HomeMy WebLinkAbout10-10769 r
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10769
BUILDING PERMIT
Permit Number: 10769 Address: 37943 EILAND BLVD
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD /ALT COMMERCIAL Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03- 26 -21- 0010 - 06400 -0030
Improv. Cost: 135,513.00 1;
Date Issued: 8/09/2010 Name: FEDJO REALTY CORP CIO CVS PHARMA
Total Fees: 1,105.50 Address: ONE CVS DR
Amount Paid: 1,105.50 WOONSOCKET RI 02895 -6146
Date Paid: 8/11/2010 Phone: (401)770 -5784
Work Desc: INTERIOR RENOVATION (PHOTO, CHECKOUT,PHARMACY, WAIT AREA)
L -L M_ 1 0- T . /O v I - 1 •I 7:7.50 - AL 35.01 ',
AWESOME CONSTRUCTION INC PLUMBING FEE 35.00 MECHANICAL FEE 35.00
AURORA FIBER & COMMUNICATION FIRE PLAN REVIEW FEES 213.00
INNOVATIVE MECHANICAL CONTRACTIN
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•• - �• -•I H -L IN L •,
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.
CITY OF ZEPHYRHILLS, FLORIDA
5335 8th Street
CERTIFICATE OF OCCUPANCY
NAME AWESOME CONSTRUCTION INC DATE 11/4/10
ADDRESS 37943 EILAND BLVD
PARCEL I.D. #03- 26 -21- 0010 - 06400 -0030 SUBDIVISION CITY OF ZEPHYRHILLS
TYPE OF BUILDING COMMERCIAL — INTERIOR RENOVATION(PHOTO, CHECKOUT PERMIT # 10769
T IN �Ep l
REMARKS P � YREWOV TI8N �n W DONE ONLY 9/16/10
FINAL DATE:
BILL BURGESS BUILDING OFFICIAL/ ib
WHITE : Contractor or Owner
YELLOW: Bldg. Dept.
PINK: Utilities Dept.
AWESOME CONSTRUCTION
CGC1507113
8/9/10
City of Zephyrhills
5335 8th Street
Zephyrhills, FL 33542
RE: Permit Pick Up
CVS Pharmacy - 37943 Eiland Boulevard, Zephyrhills, Florida 33542
To Whom It May Concern:
I, Robin Dean, qualifier for Awesome Construction (CGC1507113) give Limited Power of
Attorney to Keith V Dean III of Awesome Construction. This Power of Attorney is granted to act
on my behalf in regards to any permit revision drop off and pick -ups as required.
If you have any questions or concerns please feel free to contract our office at 954 - 345 -6776 or
my cell at 561- 756 -0742.
incerel ,
( ' 1T rZCY. ("AN—___.
Robin L Dean
President
/
Date: ' l I . / Signature: '' ,�, i ' '
� /a / 1
Subscribed and sworn to before me this . d ay of ,
41:• CAROLYN S. CHERRY
* -c_ * MY COMMISSION ► DD 952964
II 1 ' EXPIRES: February 12, 2014
,Pj '4'or os* Boded 'Nu Budget Notary Smites
3766 NW 124 Avenue Coral Springs. FL 33065 p: 954- 345 -6776 f: 954- 345 -6770
CITY OF • / / / / BUILDING
ZEPHYRHILL,S DEPARTMENT
OF ADDITION OR CORRECTION
DO NOT REMOVE
ADDRESS DATE PERMIT f
k.:V 8.-24 MO
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
will be accepted.
Q c f C.1/' cop ,' `Qc - pt 40/'10( n
0 Gam. /9 P / f L, `L ) l � . ) ? c e l of F,1„,./
It is unlawful for any Carpenter, Contractor, Builder, or other persons, to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered, any part of the work with flooring, lath, earth 780 -0020 FOR RE- INSPECTION
or other material, until the proper inspector has had ample time to approve
the installation.
OFFICE HOURS 7:30 AM - 5 PM MON. -FRI. INSPECTOR 7../
Jacqueline Boges
To: Hector Noyas
Subject: RE: FINAL
THANK YOU HECTOR NOTATED PERMIT #10769 AND CLOSED
From: Hector Noyas
Sent: Thursday, September 16, 2010 10:31 AM
To: Jacqueline Boges
Subject: FINAL
CVS PHARMACY, 37943 EILAND - FINAL INSPECTION PASSED
1
•
Jacqueline Boges
To: Kerry Barnett
Subject: RE: FINAL RESULTS
THANKS
From: Kerry Barnett
Sent: Tuesday, September 14, 2010 8:31 AM
To: Jacqueline Boges
Subject: RE: FINAL RESULTS
That was not done. CVS called it off.
Kerry
From: Jacqueline Boges
Sent: Monday, September 13, 2010 8:05 AM
To: Kerry Barnett
Subject: FINAL RESULTS
HELLO KERRY
JUST WANTED TO KNOW WAS 37943 EILAND BLVD FINAL ON FRIDAY SEPT. 10 FOR THE CVS PHARMACY?
Jackie Boges
Code Support Specialist
ext. 35
1
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City of
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: (, 2 ' ' ' / , ?<''
Date Received: 7 76 -10
Site:
379v 3 E d 6 WI)
Permit Type: /Pen ce 47 - ( C- k ALT
Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑
1) ? 6r) c sk 6 GO klked .- (PC r I
cCc0rt49V)r•P LA-3i oG it E,c„
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< R (r\ C ckre t n ck Cc0c -c - e_ c.o t
This comment sh- = shat •e kept 'th the permit and/or plans.
/
' 10 11111.
d 7
Kalvi Switzer P u s Examiner Date Contractor and/or Homeowner
(Required when comments are present)
•
A
AWESOME CONSTRUCTION
CGC1507113
July 14, 2010
Building Official
City of Zephyrhills Building Department
5335 8 Street
Zephyrhills, FL 33542
RE: CVS Store # 651 — 37943 Eiland Boulevard, Zephyr Hills, Florida 33542
Dear Building Official:
I, Robin L Dean, of Awesome Construction Inc, verify that I am an authorized representative of
Awesome Construction, assigned by CVS Pharmacy, the Lease Tenant of the property
described above, to act as General Contractor for the Major Interior Renovations work
described in the construction documents for the above - mentioned address.
I hereby authorize the firm of Robert Reid Wedding Architects and Planners, AIA, Inc. to act as
an agent in order to submit plans for review for the Interior Renovations to the pharmacy, retail,
check -out, photo -lab hallway and waiting areas within the Pharmacy facility. The work does not
include any exterior renovations or site modifications.
Should you have any questions, please do not hesitate to contact me at 954 - 345 -6776.
S' cer: ,
we : me Constructio
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this /5 day of �� , 2010 by l OCIN 2. / / t#
( ) Personally known to me (>0 Produced Id ' ificattion
Type of Identification: NOTARY PUBLIC OF FLORIDA
( ) DID TAKE OATH ( ) DID NOT TAKE OATH Sandra L. Feltner
t,7 : 0onimission a DD801612
�+
AtrIt. ,,, Expires: JULY 15, 2012
d i` BONDED THRU ATLANTIC BONDING CO., IN of ry Public — Stat Florida My Commission Expires
3766 NW 124 Avenue Coral Springs, FL 33065 p: 954- 345 -6776 f: 954- 345 -6770
• ZEPHYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrhills, FL 33542
Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)780;.0044
FIRE SERVICE USER FEES
Occupancy No.:
Plan No.: %ei -- Contractor:eSc-i#96 4„s
Business Name: C i.✓'5 Billing Address: 3176. )LrJ i246 Ave-
Business Address: 371 i ..? '/c...4 el Alms Cc-- 9trr A Pt—
Business Phone No.: Billing Phone No.: I
Business Fax No.: Billing Fax No.: I
Contact: Contact:
I
PLAN REVIEW FEES _ INSPECTION FEES _ PERMIT FEE 1 -- .1 FALSE ALARM FEE
�" Site Plan N/C _ Annual N/C Sprinkler $5 1st Alarm N/C
) Muni - Family /Commercial _ 1st Re- inspection N/C _ Standpipes $5Q — 2nd Alarm N/C
(Minimum Charge $25.? t — 2nd Re- inspection. $100 — Fire Pump $50 3rd Alarm N/C
Plan Revisions DBL _ 3rd Re- inspection $250 _ Hoods $50 , 4th Alarm 5100
_
_ 4th Re-Inspection $500 _ . Fire Alarm $50 _ .5th Alarm $150
SPRINKLER SYSTEMS (Business dosed until _ LP Gas $59 _ 6th Alarm $200
0 - 25 Heads $50 violations corrected) Natural Gas $50; _ NON COMPLIANCE $150
26 plus Heads $100 _ SPRINKLER. SYSTEMS _ Fuel Tanks - per tank $501
STANDPIPE SYSTEM _ Hydro Undergrounds $45 _ Sparklers $1 09
0 Per Riser $50 — Hydrostatic Test $65 per system _ Fire Works $500
FIRE PUMP _ Acceptance Test $45 per system _ Camp Fire $25�
0 Per Pump $100 _ Hydrant Flow 575 _ Controlled Bum $100
FIRE ALARM SYSTEM — Hood/Duct $50�
0 - 25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $501 Annual
26 plus Devices $100 — System Acceptance $50 Fire Protection 525!
SUPPRESSION SYSTEMS _ Recall Acceptance $50 _ Flammable Application $501 Annual
Wet 550 OTHER _ Waste Tire Storage .
_ Dry $50 Fire Wall/Smoke Wall $15 p er wall __ Generator < KW g 10 Annual
— $100
CO2 $50 _ LP Gas $25 per tank _ Generator >30 KW 150
Other $50 _ Natural Gas $25 per system _ Bio- Hazard Waste $100 Annual
KITCHEN EXHAUST _ Fumigation Tenting $501
❑.Hood/Ducts $50 _ Tent 10'x10' or greater $15 portent _ Pot/Applied 550
OTHER
— Fire Pump $45 _ Haz. Materials $100 Annual
— LP Installation per tank $50 —
Fire Suppression $30
Fuel Tank Installation $50 _ System Acceptance
(Per Tank) $50 _ Exhaust Hood/Duct 530
0 Natural Gas Installation 550 _ Re - inspection DBL
(Per System) (other than annual)
0 Spray Booth $50 0 Inspection scheduled DBL _
and cancelled less than.
_ 24 hours
Construction Insp. N/C
c1 Emergency Vehicle Ad $50 FALSE ALARM
PLANS TOTAL I li INSPECTION TOTAL PERMIT TOTAL TOT
GRAND TOTAL - /3, p
Comments:
i
Date: /. .26 /O
Insn ctor: l / t' 4'I
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus (813) 780 -0041
Kerry Barnett Fax (813) 780 -0044
E-mail: kbarnett@fire.zephyrhills.fl.us
Plan Review #: 10 -086
Project: Interior Modification
Number of Pages: 12
July 26, 2010
I have received and reviewed the plans for the interior modification (NFPA 101, Chapter 43)
located at 37943 Eiland Blvd and will allow the project to move forward. By paying for permit,
contractor acknowledges to comply with the items listed below. Should anyone have any
questions, please do not hesitate to contact the Fire Marshal's office.
1. Modification shall comply with the Florida Fire Prevention Code.
2. Install duct detectors, if not installed already. Detector requirement is for A/C with
greater than 2000 cfm's. Install a remote key switch in accessible location to reset the
detector.
3. Ensure certified fire extinguishers are located within 75' of travel distance throughout
building. Signage and markings shall be installed to help locate these extinguishers.
Ensure there is also on in pharmacy.
4. Install a combination exit/emergency light at the pharmacy door entering the main floor
area.
5. Interior finish shall meet Class A or Class B requirements throughout the building.
Provide that documentation. This can be emailed or faxed to the number above.
6. Though not part of the modification, if not already located, install emergency light in
each restroom.
7. Maintain safe practices during interior modification per NFPA 1.
Inspections Required:
1. Final
j or
KERRY : • ETT, FIRE MARSHAL
** *Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance with applicable fire safety codes. This review is not intended to be a final approval of the
submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance
with all applicable NFPA codes and local ordinances. In the event that further examination or site
inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole
expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure
to be in compliance with all applicable NFPA codes and local ordinances.
CVS Pharmacy
One CVS Drive
Woonsocket, RI 02895
April 23, 2010
Building Official
City of Zephyr Hills Building Department
5335 8 Street
Zephyrhills, FL 33542
RE: CVS Store # 651 — 37943 Eiland Boulevard, Zephyrhills, Florida 33542
Dear Building Official:
I. Wl 4, t( itA4(Q , of CVS Pharmacy certify that I am an authorized
representative for CVS Pharmacy, the Lease Tenant of the property described above.
I hereby authorize the firm of Robert Reid Wedding Architects and Planners, AIA, Inc. to act as
an agent in order to submit plans for review for the Interior Renovations to the pharmacy, retail,
check -out, photo -lab hallway and waiting areas within the Pharmacy facility. The work does not
include any exterior renovations or site modifications.
Should you have any questions, please do not hesitate to contact me at 401 - 770 -5784
Sincerely,
CVS Pharmacy
A Li A! --
STATE OF RHODE ISLAND
COUNTY OF(.
Swor o and subscribed before me this 1 day of 2010 bykiA ;
( ersonally known to me Produced 'den [cation
Type of Identification:
( ) DID TAKE OATH --( ErYKID NOT TAKE OATH
Notary Public — tate of Rhode Island My Commission Expires
Debra A Doiron
Notary Public
State of Rhode Island
My Commission Expires 04/26/2011
07 /12 /2010 MON 16:29 FAX Z001 /002
1 Awesome Construction Inc. Purchase Order
3766 N.W. 124th Avenue
Coral Springs, FL 33065 Date P.O. No.
6/30/2010 651 -02
Vendor Ship To
Select Plumbing Company CVS 651
8879 W Colonial Drive #147 37943 EILAND BOULEVARD
Ocoee, FL 34761 ZEPHYRHILLS, FL 33541
Terms paid when paid
Description Rate Amount
Pull permit for job and installation of customer furnished sink and fixtures 1,060.00 1,060.00
in the pharmacy and photo lab. Schedule and receive all inspections.
Forward a copy of your current certificate of insurance (WC /GL) prior to beginning work.
*Furnish all necessary supervision, labor, materials, tools, equipment, services, insurance, and
taxes to complete in all respects the associated trade in strict accordance with Purchase Order
terns.
*Any and all permit fees required are to be applied for, paid for and obtained by this
subcontractor.
*Subcontractor shall be responsible for daily cleanup and disposition of debris to the onsite
dumpstcr.
*Coordinate schedule with the superintendent and other subcontractors for sequence of work.
*Confirm with the site superintendent current revision of contract drawings that are in use.
*All work to comply with the applicable local, state and federal regulations including all
applicable OSHA regulations.
*Responsible to schedule and receive inspections.
*Responsible for punch list items related to your scope of work.
*Subcontractorexpressly warrents that all materials and work covered by this
order(a) shall be of good quality and workmanship and free of defects, latent or
patent; (b) shall conform to the drawings, specifications, descriptions and
samples furnished or specified by the buyer and; (c) if a product of the seller or
produced in accordance with sellers specifications, shall be suitable and
sufficient for the intended purposes. Without buyer's written assent, no materials
may be substituted in lieu of those specified.
* Subcontractor warrents and guarantees that the work performed by it will be
free from defects for a period of 12 months from date of completion of work and
acceptance thereof by Contractor /Owner. Subcontractor further agrees to repair,
free of cost to Contractor, any damage or defect zn workmanship or material
appearing or developing in the work of Subcontractor, within twelve (12)
months from t completion of the work and the acceptance thereof by
'4, at
. /i . J. _
•mc Construction, Inc. .
aRht?De,#` ,.:E #,..:. Total $1,060.00
954- 345 -6776 954- 345 -6770
. ,
• .
— — 1
I •....f. i Awesome Construction Inc.
Purchase Order
L i 3766 N.W. 124th Avenue
Coral Springs. FL 330(.6 Date IIII=
302010
,
Vendor !
Ship To
,
All Phase Inc
C VS 6.5 1
1 17 Fatie Street
' 37943 Ell-AN1) HOlii.EVARI)
I touma, LA 70364
ZEPHYR 1-111.../ :S. H, 334I
i
1 Terms paid when ts i 1
.
Descriptionl Rate Amount
I
Pull p in
ermit for j and installation of ail fleetrical & .1.,,iw Voltage rcAtaired for 16,0 l 6A)01,t, 0('
remodel
in the pharmacy and photo tab. Schtrdule :old reei:;.e all inspections.
Firrwaid a sxipy of your etirrent eettitie or insuiranee t WC prior t belirittinz work.
°V UM I-5h all neet.s.ary surx.rron„ labtrr, matirital9 .. ripely, equipment. itervi,aa:, inawrmte4.t. slid 1
i
taNir,, to eortiplere
m ail r the astirY:iaterl trade in tt with Nrehtse Ortki . 4
ierras,
,Nriy and all permit Ix ,i nhpireit arc to be applied for, paid for and :,btained by thi..
: subc-ontractor.
''Siibecintractra‘ shalt be responsible for daily .z-learrup and dilro*ition of riebris to the moire .
durnpstra-,
'Coordinate schedule with the superinter and other siibcontra,aon for sc4rietter or work.
.r.:.'„onfirrit with the site itopaintendent , ..:urrtrra nxvision <if comma LitalkinGS 111.11 are in irie,
' "All worn to oornply with the appli.table bleat, state and foila a? rtrizulations im,tu4 in? all
appiteable OSi IA n'tliulaiton.
. . 12;:ap.ousible, to sehedule .91 4e:1,x:dig:my .
*i•tasponlle for punch It itrart relate:4 in row. s...s,pe il,f woil,.
, I
* Subeontractorexpressly warrents that all materials ,',ind work covered by this -
I 1
order:t a) shall be of astod quality and wiirk` Ind fr‹-V of defeets, tar-11t o I
. patent:. (134 shall conform to the drawings, sr descriptions and 1 I
i
samples furnished or spee by the buyer and (e) if a produet (tith e. seller or
produced in accordance with sellers specifications, shall be suitable and
sufficient for the intended purpitseN. Without buser, written assi.701., no materials
may be substituted in lieu of those sp lied,
Subcontractor warrents turd guatariter,;s that the wort: performed by it will bc
free front defects for a period of 12 months train dale of ccsmpletion of work and 1
ageeptanee theft:it/ ll Ci tit tractlytArtwner. Sub:Oct:tee:tor further agrees to repair, .
tree of cost to Contractor, an damage or defect in workrnxaship or material
appearing or developing M the work of Suber.snrmetor. within InOwe (12) i
, 1
months iron the ermtpletim (A ih wor an d it,,.. irs,.., )1
3 • 1....."1.1 2.. '
11' 1
I
,
,
. ,
.,.'
-42 s . ,
w : sl.. Coast lon Inc,
1 l
I
I Phone # I li Fax #
b- —
, --i Total
S.16.000. 111) I
I
i 954-345-6776 i 954-345-6770
.. j
.,u.i t4 to u1:17p Innovative 8139720769 p.2
Awesome Construction Inc.
;. Purchase Order
"`'` 3766 N.W. 124th Avenue
• ' Coral Springs, FL 33065 Date P.O. No.
7/13/2010 651 -05
Vendor Ship To
Innovative Mechanical CVS 651
2505 Ranch Lake Cir 37943 E1LAND BOULEVARD
Lutz, FL 33559 ZEPHYRIIILLS, FL 33541
I Terms I paid when paid
Description Rate Amount
Clean twenty eight (28) supply /return air grills, relocate eight (8) air devices at 3,465.00 3,465.00
pharmacy expansion, furnish and install 1 new supply, relocate one (1)
temperature sensor serving pharmacy
Forward a copy of your current certificate of irmaance (WC/GL) prior to beginning work.
*Furnish all necessary supervision, labor, materials, tools, equipment, services, insurance, and
taxes to complete in all respects the associated trade in strict accordance with Purchase Order
terms.
*Any and all permit fees required are to be applied for, paid for and obtained by this
subcontractor.
*Subcontractor shall be responsible for daily cleanup and disposition of debris to the ootite
*Coordinate schedule with the superintendent and other subcontractors for sequence of work
*Confirm with the site superintendent current revision of contract drawings that are in use.
*All work to comply with the applicable local, state and federal regulations including all
applicable OSHA regulations.
*Responsible to schedule and receive inspections.
*Responsible for punch list items related to your scope of work.
*Suboornrstxotexpressly warrents that all materials and work covered by this
order:(a) shall be of good quality and workmanship and free of defects, latent or
patent; (b) shall conform to the drawings, specifications, descriptions and
samples furnished or specified by the buyer and; (c) if a product of the seller or
produced in accordance with sellers specifications, shall be suitable and
sufficient for the intended purposes. Without buyer's written assent, no materials
may be substituted in lieu of those specified_
* Subcontractor warrents and guarantees that the work performed by it will be
free from defects for a period of 12 months from date of completion of work and
acceptance thereof by Contractor /Owner. Subcontractor further agrees to repair,
free of cost to Contractor, any damage or defect in workmanship or material
appearing or developing in the work of Subcontractor, within twetve (12)
months from the completion of the work and the acceptance thereof by
Lt. CAR'izt_(} A.
A some . , 7 :.. Inc.
Phone* Fax #
954- 345 -6776 954 -345 -6770 Total 53,465•00
•
CVS CONSTRUCTION AGREEMENT
For HOLIDAY CVS, L.L.C. (Hereinafter "CVS ")
, x �g
�a"- �w..+. a„ a:&- � __.,. • _
STO ' . 0.: i - PROJECT #: ! NAME: Awesome Construction, Inc.
0651 CS 53536
ST' , ET: ; STREET:
' • 3 Eiland Blvd. 4 I 3766 N.W. 124 Avenue
CITY, STATE: ; CITY, STATE:
Zephyrhills FL 33542 ! Coral Springs, FL 33065
TOTAL SQ. FT.: 1 RETAIL SQ. FT.: j $ ATTN: VENDOR #:
Keith Dean
CONSTRUCTION CONTRACT
DECEIVED
JUN 2 2 2010
PAYMENT GROUP
This Contract is made this 16th day of June 2010Contract "), by and between CVS PHARMACY, INC.
and its affiliates and subsidiaries, with an office at One CVS Drive, Woonsocket, Rhode Island, 02895
(hereinafter referred to as "CVS ") and Awesome Construction, Inc., as Contractor, with an office at 3766 N.W.
124 Avenue, Coral Springs, FL (vendor # 3H85) (hereinafter referred to as "Contractor ").
WITNESSETH:
That CVS and Contractor, for the consideration hereinafter named agree as follows:
ARTICLE 1. SCOPE OF WORK
The Contractor shall perform all of the Work required by the CONTRACT DOCUMENTS for
General Construction, as described in the CVS DRAWING PACKAGE and as provided for in Article 2 hereof
( "Work ") for CVS Store No. 0651(cs53536).
ARTICLE 2. CONTRACT DOCUMENTS
The CON'T'RACT DOCUMENTS consist of this Contract, Conditions of the Contract (General,
Supplementary and other Conditions), CVS DRAWING PACKAGE, and, all Addenda issued prior to execution
of this Contract and all Modifications issued subsequent thereto. These form the Contract, and all are as fully a
part of the Contract as if attached hereto or repeated herein.
Contract over $60,000.dot 11/10/97 1
CVS CONSTRUCTION AGREEMENT
ARTICLE 3. TIME OF COMMENCEMENT AND COMPLETION
The Work to be performed under this Contract shall commence as specified in the Notice to Proceed from
CVS and shall be completed September 10,2010 All of the time limits stated in the CONTRACT DOCUMENTS
and herein are of the essence of this Contract. By executing this Contract, the Contractor confirms that times
designated for commencement and completion of the Work are fair and reasonable.
ARTICLE 4. THE CONTRACT SUM
CVS shall pay the Contractor for the Work performed under the terms of this Contract, subject to
additions and deductions by Change Order as provided in Article 20 hereof, and all other terms provided herein,
the Contract Sum of $114,988.00 One Hundred Fourteen Thousand, Nine Hundred Eighty -Eight Dollars and
00 /100 .
ARTICLE 5. PERIODIC PAYMENTS
The Contractor's Periodic Application For Payment is to be submitted on a Form, AIA -G702, on the last
day of each month for work performed during such month or any portion thereof. Based upon such Application
For Payment submitted to CVS by the Contractor, CVS shall make periodic progress payments on account of the
Contract Sum to the Contractor as follows:
Each application for payment shall be based upon the Schedule of Values submitted by the Contractor in
accordance with the CONTRACT DOCUMENTS. The Schedule of Values shall allocate the entire Contract
Sum among the various portions of the Work and be prepared in such form and supported by such data to
substantiate its accuracy as CVS may require. This Schedule shall be used as a basis for reviewing the
Contractor's Applications for Payment.
Within thirty (30) days of receipt of periodic application for payment, ninety (90 %) percent of the
proportion of the Contract Sum properly allocated to labor, materials and equipment incorporated in the Work
during the previous calendar month and ninety (90 %) percent of the portion of the Contract Sum properly
allocable to materials and equipment suitably delivered to and stored at the site during such previous calendar
month shall be paid to the Contractor.
The Contractor shall promptly pay each subcontractor upon receipt of payment from CVS, out of the
amount paid to the Contractor on account of such subcontractor's work, the amount to which said subcontractor is
entitled, reflecting the percentage actually retained, if any, from payments to the Contractor on account of such
subcontractor's work. The Contractor shall, by an appropriate agreement with each subcontractor, require each
Subcontractor to make payments to their sub - subcontractors in similar manner. CVS shall have no obligation to
pay or to see to the payment of any monies to any subcontractor except as may otherwise be required by law. The
Contractor shall be responsible for delivering to CVS, within five (5) days after all such payments are made,
release of liens by Contractor and subcontractor(s) in the amount of such payments.
ARTICLE 6. ACCEPTANCE AND FINAL PAYMENT
Subject to the provisions of this Article 6 and certain other applicable Articles of this Contract, Final
Payment sufficient to increase the total payments to one hundred (100 %) percent of the Contract Sum shall be due
thirty (30) days after final, inspection and acceptance of the Work, in accordance with the terms of this Contract
Contract over $60,000.dot 11/10/97 2
CVS CONSTRUCTION AGREEMENT
ARTICLE 40. AFFIRMATIVE ACTION
CVS is an equal employment opportunity employer and is a federal contractor. Consequently, the parties
agree that they will comply with Executive Order 11246, the Vietnam Era Veterans' Readjustment Assistance Act
of 1974 and the Vocational Rehabilitation Act of 1973, if applicable, and also that these laws are incorporated
herein by this reference. The parties also agree that they will not discriminate against any employee or applicant
for employment because of race, color, religion, sex, national origin, age, or any other characteristic protected by
federal, state or local law.
ARTICLE 41. COUNTERPARTS
This Contract may be executed in two or more counterparts, each of which will be deemed an original, but
all of which together shall constitute one and the same instrument.
This Contract is executed as of the day and year first written above.
CONTRACTOR CVS:
Awesome Construction, Inc. CVS PHARMACY, INC.
3766 ■ . . 4th Avenue ONE CV % /
C, a SA a .s,FL 33' •5 WOO :• ► /i / , 424'5
B �� J L ' � � �� / � Date: �` /6 /0 BY: � , Date: (.e WO
NAME: _
ai 4'61 L • ,' �/ _ � NAME: RnhPrt Gunter
TITLE: '� 1 de TITLE : Director of Construction
Contract over $60,000.dot 11/10/97 13
•
ROBERT REID WEDDING ARCHITECTS & PLANNERS, AIA, INC.
TRANSMITTAL LETTER [SENT VIA] : Hand Carry
PROJECT: CVS Special Projects & Remodel
CVS #0651 Zephyrhills, FL — Major Remodel
PROJ. NO. 1004
DATE: 7/15/2010
TO: City of Zephyrhills
5335 8 Street
Zephyrhills, FL 33542
ATTN: Building Official
WE TRANSMIT:
(x) herewith ( ) under separate cover via
( ) in accordance with your request
FOR YOUR:
( ) approval ( ) distribution to parties ( ) information
( ) review /comment ( ) record
(x) use ( )
THE FOLLOWING:
( ) drawings ( ) shop drawing prints ( ) samples
( ) specifications ( ) shop drawing reproducibles ( ) product literature
( ) change order (X) see below
COPIES DATE REV. NO. DESCRIPTION ACTION
CODE
5 5/11/10 M0651 FL — Zephyrhills — S &S Drawings B
1 5/11/10 Permit Application B
1 5/11 /10 Agent Authorization Letter B
1 5/11/10 Plan Review Check #1232 B
ACTION
REMARKS
CODE
A. Action indicated on item transmitted D. For signature and forwarding as noted below under
B. No action required E. See REMARKS below
C. For signature and return to this office
REMARKS:
COPIES TO: File (with enc!) ROBERT REID WEDDING ARCHITECTS & PLANNERS, AIA, INC.
CC: ❑ 4112 CYPRESS ST., TAMPA, FL 33607
❑ 221 COMMERCIAL BLVD., SUITE 202, LAUDERDALE BTS, FL 33308
❑ FTLD: (954) 492 -9980 FAX (954) 492 -9932 - TPA: (813) 879 -6996 FAX (813) 871 - 5203
❑ #AA CO01123 #00002655
BY: Robert Kantrowitz, Project Manager
Pasco County Parcel: 03- 26 -21- 0010 - 06400 -0030 001 Page 1 of 2
Data Current as Of: II Weekly Archive -- Saturday, July 24, .2010
I Parcel ID II 03- 26 -21- 0010 - 06400 -0030 (Card: 001 of 002) I
I Classification 11 11 Retail Stores, One Story, All Types
Mailing Address Property Value
FEDJO REALTY CORP Ag Land $0
C/O CVS PHARMACY INC ACCT DEPT Land $804,139
ONE CVS DR Building $720,512
WOONSOCKET RI 02895 -6146
Physical Address Extra Features $36,892
37943 EILAND BLVD Market Value $1,561,543
ZEPHYRHILLS FL 33542 -2523 Assessed (Non - School Amendment 1) $1,561,543
Legal Description (First 4 Lines)
ZEPHYRHILLS COLONY COMPANY Taxable Value $1,561,543
LANDS PB 2 PG 6 POR OF TRACT
64 DESC AS: COM AT SE COR OF
NE1 /4 OF SEC TH N89DG 41' 31'W
I Land Detail (Card: 001 of 002)
Line II Use IlDescriptionll Zoning II Units II Type II Price II Condition II Value
I 1 II 1100 IISTORE 1FLRII 00C2 II 11,000.00 II SF 11 $45.00 II 1.00 II $495,000
I 2 II 1100 IISTORE 1FLRII 00C2 II 27,479.00 II SF II $11.25 II 1.00 II $309,139
Additional Land Information Show Mineral Rights - 1
I Acres II 0.88 II Tax Area II 30ZH II FEMA Code I X 'Commerical Codell CMAJ2AC
Building Information - Use 11 - Retail Stores (One Story) (Card: 001 of 002)
Year Built 1998 Stories 2.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None
Roof Structure Rigid Frame w /Bar Joist Roof Cover Built -Up Tar and Gravel
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 VCT Flooring 2 None
Fuel Electric Heat Forced Air - Ducted
A/C Packaged Roof Top Baths 2.0
Line I Description II Sq. Feet I Repl. Cost New
1 I BAS II 10,640 1 $868,224
2 I CAN II 1,432 1 $35,088
3 I FST II 700 1 $28,560
4 I UUS II 864 I $35,251
5 1 UST II 120 1 $3,917
Extra Features (Card: 001 of 002)
Line I Description I Year Units I Value
1 I PAV ASP I 1998 26,116 I $10,577
2 I PAV CON I 1998 3,726 I $2,795
3 1 PNEUTUB I 1998 1 I $9,639
4 I DRINWIN I 1998 1 I $4,113
5 I LIGHTSC 1998 8 I $9,280
6 I 8CBWS 1 1998 240 1 $488
I Sales History
I Previous Owner I SEMBLER EDP PARTNERSHIP #8 LTD
Year Month Book /Page II Type II Amount
I 2000 I 02 4337 / Q996 WD $0
I II 1 II II
http: / /appraiser.pascogov. com/ search /parcel.aspx ?sec =03 &twn= 26 &rng =21 &sbb= 0010 &b... 7/28/2010
813 -780 -0020 City of Zephyrhills Permit Application 4 j 1 0 Fax -813- 780 -0021
Building Department �J, p.�Q /-
Date Received '7' b ` -t d Phone Contact for Permittin. �� i d/ i_I -- vlitpx
Owner's Name CA'/ 1 Owner Phone Number 4 I 1 iQ' 57 %'
Owner's Address ic/' Pxive, luousl ver I• ' Owner Phone Number G
Fee Simple Titleholder Name FOn } re� wH • Owner Phone Number 4 ' — 5 ffi4
Fee Simple Titleholder Address e ft) 1- CIS V CI ve w61.60CrQ , r 1 . 02e*
JOB ADDRESS CV5 6 37g4t V414 131ND �'N'�R.�1u -`7 rL 33 Z. LOT #
SUBDIVISION ZeVI# N-1Uh coi- " ( (* PARCEL ID# D 3 ^ 4°1- o t v- 6 ` - co$ (.5 Pot o)
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR Il AD I fjp n SIGN I MOVE n DEMOLISH
INSTALL REPA
PROPOSED USE n SFR II COMM n OTHER I I
TYPE OF CONSTRUCTION I I BLOCK
7ew� I rG 1 FRAME I STEEL F OTHER I I
DESCRIPTION OF WORK 1NT IOR- F•rovit N ' % it) T' INCAvi 6 r �� �
IL, ?fl (WMAG N-(AY
BUILDING SIZE
1 ,,,,,, , , , SQ FOOTAGE I � I 1-2...... �' HEIGHT 22 � • r A ,
�,n . 20'40 � I ttom
BUILDING $' 1 141q$39 VALUATION OF TOTAL CONSTRUCT j t'\ 1
I �"'
EZI ELECTRICAL I$ I 6 j 000 AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
PLUMBING $ 16 CEO / (') Ste-' <'
MECHANICAL $ 3 VALUATION OF MECHANICAL INSTALLATION
•
I 1 GAS I ROOFING I I SPECIALTY I—I OTHER 54,tb.S:Aefeei
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA niYES I—I // I
S
r
4 W Il � u ► f
I J
1 j 1
BUILDER ( A rm, '� 4 g 1 ' COMPANY mt ,, ' 4 . ,, , _ , # 4 ! ,, / � / n •
SIGNATURE �/P alit-fix � //�' REGISTERED Y/ N FEE CURRENT /+�Y / N^ ■
fd
Address j' /t)IN L ` ?r4.I 41 r t , License# ( 1 I b
ELECTRICIAN fj G L � _ Q , v COMPANY ! w�QIL) � " � CCM C `
SIGNATURE �F ' M(.t•f LO REGISTERED I Y / N 1 FEE CURRENT I Y / N 1 O �
Address (a)( ( aut 75 R.0.4t f cr,, 7 , A- pestil License # 6 - 047/i9 3 7 I/ .
F".-UMBER I 0 / _ 5t " COMPANY I Ji"' G 1 P�
, t �(}f111 r. - 0 - ✓4`C .
SIGNATURE /_.�� _ / 1 i. / REGISTERED 1 Y / N 1 FEE CURRENT I C N I
Address Ig�� C 1 GA/ C c7�G� R i)! {�iuc-T 1 P . Cr7 FL, License # IL vc.. j4a_
MECHANICAL !"--77. � 7/ -—_ k, / PcOMPANY tldr -I (/4, � j ,,, L4 it ' e 4j ,
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I
Address I Z • i Coti C i g 4.1T7' A 33si - License # I Z.440 Z.-45,25
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
KftliftERRESP
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
* ** *PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000)
** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades 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 I ND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y • - - N • ICE OF CO MENCEMENT.
FLORIDA JURAT (F.S. 117.93) 1
A te. A OWNER OR AGENT - I A / CONTRACTO - MU / . .41/1 At A
S - .§Aribpj s • r. to (or . rme• b or me t Subscribed and s or to (or affirmed) . efore me this
, Qby f l _A-a. 1 by
o is /are pers. ally known t; me or has /have produced Who is /are personally known to me or has /have produced
s identification. as identification.
*b L..� . 1� .tary Public Notary Public
Commission No. tr t, ? `f Commission No.
((! 54Ai Ojl/f .L- Ff-L i/Y .
Name of Notary typed, printed or stamped Name of Notary fun
Debra A Doiron ,, Sandra L. Feltner
Notary Public vi7, Commission #DD801612
State of Rhode Island
My Commission Expires 04/26/2011 BO Expires: JULY 15, 2012
N THRU ATLANTIC BONDING CO., INC.
I Ill1111II1111111111111111111111111111111111111111111111111
• • 2010113731
• Rcpt:1319869 Rec: 35.50
DS: 0.00 IT: 0.00
08/09/10 L. Sagastume, Dpty Clerk
PAULA S.O'NEIL,Ph.D.PASCO CLERK & COMPTROLLER
08 8393 PG 1632
NOTICE OF COMMENCEMENT
Permit No.
Property Identification No. Dj' 210 ' ZI - COW Ob 4-oo
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 :) ' 1el7
a) Street Address: 31943 VIL4ND -VD ZePF+ t HILLS-2 1=d -�f�w, r 335'(
2. General description of improvements: tN f RIWR-- iZemovA'C1bp(Z N
Tt,7IN G FIST c(3t°GIe -ovr,
1714-0T I -A-¢5 !ETA IL- Pl1- ATzjv1AG�( (- FA-LLLohy Go f rrtA.6 �41E'P r
3. Owner Information
a) Name and address: CAI* rPthEitelAL 1 GVS t7Q1 ve two t ZQ.T • I . czeoW
b) Name and address of fee simple titleholder (if other than owner) chi O ,Ir • 01 • - -
c) Interest in property ' „N
4. Contractor Information .. t it /e )6.60 1( t 2, . i five_
a) Name and address: i S�ilYlal' i s r tflLr t' o , l G (')t- t 5 )n .5 �
b) Teleph No.: C , L Fax No. (Opt.) citIti .3 (45 - - G - 11) J
5. Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6. Lender
a) Name and address:
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:
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:
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-F$A s L t /
COUNTY OF 1P- ASE+6 (4-r r. , -. , t , /
Signature of Owner or O er's Authori� rector /Partner /Manager
P PLO
Print Name ,G/
The foregoing instrument was acknowledged before me this 3d day of , 20 /6 , by ) , 'el
as (type of authority, e.g. officee;,''trust @e, attorney,
in fact) for (name of party on behalf of whom instrument was execud).
Personally Known Y ,/ OR Produced Identification Notary Signature f
Debra A Doiron :
Type of Identification Produced Name (print) Notary Public c` ,
state of RhuUu - ,;
My Commission Expires 04/Z6%20J
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.
Signature of Natural Pers n Signing Above
FORMS /NOC,rvsd2007
OR BK 8393 PG 1633
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Pasco County Parcel: 03- 26 -21- 0010 - 06400 -0030 001 OR BK 8393 P 1634
Page 1 of 1
3 of 4
Data Current as Of: Weekly Archive - Saturday, April 17, 2010
Parcel ID 03- 26 -21- 0010 - 06400 -0030 (Card: 001 of 002)
Classification 11 - Retail Stores, One Story, All Types
Mailing Address Final 2009 Value
FEDJO REALTY CORP Ag Land $0
C/O CVS PHARMACY INC ACCT DEPT Land
ONE CVS DR $804,139
WOONSOCKET RI 02895 -6146 Building $930,371
Physical Address
Extra Features $39,079
37943 EILAND BLVD Market Value $1,773,589
ZEPHYRHILLS FL 33542 -2523 Assessed (Non - School Amendment 1) $1,773,589
Legal Description (First 4 Lines)
ZEPHYRHILLS COLONY COMPANY Taxable Value $1,773,589
LANDS PB 2 PG 6 POR OF TRACT
64 DESC AS: COM AT SE COR OF
NE1 /4 OF SEC TH N89DG 41' 31'W
Land Detail (Card: 001 of 002)
Line Use 1 Description Zoning 6 1 Units II Type II Price I Condition II Value
1 I 1100 I STORE 1FLR II 00C2 11 11,000.00 II SF II $45.00 I 1.00 I $495,000
2 II 1100 ISTORE 1FLR 00C2 I 27,479.00 11 SF II $11.25 1.00 $309,139
Additional Land Information Show Mineral Rights - 1
Acres II 0.88 II Tax Area I 30ZH I FEMA Code II X IICommerical Code( CMAJ2AC I
Building Information - Use 11 - Retail Stores (One Story) (Card: 001 of 002)
Year Built 1998 Stories 2.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None
Roof Structure Rigid Frame w /Bar Joist Roof Cover Built -Up Tar and Gravel
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 VCT Flooring 2 None
Fuel Electric Heat Forced Air - Ducted
A/C Packaged Roof Top Baths 2.0
I Line Description I Sq. Feet Repi. Cost New
1 BAS I 10,640 I $1,089,536
2 I CAN 1,432 II $44,032 I
3 I FST 700 I $35,840
4 UUS 864 II $44,237
5 UST 120 I $4,915
Extra Features (Card: 001 of 002)
Line I Description I Year II Units Value I
1 II PAV ASP II 1998 I 26,116 $11,459 I
2 PAV CON I 1998 I 3,726 I $3,027
3 PNEUTUB 1998 I 1 I $9,983
4 DRINWIN I 1998 I 1 I $4,259
5 I LIGHTSC 1998 I 8 I $9,840
6 I 8CBWS 1998 1 240 $511
Sales History
Previous Owner SEMBLER EDP PARTNERSHIP #8 LTD
Year Month Book /Page 1 Type I Amount
2000 I 02 I 4337 / 0996 WD $0
1998 02 3878. I WD I $600,000
I 1992 06 I 3040 / 0179 II QC $0
http: / /apprai ser.pascogov . com/ search /parcel. aspx ?sec =03 &twn =2 6 &rng =21 &sbb= 0010 &blk = 064... 4/23/2010
P/.suo oR o N 8393 PG 1635 Page 1 of 1
__�'--�_�-��' ���� ���� �-
. • . . 4 of 4
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=����nmu� mrNn�����m
P aaCo County�/npertyA�pnaiser . 1, ,,, eotrl ii.. , ,,„„,
Data Current as Of Weekly Archive - Saturday, April 17, 2010
Parcel ID 03-Z6-21-UO1O-O64OO-0O1O (Card:OO1nf0O1)
Classification 1 10 - Vacant Commercial
Mailing Address Final 2009 Value
FEDJO REALTY CORP Ag Land $0
C/O CVS PHARMACY INC ACCT Land $71
DEPT
ONE cvSon Building $0
vvoowsocnsTnIoz8e5'o1*a Extra Features $1
Physical
Market Value $73,8e6
Physical Address N/A
Assessed (Non-School
Amendment 1) $7],uo6
Legal Description (First 4unc$
ZEPHYRHILLS COLONY COMPANY
��mospeuPsaponorTxxcT Tauab|e Value $73
64oES[AS:CUm*JSsCOROF
mE1/4Or SEC T*m89DG4z'3z"Vv
Land Detail (Card: 001 of 001)
Line Use Description Units | Type Price |��oditiqn Value
1 1 1000 COMMERCIAL' 00C2 | 6,368.00 | 5[ 0$11.25 1 z.On $7z,o4o
| 2 K 1000 IICOMMERCIALI 00C2 130,321.0011 � � | $0.01 U 1.00 $303 | II
Additional Land Information Sh_om Mineral Righ��-1
Acres 0.84 /ax soz* FsMA X Commerical c��uz��
Area Code
� o --- ~ -—'~''~~'-~~~
| Building Information (Card: 001 of 001)
Unimproved Parcei 00 - Unimproved
|
/ ��tr�Fmatorem (Cand:OO1o[OU1)
Line 11 Description II Year 1 Units II Value |
1 | CLFENCE U 1998 5 1 $1
|
Sales History
Pr�mpw���nw, senm usnsopp�nTwe����p�uo�
■
Year I Month 11 Book/Page II Type I Amount
| 2000 1 02 I 4337 / 0996 1 WD 1 $0
1998 1 02 U 3878/DD_05 0 WD $0
�
1998 1 02 U 3878/D008 U WI 1 $O
'
----- '---- --- —' ----- —_ __ ___
http://appraiser.pascogov.com/ 4/23/2010
�T�J�
TH3|
TR�� ��DC�9PECTCOP v OFTH E DOCUK8ENT E
O�F/ LOR0�PU6! ' C��C 09 D\N TH | S� FF|C
FF\QALSEAL THIS
o«'o� +� ��
'mE|L � � . - ROLLER
DEPUTY CLERK
BY___ -.....~---
Or
Aug 09 10 02:47p Aurora Fiber 8138862494 p.1
Fib- .A. ' �f,' i3i3si� 'unications
FACSIMILE TRANSMITTAL SHEET
TO: Building Dept. FROM: Rob Kirk
COMPANY: City of Zephyrhills DATE: 8/9/10
FAX NO.: 813 - 78D - 0021 NO. OF PAGES WITH COVER: 4
YOUR REF. NO.: SENDER'S REF. NO.:
RE:
NOTES /COMMENTS:
Please find the following documents from Aurora Fiber &
Communications to update our contractor certificate requirements.
6011 Benjamin Road, Suite 106 Tampa, Florida 33634
P: 813 - 886 -2621 F: 813- 886 -2494
www.aurorafiber.com
Aug 091002:47p Aurora Fiber 8138862494 p.2
i ACS • ;
04.3.837: STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS: LICENSING BOARD
`:- acute. LAO 0 72201294 .
DATE BATCH NUMBER LICENSE NBR
07/22/2010 108013415. ECA001637. Additiorial Business Qualifica:tiox:.:
€. ; The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED:
Under the provisions of Chapter.; 489 :FS
Expiration date: AUG 31, 2012
HANKINS, STANLEY R
• AURORA FIBER • & COMMUNICATIONS ,. ': CORP .
6013. • BENJAMIN RD, SUITE 10
TAMPA FL 33634
•
` CHARLIE :GRIST CHARLIE..LIEM
GOVERNOR
INTERIM SECRETARY
DISPLAY AS REQUIRED - BY LAW
Aug 09 10 02:47p Aurora Fiber 8138862494 p.3
2010 -2011 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9 - 2011 FOUONO.
IFACAITIES OR NMCHWES 0 ROOMS I SEATS 0 EMPLOYEES 11 RENEWAL I 148096.0000
O H. WASTE TAX
OCC- CODE BUSINESS TYPE SURCHARGE
280.000 LOW VOLTAGE ELECTRIC (LESS THAN 30 VOLTS) - 80.00 0-201 1
201 BUSINESS 6011 BENJAMIN RD 106
LOCATION TAMPA 33634
NAME AURORA FIBER AND COMMUNICATIONS CORP
MAILING 6011 BENJAMIN RD STE 106
ADDRESS TAMPA FL 33634
BUSINESS TAX RECEIPT DOUG BELDEN, TAX COLLECTOR PAID -1532 - 85
813. 635.6200 07129/2010' 80.00
HAS HEREBY PAp A PRIVILEGE TA%TO ENGAGE THIS BECOMES A TAX RECEIPT WHEN VALIDATED.
A BUSINESS. PROFESSION. OR OCCUPATON SPECIFIED HEREON.
Aug 09 1002:48p Aurora Fiber 8138862494 p.4
ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE (NMIrDD/YYYTI
07/09/2010
PRODUCER (813)637 -8877 FAX (813)637 -8484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4915 W. Cypress Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33607
INSURERS AFFORDING COVERAGE NAIC #
INSURED Aurora Fiber & Communications Corp :NSURERA: FCCI Insurance Group 11257
6011 Benjamin Road YSURERB: Auto - Owners Ins Co. 18988
#106 '.ISURER Southern - Owners 10190
Tampa, FL 33634 -5173 NSURERD:
INSURER £:
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 CF 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 SU3JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INT IWSK TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE POLICY EXPIRATION ',ATP II OTF (MM.DI�YYI OATF tENPDO/YYI _
GENERAL UABILITY GL0006476 01/01/2010 01/01/2011 EACHOCCURRENCE 8 1,000 000
X COMMERCIAL GENERA: L:ABIL TY DAMAGE TO RENTED
s 100
PRFIJ1CFC (Fa nmewnrwi 0 00 0
CLAIMS MADE pi OCCUR t1EO EXP (Ary one persanj $ 5
A PERSONAL A ADV INJURY $ 1 , 000,000
GENERAL AGGREGATE S 2,000,000
_ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCT - COMP/OPA3G S
1,000,000
— 1 POLICY nCT n LOC
AUTOMOBILE LIABILITY 48- 258070 -00 01/01/2010 01/01/2011 COMBINED SINGLE LIMIT s
X ANY AUTO (Ea acc dent) 500,000
I
ALL OWNED .AUTOS BODILY INJURY $
SCHEDULED AUTOS ( Par person)
6 HIRED AUTOS BODILY INJURY $
_ (Per acc dent
NON- O',MNEC AUTOS
PROPERTY DAMAGE 8
(Per accident)
GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLALIABILITY 48- 258070 -01 01/01/2010 01/01/2011 EAC'- +OCCURRENCE $ 1,000,000
T OCCLR n CLAIMS MADE AGGREGATE S 1,000,000
C Umbrella s
R DEDUCTIBLE S
RETEYTK)N $ 10,000 , 000 $
WORKERS COMPENSATION AND 001- WC10A63103 01/01/2010 01/01/2011 X I TnRY IMITS 1 rFR
EMPLOYERS' LIABILITY E.'_. EACH ACCIDENT $ 500,000
A ANY PROPRIETOR/PARTNEF,'EXECUTIVE •
OFFICEPtIAEMBER EXCLUDED? E._. DISEASE - EA EMPLOYEE S 500,000
11 yes, describe older
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LMI s 500,000
OTHER
DESCRWTION OF OPERATIONS / LOCATIONS ( VEHICLES! EXCLUSIONS AOOEO BY ENDORSEMENT r SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO FLAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of 2ephyrhills - Building Dept. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION ORUABILITY
5335 8th Street OF ANY KIND UPON TIME INSURER, ITS AGENTS OR REPRESENTATIVES.
2ephyrhill s, FL 33542 AuTHORIZEDREPRESENTATIVE ,Q
3. Bryan Yaho/DAYD ,1LSw6SC'--
ACORD 25 (2001/08) FAX: (813) 886 -2494 ® ACORD CORPORATION 1986
08/10/2010 10:08 9543456770 AWESOME CONSTRUCTION PAGE 05/05
AWESOME CONSTRUCTION
CGC1507113 0
August 8, 2010
City of Zephyrhills — Building Dept
5335 8 Street
Zephyrhllls, FL 33542
This letter is authorization for KEITH DEAN III to sign and/or pick up any and all
• permits at the City of Zephyrhills on behalf of Awesome Construction Inc.
If you have any questions, please contact our office at:
Awesome Construction Inc.
3766 NW 124 Avenue
Coral Springs, FL 33065
PH: (954) 345 -6776
F . ) 345 -6770 l ayN_____,
Y.AAZ 0‘ i
obin L. Dean
President
This authorization letter was signed before me on the 8th day of August 2010 by Robin
L. Dean as President of Awesome Construction Inc.
.051: -kkt, mom. a CHEW ci
* , INCOl RION / 00952964
., ; EXPIRES: February 12, 2014 arolyn S. Cherry
"ro, Coda, Thni WAN Now) Notary Public
3766 NW 124 Avenue Coral Springs, FL 33065 p: 954 -345 -6776 f. 954-345-6770
08/10/2010 10:08 9543456770 AWESOME CONSTRUCTION PAGE 03/05
- � • •� � .\rr G r_Y! ' rl = �;rp• , r_r_a-- • _��� \J_1 J._L
• 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000
VALID OCTOBER 1, 2010 THROUGH SEPTEMBER 30, 2011
• DOA: Receipt *: 180-6499
Business Name:AWESOME CONSTRUCTION INC Business Type: GENERAL CONTRACTOR (GENE L
CONTRACTOR
•
Owner Name: ROB IN LYNN DEAN Business Opened :01 /01/2005
Buslnetts Location: 3766 NW 124 AVE State /County /Cert/Reg:CGC1507113
CORAL SPRINGS Exemption Code'NUNEXEMPT
Business Phone: 954 -345 -6776
Rooms 4e09_ . E pleyOs .Maohlnee . Professionals
• For vending ausIneis Onq
Number of Machines: Vending Type:
Tax Amount Transfer Fee ,
, ^''� ��: �'P m ` CoIIeWOn Cost T0191 Paid
'37.00 0.00:r l ^u r fr 1 car " . 0.00 27.00
•
PHIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE
LA OF BUSINESS
HIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is
non- regulatory in nature. You must meet all County and/or Municipality planning
WHEN !VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have 'moved the
business location, This receipt does not indicate that the business is legal or that
It is in compliance with State or local laws ano regulations.
Mailing Address:
itOBIN LYNN DEAN Receipt *13A -09- 00008695
3766 kW 124 AVE Paid 07/23/2010 27.00
CORAL SPRINGS, FL 33065
• •
2010 --2011
•
•
•
•
•
•
•
•
i ,
08/10/2010 10:08 9543456770 AWESOME CONSTRUCTION PAGE 02/05
s, --r: STATE OF FLORIDA
4 , .
# :
Ay ' .0 t 1 '! DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
C '
a
- j CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395
1.940 NORTH SZ'RFLT32399 -0783
ROBIN LYNN
WEc CONSTRUCTION, INC.
3766 NW 124TH AVENUE
CORAL SPRINGS FL 33065
Congratulatlo , l With this license you become one of the nearly one million : �• , E. ti .
Floridians licensed by the Department of Business and Professional Regulation. • ,, A z-?-- -- --5 ' r t , ': k: .,� � - •
Our professionals and businesses range from architects to yacht brokers, from ti .0 ;1� :<•-• * t
boxers to barbeque restaurants, and they keep Florida's economy strong. 1 4 , 61 - ' � r � ,1 I . J � f
f . r . U.. - 4'
Every day we vsiork to Improve the way we do business in order to cave ou b �` r��
nformation our services please log } ' •!
For 1 onto �- :•
you ever. )
og www.myfloridalloense.com. ,� $ � r , - �7� - .. ; ; r
There you can find more Information about our divisions and the regulations that 4 ° ' r; *•-- --- - 1' ",��� '• .
impact you, subscribe to department newsletters and learn more about the j , " ` "' a "` = 4 spvcv .„;"
Department's initiatives.
l 7. 4 ,
.. .. a � .o"�° ' <Ti. �.• ? : -►K►
n at the Department is: License ..,. : „; -
p cense Eff iciently . Regulate Fairly �' �' # r+ , ,. -
1 N' 3:"
Our mission . We `a5� r rl q w., :. -.`ev, � W r ^' 4: ° 4''''' : fr
Constantly strive to spree you better so that you can serve your customers. el : -4 { L, • ,e: ,,, � +'':, '
Thank you for doing business In Florida, and congratulations on your new license! - �-; ti -. , ,�,, ` . .-„ -, , ..1----• ,
k1 , , ,faw., ce),„ :lai ;swat.... r ,to .. n.•t!`K:.,w* R.u4ti.=l`- '�i1r�,
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From:Shirley R. Bain FaxID: Page 1 of 2 Date:08/10 /10 10:29 AM Page:1 of 2
Phone: (954) 453 -6235
Fax: (954) 776 -4446
Fax
From: Shirley R. Bain To: To Whom It May Concern
Pages: 2 Fax: 918137800021 #1176
Date: 08/10/10 10:26:07 AM Phone: ( ) -
Subject: Awesome Construction
Confidential Note: Information in this facsimile is confidential and intended for use by the individual or entity named
If you received this telecopy in error, please immediately telephone us and return the original via U.S. Postal
Message:
This is being sent on behalf of Robin Dean at Awesome Construction.
ShirleyB.
08/10/2010 10:08 9543456770 AWESOME CONSTRUCTION PAGE 04/05
Ai lz • CERTIFICATE OF LIABILITY INSURANCE OP ID T4 DATE(MM/OD/YYY1f)
08/10/10
THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMCND, EXTEND oR ALTER THE I:OVERAGE AFFORDED BY THE POLICIES
BELOW. THIS' CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER.
IMPORTANT: lithe certificate holder is an ADDITIONAL INSURED, (he polieyQee) must be encursed. H SUBROGATION IS WAIVED, subject to --
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
Certlticete holder In lieu ot such endorsement(s).
PRODUCER HVAIAbI
Brown a brown ot Florida, Inc. NANA tin
5900 N. Andrews Ave. #300 (ac,No,E>j; _...._..._....__- ___._'...... _._.__._. ?! •No):
P.O. Box 5727 E- — .._..- -._.
ADDRESS:
irecaseece.- _.__....-. -- -- ...... ..... -
Ft _ Lauderdale FL 33310 -5727 CUSTOMER air AWESO -2
Phone:954- 776 -2222 Fax:954- 776 -4.446 ___... ...-- .-- .-- _ -.... _..---.--__._._...._......-.--.------- ........__..__.__..._._.... •
• INSURED
._.. _____. --__- • .- ..__-- ---...- ..__ —__ INSVRER(Sy AFFORDING COVERAGE - e.
INSURER A: Atnerisure Mutual Ins. Cn. i "� 23396
- --
+eesotnE Construction, inc. INSURER B
3766 N.W. 124 Avenue - --.__ . -- - - - _..... --I- -
Coral Springs FL 33065 INSURER C
INSURER D : _._.__. -... ,
INSURER E :
INSURER F :
1
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: '
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY ReouIREMtNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T•II$
CERTIFICATE MAY BE ISSUED OP MAY PERTAIN. me INSURANCE AFFOROEO BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,
EXCLU9lfNC AND l.nNnmONS OF CuoR POUCIEC. uMR3 SHOWN MAY NAVE DEEN ReUUUtU BY PAID CLAIMS.
YEW . . -- . .- ._____- _.... ...._. — __ ...
LTR I TYPE OF INSURANCE a19R 1,71:14L POLICY NUMBER ( MM/ODIY �� (MM � jpo y mY � Yl - --- -.... uMns
GENERAL UAeIUTV � EACH OCCURRENCE :$1,000,000
'DANIAGETORENTEII ---- _._.- '-.--.-.--
A d � I.:UMMERCIAL GENERAL LIABIUTY I GL2046508030010 l07/01/3.0 !07/01/11 ; PREMISES(e.camenee) to 300,000
CLAIMS•lmoe I X ; OCCUR HIED EXP!Any one person) s 10 000
I PQasoNAL mutiny 4 3 1, 000, 000
I 1 GENERAL AGGREGATE I S 2, 000,000
GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS_ COMP/OP AGG j S 2 , 000000
r----7 r ' �D-
i P I _ -� -- - ..__...... _ _ ......
OLICY . X ! .)Er_T ; LOC. I stop ben . !v i, 000, 000
L AUTOMOBILE LIABILITY I I ; COMBINED SINGLE LIMIT
l I • (EaAeadenq ; $1,000 f 000
A 1 j ANY AUTO CA20465050302 07/01/10 !07/01/11 L
' ALL OWNED AUTOS — -
RDOILY INJURY (Per pawn) 6 -- _..__...._
'
! , BODILY INJURY (Per occident); S
SCHEDULED ALTOS —_..... ...,.,_.__— �_._......
PROPERTY DAMAGE 1
VIREO AUTOS
I I ! (Per accident
NON•OWNED AUTOS �- -..._..__.._. ...._..--.-- -. .._.. _._.. •
! 1 _ ..._ .............
; UMBRELLA UM)
OCCUR I ! ` EACI, OC .unnc e
F EXCESS LIAB I I CLAIMS•MAOE i I l : AGGREGATE I E
` 1 DEDUCTIBLE I _ ...... ...... .... — ...__.... .. _ _......- ........ ......._
I1 ..__..__.. - ._... l --•-
NTION e
I I I
A I wo x I RETE ERScommas/LTon , WC204651003 07/01/10 07/01/11 ' X; wcsTAlu• ; ,tlli -,
AND EMPLOYERS• LUI91UTY Y / N
I. j ?DRY LIMBS I_. _i. EA :_. _.....
; ANY PROPRIETOR/PARTNER/EXECUTI I ( , _._. _.__.._._
OFFICER/MEMBER EXCLUDED? N/ A I L E L .EACH ACCIDENT I¢ S O O, 0 0 0 __________
(man/lime In "M ! EL. DISEASE - EA EMPLOYEE $ 500, 000
■ II yes, de=cdbg udder ; •- ------ ........... .. .- ._._........-- - - - - -- . ... --
DESCRIPTION OF OPERATIONS below 1 EL. DISEASE - POLICY WW1 3500, 000
1 •
■
oascniPT10N OF OPERATIONS / LOCATIONS 1 VEHICLES (AIIson ACORD 101. Additional Remarks Schedule, 11 more space le required)
CERTIFICATE HOLDER CANCELLATION
9HOUI.0 ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ZEPHYRS! THE EXPIRATION DATE TNERFDP. NAME WILL BC OCLIVCACD D,
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Zephyrhills
Building Department AUTHORIZED REPRESENTAT.V5
5335 8th Street
Zephyrhilis FL 33542 0a
1 PORA110N- an rights reserved.
ACORD 25 (2009 /09) The ACORO name and logo are registered marks of ACORD
From :Shirley R. Bain FaxID: Page 2 of 2 Date:08 /10/10 10:29 AM Page:2 of 2
1 CERTIFICATE OF LIABILITY INSURANCE OP ID T9 DATE(MMIDD/YYYV) 08/10/10
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in Neu of such endorsement(s).
{.V191 A..1
PRODUCER NAME:
Brown & Brown of Florida, Inc. PHONE FAX
�ac
5900 N. Andrews Ave. #300 air...). I
M
P.O. Box 5727 ADDRESS`
Ft. Lauderdale FL 33310 -5727 CI AWESO
Phone:954- 776 -2222 Fax:954- 776 -9996 INSURER(S)AFFORDNGCOVERAGE NAIL#
INSURED NSURERA: Amerisure Mutual Ins. Co. 23396
Awesome Construction, Inc. INSURER B:
3766 N.W. 124 Avenue
Coral Springs FL 33065 INSURER C :
INSURER D:
INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSH LTR TYPE OF INSURANCE NS11 WVD POLICY NUMBER (MM/D (MM/DO/YYXY) LIMITS
LTR -
GENERAL UABLITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY GL2046508030010 0 07/01/11 P Dawrence) $ 300,000
CLAIMS -MADE X OCCUR MEDEXP(Anyoneperson) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEM. AGGREGATELIMITAPPLIESPER: PRODUCTS - COMP/OP AGG $ 2,000,000
— 1 POLICY n PRO- n LOC Emp Ben. $ 1,000,000
JECT I f
AUTOMOBILE LIABLITY COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
A X ZANY AUTO CA20465050302 07/01/10 07/01/11 BODILY INJURY (Per person) $
1 ALL OWNED AUTOS BODILY INJURY (Per accident) $
SCHEDULED AUTOS PROPERTY DAMAGE $
HIRED AUTOS (Per accident)
NON -OWNED AUTOS $
$
UMBRELLA UAW I OCCUR EACH OCCURRENCE $
EXCESSLIAB CLAIMS -MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
A WORKERS COMPENSATION WC204651003 07/01/10 07/01/11 X WGSIAIU- IU
A ND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE V / N E.L. EACH ACCIDENT $ 500,000
OFFICE ER EXCLUDED? N / A
(Mandatorory y ki E.L. DISEASE - EA EMPLOYEE $ 500, ODD
in N NH)
II yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 1111, Additional Remarks Schedule, i1 more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE
ZEPHYRB THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Zephyrhills
Building Department AUTHORIZED REPRESENTATIVE
5335 8th Street
Zephyrhills FL 33542 n
_ .. ice.,'
PORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
08/10/2010 10:08 9543456770 AWESOME CONSTRUCTION PAGE 01/05
dOM
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Wi res J-iLJUr ONIIVC.
FAX TRANSMITTAL
TO: Contractor Registration COMPANY: City of Zephyrhills
FAX NUMBER: 813 -780 -0021 DATE: 8/10/10
FROM: Robin Dean
REGARDING: City of Zephyrhills Registration
TOTAL NUMBER OF PAGES (INCLUDING THIS PAGE): (5)
If you do not receive all the pages, please call the nurnber below as soon as possible.
REMARKS:
Contractor Registration:
Please see attached documents as required for our registration with the City of Zephyrhills.
Company Info:
Awesome Construction Inc.
3766 NW 124"' Avenue
Coral Springs, FI. 33065
P :954- 345 -6776
F:954- 345 -6770
If you have any questions or need further information please feel free to contact me at 954- 345 -6776.
Thanks - Robin
COPIES TO:
The documents accompanying this facsimile transmission contain information from AWESOME CONSTRUCTION. INC_ that is
GONFIDEN I'IAL and /or legally privileged. The Information is intended only for the use of the individual /entity named on this
transmission sheet. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or
the taking of any action in reliance on the contents of this facsimile information Is strictly prohibited, and that the document
should be returned to this office immediately. In this regard, if you have received this facsimile in error, please notify us by
, telephone immediately so we can arrange for the return of the original documents to us at no cost to you.
3700 NW 120 Avenue Cerel Springs, FL 33005 T 954- 345•4/ Its F 954- 345 -8770
CITY OF ZEPHYRHILLB
5335 - 8T1-1 STREET
(813)780 -0020 10769
BUILDING PERMIT
- arm ' ' um • - r: • - .• rasa: -- ""r•• a•
Permi T O
Permit 'Typo: CMMERCIAL ZEPHYRHILLS, FL.
Clasa of Work: AIDD /ALT COMMERCIAL Townahlp: Range: Book:
Proposed User: COM MERCIAL Lot(s): Block: Section:
Squsro Feat: Subdlvlalon: CITY OF ZEPHYRHILLS
Est. Value.: Parcel Number: 03- 26 -21- 0010- 06400 -0030
ImRra . Cost: 135,513.00
Data Issuerd: 8/09/2010 ` amo: .w . -7 d 1 . - .a • V - - - - v
Total Foos: 1.105.50 Addrosa: ONE CN/S DR
Amount Pald: 1,105.50 WOONSOCKET RI 02895 -6146
Data Pala: 6/11/2010 Phone: (401)770-5784
Work Cars= INTERIOR RE VOVATION PHOTO. CHECKOUT PHARMACY WAIT AREA
AWESOME CONSTRUCTION INC PLUMBING FEE 35.00 MECHANICAL FEE 3500
AURORA FIBER 8 COMMUNICATION FIRE PLAN REVIEW FEES 213_0o
INNOVATIVE MECHANICAL CONTRACTIN
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ROOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
IST ROUGH PLUMB FRE -METER INSULATION WALL, MISC.
D UCTS INSTALLED WATER MISC DRIVEWAY
P RE-SLAB SHEATHING MISC. MISC_
rx IJCTION POLE FRAME MISC.
CITY C F ZBPMYRMIILLS, FIL,CMM DA
5335 8th Strsst
CERTIlF/CATE OF OCCUPANCY
NAME AWESOME CONSTRUCTION INC OATS 11/4/10
AOORESS 37943 EII.AEU BLVD
PARCEL I.D. *03 26 - 21 - 0010 - 06400 - 0030 SUBOMSION CITY oa 2EPRZRUILLS
TYPE OF BUILDI COMMERCIAL —INTERIOR RENOVATION (PHOTO s CHECKOUT PERMIT 10769
REMARKS P H FCiRYRENUVISTIOGGITTJOILLC DONE ONLY FINAL DATE: 9/16/10
DILL BURGESS BUILDING OFFICIAL/ ab
WHITE : Contractor or Owner
YELLOW: Bldg. Dspt_
PINK: Ut/1ltlos Cont.
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