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HomeMy WebLinkAbout10-10389 CITY OF.ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10389 BUILDING PERMIT F a r - £ ; a. : § a'.a r' a'. ` ' . a , x ^' .,,. ..� � a. ? � �.' . , a .` s . . s „,a'a.T s , , Permit Number: 10389 Address: 6 834 GALL BLVD STE 105 Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD /ALT COMMERCIAL Township: Range: Book: Proposed Use: NOT APPLICABLE .Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02-26-21-0010-02400-0010 Improv. Cost: 58,469.00 7. o Date Issued: 4/23/2010 Name: ZEPHYR PLACE Lb Total Fees: 6,311.92 Address: 2220 34TH ST S Amount Paid: 2,577.48 ST PETERSBURG FL 33711 Date Paid: 4/23/2010 Phone: (727)504 -0256 Work Desc: INTERIOR BUILDOUT 1,403 SQ FT PHARMACY 1 I N I -UIL• IN BO D IN 383.52 s � •NN •N • T - 507.61 TRI- COUNTY ELECTRIC,INC. ELECTRICAL FEE 84.60 WATER CONNECTION COMMERC 161.88 AIRCO MECHANICAL CONTRS INC PLUMBING FEE 56.40 TRAFFIC IMPACT FEES 99% COM 4,929.46 PASADENA PLUMBING INC MECHANICAL FEE 39.48 TRAFFIC IMPACT FEE 1% 49.79 FIRE PLAN REVIEW FEES 84.18 FIRE INSPECTION FEES 15.00 b --7 ;1 "--- a - f . ll- C/(1) 01inrC e ayst - 0 - 2240 re- ck Y it) i Ci ' 6,_,_.: 2 ___ 1 6-1 „ 0) l C v (� 5 -1 */ tekAIi 3 S o� 6 _ 5 /o 1 / eft ,, _ . '. E ''''t 2',03 -, • • - 2ND - • H PL 4" MIS 1 ULA 1 • LIN FOOTER BOND DUCTS INSULAT: SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE -SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." ‘ 1 .,.Jes..,,,,I.,_ 60g.. air 44 it, , ill .. ' CTo R SIGNATURE PERMIT OFFI ;R i'.,.'i PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER ~^-. //'` `.' � ` . . ' /) ] ./:/' ' | | /:3IDA AG � ' CONTRACTOR �: l D�SI6NIT 8 IT! DIT 1::ID1;1':: 6834 GALL BLVD SlI 1Cr!. ■ OFF CE: DeQ ! { '/ C/ST: Z q- F[/R: RESOURCE FEES BP #10389 CHECK # 2079 PHARMACY TOTAL AMOUNT: 166.00 ACCNT COMPNY ACCOUNT CENTFR AMO1. IN7 DESCRIPTION/PERM[ DATA DR/CR 114 B45O - 363000 - 2 166.00 ****** SOLlD WASTE FEE ,.. RECEI»ED BY f -" ' ---_-_--- -_------........................... 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L PASCO COUNTY, FLORIDA Permit No. 10389 c9 Date Permitted Lf - L6 Builder Name /Owner Name J s,` 4- ,jot r t f - Control # County Parcel No. O2- 2P- Z !- 00 (0- -024 _o0/ (7 SubDiv: Address /Location 663 5 GA-8 61 L./L ,srrc /& Classification/Type of Use eD fvt ttP rrl aCy TRANSPORTATION IMPACT FEE Rate: S 2 ' ( / Sq Ft Unit: tr (-103 Exempt E Yes No How Determined Impact Fee Amount $ 49 79' 2 -6 Zone No. TAZ: SCHOOL IMPACT FEE Account (056) Single- Family Detached House Amount $ A)/14- (057) Mobile Home (058) Other Residential 1123) Collection Fee Exempt _ Yes E1 No How Determined PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone TOTAL AMOUNT $ PA Exempt j Yes [] No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt Yes No How Determined Total Amount a4' RESOURCE FEE ERU TOTAL AMOUNT Prepared By Checked By NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a copy of this form, placing the building permit owner on notice of this assessment and the conditions of payment for same. DATE RECEIVED BY RECEIPT NO. DATE BY 6834 GALL BLVD STE #105- 1403 SQ FT - PHARMACY - PERMIT# 10389 SQ. FEET PRICE MAIN OR LIVING: 1,403 $ 52.49 $104.99 - $52.50 OTHER AREA UNDER ROOF: - $ 91.00 OTHER: - $ - VALUATION $ 73,643.47 FEE SHEET $ 376.00 ADDRESS DRIVEWAY BUILDING: $ 383.52 ELECTRICAL: $ 84.60 PLUMBING: $ 56.40 MECHANICAL: $ 39.48 SUB -TOTAL $ 564.00 RADON: N/A TOTAL $ 564.00 SEWER: $ 507.61 WATER: $ 161.88 IRRIGATION: $ - TOTAL: $ 669.49 WATER METER: (N /A IRRIGATION METER $ FIRE DEPARTMENT FEES PLANS TOTAL: $ 84.18 INSPECTION TOTAL: $ 15.00 PERMIT TOTAL TOTAL: $ 99.18 PUBLIC SAFETY IMPACT FEES PD AT SHELL POLICE FIRE 5% $ - TOTAL: $ - SUB -TOTAL $ 1,332.67I PARK IMPACT FEES $ - I N/A SIF'S: $ - N/A 100.0% $ - 1.0% $ - TOTAL: $ - T I F 'S : $ 4,979.25 OPTION 25% AT PERMIT 75 °,. • - _ - k TIRE AMOUNT 99% $ 4,929.46 y�I ,t 1% $ 49.79 $1,332.67+ $1,244.81 $2,577.48 DUE AT PERMIT - / "' 4423 TOTAL: $ 6,311.92 I B4 PRE METER REL , pc N ,elt � 15 u 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 -064 Project: Revision Number of Pages: June 8, 2010 I have received and reviewed the revised plans for the interior build -out located at 6834 Gall Blvd, Suite 105 and will allow the project to move forward. Please note that this review does not eliminate any further requirements as the project continues moving forward. By receiving 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. Add emergency light in restroom. 2. Change out exit light located at the east door to a combo unit (exit/emergency light) due to the emergency light located on the opposite side of the office being obstructed. 3. A new sprinkler plan shall be submitted to show the change made from previous plan submitted. Inspections Required: 1. Final. 9 KE' ' Y B RNE T, 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. 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.: /6 9 Contractor: cl� ; 4 /✓G-'! .1/ Business Name: 1474,6 r... 4 0--___.-- Billing Address: / 7 / . Business Address: ' GQ 6:0 .5 t 1 _ l Business Phone No.: Billing Phone No.: Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES INSPECTION FEES _ PERMIT FEE _ FALSE ALARM FEE Site Plan N/C , Annual N/C _ Sprinkler $50 _ 1st Alarm N/C IMI Family /Commercial .16 sf , 1st Re- inspection N/C _ Standpipes $50 _ 2nd Alarm N/C (Minimum Charge °. 5.0. , 2nd Re- inspection $100 _ Fire Pump $50 _ 3rd Alarm N/C 0 Plan Revisions a BL ' 3rd Re- inspection $250 _ Hoods $50 _ 4th Alarm $100 4th Re- Inspection $500 _ Fire Alarm $50 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until _ LP Gas $50 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 $50 STANDPIPE SYSTEM _ Hydro Undergrounds $45 _ Sparklers $100 D 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 $75 _ Controlled Burn $100 FIRE ALARM SYSTEM _ Hood /Duct $50 0 - 25 Devices $50 _ FIRE ALARM SYSTEM _ Place of Assembly $50 Annual 26 plus Devices $100 _ System Acceptance $50 _ Fire Protection $25 _ SUPPRESSION SYSTEMS — Recall Acceptance $50 — Flammable Application $50 Annual Wet $50 _ OTHER _ Waste Tire Storage $50 Annual _ Dry $50 _ Fire Wall /Smoke Wal $1 per wal _ Generator < KW $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 $50 0 Hood /Ducts $50 _ Tent 10'x10' or greater $15 per tent — Torch Pot/Applied $50 OTHER _ Fire Pump $45 — Fire Materials $100 Annual _ LP Installation per tank $50 _ Fire Suppression $30 _ Fuel Tank Installation $50 _ System Acceptance (Per Tank) $50 _ Exhaust Hood /Duct $30 0 Natural Gas Installation $50 _ 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 Emergency Vehicle Acs $50 FALSE ALARM PLANS TOTA INSPECTION TOTAL PERMIT TOTAL TOTAL GRAND TOTAL I &— 1 Comments: Date: /- Insg ctor: /f ne_� �,�' iv !Ifs` City of Zephyrhills BUILDING PLAN REVIEW COMMENTS \ Contractor/Homeowner: I A Date Received: S 26 -/ (� Site: 6631 96 (14 l'` Permit Type: R iSl) piles Approved w /no comments: 4/ Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. i / b �/4 Kalvin Swplans Examiner Date Contractor and/or Homeowner (Required when comments are present) 813-780 -0020 City of Zephyrhills Permit Application ax -: c' -0021 Building Department .......... Date Received 2.6 -- /e Phone Contact for Pe fitting tip ■ ;- -- icy/L/5 A Owner's Name F O IV , QCt L - LC 1 Owner Phone Number � 6, 3 CA-(/ ___— Owner's Address Owner Phone Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS & 03 6- -?/ /3/ 1») 3 106 LOT # SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I 1 I 1 DEMOLISH INSTALL REPAIR PROPOSED USE L 1 SFR I I COMM I I OTHER TYPE OF CONSTRUCTION 1 I BLOCK I I FRAME 1 1 STEEL 1 1 1 DESCRIPTION OF WORK iZe u15/OA / (49 P ,-,-n C BUILDING SIZE SQ FOOTAGE HEIGHT (BUILDING $ VALUATION OF TOTAL CONSTRUCTION (ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C. IPLUMBING $ *4- l (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION e/'`-'1 ' t;l /t1CJo (GAS I 1 ROOFING I I SPECIALTY 1 1 OTHER 3 5 � (D FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 jYES NO I r BUILDER Of COMPANY 1 /66/6' t ri 50 f'- iI) ti L AAA, SIGNATURE / - ^---C — REGISTERED 169 N I FEE CURREN I Y / N 1 Address c26,0 6,3 E. (//yAkittA (': i F L. License # & ( /5 '/t)56 3%; J ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y / N j FEE CURREN I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y / N 1 FEE CURREN I Y / N I Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURREN 1 Y/ N I Address License # 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 requ (A/C upgrades over $7500) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may 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 IMPACTIUTILITIES 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 job is considered abandoned. justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the j WARNING TO OWNER: YOUR FAILURE TO PROPERTY. IF YOU INTEND PAYING TWICE FOR IMPROVEMENTS TO YO END TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) _Arc - OWNER OR AGENT CONTRACTOR -` and swom d an = • r a "'med) before me this Subscribed and swom to (or affirmed) before me this Subscribed by by Who is /are personally known to me or has /have produced Who is /are personally known to me identification. produced as identification. as iification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped °t� d 1Z f {,i ; City of Zephyrhills eedi3 f cy \ BUILDING PLAN REVIEW COMMENTS P dr ! ntractor/Homeowner: t3 — Received: 26 -/0 r�, X- oNeskic ate R g-2,40 jb te: 0 6 q CA-// 8 / ob it Type: ke_oi'3101 +0 co 0`e---k, pproved w /no comments: ti Approved w /the below comments: ❑ Denied w /the below comments: ❑ ,' This comment s , eet se k •t with the permit and/or plans. „,-, 4 -0)41 i Date , n• •. or an Homeowner Kalvin S tzer PI - xaminer (Required when commen •1 pr sent) Jacqueline Boges To: Kerry Barnett Subject: RE: screw inspect Thank you will place in inspection. From: Kerry Barnett ..._.. ....d �.�_._.w Sent: Tuesday, May 11, 2010 9:33 AM To: Jacqueline Boges Subject: screw inspect Jackie, Completed a screw inspection at 6834 gall, suite 105. It was ok. Kerry Barnett Fire Marshal 6907 Dairy Rd Zephyrhills, FL. 33545 (813) 780 -0041 CELL: (813) 813 - 714 -6326 1 Apr 22 10 03:20p Colannino 727.789.0319 p.1 APR /22/2009/WED 02:50 PIA ZEPHYRHILLS BUILDING FAX No. 813 780 -0021 P. 002 ell- 7ea0olo CI(y of Zephyrhflls Permit Application J , Fu 137eaOO2( Brim/ Deposment (C42519 • • Dote Received �1 — �/7�- (U 1 Penn. ConContact . for P ne trnp 4 elf 1. — 1 45.114 1 . . , tl Ownees Naomi '2 LP ��ee 1 �� wi kl z ` . r. S' . i 1•. . C. 1 ) owner Phone h wNumber 1 • r- 04 - t101 edAddress r x1190 .'7ci+ri mo , „� t ONner PhoneNwmaer I 1 Owne Poe Simple Tk1e1101derN.In.` .S S G 1 Owner PheneNumber 1 1 Foe Ample ltlMnoMerAddress I SADA. I JOBADDR= 1 62801 (,)AL& auz -t; !nom \- i LOTI 11 I SUBDIVISION 1 , PARCEL 1131/1 4 c �1 - dkbl� t0 -4(,7�� ) ,0 IO.IAIM ® MOM PROPS MY WI MICI 1Cp WORK PROPOSED MEVV CONSTR ADWALT mom MOPE DEMOLISH INSTALL a © Q © REPAIR PROPOSED USE BFR au CO NM O OTHER F Jr GOIDTRUCTION btOCK Q rem* L EEL Q arm. OTHER 1 � �p 1 �/ DESCRIPTION OF /YORK 1 i�f p.0 y J � ( .7� u�A 4 I � 43 f F PP - •TALL( li d�S,j P m�a BUBUILDING BUILDING �E 41� SG Foo7AOe 4 y0 _AM NllaHEIGHT �!v f' 1 '' cia BUILDING 138 1 VALUATION OF TOTAL CONSTRUCTION Ori ELECTRICAL I 1 AMP SERVICE En PROOAE1BENEROY Q W.R.E.C. �] PLUMBING 1 �C9 1 3 5 pl."--N V =I MECHANICAL 11 I VALUATION DP MECHANICAL INSTALLATIMI (D' r' + 1 sR--T n GAS n ROOFING J SPECIALTY CO OMR / ° � N FLOOR ELEVATIONS t FLOOD ZONE AREA AYES ©N `S '—` PINI 1 /WILDER I 1 t3 � ) SIGNATURE (lk 1�_ COMPANY j YI j 1 J C. 1 moistens N MN Moen Y /N :P a �: ^- i 5 rP c-. .7 l:e• 1Lot. 1St ciagt 1 " " wY V ` OOMPANY 1 TR I-(00074 .F.Lt TritC, TJ C-- 1 man= I Y/ N 1 rCCWMtdR ( YIN I d km . 37 (J5 /4 N *D C.Gem/ftelar, R. 33761 1 . the.. Iec coo 1,)5 (o I { PLUMBER 1 COMPANY 1 ' 1 SIONATVI� Aeoormeo j Yr N I rrfamnewr I YIN 1 AWN'S E 1 I ' Lim; M 4 I + I ME CNANUDAL 1 ODMPAMY I 1 SIGNATURE I meoensies I Y N( mamma YI N I 111 • Addree. I - • 1 Mores . I I O1HER I I COMPANY 1 10 UA bNATE 0601eTEMN) I V 1 N 1 Frecuale a I YIN I I • I Liao • I 1 RESIDENTIAL AO.a, 4Z PIat PRo ( PM of But UhB Bens: (Deal of lbteryp, Fermis; R - 6VI/ P.rrrA or n.ry eerevnmvon, Minimum BA (1C) wilting dales ens we nn viii. Rewind emote. Cerrsbumbn pans. Slonnww Plena eel Sw Frmoe In.mlied. MenMary Feene, 81 0iegelai eI. Wort nun Li subWlslomJUfgs pm)eas COMMERCIAL Ail ( .1 Multdieg Mae Floe e Ure &dote Awn (1) ..tof Emmy Forme. ROW I mlt fornowooesowalon. Mlnlmolnlan (10) werNblg clays aper ad deft. Required erMta. COrs1Vtllen Pew. Bbremelar Pyles w/ MIN Fnnoe inssibd. 9ION PERMIT Attach ry Feol.lae & 1 durmast. stte Mil Perm11 ter all new pre}a & Al esA+mertlsl Mfpnror ents must neat eonsplanee (2) eels or &minuted Phew ""PROP9t regliredfor el NEW eonserwabm, 1 Directions: FM oalemise meemlNty. . Owner a Convector sign sack K.ppeoed.n. mamma • 11 ever$ 1600. • Netite If Cam memeement is required. (Alis upgrade, ever $b000) Palm Nor OM owns* or Pent etAnew Sir hie men % cud oaaem re% van nob Nod Iseer Porn owner .d0tortongsema oVal THE COUNTER PERMITTING (FANS orApploatbn OnIY) - Ren.Fi Sias . Service Upgyed.o NC Timm (Pbtl9urwyfrootigo) . odveusys -Hot ever Guider lam pubic roadw Ws..n.oda ROW IIIIII VIII IIIII I!III IIIII IIIII IIIIl VIII VIII VIII III 20 10052272 VIII This Instrument Prepared By: _ Name: DT 6 I =et L. Address: 2 la Q 0 (o. Zr,/ ALi P_ C t) e, La Permit No.: y Tax Folio No:O 06 ' � ' 2 t -QQ l p - U olL•Nk. - c 01 p State of in c ��a NOTICE OF COMMENCEMENT Rcpt :1299849 Rec: 10.00 County of PAS (...0 DS : 0.00 IT: 0.00 04/15/10 S. Burns, Opty Clerk THE UNDERSIGNED hereby gives notice that improvement(s) will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement 1. Description of property (legal description o roperty and t address): 85/ ' -',. l /IA. VY \ • 4 * - W S- - �etiAP1.., �s 354 A. "i :v.P14 -44 ►-kW4 c 0 copot ,") 2. General description of improvement: I '. k. r W .- v. r ( 011 4W 0 !U pis ¢ c 3. Owner Information: `t ' PLC F •'t• r il� '1r- . r a) Name and complete a dress: p �. `� r � . 1---k-C_ Z - 3 y 4-4-. S S C ry` ' � „q 5 1,43 b) Interest in property: t 'Q.-es S ..•-. 1 1.- St- Q e_. •-\, ,, r., L kJ c) Name and address of Fee Simple Title Holder (if other than owner): U 3 3 --/ ; ` ul, y� A EASe n*,ac 4. Contractor Information: \-_ a) Company name and complete address: 1(2-C 'S n 4 ., \d �L b) Phone number: CO-L\ 3 - LA_ (1% 4 L Fax Number: C L4' 3 ZZ (ak. -1 U 5. S,zety: a Co . (. 3 rc i - Arv� F tAA- c _ L Lc-, C 1. 1,1 � - a) Name and complete address: N \-9k. 3t-/ 2 J b) Amount of Bond: $ • c) Phone number: Fax Number: 6. Lender: PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER a) Name and complete address: 04/15/10 11:46am 1 of 1 b) Phone number: Fax Number: OR BK 8311 n 501 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by in Section 713.13(lxa)7., Florida Statutes: a) Name and complete address: N \. to b) Phone number Fax Number: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Sect �n 713.13(10), Flortda Statutes: a) Name and complete address: N L A- b) Phone number. Fax Number: 9. Expiration date of I•,rtice of Commencement (the expiration date is 1 -year from the date of different date is specified): '-E- 1- l l recording, unless a WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHPATER 713, PART 1, 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, CONSUL' R NDER OR AN ATTORNEY Q H W BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE , , N t ' ME d. Z cc W //,� W Er- cn W --I / ( /��� O U O O = J J Si _„ . , ` of • or • thorized rn Z U M O a. O O = Offs. = ,'D'1 �iit n- C�p� w H I for '. , I — u. 1.1.1 U) - " Signatory's Title/Office MU?l. . O O z z 2 () >- ti- O The foregoing instrument was acknowledged before me this 1 t-'. d of 9 20 l O Z ,, , O 0 IX U ` U by G s -cuw 11&ttc -,�,.A (name of person) as the :r Ni' 441 , {yu3 0`($441 -trA• (typ >- w LL- ea authority,..e.g. officer, trustee, attorney in fact) for 1 Q t- r- cx LL (name of e-.7 h- 0 O 1 whom instrument was executed). b party on behalf of O Q O W l,dv� C U t� J U - Signature of No lic - Stat of Florida Y W m z O J ii2 Shirley L. Faulkner Print, Type, or Stamp Commissioned Name of No S Q Z NOTARY - STATE OF FLORIDA Public/Commission Number lu re. of 0 LL. O _ ui COMMISSION # DD581664 1, Lt. r? v 0 — O My Comm. Expires 08/06/2010 Personally Known �` °r Produced I 0 IL • 0 Z 0 uj w ci) /j i " - z w cn Vimi if cation Pursuant to Section 92.525 Florida Statutes LA CO 1-1-1 --- w T �l - Under penalties of perjury, I declare that I have read the foregoing and L ,,: t the s ted in it are true to the best of m wC- z - —Q 4110 . knowledge and belief. ../ //J Y in F t 0 m Signature . Owner r • , ,, ' • Authorized Officer a �ector/P - fi r� ` -C,� '11 4 ��, 813 - 780 -0020 City of Zephyrhills Permit Application 1. Fax - 813-700.0021 (�, Building Department — �j r v �Gt/ W Z' Date Received q I 71 ( u Phone Contact for Permtttin ■ gip rtar _ is . «,.:...:. Owner's Name tom" 6 I" (, LL, C. Owner Phone Number ,So (4 ... C Owner's Address I r ( j� Q �C. l „S S't�l -SJ 4 Pl 11 all i Owner Phone Number I Fee Simple Titleholder Name' i, I Owner Phone Number I Fee Simple Titleholder Address I S' JOB ADDRESS 1 (oR2 0—IAA.— !( " i OS- I LOT* SUBDIVISION I 1 PARCEL ID#I t x"O'l,ll'ry'■ ._ , t _S 6-- jt3g (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED M NEW CONSTR ADD /ALT n SIGN = MOVE _J DEMOLISH INSTALL REPAIR PROPOSED USE = SFR COMM = OTHER 1 TYPE OF CONSTRUCTION � BLOCK n FRAME ", = STEEL = OTHER r DESCRIPTION OF WORK 1 - �I�, At-x--c-7- t,.�j 0/5 1 4 -01/4k J r^ RA- 1-` l�„i1. u — / L 7/D � BUILDING SIZE I �'(Q SQ FOOTAGE "1C_. HEIGHT I I O fr " ^ 3 P r 1',a c y po BUILDING IS SS U 6 � - VALUATION OF TOTAL CONSTRUCTION CEI ELECTRICAL I$ I AMP SERVICE n PROGRESS ENERGY = W.R.E.C. tSt PLUMBING I$ I � =� � rAct-4\ = MECHANICAL I$ I VALUATION OF MECHANICAL INSTALLATION t'1 T -P� ` � - I i GAS n ROOFING n n O THER SPECIALTY � �C FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA =YES =N a__ ..: COMPANY I US ........................................................ ............................... .................... ............................... BUILDER ( ` -411-1 ........ 1 SIGNATURE `ry I REGISTERED l Y/ N l FEE CURRENT Y/ N /,address [9 0 1t l- P + .f Kil-A F 1.. 7� / — License# L(7C ISEy0‹:c' — I 41� ELECTRICIAN I COMPANY Ai, \ SIGNATUR ® _1 dc�s REGISTERED FEE CURRENT Y / N I License* I 1 d LUMBER COMPANY I 1 / ✓ ATU I REGISTERED Y/ N FEE CURRENT L Y/ N 1 C fff Address License # ECHANICA I\ I COMPANY P Ie,� SIGNATUR I Y! N REGISTERED I I FEE CURRENT l Y/ N l 58- Address I 1---- (� License # OTHER I COMPANY J SIGNATURE REGISTERED ® FEE CURRENT wpm Address J I I ] License # 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 ensile, Construction Plans, Storrnwater Plans w/ Sit 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. militrimilmtemomm Directions: 1 Fill out application completely. Owner & Contractor sign back of application, notarized If over 82500, a Notice of Commencement is required. (A/C upgrades over 85000) '" 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, Waterdwastewater 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 IMPROVEME TS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER '' - A TT • RNEY BEFORE RECORDING Y • R OTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117., , \ ' e OWNER OR AGENT / a �� ,�/ \ a � r Subscribed and swo to (or ) bef. , me this CONTRA vs y �y ( Subscribed a d and : Z(rs ore me this Who is/are •r , one' kno • me or has/have produced Who is/are personally known to me or has/have produced - 4 1 - 41 L- 4 - 5 ‘ - - 55 identification. as identification. Notary Public \\\ S Notary Public Commission No. D o ' O (.QL4 Commission No. Na _ of Notary � c ner Name of Notary typed, printed or stamped NOTARY - STATE OF FLORIDA COMMISSION 4 DD581664 My Comm. Expires 08106/2010 04/23/2010 09:02 727 - 547 -9754 AIRCO MECHANICAL PAGE 01/01 APR, /23/2009/THU 08:38 AM ZEPHYBHILLS BUILDING FAX No. 813 - 780 - 0021 P. 001 /001 " �-r� -r n«L� ens -�eo oozu any ofZephyrflms Permit Application Bn /�_ . e+ r. oar+ , • UNN Department � r 3-? � Z • Date Recek..d ., —'� —' Phone Contact for •.. 4 q! — /S11,2 owners None 111 44)C.) . �] _ � ' L ,.. �1 ( Owner Phone Number _ —LSO — + -1 Otmere Address ( �' `� S 6 S j 4 P t i��Ot for Phone Number ` l fee Simple 1We MderNeme[ SPS'w4, 1 owner Phone Number 1 • Pee dmp a TUlehokw Add► SS c.. ' JOB ADORE= [ 4r 823`1 V•kt-Arr• (m,L r " i'OS �// j . LOTY 1 _ 1 9UBOM51ON [ J PARCEL ID#1 � c • •'x\!_121= - 4i._ • . fORYAN OT AD FROMPROPEITr AMEN) . • WORKPROPOSitD E121 NEWCONBTR ADD/ALT Ei 810N 0 MOVE 0 OFIAOIIBN RICTALL RAPAIR PROPOSED USE Q -. sFR [l WWI I] OTHER 1 I Type OP OONSIAUOT*DN MI MACH p FRAME 0 STEEL ED OTHER J DP,soFNwnoei of woRf( Ti.111.4f" � OE 146%% 4 F pcA cam.( Alo Pr PUMP y ry BUILDING SIZE SO FOOTAGE 'I Flo mew eJ I • NoRo o 1. ,n - � bq 1 VALUATION OF TOTAL CONSTRUCTION GC ELFATRIOAL 13 V I AMP SERVICE Q OGRE SENERGY Q W.R.E.C. PLUMBING IS I 1 .F `J ) °3 - � ' k� i��" 1 MECNANICAI. IS I VALUATION OF MECHANICAL INSTALLATION ` t'l r 'p + [ T 1 C1 GAS 1=1 ROOFING Ej SPECIALTY Q OTHER `'�. g ,^ • FINISHED FLOOR ELEVATION& I I FLOOD ZONE AREA [DYES 1] w K« BUILDER OOMPANY [ `� � S4l r r a 1"—T 8.4.144 4 Vf:� 1 SIGNATURE 44aP"' 9 Q.) .----r--'..--'''' Rl rums r all J e E cw rr 1 (i t'1 e .+,* 0 le.1.0 WS 0•41/44 ► V.ra`l -- q° e,.se 1 1.31 I () •r / ELEGTRICVIN COMPANY 1 1 � SI newer= I YJ N '1 tee cummur 1 YIN 1 • ddrera 1. 1 -Wenn If r " 1 PLUMe6R COMPANY " [ NINANATtIRE eausveRPN I W It I Meoleneur r Yr N J SiGIVATU ..� t COMPANY iRef /' /Rl7/"M vil.rl� 1 P 1e . p , neotIEt® Y I N MI W RSIR 1 YIN I G; rutting rf� ..N� 1L•. :. _..� Licensed 1 c/7co �• 6-1 U' OTHER COMPANY OIbNATURE ReereYaeeo WHIM reeWMR[Nr ' jJ Add C --1 License! 1 - -4 — ' REEIDEiTIAL Aged, (2) Plot mono; a) eels or &Mho Pans; (I) eat of strew 1143Penult ew Penn •o-W Pe lot new eendfYdbn, MInPwn ten (10)workIngdsyeeller submittal deft. Required Nuke, Cowsbucaee Slerm eter IIed. • can tery Faollidw 61 dwap.Iar: sea Work Peet* tor aubehAe onoM,Qe pr*Jeds COMMERCIAL Mach (9) complete seu of enAlding Pans plus e Ufe 804 Pape: (1) eetof Energy Forme. ROW Permit for new construction. • "newton ten( 1t7) wer4no days atbrsubmit:sideb. Rortuirodonete. ConetactbnPla na. BlemraltorPkin .t.4411FenceWebbed, • Sanitary Fadtmee & 1 duhpibr. She Work Peewit nor eN new projsds. AN commercial ro must meet colleens WON PERMrr Attach (3)46b of Engkreerod Plane. — "PROPERT7' SURVEY requtnd for al NEN construction. • motions: . FIN oat eppkeallon owlet*. Omer &Co Ua oragnbackofapu en.eofsdated • If ow,$2100 a Notice of commencement Is required. (AID upgrades veer&GOea) • "' Agent for the nenUedeD or Pow.r of Attorney (nor the owner) mold be someone YAM notsrced letter horn owner euttarise.g awns OVtEt. THE OOUNIRR PSRMrrItdo (Front of Applestbn OnM Retool. Sawn S,.MCe Uperedu NC Fences (PIoUSurveylFooiese) DrlvewoyeNotowr Counter It on puWk roadweys..needo ROW - . 1 TRANSACTION REPORT P. /ol APR /23/2009/THU 08:41 AM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE /NOTE FILE 01 APR /23 08:40AM 817273442151 0:00:42 1 OK ECM 0438 ' VOL EMU, 813-7eo -0e2o City of Zephyrhllls Permit Application # f Fax•e 7110-0021 13,7tb'co z- I Building Department '�f" Date Received - hon ( U Pe Contact for Pernitlnn • • Q y1 f la _ /rig, Owners Name 2 EP a e *- ck. LI. C. Owner Phone Number —.c( -- so _ 6) Owners Address I r-1-1;01 Ar 1 •i •S (. -C fsry�1� "� r .� t ( Owner Phone Number I � • I L Pee Simple Titleholder Namel 4, �, I Owner Phone Number I I Fee Simple Titleholder Address 1 am., I JOB ADDRESS ( 6 (Au . (3L4J j 1:;4 I LOTM 1 I SUBDIVISION I 1 PARCELIDIII c }"QrLp*'eQ% -t�I�4414(g-41614 (OBTAINED FROM PROPERTY TAIL NOTICE) WORK PROPOSED (gI NEW CONBTR R ADD/ALT [] SIGN n Q MOVE DEMOLISH n INSTALL REPAIR PROPOSED USE Q. SFR [N] COMM Q OTHER ' + TYPE OF CONSTRUCTION CV BLOCK �F [J STEEL Q OTHER 1 DESCRIPTION OF WORK r Z J - Y v- ME ✓ j 4 .0\k '. F CI�P („I,,� /1/14.1 /� y� BUILDIN tea G SIZE , 4 . SG FOOTAGE 1 `"Ip_ HEIGHT 1 rJ l IO , t 1 • vci hUILoING (S 2 q 10a I VALUATION OF TOTAL CONSTRUCTION IX] ELECTRICAL IS I AMP SERVICE Q PROGRESS ENERGY [D W.R.E.C_ I PLUMBING Is 1 eD 3 S p it ✓ © MECHANICAL (S I VALUATION OP MECHANICAL INSTALLATION �'I r " , t LT 1 I CAS n ROOFING n SPECIALTY D OTHER �O r PINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA AYES ON s k-b BUILDER COMPANY ( PjGyy, j :47. G I SIGNATURE 1:?S-44a0.3-9(bs--d----------- �, "/ �RE016TER� I / N 1 �. I �' FEE CU eIrt I Y/N Address CI Ie9 (3 4 %( 1 .t 1— },,K,tces C ,FV.3(iAt es I ear., al y0 1 � ELECTRICIAN 1 `LECTR)CIAN COMPANY ( I ,I; SIGNATUR REGISTERED 1 Y/ N j FEECURRENr I YIN J dd es r 1 1 I 1 -Liwnse 0 J • 1 SI ON A TU LUMBER COMPANY I _ RE019TERE) I Y/ N 1 FEE CURRENT I Y/N I & Address I I ' Licence* 1 I d ECHANICA1 COMPANY 1 I PIS REOIOTER EO I Y/ N 1 FEE CURRENT I YIN I SIG NATU 68 — s r 1 Ueenee d OTHER COMPANY I I SIONATURE REGISTERED (, V/ N 1 FEE CURRENT l Y/ N I Address I 1 License it 1 I RESIDENTIAL ARadl (2) Plot Plana: (2) eete of Building Plane: (1) eat of Energy Form; R-OW Permit for now oanahuceen, Minimum ten (10) working days alter submittal dale. Required onelte Construction Plans, SbmNralar Plana wf Silt Fence Installed. Sanday Facilities 81 dumpier; Site Wort( Permkforsubdivielons/large projecta COMMERCIAL Mach (3) compete sets of Building Plans plus a UN Safety Page; (1) set of Energy Fonne. R-O-W Permit for new construction. Minimum ten (10) working days alter submittal date. Required omits. Conebudlon Plans, Stomnweter Plane wl silt Pence mantled, Sanitary Facilities 61 dunpeter. site Work Pernik for e1 new proJects. All oommerdal requirements must meat compenee SIGN PERMIT Mach (2) Bete el Engineered Plane. "'•PROPERTY SURVEY required for ell NEW censvuctlon. Directions: - I. FM out epplicedon completely. Owner & Conked= elgn bad( of applt atbn, notalfzed , 04/23/2010 08:14 727 - 344 -2151 PASADENA PLUMBING PAGE 01/01 • AFR/ 23/2009/ HU 08:41 AM ZEPHYRHILLS BUILDING FAX No. 813 - 730 - 002.1 P.001/001 • 'N' ' e.ar • ., 213- 760.0020 City of Zephyrhlg Permit Application awe 780402 1 / ?9".od y.1 EaNdaaI Dnpacimant • DI"R.calyd 4- -. t o Moan a •. . Ctlil Q - X't3 cc^^ G ain ... Ownet'e Name '2 EPl . tl�C ( <L L 11614 .n���rV1 A`,r � , � txPhoneNumbar � \� o Aeernea I ,.1 '�/0 , ^y ti'( S1 i -�ZL.0 �S 7 Pee Simple T A FL' Onner Ohms Number 1 • I • lthdlolder Name " owner Phone Number I I . Fos Mamie TRNhoklaAddress I SANTA. J JOD ADDRESS I t C U- au.o i l OS 1 IOTM ,,,,//,� f I susomSIQN t ` • . 1 PAII.CB"IDMI t'�c4— ft — di9 0 ""V'ta+'ISP' 6- 4A pnMlNRe MOPE PROPERTY bat amigo WORKPROPosto (�I N6WCONBTR E ADI ALT [J SIGN Q MOVE Q DEMOLISH o INST/U.L REIrA1R 'PROPOSED•U6E . SFR cm cool c i OTHER I TYPE OP CONa1RUCTloN BLOCK © PRIM = STEE(. U OTHER ` 1 • D 4CRlPn lc Sr oN OP WORK A+.xS: Cc O/ 144M, � F FcAppfrhA uk.4 g fW' ....) gU1L DING EITP Art FOOTAGE `Fb MIGHT 1 G 16' !t 1 _ bUILDINO - r , y a,Q 1 VAWATION OF TOTAL CONSTRUCTION • ELICTRICA4 Is . � o I AMPG!JWICE 1=1 PROORES96N6R6Y p wrtaa `Ig] KIMONO t� i • C7 3 se., P1 `i • Q MPANANIDAL is I VALUAT ON OP MROHANIQAL INSTALIATION � . J r' r t �� GAS ROOFING r"i NpRo(ALTY Q OTHER N� PINISHt1D FLOOR ELEVATIONe 1 I PLC OD ZONE AREA LJYES 1:171N 3 kt"'b BUILDER �I . � CQM PM �ia ' lr r 5F 4,.......,,„.„0 • • • SIGNATURE f..rCl� `/ ELECTRICIAN MIIIIIIIIIIIMIIIIIII COMPANY I • I A+' gwNA Itl) I5Tllle0 J Y/ • 1 Ft cunnpNT 1 YI N J dd a : �...�.� = . 'Uanm r I � ,N/Y ,did' A �I� COMPANY 1 PAISA-7 1 YIN i F66 P L • KVA6 4 4 Ci ..14 '" P i R�laral� motor i YIN • .& *dame 1 _ ' 're 5 1 . D v laconic. leon e g ' I C FC_ D l $ Z.) • PA S �'' �' SGNA�c REGISTERED R r I aaAeTg!® Y/ M i nedeuRpdNf I Y IN 1 �1V 1 .� Weasel, 1 I • • oTHER I I OOMPANY I I SIGMATuNs I Metro ( Y/ K 1 RECURRENT i YIN . 1 Address Metro al: I . RESIDENTIAL AUedt Plat Pmnn; eels 0/ 8 MlnMtum tun f�J 1 MdM+0 Para: h) net m 000 11Y Ram; I�tYW Parmlt for_ new oonslnletlal, (1O) wolId op slier etehm Mi ante. Requaed peke. COneavolen PIMm, OlemltlaNr Plane Vg SIR Fence Mailed. • COMMsRgAI Sanitary Papillate 41 demp Sae WW1( Petra* eutdMdaleier0e project Mlnk (2 M6 a of fin; Mee o Lb Sat* page: (1) ea) at Enemy Rime. ROW Permit for new coretrudkn. . SNOWY w tneri• day: eller.ubmlad dote. Rapine) mob, Cotlatrutgon Plehe, Sbnravebw MOM WEIR Fenn flwla0.d, SIGN mom eetn 6 ole es Plat Work Pernik for all nsw p►ejMe. /1N oorrerwlRal roggl tlb must meet oongNtneo ""PROPERTYSURVLIY required for a1 NEW censeudl on. MU But app1atlon completeN. Ow^s(A ConRacter moo e.* of a ppllohon, ootnrrana • If over $2000. a Nellca 0 Commencement ar acquired. (A/C upgradse over *0000) Anent (ter the weeder) or Power el Mammy for the water) soul! be et mane 0111 nommen tenor torn owner au1hodzIng mane OVER T COMYTER PERMITTING (Frani01AppllcallonOW R.roola Sees Senrlop Upgladea NO Paror (wwawaymossa Driveways-Not over Manor Mon pub4o readaayt,.npads ROW RPR- 22- 2010(THU) 10:55 Tri- County Electric, Inc. (FRX)7277917396 P.001 /004 TRI COUNTY ELECTRIC, INC. STATE CERTIFIED ELECTRICAL CONTRACTORS•EC0001256 .27837 US Highway 19 North, Unit D•Clearwater, FL 33781 TELEPHONE 727.723.3400•FAX 727:791.7396 Fax .Cover Sheet DATE: APRIL 22, 2010 COMPANY: 7RI- COUNTY ELECTRIC INC. FAX: 813.780.0021 ;pan. BOBBIE PHONE: 813 - 780 -0020 FROM: ' TOULA ADDITIONAL INFORMATION Bobble, Attached please find a copy of our State Certified License, Certificate of Insurance and a copy of our business tax receipt. If you have any questions, you can email me at dvcolannlnoegmall.com or 1 can be reached at the office phone number noted above. If possible, can you send me a quick email or phone call letting me know when we have been set up and registered. Thank you, Z 7- 9.- 0 3 Toula Colannino ego pljcse, 7. 7 _ 5 •boq 3 P kea , e kw-e Co\ Lci pek-rn aye( x Pock. Le-s . _ t+- tocA.vv-fir � c -cf, 6 , al? Number of pages Including cover sheet: 4 TRANSACTION REPORT P.oi /oi APR /23/2009/THU 08:39 AM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE /NOTE FILE 01 APR /23 08:38AM 817275479754 0:00:23 1 OK SG3 0437 —n 1.V..r Q 7Kl.fr:- �. 813.7600020 City of Zephyrhllls Permit Application it Fax-81 - 780.0021 / 13,180,03 Building Department Date Received 4— 7 _ ( 0 Phone Contact for P.armttttn • + 4 (41 444° - 41114 Ownet's Name 4 2 iP) . �- LL C. Owner Phone Number , r)-ti�Q — ..__..._61 Owners Address ( Pi4 `i .S- i, SV 11" J �� t F(' Owner Phone Number I I Fee Simple Titleholder NemerSPS ^f.,, I Omer Phone Number 1 1 Fee Simple Titleholder Address I -S7rN . 1 JOB ADDRESS 1 (L4 ()AU.. RUC/ , QS �/ " ] LOT I � 0 [ / SUBDIVISION i 1 PARCELID# t -1.' a1 � 1� 151 0,eMM20 FROM PROPERTY TM NOTICE) WORK PROPOSED En NEW CONBTR I ADD/ALT 1=1 810N 1] MOVE [J DEMOLISH INSTALL REPAIR PROPOSED USE El SFR cin comm J OTHER L 1 TYPE OP CONSTRUCTION 11.1 W T BBLLOCC�K= I t FRAME [] STEEL p OTHER 1 t � , I DESOR X IPTION OF WORK J V W7 +1 a 01 14 , o`1 S F l`-' `i^'►T1' '`I j 3 0 f �► p •�fla '+ BUILDING SIZE q �� Sell FOOTAGE 1 40 HEIGHT I i 6011 V • 1;g3 BUILDING ri SS �q 1 ( VALUATION OF TOTAL CONSTRUCTION CM ELECTRICAL IS ' O I AMP SERVICE I1 PROGRESS ENERGY I=1 W R.E.C. PLUMBING (S I 3 P elA Q MECHANICAL IS I VALUATION OF MECHANICAL INSTALLATION (D' q Cti _ 4 ` zit:I- e D GAS =I ROOFING 1=1 SPECIALTY Q OTHER NO C FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA rlYEB ON S BUILDER COMPANY I �5 J-T1 1 t✓ I SIGNATURE `�9��� ResteTERE0 1 Y/ N 1 PEE CURRENT I, Y1 N' I ••MSS • 0 Ids (VS 4&ES W a:1'9 f Pt..31/ ees I GCrci nya I 11 ." ELECTRICIAN COMPANY I I / SIGNATU• REGISre.eo 1 Y/ N 1 rift summit 1 Y/N 1 ddress 1 ] •Ucense 0 I I PLUMBER COMPANY 1 I SIGNATURE _ REmsretEo 1_ Y I N J FEECURRENY I VIN 1 Address 1 j License S 1 I 11III ` ICA COMPANY I 1 REGISTERED 1_ YIN .1 PEE CURRENT 1 Y/ N 1 Cr i � Address I 1 License 1 I 1 U OTER COMPANY SIGNATURE REEIerEReo 1 1 Y/ N J PEE CURRENT 1 Yl N I I Address I I License! 1 1 RESIDENTIAL Attach (2) Plot Plans: (2) eete of Bulking Plenz; (1) set of Energy Forms; R.O-W Pernik for new combustion, Minimum ten (10) working days after submittal date, Requited condo, Conskusrbn Plana, Stormeater Plane wl 81k Fence Initialled. Sanitary Facilities & 1 dumpeter, Site Work Permit for eusdMebns/large projede COMMERCIAL Attach (3) complete sets of Building Plena plus e Life Safely Page: (1) it of Energy Forme. R-O-W Permit for new construction. Minimum ten (10) woddna days after submittal date, Required aneke, Construction Plane. Sternswter Plans w/ Sts Fence Installed, Sanitary Paddled & 1 dumpster, Site Work Permit for all new projects. All conxnardal requirements must meet compliance SIGN PERMIT Attach (7)•sets of Engineered Plane, °PROPERTYSURVEY requited for all NEW construction. Directions: pin out sppaeaeon completely. owner & Cenaadw Sion back of application. noterbed RPR- 22- 2010(THU) 10:55 Tri- County Electric, Inc. (FRX)7277917396 P. 002 /004 < -bk F" STATE OF FLORIDA i '. � ,v r,� .w DEPARTMENT OP BUSINESS AND PROFESSIONAL REGULATION t, " '' ' '' I - ELECTRICAL CONTRACTORS LICENSING BOARD V„.- ; 17 1940 NORTH MONROE..STREET (850) 467 -1395 .'�'� TALLAHASSEE FL 32399 -0783 COLANNINO ROBERT W TRI-- COUNTf ELECTRIC INC. 267 WHISPER LAKE ROAD .PALM HARBOR FL 34683 I . ..' ''' ate of F4gaOA AC# x 8 3 3 5 0 7 Congratuladonsl With this license you become one of the nearly one million '..27: ; , r'' . D p v :; ,:,, Floridians licensed by the Department of Business and Professional Regulation rt >�tr - BEJt3x'St: Our professionals and businesses range from architects to yacht brokers, from '; - : ?> 'AO NASL II3tT16», boxers to barbeque restaurants, and they keep Florida's economy strong. 16e2ii1 ` ' ! �� : ' � % ' . ' ''� OOOtt*'6 06/30/08 418176416P Every day we work to Improve the way we do business In order to serve you better. For information about our services, please log onto www.myflorldellcenae.com, C - xF •SD ELECTRICAL CONTRACTOR gR : There you can find more Information about our divisions and the regulations thel • fir ; = .. - �� 'NO, ROBERT _ • =? ,." impact you, subscribe to department newsletters and learn . more about the s �:- a _ -ra Z IC 1p ` `t a f; �' ` : Department's initiatives. 41,,0#4;:'c' _. Y , YN 4; r. Department Is: License Efficiently; = : ' . ; Our mission at the De pa ntly', Regulate Fairly. We - ' "�' � ... , -,. constantly strive toserve you better so that you can serve your customers. itt eennap fx p. p Thank you for doing business In Florida, end congratulations on your new license! �. ynA.- asevssion. oe..►.499 „�s DETACH HERE : :: :te �,,�' r .. -1.7:• . • STA ' �QF�.FLO,RIDA' . i; , *.'`1+ :'•n. � . eA. • � , f� -. ; /1' ` io a. " , t, , . ti. '` .% ��4f ; 1 . ,, , ? : D.,t.,iA 1 3 4 I' �,.es .4- . •,,. .,_ , ' ., _ , . .• { J..:: ' f t - �. ` �r L " :°. 1C _.• ' ,, , D gg �bN f• • EA 31TION - ' 1 . , - T G� T 1 . E IN X ' r: b#roes ngTe F3nTC► NUMBER I+'TCE ': r ',Del 11,: ,'J = ' :7.004, ”, i -, - +CQ Retr x : K : : "r; »•:'.' 1 ,. r rY.ye�� -!IF µ i Is?, - 1 t y 4, ' LUnnder ' �. 'I ' Expiration date AUG 32 p 9 `8'9. *; :� /.a. _v 4 �`' • : fF ^ Y {: J a_�ra' y , l . 1 , ', i 'IP } ... ± : , � ( ) .Y 'FbRl::i''� : •' t' � _ .: y 'f.; •- .i - t.r. i. f he ,.j R r. t2■ ;P:t CTR' ' - i' '+C � '. r - ^ 2 A 1 I.-. _ER .+ E C 4 A PALM HARBOR FL 3 . / 683 ; ` --:7::.:11";-.::::7 : c `., : V Z- .?. r1: • i`:' .te ' A R /. ' , � � RZ''. Q' ,Jr•.. i ,k yv „ <t - ►'� 1 6 . � y < :. . i� i' _ <� : I : W IC.1 ~ n '7:::'.- :VY:f.:" ' . . - Lk, S' _ - Vi7Y ''. . -... ' "'� '' . .:' ::x..: INT1�R >!3 SECRETARX = lhie AEQUIRE64y LAW !:, r-i r -r -y , :•J C CC hl ice, i~ r 2 N u . "zJ ID � ,^,' In ''t tn. l . w p §4 . � m a ' L'''' C , I-. G0 - rJ • 96 . • C-4 • - -• .. .. .. • r � :a :t ■ ill 1 ,-C _ • P • w u . - -- C -• - `^2 '„„P , r rt U ( , y 47 ��• r•: r , 4 .. ': r•i I w% . '. 0 O E+ t. i rl- 1.+ -.7.71 k..0 C ,.•' ca 07 O •, l''''.. i 01 .,,,, c�7 T7 , ' .r• r,, ," r,.....:, �� C;) ^. 'V tr.) '•,'v ry t tt) `. N C") I '4: 0 �� ;. r , � �i .. >-' no si ti , :? , 0 ha i i r•. r ‘C.- "Y MI „„ '' ' r'I'' Fili w. • n17 I , . a • 1. 1,.1.' , �( r �6 . , ;,7f, 1 ;,r , ' h i ° 1. i c:i •'l1, r i ' /My h '. . • CO + '- . • POO /U00 'd 96E11 62./2/0(8J) . Dui 'Jt.14jat3 .uno3 —ta j SS :01 (f1Hl)0102 -22 -21d8 RPR- 22- 2010(THU) 10:55 Tri- County Electric, Inc. (FRX)7277917396 P. 003/004 ACOBP,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO'WYY) PROOU 04/22/2010 81 3)63 7 - 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 4915 W. Cypress Street ALTER THE OCERTIFICATE A FORDED BY THE ES BELOW, Tampa, FL 13607 Sherry Barrett INSURERS AFFORDING COVERAGE NAIC e INSURED Tri- County Electric, .Inc. minim A: FCC( Insurance Co. 10175 .27837 US Hwy 19 North INSURER B: FOCI .Insurance Group Unit NMD NBURERc; Clearwater, FL 33761 INSURER D: INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH �POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. t P M I TYPE OF INSUMNCE PolICY NUMBER 4 1 RYNI ZAI PdJCY lYNp`TIp,1N Lams GENERAL LIABILITY GL 0009973 .1 03/01/2010 03/01/2011 EACH OCCURRENCE $ X ` COMMERCIAL GENERAL LIABIU $ 100 rY DAMAGE TO RENTED 1,000.0X- 00 ■ 1 © OC CUR Ge O EX? (My w PIla , 00 CLAIMS MADE MED EX? (MT one pawn) 1 A 5.00 PERSONAL $ ADV INJURY 1 1 1 000,00'. ■.1 GENERAL AGGREGATE $ 2,000 , 0K GEN'L AGGREGATE LIMIT APPUEA PER: PRODUCTS - COMPAW *00 I POLICY 1 1 jg l l LOC 2,000,00 AUTOMOBILE Wintry MB LIMIT g ANY AUTO (Es —1 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per perwn) _ —, HIRED AUTOS NON-OWNED AUTOS ( I NI QY ddent INJURY ' I PROPERTY DAMAGE $ (Per eaoltlonU GARAGELABILRY R ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC 1 AUTO ONLY; AGO $ OIC!BBA)MBRELLA Liman OCCUR El CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE 5 $ RETENTION g $ WORKERS CONFIRMATION 001 -WCO9A -6146 ENB 03/01/2010 03/01/2011 X � g EMPLOYIRB• UNIILITY TWtnCV i Awirt9 Mt B OFFICERR/MEMBER EXCLUDEE ECUTNE E.L. EACH ACCIDENT 1 100,000 11yywa desaloe oneor EL. DISEASE • EA EMPLOYEE $ 100,000 SPECIAL PROV ISION S WOW OTHER EL DISEASE • POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPEpAL PROVISIONS CERTIFICATE H DER CANCELLATION + AI SHOULD ANY OF THE ABOVE oescRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTMICATE NOLAR NAMED TO TN! LEFT, Ci ty of Zephyrh ills BUT FAILURE TO MAR, OUCH NOTIC! SHALL IMPOSE NO OBLK#ATION OR LIABILITY 5335 8th Street OF ANY KNo UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhi l l s, FL 33 542 AUTHORD`ED RIPREOENTATNE .., / Don Leggett/BARRES 2 `` e c ;,e, '`r,+� ACORD 25 (2001/08) FAX: (813) 780 -0021 ACORD CORPORATION 1966 TRANSACTION REPORT P.01/01 APR /22/2009/WED 02:49 PM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE /NOTE FILE 01 APR /22 02:49PM 817277917396 0:00:42 2 OK SG3 0432 RPR= 22.2010('THU) 10:55 771-County :E :1ectric. Inc. ('FRX)727791 P. 001/004 "TRI -4C UNTY ELE IC.:NC. .STATE CERTIFIED. ELECTRICALCONTRACTOR808C0001286 :27837. US North, Unit O•Clearwater, FL:33761 7EL'EP,HONE 727 .7.23 :3400:FAx727 :7917396 • Fax Cover Shee • :DATE: ,APRIL22, :2010 • • :COMPANY: TRI :COUNTY.ELECTRIC INC. PAX: :813 :780.0021 .gt1'M;" BOBBIE 'PHONE: :813= 780 -0020 r •: 7TOULA • ADDITIONALINFORMATION Bobble, • Attached please find .0 copy of our State Certified License, Certificate of Insurance and a •copy of our :business tax receipt. If you have any questions, you.can email me at dvcolanninoeigmaf.com or.I.can be reached at the office . phone number noted above. • If possible, can.you send me a quick email or,phona:call letting me know when we have been eet up and registered. • Thankyou, • Tonle Colannlno e¢QQ 0,001 7C1-2c PO Ck- Le je Number of pages Including cover sheet: 4 • . � c; { < ' : N o• 7427 ;:P, ^ ~" Apr, 21. 2010 3:50PM BLUELINE MECHANICAL •1 ::. ' ..�:- 5;: L Lt �Iyl� r r( ��� ii' fi b '- - `t�,:�� � Cl gin m Z/�y r,: `,, 'r `� - ' °� . pr' �r ,. ' :t'Htn r's:G1N:HU;.0' m ;P ti . �l F ± - I 1�` • -• a7 }'rte .t- � '. f � s :' h7.:7- 1: 5 ' 4 . y � 3 ' • : ' .n4.; . .: _ �` :: : ;r_. ,..� :: :.. mss, , zi. "�A;<1 _, gyp.. F. � _ _ _ Ift,. ! y` � � `/.�n `s i y /� _ a t.;-7 . : .,M- l��. i t - Ft, -.“ - ,': ..-••••, . -m- �4 mss : - . , ,the ui`�' iA � -. Y • 4 h;r . i CO ': u` , •.,...“1 r y a , W • • • r • Apr. 21. 2010 3:50PM BLUELINE MECHANICAL No. 7427 P. 2 Blueltne Me Phone: 727 - 540 -0255 BI_M 461'1 107th Ci rcle cha North ical LLC Fax: 727-540-0244 Clearwater, FL 33762 www.bluelinemechanical.com Power of Attorney State of Florida County of Pinellas I, James Boeggeman, of Pinellas County, Florida doth constitute and appoint . Mren t_. t i.Qro of Ntirrki Florida my true and lawful attorney, and in my name to sign all documents needed for permits, change, waiver or otherwise for the municipality of : ( of 2ephtshi Its . Executed this a1 _ day of April , 2010. �aL L... / LANNA.I'fr�: J f es Boeggem / Qualifier Subscribed and swom to me this al day of Ap rr, ■ 2010. /,.`f-� /. , U`�..__ Notary Public ? x . 1,4 r` .0., ti M Commission Expires: ( . 2 A 3 // ..3 t'e* Ap r. 21. 2010 3 :5QP BLUELJ E MECHANICAL No. 7427 P. 3 • • / / / / /i± §� Ga >m C o> e = a X2 2 ® ¥ Q E -q _ � k k > § § � 4 Z / o $ ¢ zs «E_ a 17 e £ 2 F • c r — k o S. ) k /k \ 2 >n §2 2» /\ o > - � f• - z \i z ` �d (( §o ( F . z • E 7 • • c . \ Apr. 21. 2010 3:50PM BLUELINE MECHANICAL No. 7427 P. 7 CERTIFICATE OF LIABILITY INSURANCE OP ID DI " DA1t ( ) BLUEPL -2 04/19/10 I RMO= THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bouchard - Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR P 0 Box 6090 ALTER THE COVERAGE AFFORDED DY THE POUCIES BELOW. Clearwater FL 33758 -6090 Phone:727- 447 -6481 Sax:727 -449 -1267 INSURERS AFFORDING COVERAGE NAM 0 INSURED INSURER A: FOCI Insurance Co 10178 INSURER B: rocs co sercIAl Insurance co 33472 A n e la Pauaxo LLC INSURER C: soldeonoia I MPleq.sa za ce 10701 Mrs r6 . Angela 4611 107th Circle INSURERD Clearwater 21 33762 , I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIE INSURED TAMED ABOVE FOR THE POLICY PERIOD INDICATED, ?CVM1 STANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR °TIER DOCUMENT WITH RESPECT TO WH10 4 THIS CERTIFICATE MAY EE ISSUED OR MAY PERTAIN, 11-E INSURANCE APPORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. LTR 44 9 TYPE OFINSURANCE POLICY NUMBER DA (MAIDD/YYTYI DATE 1 I I .' 4 • "`" WITS GENERAL LIABILITY EACH OCCURRENCE s 1, 00 0 , 000 A COMMERCIAL GENERAL LwaILITY CPP00012908 05/19/09 05/19/10 PI` t MlsEs(" E "'occu.ncAL s 300,000 1 CLAIMS MADE © OCCUR MED EXP (Any one person) 65,000 CONTRACTUAL LIAR yo pax Sue reeks WRAY PERSONAL 6 ADV INJURY S 1, 000 , 000 — ©Xc GENERAL AGGREGATE 02,000,000 OEM_ AGGREGATE LIMIT APPLIES PER: PRODUCES - COtiPfoR A ✓GG t 2,000,000 POLICY la l JECT f] (sic • AUTOMOBILE LWBLRY COMBMED SMIGLE LIMIT B ©ANYAUro CA00014577 05/19/09 05/19/10 (Eeeca°e110 x1, 000,000 ■ ALL OWNED AUTOS 30 NAY CAIC 11911131 MOW BODILY INJURY SCHEDULED Auros (kr person) _ III HIRED AUTOS BODILY INJURY 6 NON.O•AMED AUTOS (Per occident) III PROPERTY DAMAGE 6 _ (Per occident) DARAOE UABILm AUTO ONLY - EA ACCIDENT $ ■ ANY AUTO Eh ACC S OTHER THAN AUTO ONLY: AOG 6 EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE 62,000,000 A © occuR 0 CLAIMS LIMB00007677 05/19/09 05/19/10 AGGREGATE 6 2,000,000 _ 10 DAY _ $ CANC NOTICE_ ■ DEDUCTIBLE FOR 1 NON -PAY X RErErmoN 610,000 s w. -. - COMPENSATE:* VVL 5IAIU UII+ AND EMPLOYERS' LIAYLITY ` x TORY LIMITS 1 F32 Y/N C ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH x 500 , 019606105 07/21/09 07/21/10 000 OFFICER MEMBER EXCLUDED? (ManatoryIRWI IF Sax CAM I T= NORM E.L. DISEASE - EA EMPLOYEE S 500.000 If yes. °eecnbe under SPECIAL PROVISIONS below E,L. DISEASE- POLICY LIMIT 6 500 , 000 OTTER DESORPTION OF OPERATIONS / LOCATIONS) VEHICLES / EXCLUSIONS ADDED eY EN CORSOM./dt / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF The ABOVE DESCRIBED POLICES Be CANCELLED BEFORETNE EXPIRATION CITYZEP DATE THIEREOP, THE ISSUING INSURER BILL ENDEAVOR TO MAL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TIE LEFT, BUT FALUNE TO DO SO SHALL CITY or ZEPKYRXILLS IMPOSE NO OBLIGAT1ON OR LIABILITY OF ANY MIND UPON THE INSURER, ITS AGENTS OR BUILDING DEPARTMENT 5335 8Th STREET REPRESENTATIVES. ZEPHYRh2LLS IrL 33592 Ammonium ATIVE t ACORD 25 (2009/07) . A 1988 -2009 ACORD CORPORATION. AN ABMs reserved. The ACORD flame and logo are registered marks of ACORD Apr. 21. 2010 3:50PM BLUELINE MECHANICAL No. 7427 P. 8 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), 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 lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) Apr. 21. 2010 3:50PM BLUELINE MECHANICAL Nu, 7427 P. 4 CITY OF PINELLAS PARK, FLORIDA P.O. IM 1100 PINELLAS PARK e F LO a I n 37.0-110C r1 B U S I N E S S T A X = E C, E i P 1 - - - mot, •_ STATE LICENSE Oz TO:;;. NUMBER. OTHER LICENSE * CAC0189 :f 10- 04 .si 78 I-- CACO1SS'66 BUSINESS NAME, OWNERS NAi`4E_ EUS1Nt SS LOCAL ADDRESS AND MAILING ADDRESS BLUELINE MECHANICAL LLC PANARO OWNER/MGR STEVE 4611 107TH CIR STEVE PANARO OWNER /MANAGER 4611 107TH CIR CLEARWATER FL 73762-S006 CLEARWATER PL =3'762 _. THE ABOVE NAMED PERSON, FIRM OR CORPORATION HAS PAID A BUSINESS TA ?: TO ENGAGE IN THE FOLLOWING BUSINESS A C T I V I T I E S ; CODE DESCRIPTION 1711/ HEATING AND AIR CONDITIONING CONTRACTOR HVAC INSTALLATION IN NEW CONSTRUCTION APARTMENTS L NITS AMOUNT BUSINESS TA).. AMOUNT 120.00 FOR PERIOD ENDING: p omb r 30, 2010 BALANCE DUE .00 - - - -- - -_ -- -- = -- - - - -- ._ -- -_. TH i S RECEIPT DOES NOT PERMIT THE HOLDER TO OPERATE IN VIOLATION OF ANY CITY LAW OR ORDINANCE AND IS NOT AN ENDORSEMENT OF COMPE T ANCE OR BUSINESS PRACTICE. ANY CHANGE IN LOCATION OR OWNERSHIP MUST BE APPROVED BY THE CITY, SUBJECT TO 'ZONING RESTRICTIONS. • Apr. 21. 2010 3:50PM BLUELINE MECHANICAL No. 7427 P. 6 4. • • • • • •••.... • • •. • •. . • - .. • • •.. ..• . • • • . ..-• • •••• • • , • •• • • • . _ • • • i/Jitettied Jacqueline:Bo9es 7 Z2' /2 (ll From: Jeffery Faulkner [JefferyF @mailmt.com] ` Sent: Thursday, April 22, 2010 10:14 AM To: Jacqueline Boges Cc: pasadenaplumbing @verizon.net; Robbie @ Tri County; Tim Heffilemire; Lary Morris Subject: Hope Pharmacy 6834 Gall Blvd. #105 Jackie, Here is my em . I also have the recorded NOC I will Ix' g with me when I pick up the permit. Our subs will be: Airco Mechanical 727 - 547 -9700 attn Angela i/ 0' Tri County Electric - N at -rt,tA ( 727 - 638 -2835 attn Robbie Pasadena Plumbing 727 - 381 -7969 attn Mike u G i Associated Fire Sprinkler 813- 927 -3088 attn Lary — n 0-1 5 c Thank you for your assistance. Let me know if you need any added information. Best, Jeffery B. Faulkner Design It, Build It, Inc. (DIBI) 26030 63rd Avenue East Myakka City, Florida (o) 941 - 322 -0842 (f) 941 - 322 -6170 (m) 941 - 725 -1562 1 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10389 BUILDING PERMIT Permit Number: 10389 Address: 6834 GALL BLVD STE 105 Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD /ALT COMMERCIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02- 26 -21- 0010 - 02400 -0010 Improv. Cost: 58,469.00 '--- Date Issued: Name: . ZEPHYR PLACE LLC Total Fees: 6,311.92 Address: 2220 34TH ST S Amount Paid: ST PETERSBURG FL 33711 Date Paid: Phone: (727)504 -0256 Work Desc: INTERIOR BUILDOUT 1,403 SQ FT PHARMACY TRY-i . a -- ate: 't's ' 7;7;7'77 3 E� " • B ILDIN 383.52 T --7 •�N •N • i`- 507.61 ELECTRICAL FEE 84.60 WATER CONNECTION COMMERC 161.88 PLUMBING FEE 56.40 TRAFFIC IMPACT FEES 99% COM 4,929.46 MECHANICAL FEE 39.48 TRAFFIC IMPACT FEE 1% 49.79 FIRE PLAN REVIEW FEES 84.18 FIRE INSPECTION FEES 15.00 •• - 2N. - .0 H - LU B M I U , • LI FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE -SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." 1 /1 CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 6834 GALL BLVD STE #105- 1403 SQ FT - PHARMACY - PERMIT # 10389 SQ. FEET PRICE MAIN OR LIVING: 1,403 $ 52.49 $104.99 - $52.50 OTHER AREA UNDER ROOF: - $ 91.00 OTHER: - $ - VALUATION $ 73,643.47 FEE SHEET $ 376.00 ADDRESS DRIVEWAY BUILDING: $ 383.52 ELECTRICAL: $ 84.60 PLUMBING: $ 56.40 MECHANICAL: $ 39.48 SUB -TOTAL $ 564.00 RADON: N/A TOTAL $ 564.00 SEWER: $ 507.61 WATER: $ 161.88 IRRIGATION: $ - TOTAL: $ 669.49 WATER METER: (N /A IRRIGATION METER $ FIRE DEPARTMENT FEES PLANS TOTAL: $ 84.18 INSPECTION TOTAL: $ 15.00 PERMIT TOTAL TOTAL: $ 99.18 PUBLIC SAFETY IMPACT FEES PD AT SHELL POLICE FIRE 5% $ - TOTAL: $ SUB -TOTAL $ 1,332.67I PARK IMPACT FEES $ - I N/A SIPS: $ - N/A 100.0% $ - 1.0% $ - TOTAL: $ - 7I F 'S : $ 4,979.25 OPTION 25% AT PERMIT 75% DUE B4 PRE - METER/ // OR ENTIRE AMOUNT 99% $ 4,929.46 1% $ 49.79 $1,332.67+ $1,244.81 = $2,577.48 DUE AT PERMIT TOTAL: $ 6,311.92 I B4 PRE METER RELEASE $ 3,734.44 OR PAY IN FULL $6,311.92 SQ. FEET PRICE MAIN OR LIVING: 1,403 $ 52.49 $104.99 -$52.5 OTHER AREA UNDER ROOF: - $ 91.00 OTHER: - $ - VALUATION $ 73,643.47 FEE SHEET $ 376.00 ADDRESS DRIVEWAY BUILDING: $ 383.52 ELECTRICAL: $ 84.60 PLUMBING: $ 56.40 MECHANICAL: $ 39.48 SUB -TOTAL $ 564.00 RADON: TOTAL $ 564.00 SEWER: WATER: IRRIGATION: $ - TOTAL: $ - WATER METER: IRRIGATION METER $ - I FIRE DEPARTMENT FEES PLANS TOTAL: INSPECTION TOTAL: PERMIT TOTAL TOTAL: $ - PUBLIC SAFETY IMPACT ES POLICE $ 28.69 FIRE $ 245.53 5% • 71 r 1 t: $ 497.93 . SUB -TOTAL $ 1,061.93I PARK IMPACT FEES $ - SIF'S: $ - 100.0% $ - 1.0% $ - TOTAL: $ - T I F 'S : $ 4,979.25 99% $ 4,929.46 1% $ 49.79 TOTAL: $ 6,041.18I 1403 Water and Sewer Impact Fee Calculation Land Use Type: Retail No. of Square Feet 1403 Fees Within City Limits Outside City Limits Water Distribution System $ 161.88 $ 202.35 Wastewater Collection System $ 325.38 $ 406.72 Wastewater Treatment Plant Capacity $ 182.23 $ 227.79 TOTAL $ 669.48 $ 836.85 Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Bus (813) 780 -0041 Kerry Barnett Fax (813) 780 -0044 E -mail: kbarnett@tire.zephyrhills.fl.us Plan Review #: 10 -034 Project: Interior Build -out Number of Pages: 10 April 20, 2010 I have received and reviewed the plans for the interior build -out located at 6834 Gall Blvd, Suite 105 and will allow the project to move forward. Please note that this review does not eliminate any further requirements as the project continues moving forward. By receiving 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. Separate plans shall be submitted by sprinkler contractor for review to obtain a permit to complete the work. Include all details and cut sheets associated with the modification. 2. Separate plans shall be submitted for fire alarm modification by the fire alarm contractor for review and to obtain a permit to complete the work. Include all details and cut sheets associated with the modification. 3. Add emergency light in restroom. 4. No storage around electric panel. 5. Ensure meter (electric) is addressed. 6. Key required for knox box at time of final. 7. Ensure exit doors have panic hardware. 8. Ensure any penetrations in fire wall is properly sealed to maintain the fire rating. Method shall be a listed and approved method. Ensure fire wall is marked as such in accordance to the plan submitted. 9. Install certified fire extinguishers. 10. Label building with lightweight truss placard as noted on plans. 11. Ensure that the secure drug room is not acting as an air plenum for the A/C system. 12. 2 Inspections Required: 1. Firewall 2. Final 3. Fire system inspections will be noted on separate plan review. 41 i KERRY BA ; E , 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. 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.: x Plan No.: le / �l Contractor: /J'e99l2./ Levi I -1- Business Name: i. u Billing Address: _�' • 0 ®,, - Business Address: ; AM.,�, v/ d,$" G � A y�-� Business Phone No.: Billing Phone No.: Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES _ nnua N/C INSPECTION FEES _ PERMIT FEE _ FALSE ALARM FEE — Site Plan N/C _ Al _ Sprinkler $5 0 — :1 st Alarm N/C i Muni - Family /Commercial .06 sf _ 1st Re- inspection N/C _ Standpipes $50 Alarm N/C — (Minimum Charge 525.00 _ 2nd Re- inspection 5100 _ Fire Pump 550 — .3rd Alarm N/C ❑ Plan Revisions DBL _ 3rd Re- inspection 5250 _ Hoods $50 •4th Alarm $100 4th Re- Inspection $500 Fire Alarm $50 — 5th Alarm 5150 SPRINKLER SYSTEMS (Business closed until LP Gas 550 _ 6th Alarm 5200 0 - 25 Heads 550 violations corrected) _ Natural Gas $50 -- NON COMPLIANCE $150 _ 26 plus Heads 5100 SPRINKLER SYSTEMS _ Fuel Tanks- per tank $50 0 STANDPIPE SYSTEM Hydro Undergrounds $45 _ Sparlders 5100 Per Riser 550 Hydrostatic Test 565 per system _ Fire Works $500 FIRE PUMP Acceptance Test $45 per system _ Camp Fire $25 0 Per Pump 5100 Hydrant Flow $75 _ Controlled Bum $1 FIRE ALARM SYSTEM _ Hood/Duct $50[ R 0 - 25 Devices $50 FIRE ALARM SYSTEM _ Place of Assembly 5501 Annual 26 plus Devices 5100 _System Acceptance 550 _Fire Protection $25 SUPPRESSION SYSTEMS _ Recall Acceptance 550 _ Flammable Application 550 i Annual Wet $50 OTHER _ Waste Tire Storage 550, Annual Dry $50 Fire WaWSmoke Wall wall _ Generator < KW $109 CO2 550 _ LP Gas . - tank _ Generator >30 KW 150 Other 550 _ Natural Gas 525 per system — Bio-Hazard Waste 5100 Annual Ei KITCHEN EXHAUST — Fumigation Tenting 550 Hood/Ducts $50 _ Tent 105(10' or greater 515 per tent — Torch Pot/Applied $50 OTHER _ Fire Pump $45 Haz. Materials $100[ Annual R LP Installation per tank 550 _ Fire Suppression 530 Fuel Tank Installation 550 System Acceptance (Per Tank) 550 Exhaust Hood/Duct 530 Natural Gas Installation 550 _ Re - inspection DBL (Per System) (other than annual) fl Spray Booth $50 0 Inspection scheduled DBL and cancelled less than 24 hours Construction Insp. N/C ` Emergency Vehicle Ara $50 /c FALSE ALARM PLANS TOTAL k-B Fo INSPECTION TOTAL! til PERMIT TOTAL TOTALI GRAND TOTAL ' q r /' Comments: ::or V/24,0 . Pasco County Parcel: 02- 26 -21- 0010- 02400 -0010 001 Page 1 of 1 Data Current as Of: II Weekly Archive - Saturday, April 17, 2010 Parcel ID 02 26 - 21 - 0010 - 02400 -0010 (Card: 001 of 003) Classification 1 11 - Retail Stores, One Story, All Types Mailing Address Final 2009 Value ZEPHYR PLACE LLC Ag Land $0 2220 34TH ST S Land $330,889 ST PETERSBURG FL 33711 -3226 Physical Address - See All 10 addresses (First Building $598 $4 ,732 Shown) Extra Features $48,105 6830 GALL BLVD Market Value $977,726 ZEPHYRHILLS FL 33542 Assessed (Non - School Amendment Legal Description (First 4 Lines) 1) $977,726 ZEPHYRHILLS COLONY COMPANY LANDS PB 1 PG 55 & PB 2 PG 1 Taxable Value $977,726 NORTH 2/5 OF TRACT 24 LESS RD R/W SUBJECT TO UTILITY ESMT I Land Detail (Card: 001 of 003) 1 Line I) Use ()Descriptionl) Zoning I Units I Type 11 Price II Condition II Value I 1 11 1100 IISTORE 1FLRII 00C2 I) 12,000.00 II a II $7.32 I) 1.00 II $87,840 1 2 I) 1100 IISTORE 1FLRII 00C2 II 38,000.00 II II $ U 1.00 II $184,680 I I 3 II 1100 ()STORE 1FLRII 00C2 II 21,225.00 II SF II $2.75 II 1.00 I) $58,369 I I Additional Land Information I Acres JI 1.64 II Tax Area In 30ZH _II - 4MA Code II X IJCommerical CodeJ) M3012FP Building Information - Use 11 - Retail Stores (One Story) (Card: 001 of 003) Year Built 2008 Stories 1.0 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 Ceramic Clay Tile Flooring 2 None Fuel Electric Neat Forced Air - Ducted A/C Central Baths 2.0 Line I Description II Sq. Feet II Repl. Cost New I I 1 I I BAS II 2,070 II $175,536 1 2 II SPA II 1,934 11 $139,411 I Extra Features (Card: 001 of 003) Line I Description II Year H Units I Value 1 l PAV ASP II 2008 (I 32,888 1 $25,529 I 2 I PAV CON 2008 11 1,265 I $2,135 I 3 I SPRNKFP II 2008 11 4,004 ) $2 I ( 4 CLFENCE I) 2008 II 1,520 ,179 ) $2,179 I ) 5 8CBW I) 2008 II 820 $1,784 I Sales History I Previous Owner 11 SUBURBAN PROPANE L P Year II Month I Book /Page I Type Amount IN 1 2007 I 03 I) 7386 / 1496 11 I I $475,000 I I 1996 I) 3562 / 1501 II IN I I $36,100 I I 1996 II 03 II 3587 / 0403 II IN I I $312,700 I http: // appraiser. pascogov. com / search /parcel.aspx ?sec= 02 &twn= 26 &rng =21 &sbb= 0010 &b... 4/22/2010 Pasco County Property Appraiser - Physical Address List for: 02- 26 -21- 0010 - 02400 -0010 Page 1 of 1 Welcome : Records Search : Parcel Details : Physical Addresses Physical. Address List for Parcel: 02- 26 -21- 0010 - 02400 -0010 Displaying 10 records View in groups of: 10 25 50 100 500 Street Number Street Name * Unit 6830 GALL BLVD 6830 GALL BLVD 101 6830 GALL BLVD 102 6830 GALL BLVD 103 6830 GALL BLVD 104 6830 GALL BLVD 105 6834 GALL BLVD 6834 GALL BLVD 101 6834 GALL BLVD 104 6834 GALL BLVD 105 Pasco County Property Appraiser Page Layout Modified: 2/17/2009 1:10:37 PM The Local Time Is: 4/22/2010 8:33:43 AM http: // appraiser. pascogov. com /search/physadd.aspx ?parcel= 2126020010024000010 4/22/2010 s z. f-i t•1 City of Zephyrhills BUILDING PLAN REVIEW COMMENTS ' z____ ---/ " 46." Contractor/Homeowner: D 1 k Date Received: 4 7--/ d Site: / 8 A 3 +e /05 05 81dr 4- PeitType: B V I C ail C) 3 P L CCJ Approved wino comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. / —NI Kalvin Swi zer —Plan finer Date Contractor and/or Homeowner (Required when comments are present) ,. ., S , ,, DIBI DESIGN IT. BUILD IT. INC Commercial, Industrial & Diagnostic Imaging Specialists I E, ZEPHYRHILLS PHARMACY 6834 GALL BLVD, SUITE 105 ZEPHYRHILLS, FL 33542 1,404 SQ. FT. SCKETCHES DATED 2 -25 -10 SCOPE OF WORK /COST BREAKDOWN MARCH 1, 2010 • ARCHITECTURAL/ENGINEERING DESIGN $ 2,500 - Mechanical - Electrical - Plumbing - Fire Sprinkler - Life Safety Systems - For local permit (City of Zephyrhills) • GENERAL CONDITIONS $ 4.200 Local permit fee ($500 allowance ), project management/ Supervision, liability insurance, daily /final cleaning, Dust control, dumpsters. drawing/ Printing fee, minor equipment rental. • ELECTRICAL $ 7,610 - (1) feed to future exterior sign - (17) 2x4 lay -in fixtures - (1) 2x2 lay -in fixture (bathroom) - (2) new emergency light - (2) relocate exit lights - (18) new duplex receptacles - (1) GFCI receptacle on roof (A/C service) — (6) switches , 7 r - Wire A/C unit, bath in and under sink, H2O heater - Extend PVC phone conduit (1") to data /phone board - (6) %" data sleeves - Rough in for TV in sales #100 including co—ax sleeve, Receptacle, and plywood backing CCC1511055 C6CI516i14 C6C1SMOS 2603063" Avenue E. 11yakkaCOF FL 34251 AL 43528 Office: 94131Z.0842 Fat 9413226170 Mobile. 94115.1562 mil DIBI DESIGN IT. BUILD IT. INC. Commercial Industrial & Diagnostic Imaging Specialists '. " MECHM ANCIAL $10,250 (1) 4 ton roof top unit r, = — Fiberglass duct work — Registers, grills, and dampers w " — Test and balance system •. FIRE SPRINKLER $ 1,750 ‘Pi n — Piping and heads for full coverage — Shop drawings and calculations for Fire Marshall approval • PLUMBING $ 5,600 ;.' — Reroute sanitary sewer and grease trap stubs — (2) stainless steel sinks with goose —neck faucet and Wrist —blade levels — (1) HC bathroom toilet /sink a,. — (1) bi —level drinking fountain — (1) point of use H2O heater — (1) water piping and connections • CONCRETE /MASONRY $ 0 • FLOORING $ 3,950 — VCT flooring with pattern — Vinyl base through out - — Prep floor and installation — Color to be determined — Wax floors (4) coats. seal /wax • FRAME & DRYWALL/INSULATION 4 — Pharmacy wan built to deck for security - Insulate exterior wails and bathroom walls See alt, #2 for UL 1 hr. rated wall CCCI5I9055 5 8 2603063" Avenue E. #lyakka City FL 34251 1143521 011iCG94L3 ,0042 FdL941312,6110 Mob6t901562 DIBI y = DESIGN IT BUILD IT. INC Commercial, Industrial, & Diagnoslir Imaging Specialists 1 fir ' • ACOUSTICAL CEILINGS $ 1.900 — 2x4 standard grid and flat lay —in tile • DOORS, FRAMES, AND HARDWARE $ 2,200 — (3) 3070 solid wood doors and hollow metal frames - (1) bi — fold door for data closet — (2) code key door locks — (1) lever locksets: (1) privacy — (2) keyed dead bolt for Pharmacy door and secure Drug room — (1) exit bar and security bolts for rear door — (1) automatic door closer for Pharmacy door • PAINTING $ 1,950 — (1) coat primer, (2) coats finish, walls (1) color — (1) coat sealer, (2) coats poly on doors — Paint to be Sherwin Williams Harmony eggshell • TRIM CARPENTRY $ 325 — Backing for grab bars — Install doors and hardware — Plywood for telephone /data board with cabinet • SECURITY BARS $ 1.750 — Security bars for open windows at front counter and (1) for secure drug area (allowance pending design room q k CGC1514055 CCCI516214 crosmat zs 26030 63 Avenue E. Myakka City FL 34251 AL 4353 Olfice, 941322.0842 Fat 9413216170 Mobile 9417251562 DIBI DESIGN IT BUILD IT. INC CommerdaUuduslrial&Diagnostic Imaging Specialists . TOILET /SINK ACCESSORIES $ 325 - (1) 36" grab bar - (1) 42" grab bar - (1) 24" x 42" mirror - (1) ADA handicap sign - (2) paper towel holders - (1) toilet paper dispenser — installed PHONE /DATA CABLE $ 880 Furnish and install (1) category 5E data /voice drops to (1) 12 port patch panel in rear by back door for y Computers, phone, and fax • CABINETS $ 4,300 Provide cabinets and counter tops (allowance pending shop drawings and details) Sub - Total: $54,390 Overhead & Profit 4,079 Estimated Total: $56,469 ALT #1: 4" thick 3000 PSI concrete slab, includes termite treat soil, compaction, concrete pump and wire mesh (approx. 18 yards of concrete). ADD: $ 6,100 ALT #2: Fire wall 50 linear feet of 1 hr. rated wall, UL #465 design. ADD: $ 2,070 ALT #3: fk Add (1) pull station at each exit door if required by Fire Marshall ADD: $ 1,650 CGC15H055 Cia51634 CGCISMOB 26030 63111 Avenue E lljakka CilJ F1 34251 A1 43528 Office: 941322.0842 Par 941322.6170 Mobile. 9417251562 Florida Energy Efficiency Code For Building Construction Florida Department of Community Affairs FLA/COM 2004 v2.5, Effective Dec 8, 2006 -- Form 400A -2004R Method A: Whole Building Performance Method for Commercial Buildings PROJECT SUMMARY Short Desc: 234 Description: Hope Pharmacy Owner: Addressl: 6834 Gall Boulevard City: Zephyrhills Address2: State: FL Zip: 33542 Type: Retail Class: New Finished building Jurisdiction: ZEPHYRHILLS, PASCO COUNTY, FL (611600) Conditioned Area: 1277 SF Conditioned & UnConditioned Area: 1277 SF No of Stories: 1 Area entered from Plans 0 SF Permit No: 0 Max Tonnage 0 If different, write in: • EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 1 of 8 Compliance Summary Component Design Criteria Result Gross Energy Cost 1,476.0 1,792.0 PASSES LIGHTING CONTROLS PASSES EXTERNAL LIGHTING None Entered HVAC SYSTEM PASSES PLANT None Entered WATER HEATING SYSTEMS None Entered PIPING SYSTEMS None Entered Met all required compliance from Check List? Yes/No/NA EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 2 of 8 CERTIFICATIONS I hereby certify that the plans and specifications covered by this calculation are in comp . c= , h t - Florida Energy Code Prepared By: Building Official: /4/ Date: Date: . i' -11111 7 I certify that this building is in compliance with the FLorida Energy Efficiency Code Owner Agent: Date: If Required by Florida law, I hereby certify ( *) that the system design is in compliance with the FLorida Energy Efficiency Code Architect: Don Lyons Reg No: AR0014753 N 1 Electrical Designer: Reg No: Lighting Designer: /1 Reg No: Mechanical Designer: Jason Heffelmire Reg No: PE64618 Plumbing Designer: bar � on S Reg No: 'AieOO1 Pr 5�3 (*) Signature is required where Florida Law requires design to be performed by registered design professionals. Typed names and registration numbers may be used where all relevant information is contained on signed /sealed plans. EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 3 of 8 Project: 234 Title: Hope Pharmacy Type: Retail (WEA File: Tampa.tmy) Building End Uses Design Reference Total 98.10 118.70 $1,476 $1,792 -- - - - - -- -- - - -— - - - -- ELECTRICITY(MBtulkWhl$j 98.10 118.70 28604 34662 $1,476 $1,792 AREA LIGHTS 23.20 34.30 6806 10064 $351 $520 MISC EQUIPMT 15.60 15.60 4531 4531 $234 $234 PUMPS & MISC 0.20 0.20 26 26 $1 $1 SPACE COOL 0.10 0.10 11 1 $1 $0 SPACE HEAT 10.20 13.70 2950 3977 $152 $206 VENT FANS 48.80 54.80 14280 16063 $737 $830 Credits & Penalties (if any): Modified Points: = 97.61 1 PASSES EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 4 of 8 External Lighting Compliance Description Category Tradable? Allowance Area or Length ELPA CLP (W/Unit) or No. of Units (W) (W) (Sqft or ft) None Project: 234 Title: Hope Pharmacy Type: Retail (WEA File: Tampa.tmy) Lighting Controls Compliance Acronym Ashrae Description Area Design Min Compli- ID (sq.ft) CP CP ance 100 25,001 Sales Area 383 1 1 PASSES 101 10,005 Pharmacy (Hospital) 754 1 1 PASSES 102 17 Office - Enclosed 49 1 1 PASSES 103 17 Office - Enclosed 80 1 1 PASSES 104 17 Office - Enclosed 11 1 1 PASSES PASSES EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 5 of 8 Project: 234 Title: Hope Pharmacy Type: Retail (WEA File: Tampa.tmy) System Report Compliance RTU RTU -1 Constant Volume Packaged No. of Units System 1 Component Category Capacity Design Eff Design IPLV Comp- Eff Criteria IPLV Criteria liance Cooling System Air Conditioners Air Cooled 13.00 12.23 8.00 PASSES < 65000 Btu/h Cooling Capacity Heating System Electric Furnace 1.00 1.00 Air Handling Air Handler (Supply) PASSES ( PP Y) - 0.80 0.90 PASSES System - Supply Constant Volume Air Handling Air Handler (Return) - 0.80 0.90 System - Return Constant Volume PASSES Air Distribution ADS System System PASSES PASSES Plant Compliance Description Installed Size Design Min Design Min Category Comp No Eff Eff IPLV IPLV liance I None Water Heater Compliance Description Type Category Design Min Design Max Comp Eff Eff Loss Loss fiance None EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 6 of 8 Piping System Compliance Category Pipe Dia Is Operating Ins Cond Ins Req Ins Compliance [inches] Runout? Temp [Btu -in /hr Thick fin] Thick Jin] JFJ .SF.FJ None I EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 7 of 8 Project: 234 Title: Hope Pharmacy Type: Retail (WEA File: Tampa.tmy) Other Required Compliance Category Section Requirement (write N/A in box if not applicable) Check Report 13 -101 Input Report Print -Out from EnergyGauge FlaCom attached Operations Manual 13- 102.1, Operations manual provided to owner IZI 13 -410, 13 -413 Windows & Doors 13- 406.AB.1.1 Glazed swinging entrance & revolving doors: max. 1.0 cfin/ft all '' � i other products: 0.4 cfm /ft �--� Joints /Cracks 13- 406.AB.1.2 To be caulked, gasketed, weather - stripped or otherwise sealed El Dropped Ceiling 13- 406.AB.3 Vented: seal & insulated ceiling. Unvented seal & insulate roof& ID Cavity side walls System 13 -407 HVAC Load sizing has been performed El Reheat 13 -407.B Electric resistance reheat prohibited EN HVAC Efficiency 13 -407, 13 -408 Minimum efficiences: Cooling Tables 13- 407.AB.3.2.1A -D; Heating Tables 13- 407.AB.3.2.1B, 13- 407.AB.3.2.1D, 1 3- 408.AB.3.2.1E, 13- 408.AB.3.2F HVAC Controls 13- 407.AB.2 Zone controls prevent reheat (exceptions); simultaneous heating and cooling in each zone; combined HAC deadband of at least 5 °F (exceptions) Ventilation Controls 13- 409.AB.3 Motorized dampers reqd, except gravity dampers OK in: 1) exhaust systems and 2) systems with design outside air intake or exhaust capacity <300 cfin ADS 13 -410 Duct sizing and Design have been performed HVAC Ducts 13- 410.AB Air ducts, fittings, mechanical equipment & plenum chambers d MI shall be mechanically attached, sealed, insulated & installed per Sec. 13 -410 Air Distribution Systems Balancing 13- 410.AB.4 HVAC distribution system(s) tested & balanced. Report in construction documents Piping Insulation 13- 411.AB In accordance with Table 13- 411.AB.2 Water Heaters 13- 412.AB Performance requirements in accordance with Table 13- 412.AB.3. 3 Heat trap required Swimming Pools 13- 412.AB.2.6 Cover on heated swimming pools: Time switch (exceptions); El Readily accessible on /off switch Hot Water Pipe 13- 411.AB.3 Table 13- 411.AB.2 for circulating systems, first 8 feet of outlet Insulation pipe from storage tank and between inlet pipe and heat trap Water Fixtures 13- 412.AB.2.5 Shower hot water flow restricted to 2.5 gpm at 80 psi. Public Cl lavatory fixture how water flow 0.5 gpm max; if self - closing valve 0.25 gallon recirculating, 0.5 gallon non recirculating Motors 13 -414 Motor efficiency criteria have been met Lighting Controls 13- 415.AB Automatic control required for interior lighting > in 5,000 s.f.; Space control; Exterior photo sensor; Tandom wiring with 1 or 3 linear fluuorescent lamps >30W EnergyGauge Summit® v3.22 Incorporating Florida Energy Code Version - FLA/COM 2004 v2.5 Effective Dec 8, 2006 3/30/2010 Page 8 of 8 • 0 CI O te d �.a N " C3 CQ 0 +r .fl F 0 F au en L y .:r z ct 7- w z C4 N F L ;El .� C� �- C. a OA .C:1) V i Vi L +i 14 0 d " �A +r .� v1 0 ..i . .. (-4 : O O 5 U • �J x M 1 =1 O y W 3 N 01 eei [ - - � C in it b E 1D �' ~ 47 V w E Ism b CD OS N ° w Al z im 0 w H a Q c F" U °' Z. U p 2 CO et 7 S a t7 C - M O C N .7. LLI, M a .2 i p„ cii a) L. Z u b N 0 . 0 Po u N u o d a o 0 N 0 Z 0 z — M ❑ ❑ ❑ ❑❑ ❑ ❑ o ❑ ❑ ° O r N `m 00 0 o O O 4.., ; M • • 1---: \p O O O O. 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Q LJ_ W Z J _J 0 W m = LL 9 0 _J J �r = U LL 00 N U� co o� 0 C: Z � C� © � FFF... �Y y O y y O C > 0 a r a N Revisions: z LO 0 V_ N Q ' U. U W J Q. Q LJ_ W Z J _J 0 W m = LLJ 0 0 _J J �r = U LL 00 N Z co Revisions: z < �n J Cl.. W W U Z o� U Project Number 10032 Date 04.06 -10 Sheet Number S -1