LENNAR HOMES INC. Total Fees: 408.12 Address: 600 N. WESTSHORE BLVD Amount Paid: 408.12 TAMPA, FL 33609 Date Paid: 7/22/2010 Phone: (813)769 -5277 Work Desc: REPAIR/REMODEL SEE SCOPE WORK LEN • M 1 B AR H UILDIN FEE 285.00 L - I AL 35.00 EDMONSON ELECTRIC INC PLUMBING FEE 35.00 MECHANICAL FEE 35.00 BAYONET PLUMBING HEATING & AIR C FIRE PLAN REVIEW FEES 3.12 FIRE INSPECTION FEES 15.00 BAYONET PLUMBING HEATING & AC IN 6 6 \-131 1 3( a F■• R 2N' R• `L M: MI I ULATION I LIN 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." i/ A4416) rir 4 4 li ', CONTRACTO Iia, RE PERMIT OFFI FR PERMIT PIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER SCOPE OF WORK FOR PASCO COUNTY Original Permit # 7102 Home Address 6331 Maisie Road, Zephyrhills, FL 33542 Construction Value: $30,448.00 Pre - Demolition • Disconnect electric panel from home • Keep one (1) GFI outlet in garage only for irrigation, pool (if needed) and power for repairing home • Turn off gas line in home (if needed) • Remove existing outlets and switches from electrical boxes Demolition • Remove selected drywall • Remove insulation (except foam insulation against block wall) if any • Remove/Repair any damage to existing studs • Remove cabinets, countertops and fixtures as necessary • Remove tubs, commodes, sinks and hot water heater • Remove all appliances as necessary • Remove all duct work and air handler, refrigerant lines and HVAC grills • Remove flooring -tile, carpet, hardwood, etc. as needed • Remove all interior doors and trim, mirrors and shower doors as needed • Remove /repair any copper damaged by drywall • Remove all switches and outlet plates • Note: during demolition we will bring home back to rough -in mechanical, electrical and plumbing stage. No structural changes will be made in home. Mechanical Scope of Work • Re- install all new trunk lines and duct work per what is in existing home including bath fans • Replace interior compressor unit Plumbing Scope of Work 'v K M WH PREVAILING ALLORSHALL CODES CO FLORIDA PLY E JT UI ALL LDIIdG • Repair and replace any damaged copper CODE, NATIONAL ELECTRIC CODE AN' • Install new copper after removal as necessary CITY OF ZEPHYR HILLS ORDINANCES • Install new tubs and fixtures as necessary • Repair and replace any damaged copper • Install new copper after removal as necessary Page 1 of 2 I t VIE °ATE - 2_7- to g CITY OF ZE RMILLS PLANS E XA MINER LS 600 N. Westshore Boulevard,_Suite -900 Tampa, FL 33609 • Phone: 813 - 882 -4663 • Fax: 813- 884 -2082 Cr LENNAR.COM o.anin. Plumbing Scope of Work (Continued) • Install new tubs and fixtures as necessary • Install new commodes and fixtures (at finish) as necessary • Check for any damage after demolition and repair as needed • Install new hot water heater Electrical Scopes • Repair damaged ground wire in switch, outlet, and light boxes • Keep existing recessed cans as necessary • Keep all light fixtures and ceiling fans, reinstall at finish • Install all new outlets, switches and trim plates • Install all new recess trims • Install all new light bulbs throughout homes Insulation Scopes • Install new insulation to match or better from whatever was removed during demolition • Check and install any fire stopping as needed Inspections (rough in) • Mechanical • Plumbing • Electrical • Insulation Inspections (fmal) • Mechanical • Plumbing • Electrical • Insulation • Final CIO Page 2 of 2 - . 600 N. Westshore Boulevard, Suite 900_Tampa;_FL 33609 • Phone: 813 - 882 -4663 • Fax: 813 - 884 -2082 ICI LENNAR.COM 813 - 780 -U0'1U L 11y UI LCI.JI Iyt I IIIIJ rc' 1IR r ��� Building Department #(0 ate Received- Phone Contact for Permitting _8 / __. 76 I "" 3 ( ° 3 am/ Z/1 f7(/,v Owner Phone Number (' 2')) lit/ ( r -- � r � 0 (1) wner's Name G �T 1 i ,A F wner's Address . G 3 3� N' A/1/ Owner Phone Number )e Simple Titleholder Hamer Owner Phone Number 1 1 ae Simple Titleholder Address 1 l� 3 3 1 4 /s /F #D 2F/D,S/ye41/LL. 91/ r �L 335 1 LOT # I �B ADD RESS I M n / /n 1 6 ' / L / 9 / V C ) / 1 PARCEL ID #1 03 -.2 —21— 23 0- 00000 ` ` 91 ( UBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) /ORK PROPOSED P44 NEW CONSTR I 1 ADD /ALT I I SIGN I 1 MOVE 1 1 DEMOLISH - INSTALL REPAIR ROPOSED USE I 1 SFR I I COMM 1 I OTHER I YPE OF CONSTRUCTION BLOCK I I FRAME I 1 STEEL OTHER 1 l I DESCRIPTION OF WORK 1 kEpAF/L / ke tilo0eG 4 1/1-'/ EIS /46't/GF - Til IUILDING SIZE 1 1 SO FOOTAGE 1 HEIGHT a .5'7774.y 1 BUILDING 1$ 3 /, 6 s.0 VALUATION OF TOTAL CONSTRUCTION ELECTRICAL f $ .3 �y0 AMP SERVICE ® PROGRESS ENERGY 1 W.R.E.C. l PLUMBING $ Y32 MECHANICAL 1$ 1/.2 95- 1 VALUATION OF MECHANICAL INSTALLATION GAS 1 ROOFING 1 I SPECIALTY I OTHER 'INISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES [ NO BUILDER 11111/ • 9 r COMPANY LEN/VA/ / SIGNATURE REGISTERED 1 Y / N 1 FEE CURRENT 1 Y / N Ad ess /5 . A Y6 At 0/0 CheNgi ttrrt, Alzio License# 1 CSC.,/ A 551.51 � \ COMPANY IGO"/o�u �o sSJ EC EC�rSe /L _iv C ELECTRICIAN • I ✓ r SIGNATURE REGISTERED Y / N 1 FEE CURRENT 1 Y/ N 5 TERED Address , / 034 , 5 - (tom / a 0 / 4 . O / 4 " I , vt A.316/ 3 License# 1 5 OD d 2 79 COMPANY — 8/ voNET pe_tina6,/ve,, hier�ts "N�. 9 4 C SIGNATURE / ��� r REGISTERED I Y / N FEE CURRENT Y / N Address , �0 80$ 08 8�yo�c/Fr /Nr�ce License # C PC 29 MECHANICAL . t COMPANY 94>'o /Er . v id/'/& /46 ,4 C ^ ' SIGNATURE � REGISTERED 1 Y / N 1 FEE CURRENT 1 Y / N 1 Address A0, go 8 34 G1....3y6747 License # C AC O$$ 0 6 2 OTHER COMPANY C. .S'T6t'4./4/6- Ailu ry /gc ooF'U(r, --Zvc. SIGNATURE REGISTERED 1 Y / N I FEE CURRENT I Y/ N 1 Address 2 /1 . 51/04L LAIF 81..vo SP4ING /4 /LL, F63s/60? License # CG' Co 3 1 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 fora!! new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. Directions: FIII 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 Protectibn- 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 e cited for rsl - properties. If use of fill is found to adversely affect adjacent properties, the owner may 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. faith ons set forth in If I am the AGENT FOR THE OWNER, I promise lU good that pahate permit may be r d for cal work, this affidavit prior to commencing construct plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A set aside a pro is io construed ns of the te c hn ic c al codes, nor shall Issuance a permit prevent the Official from thereafter requiring set ase any provioci requiring a correction of errors In plans, construction or violations of any codes. Every p ermit 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 s da s e demonstrate extension be may ab requested, for In r th e eaten sio from IfhwO k Building es for (90) period con consecutive days, theo c ons i dered abandoned. justifiable extension. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE YOU INTEND COMMENCEM -it T M Y R RESULT CONSULT W �� �UR PROPERTY. Y PAYING TWICE FOR IMPROVE 1 ° �� `I�il 13� • •u�i, L MENT. WITH YOU - LEN ' E - O' • ,.�'<i� ORE RECORDING YOUR NO _.61_.-. -� FLORIDA JURAT (F,S. 117,03) CCW" � _� CONTRACTOR 'ore me this 1un+f bscribed and sworn to (or af AGENT Subscribed and sworn to (or affirmed) OWNER OR A �:fl fsr!!�e this t,NE S o re me Silfir ZvI D ______ = _____— _ eTH ?PI o by ° lin/ L. /L/C y Wh•1�3 re personally known to me or has /have Who t� are pers onally kn own to m produced -------, as Idenproduced tification. ap Identification. Notary Public otary Public r DD 77 023 Commission No. 771/0 Z3 mission No. - „ _. . ■ e Notary = " Name of N ry typed, printed or stamp s' ? e 1 " - Commission DD 774023 ' ,;• ■ : c 2012 ten t Name of Notary typed, prl - :.. o P ;P" %mmission DD 77402 . ,,,;• Expires June 6, ,es•yo,9 YiiSl ' i; •. 6, 2012 �:F oe 4. `s Bondmi lTro Troy Fain IMuran0 800• Expires June L2 :1,;;'''' ®dnnBtl i?+M TV PAM IrliurAnno d90 Repair to Building 20 1) All work shall be in accordance with 2007 F.B.C. and 2008 N.E.C. 2) No work shall be covered without inspection first. 3) Any work done on any firewalls shall be inspected by the Fire Marshal. 1111111( 11111111111111111 (11111111(11111111(1(1(1111(iii 1111 2010088426 Rcpt:1311601 Rec: 10.00 DS: 0.00 IT: 0.00 06/22/10 L. Sagastume, Dpty Clerk PAULA S.O'NEIL,Ph.D.PASCO CLERK & COMPTROLLER 06/22/10 10:24am 1 of 1 OR BK 8358 PG 1684 NOTICE OF COMMENCEMENT Permit No. Property Identification No. 03- 26 -21- 0230 - 00000 -1940 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1. Description of property (legal description :) Lot 194 EILAND PARK TOWNHOMES PB 60 PG102 . a) Street Address: 6331 MAISIE RD ZEPHYRHILLS FL 33542 • 2. General description of improvements: Repair / Remodel Single Family Residence 3. Owner Information a) Name and address: STERLING, ELIZABETH PO Box 876 ZEPHYRHILLS FL 33539 b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4. Contractor Information a) Name and address: LENNAR - 15550 Lightwave Drive Ste 210 Clearwater, FL 33760 b) Telephone No.: (727) 479 — 1700 Fax No. (Opt.) 5. Surety Information a) Name and address: N / A b) Amount of Bond: N / A c) Telephone No.: Fax No. (Opt.) 6. Lender a) Name and address: N / A Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: N / A b) Telephone No.: Fax No. (Opt.) 8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes: a) Name and address: N / A b) Telephone No.: Fax No. (Opt.) 9. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is Specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA C " COUNTY OF PASCO (� c:. Signature of Owner or Owner's Authorized Officer irector/Partner/Manager STERLING, ELIZABETH Print Name The foregoing instrument was acknowledged before me this 1(' day of j ) tJ cE , 20 I U , by e L� a4 'e rl-t STf9. i. r' (f as Owner (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on behalf of whoa ent was executed). Personally Known OR Produced Identification X Notary Signature /J, T e of Identification Produced Name (print) GG /SS iP /�/° /-cecx 'r� YP Drivers License # �> j —z. ._ S _ J �'C �—' Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. , � . � r) & ��^ Signature of Natural Person Signing Above FORMS /NOC,rvsd2007 •1;�r ,. -•, ELISSA M. HOLLERAN Commission DD 774023 -- Expires June 6, 2012 ,4 ;, Iladnd rniur roy Fein inUenCB eoo- 7ms Jacqueline Boges From: John Lively [jlively713 @yahoo.com] Sent: Thursday, July 22, 2010 6:20 PM To: Jacqueline Boges Subject: Re: need additional information I'm sorry about the screw up Jackie, she cut another check for $20 today and put it in the mail. You should have it by Monday. Please let me know if that is a problem. Edmondson supposedly sent the info over to you this afternoon. Thanks, John Sent from my iPhone On Jul 22, 2010, at 11:47 AM, "Jacqueline Boges" <jboges @ci.zephyrhills.fl.us> wrote: Hey John, After you left Ms. Bobbie was going back over the permits and the amount is still showing short. Check # 7246 amount $3245.00 is not correct should been $3265.00 per my total. We show short $20.00. Lennar owes $20.00 still. Also the electric company Edmonson work man comp has expired if you can get in touch with them and let them get that over to us via fax I would greatly appreciate it. Thanks Jackie Boges Code Support Specialist ext. 35 1 JUL -22 -2010 02:56P FROM: 70 :7800021 P.2/2 • ACORD TM. CERTIFICATE OF LIABILITY INSURANCE I DA 04/118!201 m PRODUCER Phan; (879) 906-1I34 Fox 678/860959 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ASSOCIATES AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO BOX 16190 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11470 N. 53RD 37. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TEMPLE TERRACE FL 33887 INSURERS AFFORDING COVERAGE NAIC 0 AlanMY Lloe R001764 INSURED INSURER A: SOUTHERN OWNERS INSURANCE CO. 10190 EDMONSON ELECTRIC INC INSURER B: AUTO OWNERS INSURANCE CO. 15988 DBA & B J ENTERPRISES INC INSURER C FCCI INSURANCE CO. 10178 1034 SKIPPER ROAD TAMPA FL 33813 INSURER D: 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 OE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MIA L INS TYPE OF INSURANCE POLICY NUMBER POLICY ITMENTYa Four( S uAPIRATION • OATH NONDO YI OATS RIRwaYYI LIMITS GENERAL LIABIUTY 20718528 02/06/10 02/08111 EACH OCCURRENCE 4 1,000,000 X COMMERCIAL GENERAL LIABILITY p IODATED $ 300,000 I CLAIMS MADE © OCCUR MED. EXP (Any ono parson) S 10,000 • A X contra:1Wlabllly PERSONAL a ACV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2.000,000 GENT. AGGREGATE LIMB APPLIES PER PROWCTB•COMPIOPA00. i 2,000,000 — 1 POLICY n !mi f LOC ■ AUTOMOBILE LIABILITY 4133615101 02/06/10 02/06/11 COMBINED SINGLE LIMIT X ANY AUTO (Ea occident) $ 500,000 — ALL OWNED AUTOS BODILY INJURY 8 SCHEDULED AUTOS (Par moon) 3 X HIRED AUTOS X NON AUTOS BOOILYINJURY i (For aoddoM) -- PROPERTY DAMAGE $ (Par aeaidenl) GARAGE LABILITY AUTO ONLY • EA ACCIDENT 3 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA UABILITY 4340464601 02/06/10 02/06/11 EACH OCCURRENCE _ $ 1,000,000 OCCUR 0 CLAIMS MADE AGGREGATE 3 1,000,000 B $ DEDUCTBILE 3 RETENTION $ 10,000 • i WORKERS COMPENSATION AND 001 -WC10A -59769 05/02/10 06102/11 X 1TT a LI Vs I l en" EMPLOYERS' LIABILITY C AIN PROPENTOIlPAa1aWE1ECUTIVE EL.EACHACCIDENT $ 50D,000 OPRCERAC&YEN EXCLUDED? II trM.weMbuWr E.L. DISEASE -EA EMPLOYEE $ 500,000 SPECIAL PRINISIONS bole. E.L. DISEASE -POLICY LINT? s 500,000 OTHER: DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY OF ZEPHYRHILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TUC 6336 8TH STREET EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE ZEPHYRHILLS, FL 33642 TO 00 60 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY imp UPON THE INSIIRER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 4// Attention: SEAN OR KAREN/813-780-0021 - - - MIkB R 'DS_ ACORD 26 (2001/08) Certificate a 197348 ® ACORD CORPORATION 1988 JUL -22 -2010 02:56P FROM: 70:7800021 P.1'2 v 3 =Mt o�o�sos Tampa Bay's #1 Power Solution Edmonson Electric 1034 Skipper Road Tampa, Florida 33613 Phone: (813) 910 -3403 Fax: (813) 972 -9174 FAX TRANSMISSION JQC 4l DATE: 2 10 FAX NUMB FROM: , -P,'(._, RE: TOTAL PAGES: (Including cover sheet) k)3c\L CONFIDENTIALLY NOTICE The information contained in this facsimile transmittal is confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copy of this communication is strictly prohibited. If you received this communication in error, please immediately notify us by telephone. Thank you. 1034 Skipper Road • Tampa. FL 33613 • Phone: 8 T3.9t0.3403 • Fax 813.910.8546 • Www.edrnansonelectric.com Florida License 0 EC0002S79