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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 V Ai 11KI a d r, gr " > c. [' ; z ,,a e' t }ib4 sy a •• - �• -•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 `4 Vi. F: II I " ! 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„ • � , ` 6-e q co .4,-, (-P co, fin zcr ni :C, `2) u ` 1 -P.P c ` Erofy\ �Y� I r �P F (` ► F < 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 • 2 of 4 • 'J" s ° "omm9'4h"fi $ Ar + , A w 1-Q f h sr 3ff - o- .- t � � x * , & d " l‘ 7.,',4 . 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ET 1- �� t o O � -I� a ' Ow�OO =� w ~9' (1) - 0 — OCn Tlw — .Z N Q O O ,, ;-:.�- wm�U'�Dm w c o � - w ( /) —COO �G) co() o 3 PD �D W -� - I -o 7v 3 -6'', - 0ZrO0 — I -N O l n co ?0 r�O o 0 V Po > -- I C Z -I (D r �p C ° '�mOWm — D CCm N ro v `� m m n o O _I— � m D m o N m � z � — � ^ cu cn :3 7] 13 D 0 w � 4 ' (n --I m G) i io r b Cfq N O OD i O 0 L 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 N�0� �� �������m�� ���� =����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�, i • DETACH HERE . 1 r 4�4 �;1 ' - 1 ;4 l l `tit;::•' //* lip• 1iy ,`t�t' ' �J' * it 1 / ��i4,: e is il - nt �.• ;. • i ... qY . • 14 - - -, 7: _ „r; 7 � .. �• �`' t„+tJ'�,. k��' d•r.' ''• t s; r .-• r r Mr t l l '1 • 9 u r. ? ! , z � . ; . r r. rL:y.v :• �. b `• .•: % i . - ' \ �n i. x 1TM . - , •C .. . ti y 4 j a : w f X'S. a 4Cl',� n � f Yt , f � 1 ' " y. :.� t ^ f, 7 )'„',,, ,J ,.. fia" r � . •.‘%":". ' ..Gf " � 7.=t t s^-.'- Y ,, `,. - tL / 0 '.(;:44 . .,.; ; ;.„ , h i^ T r . ( '?P F tia. .,•. . •u ' tit' - : . .ti= G rF�� ! W. ■ a*ZV. .k._:)1 / ' ,-,T,,-- . ( ' ' ti .� - 1 . - .1h: '` r y� I f ^ i I • • 7 . " r ' tc. 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JR � � , . :c• r •' FIiC K 2 C { /.. °1' '- '4•'�` " k ' e .� . 1'�= r < r 1 ' � v _ c' ; ii i ? ;K ( l " `J�i r q> . +° - • •:h? * its 0' ``, �' 1 r',., %._ ', , •, 6 .,„,.: . • '. � ' � r, . 1 % 1 1 i+ ^ 1 ,. 1 � + •'.f!: r '�'' r' ., � �, 1 .. . — • /..,• •.....;... , •l 'v Vl •Y,' • •�,' w • �1.._ _ r" • - » , • Y.t %. _. + 0 •4r;'' 7'7•. ^r; n /r,P••. +(.e±,, �. :� " --)e°7-.. r * • ,..; •• • :61V-, :, n 447, 7 �,•-, t� - ;ga s :l": ' :, 4. . 04•'.,41 � , t ' ::12yr :¢' , ��.�,.,. 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 . „ .., 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 uggigrimmimmuipmgermgmpommonsegmlimpormiiiimm a 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. 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