Loading...
HomeMy WebLinkAbout10-10756 CITY 5335 - 8TH STREET (813)780 -0020 10756 BUILDING PERMIT Permit Number: 10756 Address: 5637 GALL BLVD - Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-05800-0010 Improv. Cost: 5,940.00 �, h, , . _` Date Issued: 7/26/2010 Name: ADVANCE AUTO PART Total Fees: 60.00 Address: 5637 GALL BLVD Amount Paid: 60.00 .ZEPHYRHILLS, FL. 33542 Date Paid: 7/26/2010 Phone: (863)294 -3445 Work Desc: INSTALL ATION (2) 5 TON UNITS A/C �, " � '��° �' e � %� �� � "'°4 ' =x° .�.. -�. ���¢`.� 1 t. r �� � , , ��� 60.0 6en tnt lip- -, lb an-(f ■ -4 ! 7; d) 4 ta , (10A- n .a Y ,� bu 1 ALL `• DUCTS INSULATED 1+ FINAL 1 --1 3 1 1 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 = -fore any further permits will be issued to the person owning same "Warning to owner: Your failure • - • 117i a notice of commencement may result in your paying twice for improvements to 4 our property. I y u intend to obtain financing, consult with your lender or an attorney before re t. rdin . our notice of •, encement." ry / 1 4 A er k /„.)4,;„, CONTRAC 'OR SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813 - 780 -0020 City of Zephyrhills Permit Application Fax- 813- 780 -0021 SO Building Department /0 Date Received Phone Contact for Permitting — Owner's Name 1 . , I � �.�� L ��� Owner Phone Number ��/r� Owner's Address Pd20)� 2. 1 1 V Owner Phone Number Q(lom( , _, V, ,,�}�C Fee Simple Titleholder Name ) f P- Owner Phone Number g )4,15C) JC, ) Fee Simple Titleholder Address na )1 1 JOB ADDRESS 5 Lo 2 \ G 2-,\\)6. LOT# 1 `3 SUBDIVISION PARCEL ID# - a l Q a \ -C ?�D O E. (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED _ NEW GONSTR j, ADD /ALT 1 1 SIGN 71 n DEMOLISH INSTALL F2 REPAIR PROPOSED USE n SFR ® COMM I 1 OTHER TYPE OF CONSTRUCTION I I BLOCK n FRAME I 1 STEEL n DESCRIPTION OF WORK I Ct. 6 ,000 y 1� LL 1i — RC) d — ^ r Q. BUILDING SIZE 1 S4OC SQ FOOTAGE HEIGHT (BUILDING $ / VALUATION OF TOTAL CONSTRUCTION (ELECTRICAL $ / AMP SERVICE 1 1 PROGRESS ENERGY n W.R. E.C. IPLUMBING $ (MECHANICAL E .1ALUATION OF MECHANICAL INSTALLATION IGAS 1 1 ROOFING n SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES NO BUILDER V )' f COMPANY SIGNATURE �J REGISTERED 1 Y/ N 1 FEE CURRE1 1 Y/ N Address License # ELECTRICIAN 1 ) 1 [\ COMPANY SIGNATURE /�J ll REGISTERED I Y/ N I FEE CURREN I Y / N Address ( License # PLUMBER COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN 1 Y/ N 1 Address 111111111MMEMIIIIIMII License # • Exl �- V vCg lnC MECHANICAL PIM OMPANY nec- SIGNATURE L� ' —= I ill 2 REGISTERED 1 I Y / N h FEE CURREN 1 / N Address tOr1 N � . T �l� J i �i �/� [license CI\ l„_©piA-t:?.4. OTHER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURREN 1 Y/ N 1 Address License # I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 1 1 1 1 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 for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. Directions: All out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500) 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 if shingles 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 bP 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 ", 1 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. 1 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: • d R FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR I •-• VEMENTS TO YOUR PROPERTY. IF YOU INT D TO t - TAIN F ANCING, CONSULT WITH YOUR LENDER •..._,. ATTORNEY BEFORE RECORDING YOUR ICE • MM CEME • T. FLORIDAJURAT(F Al. OWNER OR AGEN ( /, i CONTRACTOR -. �� - �'�� Su • • i • _ • and swot R I�("� - • be • r me this Subsc bed and sworn to (or affirmed) before me this / 1/ by -W1r. W b • • S Who is/. r_ .•;atez•r ni:r M - or has/hay • oduced Who is/are - • - • '- me or has/have produ •- • as identification. as identification 0601 /11/4 Notary Public t � • • • Public 7/ 6 " "''r ' , MELIS Q� F Commission No. q � v P � � ' ' ' //�� Com i Na • - - • - Na - - ti r • nted tea # OD 618306 CHRISTOPHER McCANN % : ,,, ;;,,, Bonded Through National Notary Assn. 111 Notary Public - Reg. # 7176061 � Commonwealth of Virginia M Commission Expires Jun. 30, 2012 • «• STATE OF FLORIDA 4; r DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 HAMONROE 9TRFLT32399 -0783 WEI88 WALTER JR A- EXCELLENT SERVICE INC SP 9121 NORTH MILITARY TRAIL SUITE 103 PALM BRACH GARDENS FL 33410 • STATE OF FLORIDA AU 3802888 Congratulations! With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers, from boxers to barbecue restaurants, and they keep Florida's economy strong. CAC014382 06/02/08 078159854 Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www,myfforidalicense.aom. CERTIFIED AIR COND CONTR There you can find more information about our divisions and the regulations that WEISS, WALTER JR impact you. subscribe to department newsletters and team more about the A- IZCELLINT SERVICE INC Department's initiatives. Our mission at the Department Is: License Efficiently, Regulate Fairly. We constantly strive to serve you better to that you can serve your customers. ie COIRTiss=D under the provisions of cn.4e3 n Thank you for doing business in Florida, and congratulations on your new licenses u. way AtJO 31, 2410 LO$O6010062$ 4 1 DETACH HERE AC# - :tI 4ZE OE FLORIDA • DEPAR l' $ � � ° , l 4 • Y R L ICBN B INta B O E TION SECO L00050200626 • 06 02 2008 01815 .: 54 �. -1.< ;t .: The CLASS B AIR CONDI 10 ^�a, �: t Named below IS CaRTIFt'ED - 1 Under the provisions :of - •Chat Expiration date AUG 31, 2010 MISS a LL •, r aSC � - yl,T� S7. A- SIM 9121' NORTE MILITARY RAM 3!x SUIT'S 103 PALM BEACH GARDENS .. FL 3 0ti 1 • • CHARLIE CRS ST N : CHUCX DRAGO GOVERNOR INTERIM SECRETARY • • C F ViAS.REQUIRED BY LAW Anne M. Gannon, Tax Collector P.O: Bea 3715 o West Palm Beach, FL 33402 -3715 www.taxcollectorpbc.com Tel:(561)355 -2272 A EXCELLENT SERVICE 9121 WALTER JR N Account Number: 2006 -21818 9121 N MILITARY TRAIL #103 PALM BEACH GARDENS FL 33410 -5985 Dear Business Owner: This is your new local business tax receipt. Please keep the upper portion for your records and detach the bottom of this form. Verfiy the information and display it conspicuously at your place of business, open to the view of the public. This receipt is in addition to and not in lieu of any license required by law or municipal ordinance and is subject to regulations of zoning, health, and any other lawful authority (County Ordinance Number 72 -7), Receipts may be transferred to a new owner when eyidence of a sale is provided; the original receipt is surrendered and a transfer fee is paid. 14 Receipts may be transferred to a new location when proof of zoning approval is provided; the original receipt is surrendered and a transfer fee is paid. Business name changes require a new receipt. This receipt expires on September 30, 2010. Renewal notices are mailed at the end of June. If you do not receive the notice by the end of July, please let us know. I hope you have a successful year. )) 1 44.44A Tax Collector ""•" DETACH AND DISPLAY BOTTOM PORTION, AND KEEP UPPER PORTION FOR YOUR RECORDS ** * 2006 -21818 STATE Of FLORIDA CW -008 PALM BEACH COUNTY CLASSIFICATION LOCAL BUSINESS TAX RECEIPT EXPIRES: SEP'MBER 30, 2 0 1 0 A EXCELLENT SERVICE ** LOCATED AT G/WIDE $185.85 WEISS WALTER JR AINTYWIDE MUNICIPAL LICENSE PALM BEACH GARDENS FL 33410 TOTAL $185.85 This receipt Is hereby valid for the above address for the period Ig IS NOT A BILL - DO NOT PAY beginning on the first day of October and ending on the thirtieth day of September to engage in the business,profession or occupation of: AIR CONDITIONING CONTR PAID. PBC TAX COLLECTOR CLASS B CACO24382 $185.85 BTR 339 01751313 08/10/2009 ANNE M. GANNON THIS DOCUMENT 13 VALID ONLY WHEN TAX COLLECTOR, PALM BEACH COUNTY RECEIPTED BY TAX COLLECTOR • Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend, extend, or alter the coverage afforded by the policies described herein. Named Insured(s): TriNet HR Corporation Insurer Affording Coverage and all its affiliates and subsidiaries* Commerce & Industry Ins Company (A) A Excellent Service, Inc. (Endorsed as alternate employer) 9000 Town Center Parkway Illinois National Insurance Company (B) Bradenton, FL 34202 Ins Co of the State of Pennsylvania (C) Nat Union Fire Ins Co of Pittsburgh PA (D) New Hampshire Insurance Company (E) 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 the 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. Type of Insurer Policy Number Effective Expiration Limits Insurance Date Date ® WC Statutory Limits Workers' Employers Liability A 057057094 (FL) 07/01/2010 07/01/2011 Bodily In Compensation y juryeyAccident $ 2,000,000 Each Accident Bodily Injury By Disease $ 2,000,000 Each Person Bodily Injury By Disease $ 2,000,000 Policy Limit Other: Client Number: 7G0, 8815 The above referenced workers' compensation policies provide statutory benefits only to the employees of the Named Insured(s) on such policies, not to the employees of any other employer. * TriNet HR V, Inc.; TriNet HR Corporation Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the insurer affording coverage will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. Certificate Holder: AON Risk Services Northeast, Inc. AON Risk Services Northeast, Inc. City of Zephyrhills 5335 8th Street (866) 443 - 8489 7/22/2010 Zephyrhills, FL 33542 Phone Date Issued .t _C '+c _ .,, GER7Ei~fCATE OF LIABILITY INSURANCE D PRODUCER Insurance � — 07 /�Ji 0 8 50 W, 40 Ave, THIS CERTIFICATE IS ISSUED AS A MATT ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE anton F L 833 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P hone 95T -7850 Fax 954 AL THE C_ AF�R))ED EY THE' POLICIESB — —.— ( )x87.777 INSURERS AFpORDING COVER AGE INSURED A Excellent Service, Inc INSURER A; National Insurance Company NAIC L P _ A Excellent Service of South Florida, Inc INSURER B — 9121 N Military Trail 3103 INSURER C; Palm Beach Gardens, FL 33410 INSURER D; COVERAGES INSURER E: — — THE POLICIES of INS "�`— � --`- _ - ., . --' _ � URANCE LISTED 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM I XCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS, IN 3oLL Ja INS: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION —' GENERAL LIABILITY DATE rhrMlOD1YyYY)_ GATE {MkUDDrYYYIry LIMITS — COMMERCIAL GENERAL LIA61LITY EACH OCCURRENCE 1,000,003 APP144 ❑ CLA MADE 505101 09/11/2009 09!11 /201 O irrrr' GE ■ RE D A D OCCUR PREMISES (Ea occurrence) 100,003 ❑ MED EXP (Any ono neon) 5,( PERSONAL & ADV 1,000,000 GEN%AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE Z � POLICY 0 PROJECT LOC PRODUCTS - COMP /C P AGG 1,000,000 AUTOMOBILE LIABILITY El ANY AUTO COMBINED SINGLE LIMIT r 0 ALL OWNED AUTOS �Ee accident) ❑ �� SCHEDULED AUTOS BODILY INJURY — c HIRED AUTOS • er porson — r ❑ NON OWNED AUTOS BODILY INJURY �^ � PROPERTY DAMAGE GARAGE LIABILITY (Per accident) ❑ ❑ ANY AUTO AUTO ONLY , EA ACCIDENT El OTHER THAN _ EA ACC_ EXCESS 1 UMBRELLA LIABILITY y - AUTO ONLY; AGG `^ ❑ OCCUR Ii CLAIMS MADE EACH OCCURRENCE — — LI AGGREGATE — ❑-1 DEDUCTIBLE 0 WORKERS COMPENSATION AND — RETENTION $ EMPLOYERS' LIABILITY _ 40.7 ANY PROPRIETOR / PARTNER / EXECUTIVE C] WC 9TATU- ❑ 0TH — — — WORK OFFICER /MEMBER EXCLUDED? (M LIM1Zv ER Mandatory In NH) El, EACH ACCIDENT ( describe under — — SPECIAL PROVISIONS b elow E.L. DISEASE - EA EMPLOYEE OTH R — - -� E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPE=RATIONS / LOCATIONS/ VEHICLES/ EXCLUSIONS ADDED Sy EN ^ DORSEMENT / SPI PROVISIONS � — CERTIFICATE HOLDER — . — CANCELLATI _'_' SHOULD ANY OF THE ABOVE DESCRIBE POD LICIES BE CANCELLED BEFORE THE CITY OFf:PHYaMILLS EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL C T 8TH ST DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 1 IE LOT, BUT FAILURE TO Do SO 1. lMp -� Z PWYRHILLS, FL 33542 OF ANY KIND UPON THE INSURER, I _ - ENT - • f- RLSENTATIVES.LIABfLITY AUTHORIZED REPRESENTATIVE — CORD 2 g (2 a q) QF _ ©1388 ' '-• RD CORPORATION. All rights The AC • - D name and logo are registered mark rv s of ACORD Advance Auto Parts t fi, • WORK (ORDER _ W.ortt Orvier #: Weo0249465 I Date: 07/06/2010 Trade: CA 1TAL PROJ-169000 Not To " Exceed Ault: '.S 5,940.00 • Responsible/Contact: Dwcst Vendor : Send Invoice - to Vendor ID: AC - 3514 Address: C/O IBM PROCUREMENT SERVICES Company: A- EXCELLENT SERVICE, INC. P.O. BOX 29053 Address: P.O_ SOX 11214 City: HOT SPRINGS State: AR. City: POMPANO BEACH Zip: 71903 State: ° FL Phone: ( ) - Zip: 33061 Attw: JAY WEISS, PRESIDENT Prior,. P2 - Next Business Day Phone: (866) 946 -9494 • Fax: (561) 383 - 3241 Status: Quote Approved 1 . Store Number: 9607 Reported/issued by Edwin Store Name: NORTH GALL BOULEVARD Address: 5637 NORTH GALL BOULEVARD City: ZEPHYR HILLS State: FL • Zip: 33541 O Phone: (813) 788 -7043 O Problem Descniption IU 07/06/2010 ' 12:05:13 (DWEST) Approved by Chris and Steve and sent to vendor. 06/30/2010 :11a1 :47 ( DWEST) A Excellent Service, Inc. Advance Auto Partner Vendor 9121 N Military Trail # 103 Palm Bcach Gardens, Fl. 33410 Date Jame 30, 2010 Name Site Information Advance Auto Parts Attn: Chris Mc Cann BILLING LOCATION Name Bill To: Advance Auto Parts Facility Management Attn: Chris. McCann Advonoe Auto Parts 9607 Advance Auto Parts Address 5637 N Gall Blvd. P.O. Box 2710 City, Zip Zephyrhills, Florida Roanoke, VA 24012 To disconnect and remove 2- existing 5 - ton Trane roof top units. To install 2 new AAP furnished 5 ton York package units. To furnish and install 2 - new factory fit curb adapters as needed. Job will be complete and operating ' including all labor, materials, adapters, cane to lift equipment and air conditioning permit. NOTE: Units are operational at this time but are in very poor condition. Not worth any repairs. EXISTING EQUIPMENT • • lOp EX CELt 1EN 7 SERVICE, INC, CAC ()2_V 2 PO. Box 11214 9121 N. Military Trail, #103 Pompano Beach, Florida 33061 Palm Beach Gardens, Florida 33410 (954) 946 -9494 (561) 383 -3855 (954) 481 -9494 aexcellentsery @aol.com (561) 383 -3241 FAX I hereby authorize ((L VS (C a� LQC to be listed as an authorized agent for Walter Weiss Jr, pertaining to applying for and receiving any permits involving A- Excellent Service, Inc. This authorization becomes effective on the date this affidavit is notarized and shall remain in effect for 1 year thereafter. The undersigned understands the liabilities involved in the granting of this agency and accepts full responsibility for any and all of the actions of the agent names, related to the acquisition of permits for the aforementioned applicant. _ice .i Walter Weiss, r., President NOTARY: STATE OF FLORIDA COUNTY OF: The foregoing instrument was acknowledged before me this Q Q day of .�1 , 20 ICS. (.Czr (.t)e.5-SS is � personally known produ 1 ed identification ( type of identification), did / did not take an oath. aka) - eL_AL Notion, . 4 ..IT':' „ „ MELISSA G • ;A p"'� �6% Notary Public - State of Florida t .� a My Commission Expires Nov 28, 2010 ■ %} AS Commission # DD 618306 ''4g,;7„f3tV gybed Through National Notary Assn. I P.01 /01 TRANSACTION REPORT JUL /26/2009/SUN 09:42 AM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE /NOTE FILE 01 JUL /26 09:42AM 815613833241 0:00:29 1 OK SG3 0942 • (CITCOFZEP.HYRHILLS :5335•- s8TH:STREET. • . • ;(813)78o •ioozo 1 .0756 . IBUILQTNGIRERMIT - . .... _. ! .;.� ,� ( r ; f - , - Ni i 111'; ;Permit:Number: 1 sAddress:c5637• A • . -L ' 'Permit -Type: 'MECHANICAL ZEPHYRHILLS, FL. ICtass :df:Work: A/C.CHANGEOUT . Township: • • Range: - Book: Proposed`Use: i,COMMERCIAL . /Lot(s): (Block: Section: • .Squarepeet: •• . . . . Subdivision: :CITY OFZEPHYRHIL•LS ESt.Value: • • . . EParcel'Number:• 11 =26,21-0010-05800=0010 . - "Improv Cost: • • . • '5;940.00 _ _ •:Date Issued: • 7/2612010 /Name: ,ADVANCE :AUTO PARTS Total Tees :. -60.00 • Address :5637.:GALL BLVD • . . .Amount Paid: . • '60.00 • . • • :ZEPHYRHIL'LS,. EL. 33542 • • .Date:P.aid: • 7/26/2010 • Phone: . :*(863)294 =3445 . Work Desc: INSTALLATION. 2)=.5 UNITS A/C • • • • A E SERVICE IN • DUCTS INSTALLED DUCTS INSULATED ' • '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 orcorrections not made•whenfinspections called d) work not-readyfor Inspection e) permit not: posted on :job site:f); plans -not at g) work not accessible. . • . : : NOTICE: in addition' to the of this permit, may be additional'restrictions applicableto this property that • may be•found Intthe 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 Inspectlon` shall be-made •re any permits will be issued t o the person 'o same • • "Warning to owner: Your failure • a notice of.commencement may result in your paying twice for Improvementsto l our property. I u intendto.obtainlinancing, consult with your lender or an:attorney .before re • . rdin , our notice of . ncement:" . . • : • if . 1 - i Ai Lik • . • — lir ,■ 1,-, , CONTRAC OR SIGNATURE . • • . • . • PERMIT OFFI FR . OCDMTT CVOTOCC T111 .0 MA111TLIC•IAITTLIAI IT •ADDDA\ /Ch TRICDCP TAU •