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10-11103
CITY OF ZEPHYRHILLS c %' 5335 - 8TH STREET (813)780 -0020 11103 BUILDING PERMIT Permit N 11103 Address: 7320 GALL BLVD Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD /ALT COMMERCIAL Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: Improv. Cost: 355,000.00 Date Issued: 11/09/2010 Name: TOWNVIEW RETAIL LLC Total Fees: 2,960.28 Address: 725 CONSHOHOCKEN STATE RD Amount Paid: 2,960.28 BALA CYNWYD PA 190042102 Date Paid: 11/09/2010 Phone: (610)667 -5800 Work Desc: SUBDIVIDE SPACE SAV -O -LOT RENOVATION 17,588 SQ FT - 7 ,- • •l -I •l 1 :I L, 1 1, 75.11 - . :1. 5 TOTAL ELECTRIC SERVICE OF TAMPA PLUMBING FEE 187.50 MECHANICAL FEE 131.25 ALL FLORIDA PLUMBING CONTRACTORS FIRE PLAN REVIEW FEES 1,055.28 FIRE INSPECTION FEES 30.00 THE ALERT CO r 0 A) C_I. .I i - 4 - Il 0( ylitk ' Oi l & 1 ±faC I ary\ •• - •. - . .- ..: • • 11 el N 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 yo r notice of commencement." ji be- % .4 /A .i u 0 r NTRA TOR SIGNA PERMIT OFFI 'R PERMIT EX ' ES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER GERARDI CONSTRUCTION INC 13451 City of Zephryhills 11/8/10 1550 • Licenses and Permits 2,960.28 Sun Trust Bank - Che 1022/1010 2,960.28 SAV -O -LOT SUBDIVIDE SPACE 17,588 SQ FT - 7320 GALL BLVD GERARDI CONSTRUCTION INC -PRMT #11103 c.oIumn es SQ. FEET PRICE MAIN OR LIVING: OTHER AREA UNDER ROOF: - OTHER: - $ - VALUATION $ 355,000.00 FEE SHEET $ 1,250.00 ADDRESS DRIVEWAY BUILDING: $ 1,275.00 ELECTRICAL: $ 281.25 PLUMBING: $ 187.50 MECHANICAL: $ 131.25 SUB -TOTAL $ 1,875.00 BUILDING SURCHARGE TOTAL $ 1,875.00 SEWER: WATER: IRRIGATION: $ - TOTAL: $ - N/A WATER METER: N/A IRRIGATION METER $ N/A FIRE DEPARTMENT FEES PLANS TOTAL: $ 1,055.28 INSPECTION TOTAL: $ 30.00 PERMIT TOTAL TOTAL: $ 1,085.28 PUBLIC SAFETY IMPACT FEES POLICE FIRE 5% $ - TOTAL: $ - N/A SUB -TOTAL $ 2,960.28 PARK IMPACT FEES N/A SIF'S: 100.0% 1.0% TOTAL: N/A TIF'S: N/A 99% 1% TOTAL: $ 2,960.28 SAVE -A -LOT CONSTRUCTION CONTRACT This Agreement is made this 3rd day of November, 2010 by and between IV)oran Foods, Inc. d /b /a Save -A -Lot, Ltd. ( "Owner ") and Gerardi Construction ( "Contractor "), to perform the Work identified herein in accordance with the Contract Documents. THE OWNER: Moran Foods, Inc. d /b /a Save -A -Lot, Ltd. 100 Corporate Office Drive Earth City, MO 63045 (314) 592 -9100 THE CONTRACTOR: Gerardi Construction 1604 N 19` St Tampa, FL 33605 Contact: Phil Gerardi PH: 813 248 -4341 THE PROJECT: Save -A -Lot #336 Zephyrhills FL 7320 Gall Blvd Zephyrhills, FL Appropriation No.: FL.05200.2010.NEW THE OWNER'S REPRESENTATIVE AND AGENT: Save -A -Lot, David Motley ARCHITECT (IF ANY): Owner and Contractor agree as follows: 1. Scope of Work Contractor agrees to commence its work described herein upon notification by Owner and to perform and complete such work in strict accordance with the Contract Documents. Contractor to furnish all material, labor, equipment, clean -up, sales and use taxes and necessary services to fully complete the work described as follows: As further described in the Contract Documents listed as follows: Contractor has inspected the job site and is acquainted with the actual conditions. Contractor shall not impede construction by others, customer traffic on exterior or interior of building and shall properly store materials as directed by Owner. 2. Contract Time Time is of the essence. Contractor shall commence its Work upon notification by Owner and shall complete the Work in accordance with the Contract Documents by 1/28/11 3. Contract Sum Owner agrees to pay Contractor for complete and timely completion of its Work the fo lowing sum, not to exceed: Three Hundred Seventy Thousand Nine Hundred Sixty Six and 00/100 ($370,966.00) Dollars 1 �y� 4: Contractor's Duties Before proceeding with the Contract Work, Contractor shall check the correctness of contiguous work installed by others and the failure to detect or report discrepancies will preclude the Contractor from recovery of any resulting cost, expense or damage. The Contractor shall keep the building and premises clean of debris resulting from the performance of its work. Contractor shall give adequate notices pertaining to its work to the proper authorities and shall be secure and pay for all necessary licenses, permits, tap and use fees to carry on the Work. Contractor shall promptly furnish, shop drawings, manufacturer's data, templates, schedules, reports or any other data that may be necessary for proper prosecution of the Work including distribution among other contractors. Contractor shall lay out his own work and be responsible for the accuracy of same. Contractor shall exercise the utmost diligence in obtaining all drawings, details and information necessary to perform its work. Contractor shall, before proceeding with any affected part of the work, call to Owner's attention in writing any errors or inconsistencies in the Contract Documents. Contractor shall coordinate its Work with Owner, all other contractors, subcontractors and suppliers on the Project so as not to delay or damage their performance, work or the Project. 5. Payment Contractor shall submit Monthly invoices to Owner. Owner shall make payment for 90% of the amount of labor and materials delivered and installed in the Project, less any previous payments. Each payment, including the final payment, is subject to receipt of proof acceptable to Owner that all subcontractors and material men have been paid and that no liens can attach to the property. Payment to the Contractor does not constitute or imply acceptance by the Owner of any portion of the Contractor's Work. The Owner shall make final payment within ten (10) days after satisfactory completion and final acceptance of the Work by the Owner. 6. Changes Contractor may be directed in writing to make changes in Contractor's Work. Claims for extra or changed work will be allowed only upon prior written authorization signed by Owner's Representative. Changes will be made on an agreed upon lump sum or based upon daily work sheets showing the cost of materials, labor rates and the hours worked, all as approved in writing by Owner's Representative. 7. Overtime The Owner shall have the right to order Contractor to work overtime in order to expedite the final completion of the Work and it is agreed that for such overtime, the Owner shall pay only the premium time cost of the labor plus liability insurance any payroll taxes thereon. Should it be necessary, in the Owner's opinion, for the Contractor to work overtime due to the failure on the Contractor's part to maintain the schedule or keep up with the general progress of the work, then the Contractor shall work overtime and the entire cost and expense so incurred shall be borne by the Contractor. 8. Damage to Work Contractor shall at all times and at its expense protect the Work and all labor, materials, supplies, tools and equipment against any damage, injury, destruction, theft or loss for all of which Contractor shall be solely responsible and in no event shall Owner be liable or responsible therefore. Contractor shall at its expense promptly repair or replace damage to work of others, or to the Project, resulting from its activities. 2 9. Insurance Prior to starting work, Contractor, at its expense, shall obtain and maintain ip.force, on all operations, insurance in accordance with requirements listed below. The policies of insurance shall be in such form and shall be issued by such company as may be satisfactory to Owner. Certificate of Insurance shall be filed with Owner prior to commencement of the Work. The insurance required shall be written for not less than the following limits, or greater if required by law. 1. Worker's Compensation: a. Applicable State Statutory Limit b. Employer's Liability: $1,000,000 per Accident 2. Comprehensive or Commercial General Liability (Including Premises - Operations; Independent Vendor's Protective; Products and Completed Operation; Broad Form Property Damage): a: Bodily Injury and Property Damage: $1,000,000 Combined Single Limit (CSL) Each Occurrence Minimum $2,000,000 Aggregate or Per Project Endorsement 3. Contractual Liability: Same coverage as 2.a. above 4. Business Auto Liability (including owned, no -owned and hired vehicles): a: Bodily Injury and Property Damage: Minimum $2,000,000 Aggregate or Per Project Endorsement 10. Indemnity To the fullest extent permitted by law, Contractor shall indemnify and hold harmless Owner. Owner's parent Corporation SUPERVALU Inc. and its subsidiaries, Architect if any, and their agents and employees from any and all claims, damages, losses or expenses, including attorney's fees, caused in whole or in part by any act or omission of Contractor or any of its agents, employees or subcontractors. 11. Compliance with Law and Safety All work to be furnished by Contractor must strictly comply with all applicable federal, state and local laws, regulations, statutes, ordinances and directives (hereinafter "Laws ") now in force or hereafter in effect. Contractor agrees to indemnify and save Owner harmless from and against any and all claims, loss or expense caused directly or indirectly by its failure to fully comply with such Laws. Contractor agrees that the prevention of accidents to workers engaged)in Contract Work is solely its responsibility. Contractor shall comply with all applicable safety laws and to any safety standards established during the progress of the work. 12. Warranties The Contractor represents and warrants that all goods furnished pursuant to this Agreement are free from encumbrance, free from defect and are merchantable quality and new unless otherwise required or permitted in the Contract Documents. The Contractor further represents and warrants that all Work is in accordance with the requirements of the Contract Documents. If within one (1) year after the date of Substantial Completion of the Work, any Work is found not to be in accordance with the Contract Documents, it shall be corrected promptly by the Contractor after receipt of written notice from the Owner. This shall not limit any other rights or remedies of the Owner for Contractor's breach. 13. Performance Should Contractor fail in any respect to prosecute the work with promptness and diligence or fail to correct defective work promptly, or fail as to any of the requirements herein, Owner may perform for Contractor and charge all costs to Contractor, including overhead, profit and attorney's fees. 14. Arbitration All claims or disputes between the Contractor and the Owner arising out or relating to the Contract or the breach thereof, shall be decided by arbitration in accordance with the Construction Industry Arbitration Rules of the American Arbitration Association currently in effect unless the parties mutually agree otherwise. Unless the parties agree otherwise, they shall be limited in their discovery to directly relevant documents. Responses or objections to a document request shall be served 20 days after the receipt of the request. Notice of the demand for arbitration shall be filed in writing with the other party of this Agreement and with the American Arbitration Association and shall be made within a reasonable time after the dispute has arisen. The award rendered by the arbitrator or arbitrators shall be final and judgment may be entered upon it in accordance with applicable law in any court having jurisdiction thereof. 15. Assignments and Modifications Neither this Contract nor any interest herein may be transferred or assigned by the Contractor or the Work or any part thereof be subcontracted, without the written consent of the Owner. Modification, revision or amendment of this Agreement shall not be effective unless approved in writing by the Owner. 16. Conditions for Retail Turnover Retail Turnover is the date on which substantial completion is obtained as identified as CONTRACT TIME in section 2. The following conditions will apply: GENERAL CONTRACTOR Exterior Finishes: • SITE WORK: All Exterior Site work will be 95% with no safety issues unresolved. (Paving Complete, Lot Striped, Curbs, Gutters, Sidewalks etc. Complete.) • Exterior Building finishes will be 100 % Complete ) Interior Finishes: • CONCRETE: All concrete work is complete. • DRYWALL: All drywall work is complete. • METALS: All Supports, Column Wraps will be complete • GLASS & GLAZING: All new storefront including New Entry /Exit Doors will be complete and operational. • DOORS: All Interior and Exterior doors will be complete. All DETEX Hardware will be installed and working properly. Confirmed operational with store management • MASONRY: All Masonry is complete. • ACOUSTIC: All Grid and Ceiling Pads will be installed. • PAINTING: All interior painting is complete excess paint to be removed from site. • FIRE PROTECTION: All Fire Suppression and Fire Monitoring systems will be complete, monitored and approved by the local Fire Protection Agency. 4 • EQUIPMENT: All Owner furnished equipment including, but not limited to Checkstands, Security Rail, Pallet Guard, Power Lifts, Bagging Stations, etc. are installed and operational. • HVAC: All Units will be complete and operational with new 2" pleated filters. • PLUMBING: All rough in and finish plumbing is complete. All fixtures are installed and operational. Hot water is working in bathrooms, service sink, prep sinks. • ELECTRICAL: All Sales floor electrical is complete. Including Sales floor lighting installed and operational, all office outlets, switches, cover plates and any other finish material is completed. Check stand power poles are in place and wired for final connection. All stock room wiring is complete, all panels are closed, and no material is being stored in the stock room. All Low Voltage wiring is complete. All Refrigeration wiring will be complete. (If in the GC Electrical Scope of Work) All CONTRACTORS: • For all contractors, all extra material not necessary to complete the job will be off the premises. Site will be ready for Health Inspections. Should the site not pass a health inspection, the General Contractor will pay any additional costs incurred by Save -A -Lot including, but not limited to Advertising Costs, Attorney Fees, Re- inspection Fees, overtime charges to complete work. This Agreement is the entire agreement between the parties and no modification, revision or amendment of this Agreement shall be effective unless approved in writing by Owner. THIS AGREEMENT CONTAINS A BINDING ARBITRATION CLAUSE, WHICH MAY BE ENFORCED BY THE PARTIES. The parties have executed this Agreement the year and day first written above. Contractor: Gerardi Constr ction Owner: Moran Foods d /b /a Save -A -Lot, Ltd. (Corporate Nam ) By: , By. Zg,,,,,tic Wgrti-irf 11 Title, -P'>& x Title:C6 Federal Tax I.D. Number: 1111111 11111 1111111111 11111 11111 11111 11111 11111 1111111111111 . NOTICE OF COMMENCEMENT 2010162228 Rcpt:1335309 Rec: 18.50 Permit No- DS: 0.00 IT: 0.00 Tax Folio No. 5 LS Z t cow G?3CO Q � 11/09/10 K. Garcia, Dpty Clerk THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. �� 1.Description of property (legal description): ee- i__, ct D a) Street (job) Address: ?; Lo &AL - r5c 6 L y r- Li (b F L- 2.General description of improvements: T& N f i M Paa` A4 CA/1 relet. Sj'1- -A - Lo r �-✓L a c- :-, — -n tE- 3.Owner Information a) Name and address: '5A 'A -Lc r � 1-r0 /ex- c-74 ie t..- t r'e c, Oa , E 4- /Cr'!� c r`y NO. ( ,L) b) Name and address of fee simple titleholder (if other than owner) T a.s, N V L E w '-r 9 i L / cLc ( c) Interest in property '7- &A4 u r 4.Contractor Information a ) N a m e a n d address: C - C , 2 ' -Q Ju- ,Zu cr «N . ( N� • t � / N . 19 5r, i 7-"se /A- Kc- 336 or b) Telephone No.: 7 3 •- 248 q 3 4 1 Fax No. (Opt) / 5.Surety Information a) Name and address: j•1 I It b) Amount of Bond: c) Telephone No.: Fax No. (Opt) 6-Lender a) Name and address: P lot\- F '"„ a Phone No. m m n 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: W c\o cn a) Name and address: X r-• 9 b) Telephone No.: Fax No. (Opt.) 03gs m 8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section ni 713.13(1)(b), Florida Statutes: N ? a) Name and address: O cne b) Telephone No.: Fax No. (Opt) w D 9.Expiration date of Notice of Commencement (the expiration date is one year from the dateof recording unless a different date �. o is specified): c. 0 o rn WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNE ' ' ' ' THE, EXPIRATION OF THE NOTICE OF WN COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS I ER CHAPTER 713, PART I, SECTION 713.13, G o FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE ' 1R IMPROVEMENTS TO YO ' PROPERTY. (0 A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED e N THE JOB SITE : r O r : r FIRST xi INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YO ' LENDER OR ■ —7 71 1 ' Y BEFORE r- COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENC ' NT. i ' / 23 STATE OF FLORIDA COUNTY OF PINELLAS 10. ` ` , —\ Signature ofOwner � . a uthoriaed •'; xer ,' - «„ /partner A t/ i 0 / i9 Oa /1)6i Print Name / ' '\ f rego' i was acknowl before me this " Q' day of `l , 2d V , by i ,r i VL "o 7 ` instrument as l ---4 "�' of authority, e officer, � (type ty, g. fficer, trustee, attorney in fact) for v 1. 0 n ame of a 'l, beh o w � ,� inst , y ) ( p rty , , f � Inst ent wa3 executed). Personally Known (.701 I • ication Notary Signa , .......j1, k Type of Identification Produced ` 1 Name . ; It) t I t 'l IMF C 1 6 L ( ::«r: 4i Verification pursuant to Section 92.525, Florida Statutes. Under penalties of . - 'ury, I • - , : I , . *, . d the foregoing and that t h e f a c t s stated in i t a r e true t o . . _. -_ _ ' , a����YPS, S EILA PRECIOUS / FORMS/NOC.,YSd2007 , ,� �% Notary Public - State of FI' dal ,. / air , I. .1 M Comm. Expires •:•r ; a '•' r. T a r . , „..g ,, _# 10.) Above c Commission 1 DD • 87 o l '' R »� Bonded Through National Notary Man. • w _ _ • OR BK 82463.f z 940 DATE: 11/09/10 PASCO COUNTY PROPERTY APPRAISER 14:20:35 O N - L I N E P A R C E L P R I N T O U T PARCEL -ID: 35 25 21 0010 08800 0000 TYPE: STATUS: A DLA: 100107 SC TP RG SUB BLOCK LOT TRACT: 0328004 L E G A L D E S C R I P T I O N: ASSESSED IN SECTION 35, TOWNSHIP 25 SOUTH, RANGE 21 EAST, PASCO COUNTY, FLORIDA ZEPHYRHILLS COLONY CO LANDS PB 1 PG 55 POR TRS 73 88 & 89 & POR OF LOT 8 PASCO MEDICAL ARTS CENTER PB 23 PG 24 BEING MORE PARTICULARLY DESC AS: COM AT NW COR OF SW1 /4 OF SEC 35 TH ALG N LN OF SAID SW1 /4 S89DEG 51' 40 "E 15.00 FT TH SOODEG 07' 20 "W 514.86 FT TO PT ON W BDY OF TR 73 FOR POB TH S89DEG 50'57 "E 188.54 FT TH SOODEG 09' 03 "W 16.33 FT TH S89DEG 50'57 "E 305.23 FT TH SOODEG 9' 3 "W 65.00 FT TH S89DEG 50'57 "E 154.33 FT TO E BDY OF TR 73 TH S09'3 "W 433.51 FT TH N89DEG 55'34 "W 50 FT TH S09'03 "W 117 FT TH N89DEG 55'34 "W 200FT TH S09' 3 "W 109 FT TH N89DEG 55'34 "W 259 FT TH S09'3 "W 205.36FT TO N R/W LN OF N MEDICAL AVE TH N89DEG 56'33 "W 133.84 FT TO E R/W LN OF US HWY 301 TH CV CONCAVE TO W RAD 57395.80 FT CHD NOODEG 4'19 "W 747.11 FT TH S89DEG 50'57 "E 171.18 FT TH NOODEG 7'20 "E 197FT TH N89DEG 50'57 "W 173.54 FT TH NOODEG 7' 20 "E 3 FT TO PCB;OR 7642PG342 STATE: Oi €, gO' C' F S'C O THIS E S 1C L E t41PY II`A T;T T,UNTHE FOREGOINPAG.ISA TRUE AND CORRECT:COPY OF THE D'OCUM§Cr"\ ON FILE OR OF PuBiiC RECORD IN THI FICE WITN S PsY HAND OFFICIAL Z IS DAY OR,- 'IMP---_ PAULA S. O'N IL, ; EEF2K & C, MF; BY '.. - _�__,_ DEPUTY CLEW a l 1604 N. 19th Street Tampa, Florida 33605 813.248.4341 GERAROI CONSTRUCTION, INC. Fax: 813.248.4991 October 26, 2010 City of Zephryhills Building Inspection Department 5335 8 Street Zephryhills, FL 33542 To Whom It May Concern: I, Phillip H. Gerardi, License # CGC 061908 herby give Michael White (Drivers License # W300- 544 -78- 263 -0, and Jim Keithly (Drivers License # K340- 443 -47- 467 -0) consent to pick up permits and to sign off in my position on documents requiring my signature under my license. Thank you. Best Regards, '------/Q1 ) ''2.-'v‘-ej . Phillip H. Gerardi 1 t"ss #1: \ \ 6,02, Witness #2: SWORN TO AND SUBSCRIBED BEFORE ME THIS aL DAY OF Ockba,i , 2010. m S , al) 1 a- plil '�' No-Qa- My Commfls Expires: NOTARY PUBLIC , , 7 ..QWANA AYALA ;s; % OMISSION # DD785833 4 "XPiRES May 05, 2012 Cc: P. Gerardi, E. i a't` :gi,s: =ra utarvsernce.com ° �� ; • City of.Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: J41/ a 67 Date Received: 9- 26- /r � Site: 737-o Co l f p Permit Type: ie�O e L S'1f d4/10 yar f 7 565 ` r� Approved w /no comments: Approved w /the below comments: Denied w /the below co PP � PP comments: ❑ This comment sheet shall . _ -p with the p- . 't and/or plans. Kalv'. S er — • s . er Date Contractor and/or Homeowner (Required when comments are present) 813- 780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021 Building Department Date Received 1 °le /U Phone Contact for Permitting -- S� _ Owner's Name • ; fidC' 4 Lo K;,,c /S Owner Phone Number Owner's Address //i0 eU//,1 (-1/)t4'G/f Y A4T�lri 5 .7 Zion 5 Owner Phone Number Fee Simple Titleholder Name. Owner Phone Number Fee Simple Titleholder Address 1 JOB ADDRESS 7 3 20 c) ( t� / Dc( ev C/ c2_. (^ , /1/5 LOT # SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I I 1 1 DEMOLISH INSTALL j REPAIR PROPOSED USE I 1 SFR ri COMM I I OTHER I I TYPE OF CONSTRUCTION I 1 / BLOCKS h FRA / ME I I STEEL 1 I 1 I DESCRIPTION OF WORK S J 1 454+" 5;4)190r //'e i//Dee A: , s,»df' A4 7/ 7 ; t?5 BUILDING SIZE O l X 2'C{ ` SQ FOOTAGE /7 CC W HEIGHT I (BUILDING $ VALUATION OF TOTAL CONSTRUCTION 32 SJOaa . Ua I ELECTRICAL $ AMP SERVICE I i PROGRESS ENERGY I I W.R.E.C. PLUMBING $ -- L f t V r . Gi Mfils' IMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION Q) S abS IGAS I 1 ROOFING ri SPECIALTY I 1 OTHER 3 w i(O FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 (YES O c"1 C (IY‘ 4j*/L BUILDER --' re/. ' COMPANY K S & � lA C .11 0,-i SIGNATURE REGISTERED I Y/ N I FEE CURREF I Y/ N J Address f dd 6 t ctC pi-z, sir ��� License # �p ELECTRICIAN cC e '-) COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREF I Y/ N I -3 Address 1 -- ---4 License # PLUMBER ...L e, /''ti — "� CP\ COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREF I Y/ N I Address ,,� License # MECHANICAL l jCJ A ° COMPANY SIGNATURE REGISTERED I Y/ N J FEE CURREN 1 Y/ N I Address 1 License # I OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREF I 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 required. (A/C upgrades over $7500) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division — Licensing Section at 727 -847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89 -07 and 90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency- Asbestos abatement. Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for Tots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to . violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the, job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU • OTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 1 03) ; 'Cl �� n y OWNER OR AGENT d / CONTRACTOR Subs�r g and sworn to (or •ffirm-d •efd - t'iis Subs 'bed s and sworn t• or affirmed • , W; �( u by.. a1JJ - - W. Vf� by n Who Is /are personal! own to me or ha /have pros ced o is /are personally'nown to me or has /have pr•:uced as identifica as !den cation. c Notary Public • Notary Public =.: �A • mission . + ►': 1833 sib" "�� : JACQUELINE BOGES Com ni 6ion ` �t''`' Expires member 12.2010 Commission 40. ( Commiss+un DO • 41, Bonded Ti9u Troy Fain Yw6no.I0041F7019 y *� �= Expires December 12, 2010 Rf,�ti A"""' d fiiu t._,f..� lorumna6oP•3.6.7019 Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped 11/03/2010 13:21 8138992968 TOTAL ELEC PAGE 01/01 . JaCiK t e._. 813400.0010 City of Zephyrhflls Permit Application Fax- aiaaaO•oozi Building went /H0' • Date Received d � Phone Canted for NEIGH : • ,<e, _ _ - — _ • Owner's Name .• g • s. Owner Phone Number Owner * Address I /O9 /r6 /DrrAl%!�• chirAtt J2 lb. S 1 OwnorPhan* Nunr I . 1. • Fee Simple Titleholder Name I 1 owner Phone Number ( I Fee Simple Titleholder Address I 1 JOBADDRESS 17 3 a , 6411 1 3 oR JrvAird Z_rr iJ %s 1 Lora 1 I SUEDIVtauOtf 1 1 , PARCEL 1131/1 • OBTAINED RIM PROPERTYTAXNOiIDCI WORK PROPOSED F NEW CONSTR 5 ADO /ALT Q SIGN E21 �] DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR 0 COMM r1 OTHER TYPE OF CONSTRUCTION [::i D / BLOCK �] FRAME 1 STEEL L] // 1 n DESCRIPTION OP WORK � 154 Ll44t' 4 ,} f 84 cpq par' ,04 ' / 5:4'r A/d T 4 . r BUILDING SIZE 1 r - )( 2 , Eli FOOTAGE /7511 t G I HEIGHT I. I • OBURDINO IS VALUATION OF TOTAL CONSTRUCTION 4i 3Z.S: EEI.ECTRICAL . IS Q)) J 00 /%. op ) AMP SERVICE ©. PROGRESS ENERGY E3 W.R.E.C. n1PLUMBING IS W 1 If _[ f�{ I ill QMECHANICAL IS VALUATION OF MECHANICAL I STALLATION 5) .. �r+1 s nOAS ROOFING El SPECIALTY i OTHER Z V 1(0 C FINISHED FLOOR ELEVATIONS 1 FLOOD ZONE AREA YES , • J gi CV .UiLDPR COMPANY I Clio J �.fi u s C � io�✓ I ' �I SIGNATURE MOISTENED 1' / N P10 CURED ) Y 1 N t Address I/If/I ,�� Lbws* a 1 • PIz 5,� � EtE s e l SIGNATURE `I� l , 4COMPMtY trOR1 0 WtIG S EYJU of Tx .�c • . REOI8roRED t Y I N 1 POE DUa10n i YIN 1. . -- ,, Address ' Alb" U! r •• �1 ■ 1137 y, Uomse4 _ 0001 '39 -. I; ", PLUIa8ER COMPANY 1 SIGNATURE Requiem 1 '1/ N i .. RN CURRE. 1 Y I N 1 Address I I Ltoeru.# 1 MECHANICAL COMPANY I . SIGNATURE t '( Y/ N I' Rte Curgken L Y!i$..1 : Address I 1 License* 1 OTHERURB ' COMPANY r i + r .. Address 1 ( , 1lrimas a 4 :, RESIDENTIAL Attach (2) Pbt Plans; (2) sets of waking Pans: (1)set of Energy Fomu R,0 Per:46r' Donelca llan. • . Minimum ten (10) wing days SRN aubndtal die. Roquead emit, Oaactl Nine, ms, 8benwater Plans wI S0(Penc I GAME , • ; Ssn wry Faola*.8 dumpsite; Site Work Paine! tor pre oa • . COMMERCIAL Attach (3) Oc.ptete sake of Building Plane plus a Life Safely Page; (1) art of Energy Fonm, R-O-W Permit for new cotlithirdlOrt Minimum MI (10) waiting days after sub IUa* date. Required omits. Construction Planet 8lormwaar Pane vd SIR Finns inaalled • sentry Faollee 8 1 dtmpsar. Silo Work Permit for eB new pro(acia. Al corhm.rdeI ragukemanls must meet oompNsnca SIGN PERMIT Attach (Z) sem of Engineered Plane. • '"'PROPERTY SURVEY GROW tarsi NEW mrrawtlon, Dtrsction.r FR out applcstlon completely. a - " Owner 8 Oa nlscicrrlgn beck of appiloseon, noartted V over 83000. a Rollo* of Coremeno mantle required. fAJC uparrWu over 51100) • . " Agent (Tor eve contemn or Pacer of Attorney (for Ire oww) would be someone whhttotidted alteitrom owner eu5wrRfp Srg me tRUA x - . OVER THE COUNTER PITTING (Frond of ApplloeSon Ord);) a ' a .: Raroole I shingles Sewn= Service Upgrades A/C Fences (PIWlSn.vey/FOOIege) Driveways -Not over Counter I on public roadwaya..needs ROW ' 100/100"d PZO# e4:II 01O1/SO/11 :u0JA ...y ... rvp u. "MY oparunad .rr.l.... «..•• • Jot Ms.% M O DI I RINalvad / / atee ceanet w. /3 / • - • AS Minds PhonaNUhbw dame" Addrms I /uo ,'O, »r o!' ceAr /IAN/ rL $/ c ao S 1 owner norm Hum fw amps TIIMINsdar Name 1 I Owns now Ntrnbor I _ _ . I Fee Cpnpla TNMholaor Addraoa 7 . / • JOE ADDRESS 1 7 3gc� G+411 adr( A zr, yehills 1 L.T. L SUDDIV...., 1 I, PARCEL KIAI I �,. Gen'AING3phOMFROFIRYTAXNOWA • WORK PROPOSED Nt1N INSTALL ©_t CONSTa E AOOb1LT © SIGN M Q DEMOUSN LLJJ RE PMR PROPOSED uN)R (D 5FR Q COMM C=I OTHER L. . - 1 TYPE of. CONSTRUCTION . aL00k Q FRANKS STEEL Q oascRlrTtoNoP+snout Ir46 �w� ` ,2cer ..�7, , /a/i dpi ,e. .3-4.e. , /o/.s.ad _� aULWNGen r it's ?4 IanFooTAAEi /ls 1 HEIGHT I Cl �L D I N G L..r 1 VALUATION OF TOTAL CONS1RUG'noN ii 31 6;00 • 1J0 =ELECTRICAL Ii I AMP SERVICE Ei PROGRESS ENERGY (= w.H.E.c. pPLUAtewm I 1 0 c - ' r a • flMECHANICAL IS I VAWA•FION OF MECHANICAL INETALLATTON /.) Su• r (..�L L 1 FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA 1QM `' w 1,4 Ce MASER COMPANY IA S &I'D ( L., 4 6( C '� r I SIONA1 UHE L -- N6aMTErIPai 1 t / N ( Re COMP 3 YIN ) Addnw I 1 Lltratrae IS I I ELECTRICIAN COMPANY SIGNATURE) YI N 1 rECLEM ) Y/N 1. Addrew !I _ kt, LIM N a I af ( � P 2 S"C TURF I .- nrilaaNWEP .Cl1 RN C1 E mi r ,QA-% '6 .w 9 Uwe"Y 013.76° �`l�) / j� , Do& ( FwECIU ICAL l4 //' rL �'' ai 1 PANY L � . L•gieT ., SIGNATURE edFr G ` wta9TENE0 NUMMI Fse wpRIP ECI it t i-" 7, Audrasa ' • 11 !: - - - Urahoa ll I RAMP 14.6 s4 1 opign comPANY Y1 N PwartraP IMMATURE till PROPlp Addraee I ........,...._.. — ...--I N -- F„I„I,i„N RPSIDIRMAL Asses (7) Pbt Plena: 0) 0010 of EuMdbq MGM (1) wt Weiler,/ RIM R.O•w Pe1IM far naa 03011010111 UMMIuR Om (10) madNrq days 'Aar 'Penh" dl e. R sydrad aalw. Comaruedon Ploru,, StonmisMr Plats wl SN( Final ONSI ad, Sarfily Rook. a 1 damssU r MM Worn Patndt for wrdLeoloeaANaa P1O10010 __. G ERCIAL.. Mash (1) g) plan, psetDtalaag. fisttaphraURSaWy Rase 4 Form of orO*Penni for nw coodruc __. .._ . ._ . � MAN Me woos doe b 1 dumper. b W alsolad dots. Ponge s ira ta0rda. Al mmmeidal irGammanle must mod C1 Acs owl PF.RNNT mach (Z) Days oI Moored Plww. ....PROPERTY SURVEY hgrarod kw al NEW aomAtmlelo FN out appraat1an raaylwlriy. Owner a Cudrmabr sign badt of eopWrloo. Nguema V avw';7a0O. a Rotlw of Comwteocemoa! M ragdr.d. (ANC uParddas char ga00) Awl (lay Pr canbactor) Or Pawn of Mnm.y (for lie CtMw) wad by salnsorw ugh rrolppzea Mgr from mow au horhdnD NNW OVER THE COUNTER PERLETTMNG (From ot APpNWIon Orly) ftwoalti If trplas Suwon Service Umbers AIC Faneaa (Piouauvor+Footaaa) DrIvaways.Nbt over Caauw Kan pals hudwsye.araods ROW Z00(ZOO'd LPO# 80:i1 OLOZ/SO /II : tool 3 Nov 01 10 11:37a Steve Rogers 8139649434 p.2 From: 11/01/2010 08:58 #007 P.001!001 --•----- ...13 .,. c.Rgn.11•••... y r,«,.,...,... noerak ueiarvnart l , Jot" ?a u 1, / f peons canna. nor Pena . . � , 7 _ O 3' • - Owner's Name is 1P FO e PE Lt / .fi Owner Phone NtMber Owner's Address /1/0 Pvle7..46t rifr deof. Sl s I Omni Pawn Man6er 1 Fee *Mph, 1 al abvld am. . I j owuarPfian Number t fee Semis Tlieholde rManes I JOB ADDRESS 1 3 8v Cpl: it a o.t /rrr -Zed 24_,a$ -A Il /S 1 Lore f , WIW$l=k 1 1 PARCEL (Di SlJp I7.TAtrrn eAODPnOeaem me NOtY.EJ WORK PROPOSED MN COMM ADOrALT r SIGN DEMOLISH i [ INStAU. � EJ Q REPAIR PROPOSED USE J SFR Q CORN £ J crr i st 1 I TYPE OF CONSTRUCTION En BLOCK CI FI B/ LE r1 STEEL EJ ( I IEScRFTIDNoFvroax ISai e t r L •��u i A.e ..z >< � I BUILDING Sag I /7'w 24-V 1 =FOOTAGE. + / 15- " I MEOW 1 Flamm; r i vALWITTON OF Tam_ cagsmucnou 11 32 Soto. QELEC RICAI. IS I AMP SaWrce n PROGRESS ENERGY p WILCO. numaiNa 1 (I) e r is I VALUATION OF NECHANICAL INSTALLATION , Sat; s [QGAS p p arec)war r---1 an �� �° FINISHED 1%DOR ELEVATIONS 1 1 FLOOD ZONE AREA EJYES , 0 C elk WIDEN 1 f COMPANY 1Jg.C•� ITOn UClrui✓ I 91IJIIATIJRE REGIME] ED 1 Y f N 1 MEOW/EN ( TM _I Address 1 • 1 Unmet I 1 ELECTRICIAN i I cONPMIY I 1 SIGNATURE amsren® I f 1 11 1 FEEawEN E YIN I Address - ( 1 i , : PLUNDER rai ��� ` J� manor, I JILL P "f- -- P = t ► t INi1Ai � .1J�C pi X?r3 18KiNA7tlNE [ , 1 Y +� 1 N f �aaae / +1 Y ] c� OE' � � � r ... his Reg E.eu.1 i L+ - ; TAMPA 1. 3 ?tc 7 9 mere. sr IC f-e: -/ t l !n 6/3 oCZ YBZHANICAL I I COMPANY I SIGNATURE Necenre� UY I mamma 1 YIN Addres I !!tene I I OTHER COMPANY I SIGNATURE tt} e 1 Y/ N I FEE CURO t Y 1 N I Address I iJeeaee i I I iliFFllHilit4( NEBILIENRAL Math OMR P1am(2 sob c( Wilke Pl.i (1) aolM Enemy Fanre ;R- O- W Permit lot now mneWCSen, Mama ten (10) v ann dots Met s *mJtWdais. Remind me , Canoe edam Male, Senewerter Rem Pei SIR Fence hebellW, Slaw, Swain & 1 dorepaees; McINark Permit roreubdIAannolergerends C O I W f J R C AL M is e r Moments ale aMINN) Rane Rte a U N S a ll y Pam (I) seta/ Sem Rms. ftaW Pall I for new construction. lalo rw Wa MN Wadding deye Afar erbrrllaieine Recite. do me. Ce rrlas3. rr Plana. abrmwet er Plans wnutF.rro.InsaN.q, Satimy Amelia A 1 drespeter. Slte Mole Pewit Oar 4 ear pAGeob.. AM a.remwdol wgfienwnw mud me.aw,Pllaaa SIGN PB WT Mach RI eels aiEnti leer d FIeae. PROPERrY !JIMMY required rural NEWmeson. Lllteettotla Fit out applcatonccaplatert. Ow i Contactor Won back of eplAealan, aolaLred U over $7= N. • Nodes atCwwaeo®warre ngried, (NC upgrad e ever $7 0i " Agent OM the contractor) er Power of Mornay aor the Gana) week! be someone welt Worked War frorn owner outwitting earn mat WOE COISIIER PEWITS= (Front or Aoaicetice Only) Remote If seklpes sewers Service Warbles NC FORDS (PIaUSrrenFooldgeI Driveway. -Not over Gander Noe entire madwaycarods ROW Flor E E fficiency Co de Fo Building Construction Flor Qe meri o f C ©mmun A ffair s Energ i� FJalGom -2008, E f�e March 1, 9 - rill A, Q$ Method A: Whole : Building Performance fire co l m e midi s PROJECT SUMMARY Short D esc: Save A Lot Description: City: Save Zephyrhills A Lot O Save A Lot Addressl: Townview Square shopping Center Addressl: State: Florida Zip: 0 Type: Retail Class: New Finished building Jurisdiction: ZEPHYRHILLS, PASCO COUNT FL (6 11600) Conditioned Area: 17540 SF Cond & U Area: nconditioned No of Stories: 1 Area e ntere d from Plans 17540 17540 SF SF Permit No: 0 Max Tonnage 27.6 If different, write in: rib' ' ( , — .:.e... ,,,G No 722 \ ., S • r *�Ia/p -o : STATE O ' a i 4 / .= ''.Os.r� ' / �.!c[ ORIOP;•: G�� �.` U 9 2011 '�� ' � i,, ONA"� `,` Jo E# 5 482 Energy Summit® Fla /Com 2008. Effective: March 1, 2009 9/8/2010 Page 1 of 8 , Compliance Summary Component Design Criteria Result Gross Energy Cost (in $) 16,290.0 23,942.0 PASSED LIGHTING CONTROLS PASSES EXTERNAL LIGHTING None Entered HVAC SYSTEM PASSES PLANT None Entered WATER HEATING SYSTEMS PASSES PIPING SYSTEMS PASSES Met all required compliance from Check List? Yes/No/NA IMPORTANT MESSAGE Info 5009 -- -- -- An input report of this design building must be submitted along with this Compliance Report EnergyGauge Summit® Fla/Com -2008. Effective: March 1, 2009 9/8/2010 Page 2 of 8 CERTIFICATIONS 1 hereby certify that the plans and specifications covered by this calculation are in compliance wi • th- Florida Energy Code / Prepared By: John Makar Building Official: J /, . Date: - 0. ( Date: % I certify that this building is in compliance with the FLorida Energy Efficiency Code Owner Agent: Date: If Required by Florida law, 1 hereby certify ( *) that the system design is in compliance with the FLorida Energy Efficiency Code Architect: Reg No: Electrical Designer: Matthew Otto Reg No: 58722 / FL Lighting Designer: Matthew Otto Reg No: 58722 / FL Mechanical Designer: John Makar Reg No: 54827 / FL Plumbing Designer: John Makar Reg No: 54827 / FL ( *) Signature is required where Florida Law requires design to be performed by registered design professionals. EnergyGauge Summit® Fla/Com -2008. Effective: March 1, 2009 9/8/2010 Page 3 of 8 Project: Save A Lot Title: Save A Lot Type: Retail (WEA File: FL_TAMPA_INTERNATIONAL_AP.tm3) Building End Uses 1) Proposed 2) Baseline Total 1,060.90 1,834.60 $16,290 $28,167 ELECTRICITY(MBtulkWhl$) 1,060.90 1,834.60 310870 537542 $16,290 $28,167 AREA LIGHTS 214.80 549.80 62923 161081 $3,297 $8,441 MISC EQUIPMT 256.70 256.70 75227 75227 $3,942 $3,942 PUMPS & MISC 0.00 0.00 2 2 $0 $0 SPACE COOL 475.10 675.10 139218 197800 ._......... . $7,295 $10,365 SPACE HEAT 0.50 1.40 148 421 $8 $22 VENT FANS 113.80 351.60 33352 103011 $1,748 $5,398 Passing requires Proposed Building cost to be at most 85% PASSES of Baseline cost. This Proposed Building is at 57.8% EnergyGauge Summit® Fla/Com -2008. Effective: March 1, 2009 9/8/2010 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) I None Project: Save A Lot Title: Save A Lot Type: Retail (WEA File: FL_TAMPA_INTERNATIONAL_AP.tm3) Lighting Controls Compliance Acronym Ashrae Description Area Design Min Compli- ID (sq.ft) CP CP ance Front Sales 25,001 Sales Area 15,850 3 2 PASSES Front Cash 25,001 Sales Area 1,690 2 1 PASSES I PASSES I EnergyGauge Summit® Fla /Com -2008. Effective: March 1, 2009 9/8/2010 Page 5 of 8 Project: Save A Lot Title: Save A Lot Type: Retail , (WEA File: FL_TAMPA_INTERNATIONAL_AP.tm3) System Report Compliance AC -1 AC - 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 11.20 9.50 12.00 9.70 PASSES 240000 to 760000 Btu/h Cooling Capacity Heating System Electric Furnace 1.00 1.00 PASSES Air Handling Air Handler (Supply) - 0.40 0.90 PASSES System - Supply Constant Volume RTU -1 RTU -1 Constant Volume Air Cooled No. of Units Split System < 65000 Btu/hr 1 Component Category Capacity Design Eff Design IPLV Comp - Eff Criteria IPLV Criteria liance Cooling System Air Conditioners Air Cooled 15.00 12.23 15.00 PASSES Split System < 65000 Btu/h Cooling Capacity Heating System Electric Furnace 1.00 1.00 PASSES Air Handling Air Handler (Supply) - 0.40 0.90 PASSES System - Supply Constant Volume PASSES Plant Compliance Description Installed Size Design Min Design Min Category Comp No Eff Eff IPLV IPLV liance None EnergyGauge Summit® Fla/Com -2008. Effective: March 1, 2009 9/8/2010 Page 6 of 8 Project: Save A Lot Title: Save A Lot Type: Retail (WEA File: FL_TAMPA,_INTERNATIONAL_AP.tm3) Water Heater Compliance Description Type Category Design Min Design Max Comp Eff Eff Loss Loss liance Water Heater 1 Electric water heater <= 12 [kW] 0.92 0.86 PASSES PASSES Project: Save A Lot Title: Save A Lot Type: Retail (WEA File: FL_TAMPA_INTERNATIONAL_AP.tm3) Piping System Compliance Category Pipe Dia Is Operating Ins Cond Ins Req Ins Compliance [inches] Runout? Temp [Btu -in /hr Thick [in] Thick [in] [F] .SF.F1 Domestic and Service Hot Water 1.00 False 105.00 0.28 1.00 0.50 PASSES Systems PASSES EnergyGauge Summit® Fla/Com -2008. Effective: March 1, 2009 9/8/2010 Page 7 of 8 Project: Save A Lot Title: Save A Lot T.ype: Retail (WEA File: FL_TAMPA_INTERNATIONAL_AP.tm3) Other Required Compliance Category Section Requirement (write N/A in box if not applicable) Che k Report 13 -101 Input Report Print -Out from EnergyGauge FIaCom attached Operations Manual 13- 102.1, Operations manual provided to owner 13- 410,13 -413 Windows & Doors 13- 406.AB.1.1 Glazed swinging entrance & revolving doors: max. 1.0 cfmlft all n other products: 0.4 cfin/ft Joints /Cracks 13- 406.AB.1.2 To be caulked, gasketed, weather - stripped or otherwise sealed 1V Dropped Ceiling Cavity 13- 406.AB.3 Vented: seal & insulated ceiling. Unvented seal & insulate roof & side walls System 13 -407 HVAC Load sizing has been performed �► Reheat 13 -407.B Electric resistance reheat prohibited 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, 13- 408.AB.3.2.1 E, 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 cfm ADS 13 -410 Duct sizing and Design have been performed HVAC Ducts 13- 410.AB Air ducts, fittings, mechanical equipment & plenum chambers 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. Heat trap required Swimming Pools 13- 412.AB.2.6 Cover on heated swimming pools: Time switch (exceptions); 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 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 buildings >5,000 s.f.; Space control; Exterior photo sensor; Tandom wiring with 1 or 3 linear fluuorescent lamps >30W EnergyGauge Summit® Fla/Com -2008. Effective: March 1, 2009 9/8/2010 Page 8 of 8 . 0 ti L o Q VI WI . - . CC d (3- 0 u CA H ' C3 a) ' S L = Ti •■• r. - cd o a z z 0 °' o a 0 0 0 0 tic Q E.* •C i Cb O o r: c N g aa � z en el O t ' a, el .. 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N M 3 . ; 0 el 03 a a w 0 7 6J ..1- Z a Z E at a Ccl Z cq 0 0 O 0 "' 0 ,M O NI Z O Z o a Jacqueline Boges From: Jacqueline Boges Sent: Friday, October 29, 2010 8:15 AM To: ' mwhite ©gerardiconstruction.com' Subject: permit fee Attachments: SAV -O -LOT SUBDIVIDE SPACE.xls; contractor certificat.docx Good morning Jim, I have finished up the permit cost and it is attached for you to review. NEED Subs to register if they have not and sign on the permit application. They can contact our office at 813 - 780 -0020 if they have questions I have attached the contractor registration information for you . They may fax over any paperwork for the register our fax number is on the form also. We will need the NOC and a copy of the contract from the owner you may bring that with you when you pick up the permit. • You may pick up the permit when all the above is done. Our office hours are 7:30am -12 noon, close for lunch reopen at 1:OOpm- 4:30pm. We accept checks or cash. Jackie Boges Code Support Specialist ext. 3513 1 Jacqueline :Boges From: Michael White [mwhite@gerardiconstruction.com] Sent: Friday, October 15, 2010 6:33 PM To: Jacqueline Boges Cc: 'Phil Gerardi'; 'Motley, David D.'; 'Elizabeth White' Subject: Save -A -Lot Permit - 7320 Gall Blvd - Zephyrhills, FL 33541 Jackie, Thank you for taking the time today to go over the City of Zephyrhills requirements to submit and pick up permits. You were very thorough and pleasant to speak with. The contract amount for the Save -A -Lot project is $355,000. Please confirm the review process can now commence, given this emailed confirmation. I have copied Dave Motley (Project Manager for Save -A -Lot) and Phillip H. Gerardi (Gerardi Construction's owner /President /Qualifier) so you can be assured that this information is coming direct from the source. We will bring a copy of the signed contract (once it is executed,) when we come to pick up the permit as we discussed earlier. We really appreciate the City of Zephyrhills accepting this email for the time being, in order to get the review process started, as we are on a fast track schedule, and need to get started soon. Does the City of Zephyrhills have an early start permit that would allow us to get started, in case the Fire Marshall's plan reviewer can't get to it for the 3 weeks that you quoted to me over the phone? If so, please email me the instructions on what is needed to do so. Thank you again for all your help, Michael White, LEED Green Associate Project Manager/Permit Coordinator Gerardi Construction Inc. 1604 N. 19th Street Tampa, F133605 Office 813 - 248 -4341 Cell 813 -433 -3868 Fax 813 - 248 -4991 mwhite @a,gerardiconstruction.com 1 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 -127 Project: Interior Renovation/Reconstruction Number of Pages: 21 October 27, 2010 I have received and reviewed the plans for the interior remodel /reconstruction of a single tenant space into two separate units located at 7320 Gall Blvd and will allow it to move forward under the following conditions listed below. Paying for permit, the contractor acknowledges complying with those conditions. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. Inspections Required: 1. This structure contains and existing fire sprinkler system, however, now the structure is being divided into 2 separate units. The fire sprinkler system shall be separated into two systems each having its own riser. If unable to do, then system shall have a water flow valve installed at each unit to indicate where the flow is occurring. The FDC connection shall be a 5" turndown Storz connection. There shall be a sign above the connection stating FDC. Lettering shall be 6 "red reflective letters on white background. Separate plans, cut sheets, details, calcs, etc... will be required to obtain a permit to complete this work. Ensure the all canopies have sprinkler protection. 2. This structure contains and existing fire alarm system, however, now the structure is being divided into 2 separate units. The fire alarm system shall be separated into two systems if the sprinkler system is separated. If not, the system shall be an addressable system with every device programmed to the panel with a location. The device shall be labeled to match the panel program. Ensure duct detectors are tied into the system. Separate plans, cut sheets, details, calcs, etc... will be required to obtain a permit to complete this work. Ensure there is an outside strobe horn at the main door of each unit. 3. Extinguisher location may need to be changed to ensure they are visible. Extinguisher placarding may be required showing location. 4. Ensure secondary exits have panic hardware. 5. Ensure address is located at front and rear of building. 6" numerical numbers required. 6. The building contains lightweight bar joist trusses. Per FAC 69A- 60.008, a lightweight truss sign shall be installed on the building. An "R" sign will be the correct one. It shall be located at the main door and every 100 feet. It shall also be required at each secondary exit door. 7. Ensure main disconnect to each unit is visibly marked. 8. Once project is complete, a key for the knox box will be required. 9. All penetrations to fire wall shall be done in an approved, listed method. 2 Inspections Required: 1. Screw inspect on firewall 2. Firewall final 3. Building Final 4. Additional inspects will be required on the other plan reviews to be conducted. i.0*4 KERR BARNETT, 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. ZEP- IYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keilh Williams Bus (813)780 -0041 Fax (813)780 -0044 FIRE SERVICE USER FEES Occupancy No.: //�� Plan No.: /D — 7 Contractor: /7`/"" O /7 Business Name: yyC /7 /az:7T Billing Address: Business Address: 770:5 K-:,-)41-// Business Phone No.: Billing Phone No.: y/ -Q 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 uIti Family /Commercial 06 sf 1st Re inspection N/C _ Standpipes $50 _ 2nd Alarm N/C (Minimum Charge $25.00 2nd Re- inspection $100 _Fire Pump $50 3rd Alarm N/C GG 5th Alarm $150 Plan Revisions DBL 3rd Re- inspection $250 _ Hoods $50 _` 4th Alarm $100 p o8 _ 4th Re- Inspection $500 _ Fire Alarm $50 r �� 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 _ F uel Tanks- per tank $50 — STANDPIPE SYSTEM _ Hydro Undergrounds $45 _ Sparklers $100 ❑ Per Riser $50 Hydrostatic Test $65 per system Fire Works $500 FIRE PUMP _ Acceptance Test $45 per system Camp Fire $25 Ei Per Pump $100 _ Hydrant Flow $75 _ Controlled Bum 5100 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 u Waste Tire Storage 550 Annual _ Dry 550 i re Wall /Smoke Wall 513 per w all — Generator < KW $100 CO2 550 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 __ Haz. 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) D Spray Booth $50 Inspection scheduled DBL — and cancelled Tess than — _ 24 hours _ Construction Insp. N/C Emergency Vehicle Ac $50 „,e, FALSE ALARM PLANS TO INSPECTION TOTAL © -c._l PERMIT TOTAL ( / 47 , z�7 TOTAL r GRAND TOTAL Comments: Date: l4 inspgctor: 1i,� Oct 29 10 02:43p Steve Rogers 8139649434 p.1 • October 29. 2010 FAXED to: (813) 780 -0005 To: Jackie @ City of Zephyerhills From: Stephen Rogers; Treasurer @ All Florida Plumbing Contractors Inc Subject: Contractor Certificate Requirements Chris Rogers asked me to assemble this material and fax it to you. The General Liability Certificate with Zephyrhills as certificate holder is being faxed to you direct from our insurance agent- Kilbride Insurance. Please notify us if you have not received it. It was faxed to (813) 780 -0021. This fax includes: * State Certified License * Occupational License w/ receipt for recent renewal * Workmen's Comp Exempt Certificates * IRS Notification of S -Corp Status & Corp Name * Permit pick -up authorization letter, which includes: * Business address; phone & fax numbers Please let me know if we are missing anything (813) 505 -9911. Thank You. Nov 01 10 11:37a Steve Rogers 8139649434 p.1 NOV 1. 2010 TO: Jackie t FAX # 813 - 780 -0021 FROM: Christopher Rogers SUBJECT: Form Signed Please confirm receipt of this form in good order via AFPCINCO email.com. Let us know if you need anything else. Thank Wm. .......-OCT, 29. 2010 12:52PM A. KILBRIDE INSURANCE, INC. NO. 5669DAEP, 11YYYY) 4 OIZI CERTIFICATE OF LIABILITY INSURANCE 11p/29/2010 THI CERT IFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: IF the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed, If SUBROGATION 13 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 lion of such endorsement(s). _ PRODUCER CON Eric Ma les A KILBRIDE INSURANCE I A N .EX ($13) 93 -7467 ttx/cc,Ner.($13) 932 -7 336 1401 W. Busch Boulevard „ 8 @aki1bride.com Tamps, FL 33612 cuSTOMFRIOR a19URER(9) AFFORDING COVERAGE MO INSURED All Florida Plumbing Corit ractors Inc INSURER A : North Pointe Insurance Company , 4408 Endicott Place INSURER e Tampa, FL 33624 INSURER C, INSURER D: INSURER E : INSURER F : . COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. •' sue 1. Y b - • 1 j"_ UR TYPE OF INSURANCE 1 ; POLICY NUMBER MIDO .D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY P EM8ES (Ea c v $ 100,000 CLAIMS-MADE 1113 OCCUR MED EXP (Any one person) 5 5,000 A, 3093001851 12/08/0912 /08/10 PERSONAL BADVINJuRY s 1,0001000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 1[ POLICY PLOT I I LOC S L ILTTY COM$INED SINGLE LIMIT S _ (Ea aeeldeni) ANYAUTO BODILY INJURY (Per person) S — AU. OWNED AUTOS BODILY INJURY (Per amldeni) S _ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per ambient) NON -OWNED AUTOS S _ 5 UMBRELLA OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE 5 L_. — DEDUCTIBLE s RETENTION S S WORKERS COMPENSATION T gg S I JOTH .- AND EMPLOYERS' LIABILITY VIN ANY pROPRIErORIPARTNEMexecUTIVE ❑ N E.L. EACH ACCIDENT S oFPICERIMSM$ER EXCLUDED? (M, , in NH) E.L. DISEASE - EA EMPLOYEE S DESCRIP OF OPERATIONS below E,L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Mach ACORD 101, Addldonal Remade Schedule, if Mere specs is required) Plumbing #CFC1426997 License Qualifier: Christopher Carucci CERTIFICATE HOLDER. CANCELLATION City QC gePhsyhll] 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 5335 8th Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Zephyrbills , FL 33542 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jackie AUTHORIZED REPRESENTATIVE Fax(613)- 780 -0021 aF:Pbee.e."-. 0 99884009 ACORD CORPORATION. All rights reserved. ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD Oct 29 10 05.22p Steve Rogers 8139649434 p.1 ) rl& October 29. 2010 FAXED to: (813) 780-0005 To: Jackie @ City of Zephyerhills From: Stephen Rogers; Treasurer @ All Florida Plumbing Contractors Inc Subject: Contractor Certificate Requirements Chris Rogers asked me to assemble this material and fax it to you. The General Liability Certificate with Zephyrhills as certificate holder is being faxed to you direct from our insurance agent- Kilbride Insurance. Please notify us if you have not received it. It was faxed to (813) 780 -0021. This fax includes: * State Certified License * Occupational License w/ receipt for recent renewal * Workmen's Comp Exempt Certificates * IRS Notification of 5 -Corp Status & Corp Name * Permit pick -up authorization letter, which includes: * Business address; phone & fax numbers Please let me know if we are missing anything (813) 505 -9911. Thank You. herkco- cior-74 6en t_16)to Oct 29 10 05:22p Steve Rogers 8139649434 p.2 HILLSBOROUGH COUNTY BUSINESS TAX RENEWAL INSTRUCTIONS Chapter 205.0535 (5) Florida Statutes requires one of the following: FEDERAL EMPLOYER IDENTIFICATION NUMBER - OR SOCIAL SECURITY NUMBER 1. SIGN and return entire form in enclosed envelope. Your validated Business Tax receipt will be returned to you. 2. Business Tax receipts expire midnight, September 30th. Failure to display a valid Business Tax receipt after September 301h is a violation of Hillsborough County Ordinance 95 -4, as amended by 02 -5. MAKE CHECK PAYABLE TO: DOUG BELDEN, TAX COLLECTOR P O Box 172920 TAMPA, FL 33672 -0920 2010 - 2011 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9 - - 2011 FoLIONo FACILITIES OR MA CMNES 0 I ROOMIS o I ( SLA IF 0 1 I EMPLOYEES 1 I (I 228429 1 H WASTE TAX CATEGORY CODE BUSINESS TYPE `.iuRCftARGE 090.020 PLUMBING CONTRACTOR 40 00 18.00 19uS'NESS 4408 ENDICOTT PL - - I ()CATION TAMPA 33624 NAME CARRUCI CHRISTOPHER _ MAILING ALL FLORIDA PLUMBING CONTRACTORS INC - AOD.RESS 4408 ENDICOTT PL TAMPA FL 33624 BUSINESS TAX DOUG BELDEN, TAX COLLECTOR , HEREBY PAID A PRIriLEG° TAX TO ENGAt.: 813- 635 -5200 _ I I - .LS MESS PROFES SIDNOR CSC uPILTION SPECIFIED HErrEON. THIS BECOMES A TAX RECEIPT WHEN VALIDATED. - - ` 4206 22842900007 000018002 000040006 • Oct 29 10 02:45p Steve Rogers 8139649434 p.6 12 -11 -2009 COG 1■16 ALEX SINK STATE OF FLORIDA CHIEF FI NlNCIAL.OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE 12/11/2009 EXPIRATION DATE: 12/11/2011 PERSON: ROGERS CHRISTOPHER S FEIN: 271106472 BUSINESS NAME AND ADDRESS: ALL FLORIDA PLUMBING CONTRACTORS INC 4407 ENDICOTT PLACE TAMPA FL 33624 SCOPES OF BUSINESS OR TRADE: 1- REPAIR SERVICE 2- CERTIFIED PLUMBING CONTRACTOR 3 - INSTALLATION SERVICES IMPORTANT: Pursuant to Chapter 440. 06(14), F.S., an elficer of s corporation who elects exemption from Ws chapter by filing s certificate of election ender this section may sot recover benefits or campnosstion wader this chapter. Pursuant to Chapter 440.05021. F.S., Certificates ol electiaa to be exempt... apply only within the scope of the business or trade listed os the notice of elect/ea to he exempt. Pursuant to Chapter 440.06(131. F.S.. Notices of election is be exempt ad cenilicaes al election to be exempt shall be subject to revocation i1, at any time atter the 'fling a1 the notice or the isausoce of the certificate. the persos named on the astice or certificate no longer meets the regniremems oI this sectios for issuance of a certificate. The department shell revoke a certificate et any time for Isilore of the person sealed on the certificate to meet Oro regeiremeets of this section. QUESTIONS? (850) 413 - 1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 ;-3iT : - 12-11 -2009 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 12/11/2009 EXPIRATION DATE: 12/11/2011 PERSON: CARUCCI CHRISTOPHER FEIN: 271106472 BUSINESS NAME AND ADDRESS: ALL FLORIDA PLUMBING CONTRACTORS INC 4407 ENDICOTT PLACE TAMPA FL 33624 SCOPES OF BUSINESS OR TRADE 1- CERTIFIED PLUMBING CONTRACTOR IMPORTANT: Puissant to Chapter 440. 051141. F.S., an otllcer of a corporsNoa who elects eaetaptios from this chapter by HIfsg a certiltcate of election under this sorties may sot recover benefits or compsNoaUan enter Ibis chaplet. Peruses to Chapter 440.05112), F.S., Cerrilicetes of election to be exempt... apply only within the scope of the business or trade listed en the Notice of election to be exempt. Persona to Chapter 440.05(10, F.S., Notices of olectioe is be exempt sod certificates of election to be exempt shall be subject to revocation i1, st any time alter the lilieg of the notice or the issuance al the certificate. Iba person named on the satire 01 certificate AO longer meets tea tequiremeats of this sectios for issusace of a certificate. The dapentaeot shall revoke a certificate el say time ler !allure of the persos named on the certificate to meet the requirements of this section. QUESTIONS? (8501 413-1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 Oct 29 10 02:45p Steve Rogers 8139649434 p.8 All Florida Plumbing Contractors INC. 4408 Endicott P1 Tampa, FL 33624 813 -318 -1263 813 -425 -6341 Fax Afpcinc u4rmail.com #CFC1426997 Power of Attorney 1 Christopher Carucci hereby give complete power of attorney to my business partner of All Florida Plumbing Contractors, Inc. Christopher Rogers. I allow him to act on my behalf for contracts, licensing & permitting, and any other documentation or preparation that has to deal with our business. C� * / Christopher Cate i / Date Notary: : rtS Print • Signature Date C. SIM1NSKI Notary Piddle - Stab of Florida MY Comm. Expires Mu 11.2013 ,a COmf1$IiQA • DD SUM boned Thrace *Hong Rotary An Oct 29 10 02:43p Steve Rogers 8139649434 p.3 ;��'-T STATE OF FLORIDA '. ,itvi DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION g , _: 7 CONSTRUCTION INDUSTRY LICENSING BOARD s •. 1940 NORTH MONROE STREET (850) 487 -1395 TALLAHASSEE FL 32399 -0783 CARUCCI CHRISTOPHER SAMUEL ALL FLORIDA. PLUMBING CONTRACTORS INC 4407 PL FL 33624 -2383 -- Congratulations! With this license you become one of the Weary one million • STATE OF FLORIDA ' AC Floridians licensed by the Department of Business and Professional Regulation, a-a D RO 43f RbSINSSS AND Our professionals and businesses range from architects to yacht brokers, from ' t,-, ' .- °R OFBSSIONI . ,: )(G1T>G►TTON boxers to barbeque restaurants, and they keep Florida's economy strong. : . Every day we work to improve the way we do business in order to serve you better. CFC14t699 0$1f 10 108058538 For information about our services please log onto www.m - There you can find more information about our divisions and the r ulations� CARTIFIHRISTIPHEROAMUE impact you, subscribe to department newsletters and learn more about the A •D P LUOBIl N G CONTRA C Department's initiatives. ALL FLORIDA F.O PIi>Dbl8I1ZtG CODTI�RACTORS Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! ><s CERTIFIED under 2 011 12 2 L L.1 ch:4E9 rs at too dace, - - AUG 31, :2 0083/03130 : -:._ .% DETACH HFRF AC ,:. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND ggROFESSIONAL REGULATION. CONSTRUCTION I�NDUS•TRY L CE'> ING: BOARD SEQ#L14008303130 DATE AATCH NUMB LICENSE -NBR 11. •- 0 8 . /31/2010 . 10 CFC1426997- . The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of :'Cha 4 p.ter '8.g PS. ' Expiration date: AUG 31, 2012 CARUCCI, CHRISTOPHER SAMUEL ALL FLORIDA PLUMBING :CONTRACTORS .INC 4408 ENDICOTT.'PLACE' TAMPA FL 33624 CHARLIE ' GRIST GOVERNOR CHARLIE ALIEN I •-CII.SPI AV AC. O noon nv I /,\. SECRETARY { 11/03/2010 10:38 8138992968 TOTAL ELEC PAGE 02/08 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION P ' - (850) 487-1395 r. 1 ' '..-- ELECTRICAL CONTRACTORS LICENSING HOARD A, 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MADISON, JOHN MILTON TOTAL ELECTRIC SERVICE OF TAMPA INC 8929 MAISLIN DRIVE TAMPA FL 33637 19 - , .,,, i 0, 9: 74 , 4 , f ;2 4(c-) -: ..,--, ,,' .. t." . ' t.A10.1 ,V ). ? t0/4.0": t yl, <1....;) Congratulations! With this license you become one of the nearly one million .. . t. . k.",,i. i7-.: ::„ , • . c":. I ,) -- s .- -' Floridians licensed by the Department of Business and Professional Regulation. g , .4 ,-.:. . T.- ,.' rTt, .• , . • , , .,..,. 'p 4 , Our professionals and businesses range from architects to yacht brokers, from i _,_;;,_' boxers to barbeque restaurants, and they keep Florida's economy strong. 1 '9*'l ai, -sl , ' '•:. ..',Il:rtri(Fg.f.' ,,,:;:, .... .0.---t -- ii.,, . Every day we work to Improve the way we do business in order to serve you better VVI: , „7 s4;x _ -.1. ,s s ., , _.;,.,, .7,7,.., , , .. For information about our services, please log onto www.myfloridalicense.com. -- trr=•\, ,„,,, ,, ,, i . , ,,, .,.. ,..., ..„ ,.., There you can find more information about our divisions and the regulations that t 4., ' _ Th ".:W.J. impact you, subscribe to department newsletters and leam more about the :;I "3 .0_ t : 5e kt ,_, g ; ,. „ .„ Department's initiatives. ,- .,..,,. . . . , ... , ,,,, 4,z) .,) • 0 ..- . ..,0 . -,..1(ifrAS' Our mission at the Department is: License Efficiently, Regulate Fairly. 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BUILDING SERVICES DIVISION CERTIFICATE OF COMPETENCY CERTIFIED ELECTRICAL CONTRACTOR EC0001439 10/31/2011 Certificate Number License Expiration Date Issued to: MADISON JOHN MILTON DBA: TOTAL ELECTRIC SVC/TPA INC Workers' Comp: 06/01/2011 laming OlYieer COT ALONG DOTER DOTTED LINES,FOLD ALONG THE MIDDLE DOTTED LINE, PLACE IN MALLET SIGN YOUR CARD This card is- non - transferable and is revocable for cause The contractor listed hereon will be held responsible for all permits issued under this card. If this card is lost or stolen, eAtify the Hillsborough Co. Contractor Licensing Team,;hmediately at (813) 635- 7308/7309. Your card mueb be newel prior t expiration date j shown on th o �• r 7 ignature'- not valid unless signed C94TIPSC,TS OF c01IPSSENC: H1tf.8B0RO0OB COVRT4, FLORIDA Type: CERTIPIED ELECTRICAL CONTRACTOR NO PERMIT UNTIL STATE REGISTERED, IF APPLICABLE 100001439 10/31/2011 Certificate No. Expiration Date Issued To 11.078ON JOEN MILTON DBA:TOTAL ELECTRIC SVC /TPA INC Morkers'Comp: 06/01/2011 Ieaving Officer I 11/03/2010 10:38 8138992968 TOTAL ELEC PAGE 04/08 2010 2 2011 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 940 - 2011 FOLIONO. AACtinikS OR MACHINB3 ROOMS SEATS EMPLOYEES 15 f RENEWAL I 0{ 0 0 23267.0000 EMP H. WASTE TAX OCC. CODE BUSINESS TYPE SURCHARGE 090.008 CONTRACT R- MASTER ELECTRICIAN 36.00 2011 BUSINESS 8929 MAISLIN DR LOCATION TAMPA 33637 NAME MADISON JOHN MILTON /DBA/TOTAL ELECTRIC SERV/TPA II 1�4AJLING 8929 MAISLIN DR ADDRESS TAMPA FL 33837 -0000 BUSINESS TAX RECEIPT DOUG BELDEN, TAX COLLECTOR PAID -10517 - 85 HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813436-5200 07202010 38.00 IN BUSINESS PROFESSION, CR OCCUPATION SPECPIEO HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATES. • 11/03/2010 10:38 8138992968 TOTAL ELEC PAGE 05/08 ACORDTM. CERTIFICATE OF LIABILITY INSURANCE ��`' 1 1/o1 /Solo PRODUCER , 1 -877 -266 -6850 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Psyche: Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 150 sa wgrasa Dr ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Rochester, NY 14620 INSURERS AFFORDING COVERAGE INEURED INBURERA: ILLINOIS NATIONAL INSURANCE COMPANY Psyches Business Solutions, Inc, TOTAL ELECTRIC SERVICE OF TAMPA, INC. INSURER se TOTAL ELECTRIC SERVICE OF TAMPA INC INSURER C: 911 Panorama Trail South Roohaster, NY 14625 877 - 266 -6830 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR POLCY INFECTIVE POUCYI7RETATNNI LM ME OF INSURANCE POLICY NURSER OATS BIMEIDAM) DATE (MADE VY) WAITS GENERAL LAALITY EACH OCCURRENCE 1 COMMERCIAL GENERAL LIABILITY 1 I CLAIMS MADE D OCCUR FIRE DAAUOE (MTsM M) LIED EIP (Aryans PMOI) S ,_, PE A. RSON I AOV INJURY S _ GENERAL AGGREGATE S GENT. AGGREGATE LIMIT APPLIES PER PRODUCTS – COMPICP AGO S POLICY n JECI' 11 LOC — — • AUTOMOBILE LIABILITY � • ANY AUTO COMBINED SINGLE UNIT aooMAN) -- 3 _ ALL OWNED AUTOS ' BODILY IILRIRY SCHEDULED AUTOS IPM parson) S HIRED AUTOS BOOILYINJURY NON -OWNED AUTOS (PM Oe00N10 S — PROPERTY DAMAGE (PM aeDDNq S ._ - . GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S R ANYAUTO 1 OTHER THAN AUTO EA ACC $ ONLY: AGO 1 EXCESS LIABILITY EACH OCCURRENCE S OCCUR D CLAIMS MADE AGGREGATE $ DEDUCTIBLE ' RETENTION $ , $ WORKERS A ~ TI EMPLOYERS' 012007139 06/01/10 06/01/11 X I maim 1 I oTH TORY UNITS ER E.L. EACH ACCIDENT 1 1,000.000 E,L DISEASE–EA EMPLOYEE 1 1, 000, 000 E.L DISEASE – POLICY LIMIT 1 1,000,000 OTHER E 8 $ DESCRIPTION OF OPERATIONWLOCATIONEANWISLESEDICLUSIONS ADDED BY AIDORAlMENDSPECYLL PROWNOIR{ WORKERS COMPENSATION COVERAGE 28 PROVIDED TO ONLY THOSE EMPLOYEES LEASED TO, BUT NOT SUBCONTRACTORS OF THE NAMED INSURED RCOVERAGE igl MADISON IN O 000143 E 9 A & E ROY BC13001371 TOTAL ELECTRIC SERVICES OF TAMPA INC. 8929 MAISLIN DRIVE TAMPA CERTIFICATE MOLDER 1 1 ADDITIONAL NUUREa INSURER LETTER: _ CANCELLATION SHOULD ANY OF TNI ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE CITY OF ZBPEYRBILLB TNERROF, TN■ ISSUING INSURER WILL ENDEAVOR TO MAIL is_ DAYS WRITTEN NOTICE TO THE BUILDING DEPARTMENT CERTIFICATE HOLOOR NAMED TO THE LEFT, OUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION 5335 8TH STREET OR UAWUTY OP ANY HIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. j :EPIHYRB IIO M j ILLS, FL 33542 USA AITRIMRENDEINTAT , 1 1C c ACORD 23-5 (7197) 18158478 II ACORD CORPORATION 1988 11/03/2010 10:38 8138992968 TOTAL ELEC PAGE 06/08 Client#: 6725 TOTAELE ACORD. CERTIFICATE OF LIABILITY INSURANCE DATERAINDO/YY"Y) 11/0212010 PRODUCER THIS CERTIFICATE I8 ISSUED AS A MATTER OF INFORMATION Lanier Upshaw, Inc. ONLY R AND THICONFERS TIFICATE DOES UPON AMEND ,EEXTEN OR 1115 US Hwy 98 South ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. __ ,'.O. Box 468 Lakeland, FL 33802 INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURER A: Westfield Insurance Company 24112 Total Electric Service of Tampa, Inc. INSURER B: 8929 Maislin Drive INSURERC: Tampa, FL 33637 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POUCY EFFECTIVE POLICY EIOIMATION LTR arm TYPE OF INSURANCE POLICY NUMBER DATE fMMIODM'YYI DATE aallDD(YYYY1 UNITS A GENERAL uABLrrY T RA5544989 11/01/2010 11/01 /2011 E ACH OCCURRENCE 51.0 00,000 X COMMERCIAL GENERAL LIABILITY MA LIR FFIEN7 g„ 6100.000 CLAIMS MADE © OCCUR WED EXP (My one parson) 55.000 X PD Ded:1,000 PERSONAL a ADV INJURY 51.000.000 GENERAL AGGREGATE 82.000.000 GENL AGGREGATE UNIT APPLES PER PRODUCTS - COMP/OP AGG 82,000,000 - POLICY n JEST n LOC A AUTOMOBILE LIABILITY TRA5544989 11/01/2010 11/01/2011 COMBINED SINGLE LIMIT X ANY AUTO (Es accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY $ _ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Peracddenl) "— PROPERTY DAMAGE $ (Per acoldent) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ H ANY AUTO - OTHER TITAN EA ACC = AUTO ONLY: AGG $ A EXCESS I UMBRELLA LIABILITY TRA5544989 11/01/2010 11/01/2011 EACH OCCURRENCE 62.000.000 _ OCCUR 0 CLAIMS MADE AGGREGATE 52,000,000 I DEDUCTIBLE RETENTION $ 1 6 $ WORKERS COIAPATIDN AND I T 9 - I I FR � EMPLOYERS' LIAIILITY ANY ( � in EL EACH ACCIDENT $ In EXCLUDED? If yyeess� ducd under E.L. DISEASE - EA EMPLOYEE $ S PR OVISIONS below EL. DISEASE - POUCY LINT 6 A 074 Rented & TRA5544989 11/01/2010 11/0112011 650,000 w/$500 Ded. Leased Equipment DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: License for John Madison #EC0001439 & Roy W. Baker EC13001371 CERTIFICATE HOLDER CANCELLATION 10 Days for Non•Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIE EXPIRATION City Of 2 ephyrhnla- sYilding DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AR DAYS WRITTEN Dept. NOTICE TO THE CERTIFICATE HOLDER NAND TO THE LEFT, BUT FAILURE TO DO SO SHALL 5335 8th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Zephyrhills, FL 33542 REPRESENTArwla, AUTHORIZED RB IMTATNE i+S.at".•� 5. ' �.e. ACORD 25 (2009/01) 1 of 2 #8153259/M152961 0 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FRANC 11/03/2010 10:38 8138992968 TOTAL ELEC PAGE 08/08 1 t ► \ ► LECTRIC SERVICE OF TAMPA, INC. ELECTRICAL CONSTRUCTION 8 DESIGN November 1, 2010 The City of Zephyrhills Attn. Jackie - Building Dept. 5335 8th St. Zephyrhills, FL 33542 TO WHOM IT MAY CONCERN: I, JOHN MILTON MADISON, LICENSE #EC 0001439, HEREBY AUTHORIZE THE CITY OF ZEPHYRHILLS TO RELEASE THE ELECTRICAL PERMITS TO BOB FLEMING FOR WORK TO BE PERFORMED IN THE CITY OF ZEPHYRHILLS BY TOTAL ELECTRIC SERVICE OF TAMPA INC. AT THE FOLLOWING ADDRESS: 7320 Gall Blvd. FOR: THE REMODEL OF FOOD STORE I AM HEREBY AUTHORIZING THE ADDITION OF BOB FLEMING OF TOTAL ELECTRIC SERVICE OF TAMPA INC. TO APPLY, SIGN AND PICK UP ANY PERMITS FOR THE ABOVE MENTIONED JOB. _ /.. JOH MILT i N MADISON State of Florida County of Hillsborough The above signature is acknowledge before me this 1ST day of NOVEMBER 2010. JOHN MILTON MADISON personally appeared _who is personally known to me or has p duced N/A identification. Notary Signature 1 liro_MIupou•00111102 AMBER MORALES. NOTARY a " �0`"1400� a My commission expires: 2/15/2011 —�••� 8929 Maislin Drive • Tampa • Florida • 33637 • Office • 813.899.4948 • Fax • 813.899.2968 11/03/2010 10:38 8138992968 TOTAL ELEC PAGE 01/08 TO TA 1. ELECTRIC SERVICE OF TAMPA, INC. ELZCTRICAL CONSTRUCTION R DESIGN FACSIMILE TRANSMITTAL SHEET TO: FROM: Jackie Amber Morales COMPANY: DATE: City of Zephyrhilis 11/1/2010 FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER: ( 1513) rigo -00447 PHONE NUMBER: SENDER'S REFERENCE NUMBER Save -A -Lot Project RE: YOUR REFERENCE NUMBER: Address and Contact Information And Contractor Requirements ❑ URGENT ❑ FOR REVIEW ❑ PLEASE COMMENT ❑ PLEASE REPLY ❑ PLEASE RECYCLE NOTES /COMMENTS: / Sake License Total Electric Service of Tampa, Inc. v / I2c31s+ e Uc er Se 8929 Maislin Dr. p Tampa, FL 33637 ✓ 4 ReCC 1,u f C Phone (813) 899 -4948 Fax (813) 899 -2968 .J Email a3 � ctric.9etvice ne L71r A 1 C97tota>P>Pctt s ,:..p n ✓ C1.71 tack' 1 n fb johnQ.totalelectricservice.net 8929 Maislin Drive, Tampa, Florida 33637 • 813/899 -4948 — FAX 813/899 -2968 2- - . . . . . . . ... A c# 4 4 821 82. . ••,..,:, . . . :. • • .... • STATE OF FLPRIDA . .. . .• .: ......:, • ,., .• . • • . .. .... . . ‘ • : • • .; 0,0AR*ENT • . @S' SUSINEsS ' Aim PRgFEs SZ MAL REGULATI on . . • • • • ::, • • :. - . . , ..::• , ..: g . : • ‘ ,... .: .. '.;:OOlfiS AUCTX01c. INDy$TRY LIcErisiNG• • BOARD . . . • SEQ# Lir*O7 0 fi. b 6 1, 0 OA rE BATCH A:UMBER : . . . 0713.2045.4 til9tio4 iti th,d6O.265 2.- . . • • • ' . . . . . . ' . • ,-. . .,.... . ,, , ., NO tii`.101.0E0 O r gAit , 4° H, `,P.RAPTGR . s,i..': • , ' ': • . . :.::" . * ' . ' . tedi.. " .el,: *;. - 40EL'ILTSTARED... .4.:' .. .. . . . ... tyrtdot' tb:/: Oi :-.),,=,.,- , 0....q....:_.C#Opr. 4 89 PP • . ,, ....... . . . . rapiration clatli* .„ .v. , ... . (Z NDIvinuA4. - Nrar,s, -z".1 .77;.LOTOAT.4. liztrlisrNG . REQUIREMENTS:,PRXGR:To'140#TIOCTING Tg-ANY AREA) . . . SANDERS,'W.AtZACE .•-' :••..• • TIM ALERT: • cOtaRazo{:i..,.•:.• : .;{:.:)., . . .;.:.. s40.1 E 01i Idgi.:AV/E . .;•' .. ! ' ''' ,'.; :::. . • • • TAMPA , . . PL 3617-8709. . .. . •• • ' .' : : " ..f:'•' . . , ' .: • • L , .. .• 'CHAR./42H .0.40,Ii . • • : . .... . ,:,: GOVVRXI7p CHARLES W. DRAGO • • SECRETARY j DISPLAY AS REQUIRED SY LAW • ,.. ... : . tuanommtiatonwrimmamwww-0 ,...!..•. ,... .::..,•,... ••.. • - . OFFICE DISPLAY CARD DEVELOPMENT REVIEW SERVICES DEPT. CONTRACTOR LICENSING ..• , . CERTIFICATE OF COMPETENCY . • . . .• 0:128.1? '-).'" ' -',.. C.d.! IP • I.D.# - „/ .. . • N. .• . • Be it known that,1 C ,YSA ,.. • .• \• . ... • -- . FA: n•et MECHAN I C0‘.. (C01 .._ ,, ,... • 4 ::4 .:4 I AL.,::,. .), C/0 THE AI- . Cp.. , %..,, , .,,/,. 54U1 • r '01: . $K,Aivr.. ''' . i: _. _, ... • TAMPA .". ...-!..,-;-:-.:. • ; UNDER SEC. 18 PASCO COUNTY CODE HAS MET THE PROVISIONS FOR A CERTIFICATE OF COMPETENCY . PEX IRIN;--0,.. .,. 1 . ., • .cr o C 1. ... _. ,../1 .... . • . • . . E.- _••,,,,, BUILD • .• .•••,-, • : --"," :, -• : .. , . ileietallSAIIMMU ..,‘.:•:.. t IAL '44 t, Mechanical Contractor 5401 E. Sligh Avenue Air Conditioning FL RM0016652 Tampa, Florida 33617 -8709 Heating FL OB0002481 Ph (813) 626 -4111 • Fax (813) 628 -4349 Heat Pumps NOVEMBER 5, 2010 CITY OF ZEPHYRHILLS — BLDG DEPT. 5335 8th ST. ZEPHYRHILLS, FL. 33542 ATTN: JACKIE FROM: WALLACE C. SANDERS THE FOLLOWING ARE AUTHORIZED TO SIGN /PICK UP MECHANICAL PERMITS ON MY BEHALF: W.C. SANDERS MIKE SANDERS ALLAN CRISWELL KIT GALGANO SI E LY , A WALLAC . ! . S r DERS PRES IDENT THE ALERT COMPANY a rL.4.4_ NOTARY W.C. SANDERS IS PERSONALLY KNOWN TO ME. THIS 5th DAY OF NOVEMBER, 2010. 411.N AaN6. OMM w * MY COMMISSION S DD 918175 � EXPIRES: April 11, 2013 ' de Bonded Tin au* Noy Swim „ 21 0 �.; zh LL O w ;a �. : ` ij to S^ Q ` :r ...,,: %.,, I W C Z fY r+ 0 :: , Z to Q i 1.: 43 ,- : sn ... - 6 V r:l..a `� l � m , .d . rx ir7 ;i. :x.: . 4.a . C 1 44) ,..t . , CO 0 � w 7+� 1 u @ = Z 3 x 1 r G 1m.�* Q. I� Zr. r r: a a . � • C . r SJ E +1 1 C 5 .' .a C;4: i4 inl . .. 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Q u. • mO � l� z 11/05/2010 07:37 FAX WEST- 12001/001 A► C �� OP ID: AC �..-- CERTIFICATE OF LIABILITY INSURANCE j °"'E''""'°°'TT"' 1/05110 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE•OdES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, "THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder hen ADDITIONAL INSURED, the pollcy(1..) must be ;eddied. If SUBROGATION 18 WAIVED, subject to the bans and Gandltlone of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in u of such indorsement(.). - PRODUCER 813- 935 -4440 West Caput Insurance, Inc. 013. 996.4450 FAX 0377 Gunn Highway 1 uuc Nor Tampa, FL 33626 GEORGE LACKEY cuaTOIiwRID. : ALERT -1 — IMBED THE ALERT COMPANY INS" 61 000`a""o --- NAlOp — INSURERA : SOUTHERN OWNERS INSURANCE & WALLACE SANDERS I MUM a : BRIDGEFIELD INS CO (SUM) 5401 E. 8LIGH AVENUE INSURER C :AUTO-OWNERS INSURANCE CO TAMPA, FL 33617 -8710 INSURER 0 : MEURER E _ IN.URERP: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIEs. LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIMS. -– TYPE OF INSURANCE yin POLICY NDMSER MOTS GENERAL LNEILnY EACH OCCURRENCE 5 1,000,000 A X COMMERCIAL GENERAL LIABILITY 054812- 20702154 -10 01101110 01/01/11 DPRadliiis i rte° M 300,00C CLAIMS MADE El OCCUR MED EXP (Any an person) 5 10,00C PERSONAL a Atm InuuRY $ 1,000,00C GENERAL AGGREGATE 5 2,000,000 GEN L AGGREGATE LINT APPLIES PER: PRODUCTS - COMP/OP A ,G 8 2,000,00C POLICY r lR : n LOC 8 AUTOMOBILE LMIIILITY - COMBUe3O SINGLE LIMIT C X ANYAUro 41.73641140 01/01/10 01/01/11 (EB°O`�0") s 1,000,00C — AU. OWNED AUTOS BODILY INJURY (Per na pawn) 1 SCHEDULED AUTOS BODILY INJURY (Pa sa onn) 5 PROPERTY DAMAGE HIRED AUTOS (pr 00:111M) 5 — — NON-OWNED AUTOs 8 $ uM.RELLA LIM X OCCUR EACH OCCURRENCE S 1,000,000 C ._ LRCMS LIAR CLMM8.MA AGGREGATE 1 1,000,000 41- 736.811.01 01101110 01/01/11 DEDUCTIBLE 5 X RETENTION . 10.000 s AND EMPLOYERS' MPLOYERS' MTN IO yyR 1 IMIT I I O7 AND EYERe *SA11O Y Y! N X J TORY l TU �EB H. _ B ANT MOIIRIETORIPARTNERIEXECUTNE 0 0830. 38724 01/01/10 01/01111 E.L. EACH ACCICENT 5 500,000 OFFICER/MEMBER EXCLUDED? N ! A � Myya y In N E.L DISEASE • EA EMPLOYEE $ 500,000 DESCR O OP bow E.L DIS EASE • POLICY UNIT s 500,000 DESCRIPTION OP OPERATIONS 1 LOCATIONS ! VEMCLES (AIMCI, ACORO 1sT, Addllbnsl Romans asmsdnlo K man WEI lo rq:dnd) PHONE 0113750.2313 - _ CERTIFICATE HOLDER CANCELLATION CITYZEP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN CITY OF ZEPHYRHILL$• ACCORDANCE NMTN THE POLICY PROVISIONS. BUILDING DEPARTMENT FAX: 760-0021 ATTN: JACKIE Aun1DRDSiD REPRESENT "TME 5335 8TH STREET ZEPHYRHILLS. FL 33542 019082009 ACORD CORPORATION, All rights reserved. ACORD 26 (2009/09) The ACORD name and logo am registered marks of ACORD