HomeMy WebLinkAbout11-11412 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 11412
BUILDING PERMIT
Permit Number: 11412 Address: 7050 GALL BLVD
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD /ALT COMMERCIAL Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35- 25 -21- 0010 - 10500 -0000
Improv. Cost: 10,000.00
Date Issued: 1/24/2011 Name: FL HOSPITAL OF ZEPHYRHILLS
Total Fees: 152.50 Address: 7050 GALL BLVD
Amount Paid: 152.50 ZEPHYRHILLS, FL. 33542
Date Paid: 1/24/2011 Phone: (813)783 -6189
Work Desc: DEMO INTERIOR ONLY 3,560 sq ft - FLOOR/DOORS/ SINKS OBSERVATION ROOM
-•..• •0 -1 •1 1 ., 7. , - -V - . n
CPI ,11
•• •. -•1 17: . • yr •■
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
CON - CTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
• • This - Instrument Prepared By:
Naute: Rodda Construction, Inc., 250 E. Highland Drive. Lakeland, FL 33813 `
Permit No.
T a x F o l i o N o . 3S—S "I - 6o1u -tO - 000
NOTICE OF COMMENCEMENT
STATE OF Florida
COUNTY OF Pasco
THE UNDERSIGNED hereby gives notice that improvements 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 of property, and street address if available)
Florida Hospital Observation Area Legal: 35- 25 -21- 0010 - 10500 -0000 _
7053 Zephyrhills, FL 33541 Dairy Rd. ' 1110101111111011101011111010 11 IOil 1101111
ep
2. General description of improvement: demolition 2011010069
3. Owner / Tenant information
a. Name and Address: Florida Hospital Zephyrhitls, 7050 Gal! Blvd,Zephyrhills, FL 33541
b. Interest in property: Owner
c. Name and address of fee simple titleholder (if other than owner):
ct Contractor:
a. Name and address: Rodda Construction, Inc., 250 E. Highland Drive, Lakeland, FL 33813
b. Phone number: 863- 669 -0990 Rcpt :1346678 Rec: 18.50
S. Surety DS: 0.00 IT: 0.00
a. Name and address: N/A 01/21/11 C. Cook, Dpty Clerk
b Amount of bond $ _ _ . _ _ . _ _
c. Phone number: PAULA S . O' NE I L , Ph . D . PASCO CLERK & COMPTROLLER
6. Lender 01/21/11 0:S a 1 of 2
a• Name and address: N/A OR BK 8 PG 3918
b. Phone number:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided in section 713.13(1)(a)7., Florida Statutes:
a. Name and address:
b. Phone number:
8. In addition to himself, Owner designates the followingperson(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b)., Florida Statutes:
a. Name and address: Rodda Construction, Inc., 250 E. Highland Drive, Lakeland, F! 33813
b. Phone number: 863- 669 -0990
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different
date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA
STATUTES, AND CAN RESULT IN YOUR PAIING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND/k''OSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND
TO OBTAIN FINA•N ING, CONSULT , TH YO RI LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NO E-OI 9Y OENCEM ' // •
(Signiture of Owner or Owner's Authorized Officer/Director/P rtner/Manager)
gl'ad6/6)--ci �n er t ilf/ R .
(Signatory's Tide/Office) ,rnf {�J� i, /�
trume t was knowled ed before me thi � day of d , 2011, by L/V la-el �a 1'lE'1'�
( nam e ofp person) in It a� g
(name of as / Ole (type of authority, ... e.g. o cer, trustee, attorney in fact) for (name of party on
beh !f f who instrument execute
/0 /j . 4 . KATHLEEN S. MoCALLUM
• (� . � ' , NOTARY PUBLIC
( gnature of Notary Public - Sta of Florida) �. , = STATE OF FLORIDA
•�: • -, : Commit DD7211233
(Print, Type, or Stamp Com ssioned Name of Notary Public) ' , Expires 1/1$/2012
Personally Known OR Produced Identification Type of Identification Produced
DATE: 01/21/11 PASCO COUNTY PROPERTY APPRAISER 10:45:02
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 10500 0000 TYPE: STATUS: A DLA: 100107
SC TP RG SUB BLOCK LOT TRACT: 0328004
PARENT: 35 25 21 0010 07200 0000 DATE - SPLIT: 050205 /VGL CLASS: 73
NOTES: 83Z /C #346;CMB 1- 104 -1,1- 106 -0,1- 122 -0;CMB 1 -103 -0 LETTER CD-
,1- 121- 1,6- 0- 4,6 -0 -5 HERE 94WHOLLYOK;SPL 1 -103 -1 OWNER CHG-
NAME: ADVENTIST HEALTH SYSTEM/ 7050 GALL BLVD
/ADDR SUNBELT INC
FS119 CODE: ZEPHYRHILLS FL 335411347
STREET ADDRESS: 7052 GALL BLVD ZEPHYRHILLS F
VALUE & TAX INFO: E X E M P T I O N I N F O: SOH HX APP
LAND AG: NUM CD H W D V T PCT HX -OVRD YEAR DATE S YR DVD%
-MRKT: 2958514 001 19 0 0 0 0 0 1995 030194
BLDG: 28061153
XFOB: 257847
APPR: 31277514
SOH:
NS ASD: 31277514 OR BK 8504 z 3919
RPG: 2 of
EXEM: 31277514
BS TXB:
S DVD:
S TXBL:
AREA: 30ZH ACRES: 27.89 SPEC HX:
BC TXB
ADD EX:
C DVD:
C TXBL:
PRIOR YR VALUE: 32435930
PRIOR YEAR MKT: 32435930
HX VAL: 0 NON -HX: 31277514 MKT DIFFERENCE: 0
MKT CHG HX: 0 NON -HX: 1158416- PRIOR HX VALUE: 0
MC LAND HX: 0 NON -HX: 0 PRIOR HX PCT:
PHYS HX: 0 NON -HX: 0 PRIOR NON HX: 32435930
PRIOR N -HX ASD: 32435930
S A L E S :
YEAR MON BOOK PAGE SALES -AMT INST XFER QUAL ST LIFE I/V TOI
1982 01 1170 1830 410000 V
1982 01 1170 1881 145000 V
1984 11 2051 0751 V
1992 10 3164 0724 QC I X
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 FOLLOWING DESC PROP
LYING W OF DAIRY RD R/W AS NOW LOCATED TRACTS 103,105,106,119
,120 & 122 & E 100 FT OF TRACT 104 & E 105.76 FT OF TRACT 121
EXC W 187 FT OF E 267 FT OF N 172 FT OF TRACT 103 & EXC US
HWY 301 R/W & EXC R/W FOR DAUGHTERY RD;& ARBOR RIDGE
SUB PB 22 PG 44 LOTS 5,6,7 & 8 OR 3041 PG 160
OR 3154 PG 65 OR lGLST1 £ G R, CY OLP AS
THIS IS TO CERTIFY LO IDA THAT OUNT THE FOOING CO IS A
TRUE
ON FILE OR AND OF CORRECT PU:LIC COPY RECORD OF THE IN THIS DOCUMENT OFFICE
/V l-NWS MY HAND AND OFFICIAL SEAL THIS
DAY OF 4 _ AA 2
PAT S. O'NEJL, E. & CO PTROLLER
�� DEPI_;TY CLERK
/ *e` 6
IJ /. I'1 il: \. ti .
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
l'
CC
ntra /Homeowner: GJ 4, ! 2�d 7 )
Date Received: /, - :- "/ c1
Site: 76;,-57) G .6v
Permit Type: - ?,/4S,V7iZ`::: (..1qfi.,: 2,7
Approved w /no comments: ❑ Approved w /the below comments: ❑ Denied w /the below comments: ❑
1 1
2 k 1 ' / / C�:�C
C.
P ? & 44i :.
This comment et sh. .'- /- . t with the permit and/or plans.
Kalvin 'tz - P1. . Examiner Date Contractor and/or Homeowner
(Required when comments are present)
Client #: 4424 RODDCON
ACORD)TM CERTIFICATE OF LIABILITY INSURANCE DATE(M
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER 0 ' a RM ' • ,
Lanier Upshaw, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1115 US Hwy 98 South HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 468
Lakeland, FL 33802 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Westfield Insurance Company 24112
Rodda Construction, Inc. INSURER B: Bridgefield Employers Insurance 10701
250 E. Highland Drive INSURER C:
Lakeland, FL 33813 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.
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YYYY) DATE (MM/DD/YYYY) LIMITS
A GENERAL LIABILITY CMM4641613 12/31/2010 12/31/2011 EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY PRFMISFSO REND nre1 $150,000
CLAIMS MADE X OCCUR MED EXP (Any one person) $10,000
X PD Ded:1,000 PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000
n JE
— 1 POLICY CT IJC I LOC
A AUTOMOBILE LIABILITY CMM4641613 12/31/2010 12/31/2011 COMBINED SINGLE LIMIT
X ANY AUTO (Ea accident) $
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON -OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT _ $
1 ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY: AGG $
A EXCESS / UMBRELLA LIABILITY CMM4641613 12/31/2010 12/31/2011 EACH OCCURRENCE $10,000,000
OCCUR CLAIMS MADE AGGREGATE $10,000,000
$
DEDUCTIBLE
X RETENTION $ 0 $
B WORKERS COMPENSATION AND 83037282 01/01/2011 01/01/2012 X 1 TORY I MITS 1 I
EMPLOYERS' LIABILITY
AQN�YCCPROPRIIEETgOR /PARTNER/EXECUTIVE VM E.L. EACH ACCIDENT $1,000,000
(Mandatory In NH� EXCLUDED? I N I E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1 ,000,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION 10 Days for Non - Payment
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Zephyrhills DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL nrl DAYS WRITTEN
5335 8th Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Zephyrhills, FL 33542 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRE ENTATIV
ACORD 25 (2009/01) 1 of 2 #S155571/M155264 0 1988 -2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD ALM
n v rr . w ti v '^ y T: v Al. J 1 h 1 G WE I L -V01 1.1 LJF
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
,CONSTRUCTION INDUSTRY LICENSING BOARD S Q# L1006030241
DATE HATCH NUMBER LICENSE NBR
0,.6/03/010 090461264 Ct 0614.9.0
The GENERAL CONT
Named below IS CE tTIFTED
•
Under the provisions of Chapter 489 FS
Expiration date: AUG 31, 2012
• RODDA CONSTRUCTION � .. RUCTION .. NC
2128 EAST EDCEWOOD'DRIVE
SUITE 109
LAKELAND FL 33803
CHARLIE GOVERR INTERIM Idb S ECRE-
I2Y
DISPLAY AS REQUIRED BY LAW
POLK COUNTY LOCAL. BUSINESS TAX RECEIPT
ACCOUNT NO. 13075 CLASS: B EXPIRES: 9/30/2011
OWNER NAME LOCATION
RODDA, JOHN A 250 E HIGHLAND DR
LAKELAND - IN
BUSINESS NAME AND MAILING ADDRESS CODE ACTIVITY TYPE
230150 CONTRACTOR GENERAL
RODDA CONSTRUCTION, INC
250 E HIGHLAND DR
LAKELAND, FL 33813 -1725
PROFESSIONAL LICENSE (IF APPLICABLE)
DBPR CGC061496
OFFICE OF JOE G. TEDDER, CFC * TAX COLLECTOR THISPOLKC. UN
OTLOCALBUSINESSTAxRECE1PTMUST
CONSPICWSLY D AT THE BUSINESS LOCATION BE
PAID - 1201248. 0001 -0001 07/08/2010 07/08/2010 NGG 12 57.75
CITY OF LAKELAND
2010 -2011 BUSINESS TAX RECEIPT
Business Tax Office, 228 S Massachusetts Ave., Lakeland, FL 33801
THIS BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30, 2011 RECEIPT NO: 01201
Account Number: 1205483 Business Classification(s) Class Category Quantity
Workers: 50 PROFESSIONAL FIRM OFFICE 13555 1
Square Footage: 10900 GENERAL CONTRACTOR - CLASS A 4601 2
Fee: 902.64
Location Address
250 E HIGHLAND DR
This business tax receipt does not permit the holder to operate in
Business Name $ Mailina Address violation of any City law . ordinance or regulation Any change in
location or ownership must be approved by the City Business Tax
RODDA CONSTRUCTION INC Receipt Section subject to zoning restrictions This Business T ax
JOHN RODDA, OWNER Receipt does not constitute an endorsement. approval or
disapproval of the holders skill or competence or of the
250 E HIGHLAND DR compliance or noncompliance of the holder with other laws.
LAKELAND, FL 33803 -3656
RECEIPT MUST BE CONSPICUOUSLY DISPLAYED IN YOUR PLACE OF BUSINESS VALID ONLY WHEN SIGNED
813- 780 -0020 City of Zephyrhills Permit Application Fax - 813- 780 -0021
' Building Department f, ni,t t_ I
■ •
Date Received ■� Phone Contact for Permitting (- - ) ) (UI
- 1 17 17 • misu -El •mmmmmmmmm mans mu .
Owner's Name Era d, / � � Owner Phone Numbe -- RI —00 .) C0
Owner's Address L OE l P 0 `hol it sp � —
_JV■
Fee Simple Titleholder Name Owner Phone Number . _.
Fee Simple Titleholder Address 1
JOB ADDRESS �5 ,ii I al kik . LOT #
SUBDIVISION PARCEL ID# -)--S - v i ' ) - Ou 1 y - . J
L1 ,
(OBTAINED FROM PROPERTY TAX N ) " 11
—
WORK PROPOSED NEW CONSTR _ ADD /ALT I I SIGN (n DEM (iSH
INSTALL REPAIR
PROPOSED USE n SFR I COMM I I OTHER I
TYPE OF CONSTRUCTION n BLACK l � FRAME I I STEEL n II (� , � 1 /
DESCRIPTION OF WORK
Q o f F+�� n W 1 ∎ C 'c J SQf t 00V i ``:'t` Q J S r , lc"J
BUILDING SIZE �[7- 1 SO FOOT ) k\ HEIGHT ` /h �L 1 "
— �` LiA le
P)2 BUILDING
� IJLhJ $ (`� 000 , ( �1 /�. OF TOTAL CONSTRUCTION
1 (ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY n W.R.E.C.
nPLUMBING $
/ ._.
I (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION -rd `_�.
nGAS n ROOFING In SPECIALTY I OTHER I • V-
FINISHED FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA InYES NO
1 1 1 1 1 1 1/ 1' 1" 11111 1 11 1 1 1 1 1 1 1 1 1 1 1 ' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1' 1 1 1
BUILDER
trip ' 1/ *s , /� SIGNATURE COMPANY fit , •F` 5 &kLk) c `
— _` REGISTERED
�q �� -t� � N �y�yr-• FEE CURREN I Y / N I J
Address 41 �l ' 11 l�� i,_- "' 1" #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y / N I FEE CURREN I Y / N I
Address License #
PLUMBER r COMPANY
SIGNATURE REGISTERED I Y / N I FEE CURREN I Y / N I
Address
License #
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURREN 1 Y/ N I
Address ^�
License #
OTHER /// / _ COMPANY
SIGNATURE / REGISTERED I Y/ N I FEE CURREN 1 Y/ N I
r
Address
I
License #
IIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIII1IIIIIIIIIIIIIIIIIIIIIIIII1IIIII
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -0-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.
J ... 1 1 I ..' 1 V
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 Attomey (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 govemment 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.
1 understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone "V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN - • TO OBT FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR • F C' NCEMENT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to (or affirmed) before me this Su scribe and swore jj - . 7 � F
by , /O by • 1 .A \ 0 .:7.
Who is /are personally known to me or has/have produced o is/ re perso . own to me or has/have • •.•uce•
as identification. - .entifica
srAr
Notary Public ��,��/ • _ Public ,„„„,
a 'LEE ° S. MCCALLUM
Commission No. Com ission No.
"' mm D00728233
M1
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped - EApires 1/16/2012
'a.,,gu ' Florida Notary Assn., Inc
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 #: 11 -002
Project: Demolition — Observation Rm.
Number of Pages: 2
January 6, 2011
I have received and reviewed the plan for the demolition of the observation room located at
7050 Gall Blvd and will allow it to move forward. By paying for permit, contractor
acknowledges to comply with the items below. Should anyone have any questions, please do
not hesitate to contact the Fire Marshal's office.
1. Plan submitted was not the complete set of drawings according to the cover sheet and
only is showing the demo. No renovation/modification /build -out is allowed until
those plans are received and reviewed.
2. Ensure all fire protection systems remain operational during demo. If a system has to
be temporarily shut down, this office shall be contacted and a fire watch
implemented.
Ay <
KERRY BAR r 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.
ZEPiiYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrhills, FL 33542
HIC Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044
FIRE SERVICE USER FEES
Occupancy No.: / �
Plan No.: /f -t1J 2. Contractor: rey e.40 n` 1 %'4e
� -0J Gy7
Business Name: / L j-k Billing Address: 2 ; 2 ,---4 ,k.,c r 6 Je
Business Address: 1 s-O �.. -i' ZA/ ,, -. ,�`
Business Phone No.: Billing Phone No.: /,,,.9 _57f
Business Fax No.: Billing Fax No.:
Contact: Contact: / 4
PLAN REVIEW FEES INSPECTION FEES _ PERMIT FEE FALSE ALARM FEE
_ Site Plan N/C Annual N/C _ Sprinkle $50 —
1st Alarm N/C
Multi - Family /Commercial .06 sf — 1st Re- inspection N/C _ Standpipes $50 — 2nd Alarm N/C
• arge . i'll>. _ 2nd Re- inspection $100 _ Fire Pump $50 _ 3rd Alarm N/C
• - DBL ^ 3rd Re- inspection $250 — Hoods $50 nth Alarm $100
4th Re- Inspection $500 _ Fire Alarm $50 ° th Alarm $150
MS (Business closed until LP Gas $50 _
SPRINKLER SYSTEMS Eth 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
0 Per Riser $50 ` Hydrostatic Te $65 per system r Fire Works $500
FIRE PUMP — Acceptance Test $45 —
$4 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 Wall $15 p er wall — 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
Ell Hood /Ducts $50 _ Tent 10'x10' or greater 515 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
Natural Gas Installation $50 Re - inspection DBL
(Per System) (other than annual)
El Spray Booth $50 ri Inspection scheduled DBL
^
and cancelled less than _
_ 24 hours
— Construction Insp. N/C
Emergency Vehicle Acs $50 FALSE ALARM
PLANS TOTAf 7( 4„f4— INSPECTION TOTAL T 1 PERMIT TOTAL 7 TOTAL L
GRAND TOTAL I C bL) 1
Comments.
Date:
f
Insrt A/ / A y n
RODDA
CONSTRUCTION INC.
General Contractors& Construction Managers
Florida Hospital Zephyrhills
Observation Area - Demolition Only
bid proposal
12/23/2010
General Requirements
Builders Risk Insurance by owner
Payroll - Overhead $ 1,500
Dumpster by owner
subtotal $ 1,500
Demolition
Selective Demolition $ 5,000
Concrete & Wall Cutting $ 1,000
subtotal $ 6,000
Mechanical / Electrical
MEP Demo $ 2,000
subtotal $ 2,000
Subtotal - all line items $ 9,500
CM Fee $ 500
TOTAL $ 10,000
Not included in the above proposal:
permit, impact, connection, tap, water meter, utility relocation, or any other type
of governmental fee
250 E. Highland Drive Lakeland, FL 33813 0: 863 - 669 -0990 f: 863 - 667 -3778 Lic. #CG- C061496
AC# STATE OF FLORIDA
DEPARTMOTT.OF BUSINESS AND PRO 'ES,SIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSINO BOARD
SEA# L34343603024 16
DATE BATCH NUMBER LICENSE NBR
06/03/2010,1190461264, CGC06149
The GENERAL CONTRACTOR
Named below IS,-CERTIFIED
Ceder the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2012
RODDA, JOHN A
RODDA CONSTRUCTION INC
212$ EAST EDGEWOOD DRIVE
SUITE 109
LAKELAND FL 33803
CHARLIE GRIST CHARLIE LIEM
GOVERNOR INTERIM SECRETARY
DISPLAY AS REQUIRED BY LAW
POLK COUNTY LOCAL BUSINESS TAX RECEIPT
ACCOUNT NO. 13075 . CLASS: B EXPIRES: 9/30/2011
OWNER NAME LOCATION
RODDA, JOHN A 250 E HIGHLAND DR
LAKELAND - IN
BUSINESS NAME AND MAILING ADDRESS CODE ACTIVITY TYPE
230150 CONTRACTOR GENERAL
RODDA CONSTRUCTION, INC
250 E HIGHLAND DR
LAKELAND, FL 33813 -1725
PROFESSIONAL LICENSE (IF APPLICABLE)
DBPR CGC061496
OFFICE OF JOE G. TEDDER, CFC * TAX COLLECTOR THIS POLK COUNTY LOCAL BUSINESS TAX RECEIPT MUST BE
CONSPICUOSLY DISPLAYED AT THE BUSINESS LOCATION
PAID - 1201248.0001 -0001 07/08/2010 07/08/2010 NGG 12 57.75
CITY OF LAKELAND
2010 -2011 BUSINESS TAX RECEIPT
Business Tax Office, 228 S Massachusetts Ave., Lakeland, FL 33801
THIS BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30, 2011 RECEIPT NO: 01201
Account Number: 1205483 Business Classification(s) Class Cateaory Quantity
Workers: 50 PROFESSIONAL FIRM OFFICE 13555 1
Square Footage: 10900 GENERAL CONTRACTOR - CLASS A 4601 2
Fee: 902.64
Location Address
250 E HIGHLAND DR
This business tax receipt does not permit the holder to operate in
Business Name $ Mailing Address violation of arty City law, ordinance or regulation Any change in
location or ownership must be approved by the City Business Tax
RODDA CONSTRUCTION INC Receipt Section subject to zoning restrictions This Business Tax
JOHN RODDA, OWNER Receipt does not constitute an endorsement, approval or
250 E HIGHLAND DR disapproval of the holder's skill or competence or of the
compliance or noncompliance of the holder with other laws,
LAKELAND, FL 33803 -3656
RECEIPT MUST BE CONSPICUOUSLY DISPLAYED IN YOUR PLACE OF BUSINESS VALID ONLY WHEN SIGNED
Pasco County Parcel: 35- 25 -21- 0010 - 10500 -0000 001 Page 1 of 2
Data Current as Of: Q Weekly Archive - Saturday, December 18, 2010
Parcel ID I 35- 25 -21- 0010 - 10500 -0000 (Card: 001 of 004)
I Classification I 73 - Hospitals, Private
Mailing Address Property Value
ADVENTIST HEALTH SYSTEM/ Ag Land $0
SUNBELT INC Land $2,958,514
7050 GALL BLVD
ZEPHYRHILLS FL 33541 -1347 Building $29,209,434
Physical Address 7 See All 5 addresses (First Extra Features $267,982
Shown) Market Value $32,435,930
7053 DAIRY RD
ZEPHYRHILLS FL 33541 1349 Assessed (Non - School Amendment
1) $32,435,930
Legal Description (First 4 Lines)
ZEPHYRHILLS COLONY CO LANDS Taxable Value $0
PB 1 PG 55 FOLLOWING DESC PROP
LYING W OF DAIRY RD R/W AS NOW
LOCATED TRACTS 103,105,106,119
Land Detail (Card: 001 of 004) I
Line Use Description Zoning Units I Type I Price Condition I Value
1 1 7300 11 HOSP PVT 11 00C3 11 11,000.00 11 SF U $8.90 0 1.00 1 $97,900 1
2 1 7300 11 HOSP PVT 11 00C3 11 39,000.00 1 SF 11 $6.48 II 1.00 1 $252,720 1
3 1 7300 11 HOSP PVT 11 00C3 111,113,124.061 SF 11 $2.25 11 1.00 1 $2,504,5291
4 1 9400 1 RIGHTOFWAY 00C3 6,167.94 1 SF 1 $2.25 0.10 �j
5 ( 7300 1 HOSP PVT 0 0 • • 45,323.00 SF $2.25 1.00 I $101,977
Additional Land Information I
Acres 11 27.89 11 Tax Area 11 30ZH 11 FEMA Code 11 X 11Commerical Code1) MMED3DC 1
Building Information - Use 85 - Hospitals, Public (Card: 001 of 004) I
Year Built 1985 Stories 4.0
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 Asphalt Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 43.0
Line 1 Description 11 Sq. Feet 11 Repi. Cost New AS 1 2 11 B 11 9
294,779 ,9 1 $51,462,518
$850,205
3 II CAN 11 9,072 11 $475,207
Extra Features (Card: 001 of 004)
Line Description Year Units Value
1 PAV ASP 1985 243,370 $49,283
2 PAV CON 1985 2,304 $864
3 SPRNKFP 1985 84,901 $63,676
4 CON PTO 1989 3,600 $1,350
5 ELEVATR 1985 3 $65,419
6 SWC 1985 6,300 $2,363
7 ELEVATR 1985 2 $32,805
8 ELEVATR 1985 2 $35,429
I Sales History
0
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