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HomeMy WebLinkAbout10-10783 CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 10783 BUILDING PERMIT f <� �a � ' e ,1 '� �'#a ` s fwt , Permit Number: 10783 Address: 6429 GALL BLVD Permit Type: SIGN ZEPHYRHILLS, FL. Class of Work: MONUMENT SIGN Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 03- 26 -21- 0020 - 00000 -0030 Improv. Cost: 25,100.00; :77 . Date Issued: 8/03/2010 Name: WALGREENS Total Fees: 267.50 Address: 6429 GALL BLVD Amount Paid: 267.50 ZEPHYRHILLS, FL. 33542 Date Paid: 8/03/2010 Phone: Work Desc: CUT DOWN EXIST COLUMNS /INSTALL EMU D/F W 40 /CABINET 26.90 I ' - - S = C , c 232 50 : UILDI F 35.00 SIGNXPRESS ' V O � ((6 1� ELECTRICAL ROUGH FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR.NOTICE REQUIRED PROTECT CARD FROM WEATHER ^ - City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: S Jcp,„ Date Received: -- Z l d Site: (a 2 9 Cs A- // 4 , ..___ Permit Type: -) 772 A / G/ /F - / a) '��6Q .% Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑ I J ,Y l u ,5 f 0,-e t.4- 4(1 ..(70, 1' 6 6:- ' ft) L S o (( 61,;") el (� tV0 , S70- o4 2) 14 1/ L,d k_ LJJ b( I. h ACCnr(fq n 4- P tAJd t 206 7 FB q 0 I 2 08 OCC- This comment she shall b- --pt with the permit and/or plans. ` 2 10 -As IL' Kj KalvlSwitzer — Pl. .1 :!. 1 iner Date Contractor and/or Homeowner (Required when comments are present) Date Rec e,,ed � g i - 4 !O Phone Contact tor Permitting ' UJ V 7 2 7 0/7 �V V o • "*. (06 3 Owner's Name WO_t 3Y C.E i Co I (� i Owner Phone Number $ 1 3-90 UO"i D Owner's Address J 40 Ld (. 1�0� � p 1`[ Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS ( ( c -ic i/ rd ) zep h\( rho H5 FI 33591 LOT # SUBDIVISION PARCEL ID# LJ 3 —2 Le —2) - - OJ2-D (J --a3 o (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I NEW CONSTR ADD /ALT 1 I SIGN MOVE n1 DEMOLISH INSTALL REPAIR - PROPOSED USE I] SFR I COMM I] OTHER I I TYPE OF CONSTRUCTION I I BLOCK 1 1 FRAME l STEEL I,4 OTHER kYAtAGnv GC.T DESCRIPTION OF WORK N I W G � W h gKt51-1P1 �0�4Ntnf 6 (NAT. C i .e t rtew E•M. O /F�..s 11, DiF As I I •(`t.,."1 Ka t BUILDING SIZE I SO FOOTAGE g. 2bP HEIGHT :.... ........:�,:•:::....... .....:::.... ,,••:,:, ::::- :,::,....:: :•:: rtdtr ....:: •, •:,.... ,..,..::••:, ... ,.... , . .. • . it ttrtmmnrttwinn_rtt Iti4-0 . I I BUILDING $ gS v ()Q , 00 VALUATION OF TOTAL CONSTRUCTION y I o y 1 ^ ' ELECTRICAL $ /O tJ r 00 AMP SERVICE 1 PR OGRESS ENERGY n W ,r : <• / je I PLUMBING $ 1 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION / Ji / r / , U I 1 GAS ET ROOFING I 1 SPECIALTY I ] OTHER � I S FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES NO n n 2 �' - _ ' n l Tit cn+14, •m�i.4tr "tWat ` ,.1 :•i'miti5 till1.: "wx«, " ev"G. 4 3 tCmm� j ' ) __.s.�, ""'•""'" ""iit�ic;a � :. fi`aEu•" m"•'dl�i' •�"�:- :..^^•' .. FQ'. � :.... /()C c... ,,..r .......'..... 's .zs_ a , // II � • i G �It /�'/ BUILDER COMPANY `� SIGNATURE REGIISSTERED I Y/ N I FEE CURRENT I Y/ N 1 Address I SA) License # I ELECTRICIAN ali t.... 2 � / /7�'t� ,." COMPANY 1'�'C.IGI 4. C -+C. ,' <STr1 SIGNATURE 1 vi* , tl REGISTERED I Y / N 1 FEE CURRENT 1 Y / N I Address 1 10 g 31 L4'4 44, f=G 313 - 7 License if I Es - 1 .ADbfl 4 1.1 PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y N Address I • I License # I MECHANICAL COMPANY SIGNATURE 24.STERED I Y/ N I FEE CURRENT I Y/ N I ,( Address ( ‘ - -y- n / ,, _ _k Linse i ce ` # I COMPANY OTHER I // � L 1l 44 -erbn souse C C Cco P� 5- tt- 3 SIGN T / REGISTERED I Y/ N I FEE CURRENT I Y/ N Address I ) b' 3 r // ll•fJr SI - L ] 337 7 -7 License # I k 5 - I 1 Ob o l f ( 4 ;14 iii it1 411+1 4Wa;g ,4..:44 - 4 sir,_ .1:44f i9 - 4C� � .tCP — Fri: 1:�':'F4.4f4 4F— i 4 - - - aeI 4e0F dl[..... .,:;;;: 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, Starmurater Plans w/ Silt Fence installed. Sanitary Facilities 8 1 dumpster; Site Wok 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. - : _ - Fi Er`.1ft#?AH 'qH9 i!@KREI.Iff� i� 4fggiFari ltt : 4gilt -t `tr 7�`RNIfft$iitt:4gi@6M � 4a�haAalr .7,;:..: .. ...�t,;lTi i44 :P• ::. Directions: Ali out application completely. Owner 8 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 F ences (Piot/Survey/Footage) Driveways -Not over Counter 1 on public roadways - .needs ROW TICE: Of UELO REST RIC, TIONS s1Gr, • i ;lands bra a ;,e!ihrl ,,iay be subject to "deed r- •s . hich may be more Te;trictive than Cci my �u bun , undersigned ,.;sire,,, rsponsibrtity for compliance ' tn applicable deed rests coons. 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 1, 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 prior to issuance of a permit and that all work will be o meet that no work or lawallation n. has construction, County and City codes, zoning regulations, and land development regulations standards of i 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 - Welts, 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. 1 understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes: Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDE - OR AN ATTORNEY BEFORE RECORDING YOUR OTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 11; .03) c • OWNER OR AGENT 4_' / CONTRACTOR `� � ' I / ' �-'1, �Subscribed and - • to (or a �m�) before me this r /..Ja _� � Q VrT • C -201'0 •2 ' 7 , ce S w p • too ,mw t Q me (W .e o is/are pe nally known to me or / Ln F/ ve VJho is/ personally known Yme or has/have produced as identification. _ as identification. t/C-/p,e ,1y/� rte` Notary Public Commission No. Notary Public Commission No. •P ► Not T.'77 : , s e. o % Ped Michelle L Lott Name of Notary typed, printed or stamped ` My Commission DD854388 �o� W Notary Public State of Florida Expires 02/23/2013 ' f, Michelle L Lott , Ec My Commission DD854388 Of f‘ Expires 02/23/2013 . ' - STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ..:. ---."... ,.. .'",j; ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 ,.. 4 1940 NORTH MONROE STREET T9 FL 32399-0783 GRIFFIN L WILLIAM HULL INTERNATIONAL C & C CORPORATION DBA SIGN X- PRESS 10831 CANAL STREET LARGO 33777 . . .;•—•...... boxrs to berbeque retaurant, and they ke .,.,. • - . Apt a 9.1.6.3t17 • —. : ilf - - . ' ..- • • I With this license you become one d' the nearly one million - AIME :Inifttii • ' ' = by the Department at Buninessand Profession& Regulation. ., . ..,. .: Q . . ... . . . _ ... ..,.. .. .... . . Our professionals and businesses range from architects to yadit brokers. from !. A: ... :....•.., ..-----.-•: . ..::•-•:,..1 : - :. „.. .: • ...• . .. . . . • . . essM nondeV tr. anornY *Ong. ..:ty '. . (4/21441iit 0.000•06.9; more about tne '...:•.: • ..... : .:: • ........;. • • ".... •., ..,.,' f .* .• • . . the way we do business In order serve you better. .: ...': • ._. ., : .:,,.....4—• . . •-• . ..-- . • — • ,,,,;,.„. Every day we work to improve juv , .., • .,, , . 6 - A . - ... . 4 : . . - t"'w:L. .,,' - For hiforrnetion about our services, please log onto saw Thar you OM find more informetlon about our divisions Snit iiiii - regulations that .... i .;,..i. ki.:::::: „...,,!' ..... ... .. l r: it:1k Tx ... 69 ,- inpa you, subscribe to deportment newsletters and learn • v t c • 4 Departments Initiatives. •,-; •;"..T . ,11/4‘1. ' ' ' ''' : - ... .• ..11Citt • • • ....4 . '; , "e.;.' Oar mission of the Deportment Is License Efficiently. Regulate Fairly. We • . constantly *halo ser ge you better so Met you am save your metronome. •-• ' la.. . ''"*.o ; woe" . . irome Wiim.41.11 mt , - .• That you for doing business in Florida, and congrotulagnne on Yournovi nooluel 11 . 7 14,14.4'4;;L:** ..i Scici ... . . siCIOS • • DETACH HERE • --.47: `.. " \ f. . . . " : . . : • '. ...: '''' ' . • .' -' - -5 ' . ; . ' :: 7 :, ,j;::.4 .If. - ' • i . . '. .., ' "1.'•": *., .: :. . . . . . • . • Ao• „ : s . . ...•: ..:.,..-::, .:::..:::„ :,...e...c:.. . .: . • -:, . ;6, - ,• , . q .. .: .. .• "'i' 4 `,„.!_.. :: .. ' , ,i: - , ' . ' ":- • 1 " -, iii. ,. ..,. . :.. p . : :,. ..i...f .,. .. , 4 :# ' 1 0 • . V • ; . , s4 ^. V - C ' . igIELATION :. • . 1 -'.-t?r t liitiV 1C., • ' •; t 1 ;*t• 4 cailk s 4 /1 4t . .: . ..• .. • . . . -. 14""2""ilt .. t . Ot, •'• . .4 : t ..* . ' . * ••••• • 1. - •.%-. ' • . . . - ' • • rir rftr' '' iii*Nt '' . ,' .4. • ' •• " 4 4' ;' * \ -,•" V '14 . 4 . .. .. • 1 i . . , . . . ,. ... . • • .1 ' ,4. • t t• , - .,-- ' - ' "..• t! . " ' : • • . • lies: 4 ' -= ' 7 '14) •-• --;• - - . • • . • • • . , ifficm:,...41 . . • . . • •- , - - •• -- ,, , , . ..,• • _...4.-„...,,..1.4 •• „_:--- - _ ..1 ,t;.., . • .. . . .: -.,, • 1 7 : 7 , 1pieltv!..k... , :7 - :1 • •• . a . • . 4...,,„•,4. 00 o • • • • •' ' ' • - , '4 . Alk-f ' -= 1 1141.i ". 4: ).7 't . ' ' . it pftas • . • • . .:7 , • •:.0 t • '. `... . ' . . .. • . . t , t , . . c ' , 4 . ,‘ . ' • • , or t •••: • 4 . : ,Yrii ; 3.11.7 --. ..7. . • . . , N. ' . . . . cau1 i . . # . , cs oifie * ti •• . • .4.. , • SYLAW TO/ 2111 33Vd air° CST Stott ttooSiLL 21 :ye et/$/P9 Date: 1 i ' ( 1 a To Whom It May Concern VARIOUS MUNICIPALITIES William Griffin State License: ES- 12000419 International C & C Corp dba Sign Xpress 10831 Canal St Largo, FL 33777 1 authorize the following individuals to act as my agent in all areas of permitting and licensing procedure with the municipality to which this is presented. This authorization is for sign permits at various locations ✓ This authorization is for the following location: l/JQ.Q 11QJti'O .11 S/oo ci It y 9 CR-c>'.0 61 vd , :Weehicir hr )1s, Ft_ 3 3Si-f1 Authorized Persons Stephanie Arce West Central Florida Permits Maritza Dandache West Central Florida Permits Brian Kelleher West Central Florida Permits Jim Russell West Central Florida Permits 1 n , Date -) Q --- 1 Signed: 0 Contractor CONTRACTOR'S SIGNATURE NOTARIZED: State of Flori County of I /`'� f 0. S Subscrib before me on this n G day of 20 b fri (Np... O` Y �,CY �(c.0 C /144 17 "„Pi, ho is e sonal ly known to ----:)' Notary Signature Commission Number ' sion Expires: , K •� ;: MY COMMISSION # DD 909574 • off EXPIRES: January 10, 2011 4, 7.0v Bonded Thru Notary Public Underwrtters s • 1 O 1 Corporate Headquarters Icon Identity Solutions Identity Solutions 1418 Elmhurst Road Elk Grove Village, IL 60007 Tel: 847.364.2250 July 13, 2010 Fax: 847.364.1517 www.iconid.com To Whom It May Concern: Icon Identity Solutions, Contractor for the Walgreen Pharmacy # 05604, address: 6429 Gall Bvld, Zephyrhills, FL 33541 -2570, grants permission to "Intemational C & C Corp dba Sign Xpress. " or their agent to apply for and secure permits for all signage at the referenced address. Furthermore "International C & C Corp dba Sign Xpress. " or their agent is authorized to complete installation for any and all signage at the same referenced address. —� 4 t Date:7 /13/10 S• - yP- ek, '• •' -ct Manager Subscribed and sworn to, before me, this 13th day of July , 2010. 411111111N1 i lir Seal otary Public OFFICIAL SEAL / JANE A CONSALVO NOTARY PUBLIC - STATE OF ILLINOIS MY COMMISSION EXPIRES:08/03/13 . . p ` csa. Chicago • Columbia • Dothan • Houston • Ontario • Philadelphia • Tampa 11110 Wa CONSTRUCTION DEPT. MAIL STOP 1630 106 WILMOT ROAD DEERFIELD IL 60015 June 14, 2010 To Whom It May Concern: Walgreens Company, Property owner for the Walgreen Pharmacy # 05604, address: 6429 Gall Blvd, Zephyrhills, FL 33541 -2570, grants permission to "Icon Identity Solutions" or their agent to apply for and secure permits for all signage at the referenced address. Furthermore "Icon Identity Solutions" or their agent is authorized to complete installation for any and all signage at the same referenced address. Ai . ALA 117 vl/te l � an r Sarah Bolger Date r Walgreens Authorized Agent Subscribed and sworn to, before me, this 1 5 day of a f 2009. a0 0 -0 Seal Notary P lic / OFFICIAL SEAL INGRID M HOFFMANN NOTARY PUBLIC - STATE OF ILLINOIS cc: File MY =MISSION EXPIRES:09+03/12 C International C rums ��-- SERVICE • INSTALLATION 10831 Canal St Largo, FL 33777 PH 727 -541 -5573 Fax 727 -544 -7745 TO WHOM IT MAY CONCERN: THIS LETTER IS TO INFORM YOU THAT INTERNATIONAL SIGN & DESIGN CORP HAS GONE OUT OF BUSIINESS AND HAS RE OPENED AS INTERNATIONAL C & C CORP. DBA SIGN X PRESS UNDER STATE LICENSE NU R ES12000419. I A STILL THE QUALIFIER AT THE SAME ADDRESS OF 10831 CANAL ST. LARGO, FL. 33777. r j j O w t ti 1 - 3 SIGNATURE OF QUALIFER WILLIAM H. GRIFFIN LICENSE # ES12000419 STATE OF FLORIDA STATE OF FLORIDA COUNTY OF PINELLAS SWORN TO AN UBSCRIBED BEF • - E ME THIS `f DAY OF �; , 2010 by William H. Griffi is personally kno to me / Or produced as identification. NOTARY PUBLIC MY COMMISSION EXPIRES 4P : r GARY FICI03 ,•• :,t MY COMMISSION i DO 609574 s .I.. i EXF S: January 10 2011 '�f . Y B.Si dTMuN yPt clMdinreiMrs c� CERTIFICATE OF LIABILITY INSURANCE OP ID B8 DATE (MM /DD /YYYY) INTE -17 04/21/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brown & Brown of Florida, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 15519 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa FL 33684 -5519 1 Phone: 813 - 226 -1300 Fax: 813- 226 -1313 INSURERS AFFORDING COVERAGE NAIC # INSURED International C & C INSURER A: ZENITH INSURANCE CO ' 13269 Corporation, International INSURER B: southern Owners Insurance Co. 10190 Linear Matrix Corporation Int 1 Sign and Design Corp INSURER G: AUTO OWNERS INSURANCE 18988 10831 Canal Street INSURER D: Largo FL 33777 -1696 I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD"L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD TYPE OF INSURANCE DATE (MM /DD /YYYY) DATE (MM /DD /YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 UAMAGh TO HENIEU B X COMMERCIAL GENERAL LIABILITY 20718180 -10 04/15/10 04/15/11 PREMISES(Eaoccurence) $ 50, 000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5, 000 X $1, 000 DED PD PERSONAL &ADV INJURY $ 1,000,000 ■ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY PEA LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY C X ANY AUTO 9669517500 04/15/10 04/15/11 COMBINED SINGLE LIMIT $ 1, 000, 000 CO accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ I ' , HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) ■ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ I i EXCESS / UMBRELLA LIABILITY ', EACH OCCURRENCE $ { OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE I i i $ RETENTION $ /� $ WORKERS COMPENSATION WC S1A1 U- 0I AND EMPLOYERS' LIABILITY Y / N J` X TORY LIMITS ER A ANY PROPRIETOR /PARTNER /EXECUTIVET - 7 Z830005723 09/15/09 09/15/10 ' E.L. EACH ACCIDENT $ 1000000 OFFICER /MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER B Installation 20718180 -10 04/15/10 04/15/11 Limit 20,000 Floater DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ZEPHYRH DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Zephyrhills REPRESENTATIVES. 5335 Eighth St AUT ZED REP ESENTATIVE Zephyrhills FL 33542 fi'iZ ACORD 25 (2009/01) ©19 8 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ''.1-...i;', + %/ 4 .^¢,i r P P. 0 . Li O; �� ,r: 1., ,'�`� ; . P I NELLAS PARK, FLO ' ► 78. -%\ D U S I N E S S T A ; � E - T u 11 STATE LICENSE # : TA + r ; OTHER LICENSE #: ES12000419 10 - 41 :SF I -ES 12000419 BUSINESS NAME, OWNERS NAME . O `' .. ` LOCAL ADDRESS AND MAILING ADDRESS SIGN X -PRESS DBA . GRIFFIN - OWNER /QUAL WILLIAM 10831 CANAL ST INTERNATIONAL C 8 C CORP 10831 CANAL ST LARGO FL 33777 LARGO FL 33777 == ===== mesa========== a= = == =_-_ ====-===" === ==== === = = = =_ = = = == = = = = =s == = == THE ABOVE NAMED PERSON, FIRM OR CORPORATION HAS PAID A BUSINESS TAX TO ENGAGE - IN THE FOLLOWING BUSINESS ACTIVITIES: CODE DESCRIPTION 3993/ SIGNS AND ADVERTISING SPECIALTIES SIGN FABRICATION AND INSTALLATION UNITS AMOUNT BUSINESS TAX AMOUNT 200.00 ======================= _ = == _ =_ = =__ = = == RENEWAL NOTICE 200.00 FOR PERIOD ENDING: September 30, 2 O BALANCE DUE 200.00 c aratasnatuaraissamsatasuazaranstassanumamme a=ss= = == =asesssssasarimssss siwisssosaasnsssssa= ss THIS RECEIPT DOES NOT PERMIT THE }H�OpLDER TO OPERATE . ..,Y GL ATIUN >t F ANY CITY LAW .OR ' 'I , °' AND IS AM ENNDOR ' , w r H t. , y , , �I P�l11C"�`I�'E . � ' ,, .. , "�` 'Y"ZON OR i - , � ii: SUBJECT TO ZONING RESTRICTIONS. 1 , ` i - ' . * . ft,., Ate;+ it.i ,,,.`* 7•" wsYr,114 i F , It i 1 irt s )> �FC� W Y • 4 '' 1 ' r ,4' J' " �` ;4 Illllllllllllllllllllllllllllllllillllllllllllllllllllllllll NM 1 it I. V I - ((MI \t !•.111• N i 2010110566 Rcpt.: 1318874 Rec: 10.00 Permit No. DS: 0.00 IT: 0.00 Tax Folio No.t(3_ U_21_60 0 COW() £)b3 08/03/10 K. Garcia, Doty Clerk 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. [Description of property (legal dercriptrion : , Pr , Y PG t, a.biz. t (4 3, q' -t L - C;t5 /S � 8 a ) S t r e e t ( j o b ) Address: L L I � y eph 1r . 4 l I F .1 �3 i5_YL_ 2.Generai description of improvements: cl l J 3.Ownex Information ,J — - - --- - -- - a) Name and address: I • II ' a AN . r It ii . s V i , r ii. 1ict,T2 QetA e f f 1 r 1.1 &' (}Q 15 - 921 b) Name and address of fee s • k titl - older (if other than owner) `° ` � `= c) Interest in property 4.Connaotor Infionmation fy,1-F - • i f / e Cr a 0 r 6 Sty - re. 3 7 7 77 e a Nerve and address • - f) . / /f %IIii41/a. a ..awr r��a.∎ -..�. -- go *IY lit w (Old) b) Telephone; No.: -- ;,.,.ra ��!. Fax No. -- - S.Su ety Information _ -- 5 Y/ - S 3 - = a) Name and *deem b) Amount of Bond: c) Telephone No.: Fax No. (Opt) 6dendetr a) Name and addresc Phone No. 7. Identity amnion w the State of Florida designated by owner upon whom notices or other documents may be served: a n D within a) Name and address: As o n b) Telephone No.: Fax No. (Opt.) _ oo w `o 8.ln addition to himself owner designates the following peraoa to receive a copy of the Lienor's Notice as provided in Section m z o - 713.13(1)(b ),Fled &Sheri: m 03 2 a) Name and address: . 5 f�^ b) Telephone ne No.. Fax No. (Opt-) cm b J 9. date ofNance of (the expiration date ho one par Sae data of reeor�diag anions a different date rev L _u I — o y C WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER Tux EXPIRATION OF THE NOTICE OF s Alit! U E TED IMPROPER PAYMENTS au= [.SA n= 713, PART 1, SECTION 713`13, -' 3 t FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYDIG TWK5 POOR 10 YOUR PROPERTY. N \, A NOTICE OF MUST BE RECORDED AND POSTED ON 1BE JOB SITE BEFORE THE FIRST w 3 ` , DencI JN. 17 YOU IN/MD 1t0 OBTAIN FINANCING, CONSULT YOUR TINDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. o Y r 3 ... ) STATE ORNUOIDA m COUNTY Or ‘ A. 10. C- C -C, ' /ct �ti., IX . s' Owneror Owner's Aiabart —a '5'i�/ o ( t I V e. ✓1 O Li 64. (- i 1{ h !'tint Nome a cknowledged before me this , -th y I y c The foregoing instrument was day of 7 /71 20 t (J , b ,) f1 Y I ve 11 Cl 1 as ) I( I (� (`(o rc� l tr\o, h r ' ',—, r c I-5 r (type of notb trH a ,, e.g. °Meer, Imam, attorney la iKt) for i l (mammae of party on WNW atwawa t•stror.at was anaeantai). Pence* 1Cncrw t , OR Produced Identification Notary Signature Jll� fi• yll ,all P.. ) Type of Ideall6ostiote Produced N1.mo (peiat) _J_. I/ Tyr l (l H. (',-: IC in a l) )1 Verification ptaroseat to Section 92.523, Florida %tu as Ungar penalties of perjury. 1 declare that 1 have read the Tangoing and that the facts staled in it are true to the beat of arty knowledge and belief Saar �� y` - , < , y! ' ,,� OFFICIAL SEAL °t>'1a re1Poke sf Um 10.) Above INGRID M HOFFMANN NOTARY PUBLIC - STATE OF ILLINOIS MY COMMISSION EXPIRES:09P03/12 • STATE I: PLORiikA, CO J ieF PASCO THIS IS TO CERT , 'THE ROREGCING 'iS A TRUEAND CORRECT COPY OF HE'DOCUMENT ON :FILE OR (1F P� LCi RECORE:''IN T�,IS OFFICE WITNE ' MY PlAt i AN ci"FiCIQ SEAL THIS DAY7OFF1 / Div PAUL `�" O'N ty,. I !'. `CONIPTROLL,_ER EEEVELD TECHNICAL =VICES, INO. ll 0/144 4 a Pyeao .5)/1) Witt- Z CiUS tr 6604- ,ZEPH YZ /15, FL., ‘141a Vrt.o t- 7y _ /4o /n/Hg r� &E-s = s ly TP2E tIw 5- /o'er" ire = 4,00-= . 106 / P. 5/cf.J . 4 ?-8 S=Bz` row = 249 "7 1/ 1/yt7 /f36.va. y1 ■17 GCE 2uE 5600. 0477 = 4D05)(9 /z) t 2to.9(i5)(4433) 1 S / a t g 36. = 3 6 4 ' 4' f %ices z 3 g , e z . / r l T / D o c c = 3 6 2 ¢ r i � � _ ! 8 /L 3 i c T / � ✓ o c , 6 ' 1 e ' 2 . ) c7566 TuE P �, 8 x 8 X 4 �, A5.40 iJ/ 'G. ��c -/boa = /8 -5�� _ /B /z 3 , '7>. — /off ; ,�f 5¢ `� /93Z5- @ 8 g rte'D 7 o = /8/Z3 = 2 ?/8-4* ox) 2 E4'D Atee v . 7k/i)- 4 z / *x is) Z( /.4vo) 38 fr8g e /2E¢'D. Se 64<s72,€ d vcff-&o7,.00 x 3' -o "tV x 41€ ZS6P (f '7 mw /969 & iz t) �f7 = (2 ')(3,0)4. s)06 -- o) &' ' 'sT Aeessux6 _ (2) 0)614 ezeo) &U j'ry /,v6 /2 s /5 .97 (t d io = c A/te jZ /N6 kTs s/7 /111. (h'o'c) = (/v8cen )(¢. %) = 2�}3O °FTC` AX:011PLIRS WITH: t sue.. ' 36'24-6 'a #$CE7•5 ot t 1111rr�, ` + E �F �F( O ii William B. 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