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Home My WebLink About11-11788 , CITY OF ZEPHYRHILLS ✓ 5335 - 8TH STREET �sis)�so-oo20 11788 BUILDING PERMIT Permit Number: 11788 Address: 5749 GALL BLVD Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD/ALT COMMERCIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-02700-0010 Improv. Cost: 2,345.00 Date Issued: 4/19/2011 Name: EASPAS ENTERPRISES LLC Total Fees: 230.28 Address: 1262 TRAVERTINE TER Amount Paid: 230.28 SANFORD FL 32771 Date Paid: 4/19/2011 Phone: (407)732-4557 Work Desc: REMODEL BATH MAKE INTO HANDICAP ADD EXIT LIGHTS/ DEMO WALL BLD WALL 75. . �� S PLUMBING FEE 60.00 FIRE PLAN REVIEW FEES 35.28 �; .s ��, �lw,�b � n . � ,�, � � t 1 FOOTER BOND DUCTS INSULATED SE 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 acxessible. 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." �� L -� ; _ � CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Zephyrhills Fire Rescue 6907 Dairy Road, Geph��rhills, FL 335�? i'ire Marshal 1.3us (813) 780-0041 Kerry Barnett E�a� (81 �) 780-UU44 E-mail: kbarnett(a)tire.ze�hyrhills,(l.us Plan Review #: 11-039 � � Project: Remodel Number of Pages: Packet April 15, 2011 I have received and reviewed the plans for the remodel located at 5749 Gall Blvd and will allow this project to move forward. By paying for permit, contractor acknowledges to comply with the comments below. Shouid anyone have any questions, please do not hesitate to contact the Fire Marshal's office. 1. Ensure there is one certified fire extinguisher located in the space. 2. Ensure address is located on front and rear door. 3. Ensure address is noted on this space's electric meter in the rear. 4. Instal I a lightweight truss sign in accordance to the Statute to the left of the main door. Paperwork has been supplied with this review. Inspections Required: l. Final � �� ., KERRY B T, FIRE MARSHAL ***Please be advised this review of plans submitted is a cursory review to assist the contractor in compliance with applicable fire safety codes. This review is not intended to be a final approval of the submitted plans. it is the contractor's sole responsibility to ensure that the plans are in complete compliance with all applicable NFPA codes and local ordinances. In the event that further examination or site inspection reveals areas of non-compliance, it shall be the contractor's sole responsibility, at their sole expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure to be in compliance with all applicable NFPA codes and local ordinances. 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 . Building Department Date Received �— %/ Phone Contact for Permitting 81 3 7 8 3-- 5 4 9 3 Skip & Linda Deeds OwnerPhoneNumber 813-788-7772 Owner's Name Owner's Address 5914 Gal l Blvd . Z' hi l I s FI, Owner Phone Number Fee Simple Titleholder Name Easpas Enterpr i ses LLC Owner Phone Number FeeSimpleTitleholderAddress 1262 Travertine Ter. Sanford, FL 32771 JOBADDRESS 5749 Gall B1Vd LOT# � SUBDIVISION PARCELID# 11-26-21—OOIO—OZ�OO—OOlO (OBTAtNED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR 8 ADD/ALT 0 SIGN 0 0 DEMOLISH INSTALL REPAIR PROPOSED USE 0 SFR Q COMM XD OTHER TYPE OF CONSTRUCTtON 0 BLOCK 0 FRAME 0 STEEL � Interior remod�ling DESCRIPTION OF WORK BUILDING SIZE � SQ FOOTAGE C� HEIGHT BUILDING $ 2 345 . OO VALUATION OF TOTAL CONSTRUCTION LECTRICAL $ � AMP SERVICE � PROGRESS ENERGY � W.R.E.0 �PLUMBING $ �� MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �""�3 fI �'�'�� t y �GAS � ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO � l� �� '�� John L. Smith Const, Inc BUILDER j� COMPANY SIGNATURE , REGISTERED Y/ N FEE CURRE� Y/ N oats R Z'h' ls, FL l.icense# CBC 059519 --� Address > � First Class Electric ELECTRICIAN COMPANY SIGNATURE i REGISTERED Y/ N FEE CURRE� Y/ N Address � 141 B r ry R. ' h i 11 S, FL License #�� - (i(� �./ �.��? 1t ' � �L ,�s � �� P�.�mb�'►�� PLUMBER � r /�� COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Add�ess License # MECHANICAL � COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # � OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # r 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 8 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 8� Contractor sign back of application, notarized If over $2500, a Notice of Commencement is requ (A/C upgrades over $7500) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same ��„� a..�.. ��-� i ...� OVER THE COUNTE 1�a'"� �j�ron o pp �aa ion I ar..�r..rw. �+a�«.— — Reroofs if shingles Sewe.rS � Service Upg�ades^R/£� ences (PIoUSurvey/Footage) � +'�� ' , ,, � V 4 y Driveways-Not er �ounter if on'public roadways`:n�l9�ft0 ' � ° <<' ' •� �� F� � ' � . . , . , ,�, .�;, , < s ..: . .. ��.�w ��+, ,� ' ` ' 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 adve�sely 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 specificalty 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 LEND R AN ATTORNEY BEFORE RECORDING YOUR TICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 4 7. 3) , � _� �' _ • � - �� _ � /� l ��" _.�� < OWNER OR AGENT /�"� CONTRACTOR Subscribed and s o(or affirmed) before e this Subscribed and, o�L .t.�° r affirmed) befora �e is b y� () �� \ �� r,�( I Y� l Who is/are p onal to me or has/have produced Who is/are personally kno to me or has/have produced as identification. ��v� �-�:r�' �� 1l' as identification. � Notary Public Notary Public Co ' on No. Commis ' o. ,�p111N�� \\I/t Na e��t�f� Florida Name of =• ��f�� e tafe of florida •'s My Comm. Expires Apr 6, 2014 • •: My Comm. Expires Apr 6, 2014 ;� Commiaaion N DD 979617 =�? Commission � DD 979617 '•.,�a�Y�.•�` �� T � ��°� �� `�`,` BorWed Tluouph NHional Notxy Atsn. �� N�tior►�I Msn. Pasco County Parcel: 11-26-21-0010-02700-0010 001 Page 1 of 1 Data Current as Of: Weekly Archive - Saturday, April 16, 2011 Parcel ID 11-26-21-0010-02700-0010 (Card: 001 of 002) Classification 17 - 1 Story Office Mailing Address Property Value EASPAS ENTERPRISES LLC Ag Land $0 1262 TRAVERTINE TER Land $58,073 SANFORD FL 32771-3686 Building $97,848 Phvsical Address - See All 6 addresses (First Extra Features �1,553 Shown) 5739 GALL BLVD Market Value $157,474 ZEPHYRHILLS FL 33542-3453 Assessed (Non-School Amendment Leaal Descri�tion (First 4 Lines) i� $157 See Plat for this Subdivision �" Taxable Value �157,474 CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 1 2 3 4 5& 6 BLOCK 27 OR 7920 PG 686 Land Detail (Card: 001 of 002) Line Use Description Zoning Units Type Price Condition Value � 1700 1STORY OFF OOC2 7,000.00 �F $7.00 0.90 $44,100 � 1700 iSTORY OFF OOC2 5,750.00 �F $2.70 0.90 $13,973 Additional Land Information Acres 0.29 Tax Area 30ZH FEMA Code � Commerical Code M3012ER Buildina Information - Use 17 - Offices (One Story) (Card: 001 of 002) Year Built 1979 Stories 1.0 Exterior Wall i Concrete Block Stucco Enterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wali 1 Drywall Interior Wall 2 None Flooring i Cork or Vinyl Tile Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C Central Baths 6.0 Line Description Sq. Feet Repl. Cost New 1 AOF 4,312 $276,184 z CAN 1,540 $29,591 Extra Features (Card: 001 of 002) Line Description Year Units Value 1 PAV ASP 1979 7,670 $1,553 Sales History Previous Owner MCALVANAH TIMOTHY P& �Year Month Book/Page Type Amount 2008 08 7920 / 0686 WD $350,000 2004 03 5814 / 1758 (�C $p 2002 12 5689 / 0177 C�C $p http://appraiser.pascogov.com/search/parcel.aspx?sec=11 &twn=26&rng=21 &sbb=0010&b... 4/18/2011 Propasal John L Smith Construction, lnc. 4240 Coats Rd. Zephyrhills, FL 33541 813-783-5493 CBC 059519 Date Mar. 25, 2011 Proposai Submitted To Work To Be PerFormed At Name Skip & Linda Deeds Street 5749 Gail Bivd. Street 5914 Gal) Blvd. City Zephyrhills, FL City Zephyrhills, FL 33542 Date of Plan N/A Telephone # 788-7772 Architect N/A We hereby by propose to furnish all materials and labnr for completion of: Demo and remodeling as per attached drawings and Spec sheet. All material is guaranteed to be as specified and the above work to be completed in accordance with the drawings and specs submitted for above work. All wo�k and materiafs to meet lacal industry standards and existing codes in effect at date of proposal. The above work to be performed for the sum of: Twenty three hundred, forty five and 00/100 Dollars ($ 2,345.OQ ) with payments to be made as follows: See attached Spec shee� Any alterations or deviations from the above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the proposal price. AI! agreements are not binding as a result of strikes, accidents or delays beyond our control. Owner to carry fire, wind and all other necessary insurance required upon above work. Workers Compensation and Public Liability Insurance to be furnished by the builder. Cost of collection and attorney fees in the event of any default by the owner or in the event that the Builder must initiate any collection p�oceedings or must engage the services of an attorney for any purpose whatsoever relating to this agreement, including but not limited to seeking the enforcement of the terms and conditions of this document, the Owner acknowledges, agrees, confirms and warrants, that they shall be responsibte for all costs and attorney fees inc,ur by Builder. Respectfully submitted �� --- �` -�" / � � �' Per lohn L. Smith Construction, Inc. This proposal may be withdrawn by us if not accepted within 10 days. Acceptance of Proposal We, the undersigned have read this proposal and do agree to the terms and conditions as listed above and to any attachments, if attached. We do further acknowledge that by our acceptance of this proposal that it now becomes a legal and binding contract between the named parties. We authorize you to do the work as specified. Payments wilf be made as outlined in this agreement. n ��/� % / �� / l ! s�� _�....s..�,�� ._.._�.�:� � S 7 � 9 � � / / �. � � � / ; -- , �IJCZ, � ,. � , ; 1 � ��' D ►�r � fl ? i � . ��d � ; � �' �� o s� � � � � � �� i I __,_ j f ��d d /� � l c'� .� / � 1 � ; /v��/O ' ,; i • � ;1 i� � � j � 's,� W� � � � � `� �� , F � / vE��oF�� RE�I�EW ��YE��_.1.� � --- ? � Y ��Sl �'�gi�1Ati S �i� QF ��.PM`f �Z�' 1 �.j c � , �'�� p S EXA1Uill�l�i - - � -- - �W._..�-- ! g`I ZgY � �i 4 �atie' � �,S' `� !� � � � � I w�' �� .� ; l � I �Q"� �------_...__,_� 1 , � �, , � � — — � � , �4 L : � �, COMFLY ��' � �(�1�g�CSHAL ��pBUILD�G � ��,�G CODES, � C CODE AN� — --Tr , COD NATIONALELECTRI �jF ZEPHYRHILLS ORDINANCES i ' ' s' ° , �I . , . �` ; � ��". j � _ � f G � . � _ � �.� � ga ��i � � � � �,�� , �e advised this review of p{ans su itted is a � cu o r�view to assist the contractor in co liance with ap lic bie fire safety codes. This review is � intended ('�`7 �� t a final approva! of the submitted pla . 1} ig �r�.��'� Q ��✓' contr ct �x ians are ,. , �� t �`� co p�ec r��e'�rith�tt �' �'�� ; P#� JF�' locai ordinances. !n t�^ �vent 9ha; . -ri�e� r; {�.�, at�� -� � � k,.� � z � site inspection reveals ��u� �� rc , �r� � - � ' ` ��,.� � � �� thecontractor'ssUl�res��3in��,!� �r,�.. c��r�,:�>/,,,_„ �-, � G �� bring those a, as ;n c:��;�n�� ; ;� ��. responsibility for the c"r�:� ��.<<: �r ., ��- , � ca��f�� , with �� applicablf ?�'�=; ' • � ��"��r S c a /�,. ;r` _. / ' i �•� �` � �- 7�' 9 C a �/ � �� d : � � � Cx,.� �; �l�a�, � : � �Co�d e =,' � � �� : � 3 � �� o S� d' ;; ' � ��ii� � r�4d/L '� �l�,�i 1 ; , i � /S , ; i � f� � i� � � i l �� L ; � � i� �� ; �2EVIEW DATE - � ; � ; �ITY OF ZEPHYR IL_l.S � ' ; �LANS EXAMINEf� � ` I � o � 75 .�., �, � i � ; '� __ _,__i � , � �------- - , . ; , :, � , - � - �,�,WORKSHALLC t ' l " �AILING CODES,FLORIDABUILDING � b ��-� E �Np�pNALELECTRI CCODEAI � ID � OF ZEPHYRHILLS ORDINAI`10ES i ; � . -- --- . � S � ! 'j 4 , � -_ �►�``� �� _� �„ � .8, �, �<� � A ' i � ��d � ..y'�'% Q !3a ��5 � �..... m____�......_..�.�.._ � � a .,�. _ . :_ __.__._ _�,�__. ae__ �..._..�.� � D . ' � �^ �.jz�� , , �.,,,�� - ' � � �- — ,5��p/ � SGa/� �� ..� /� A�,,,._° �' CERTIFICATE OF LIABILITY INSURANCE DA 04/05/11 m � PRODUCER Bauer & Associates THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 12210 Us Highway 301 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Dade City, FL 33525 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (352)567-3702 Fax (352)523-0434 INSURERS AFFORDING COVERAGE NAIC # INSURED JOHN SMITH DBA/ iNSURERA. AUTO OWNERS INSURANCE INSURER B: JOHN L. SMITH CONSTRUCTION INSURER C: 4240 COATS ROAD INSURER D ZEPHYRHILLS, FL 33541 INSURER E. COVERAGES INSURER F THE POLICIES OF INSURANCE LISTEO 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 TypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD DATE (MM/DD/YY) DATE (MM/DDlYY) _ LIMITS GENERAL LIABILITY EACH OCCURRENCE 300,000 d COMMERCIAL GENERAL LIABILITY 20632794 05/01/10 05/01/12 PR M SES Ea occureDnce) 50,000 CIAIMS MADE d OCCUR MED EXP (Any one person) S,QQQ A PERSONAL & ADV INJURY 300,000 GENERALAGGREGATE 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PROOUCTS - COMP/OP AGG 600,000 d POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE DEDUCTIB�E RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR ! PARTNER / EXECUTIVE E.L. EACH ACCIDENT OFFICER / MEMBER EXCLUDED? If yes, describe under E.L DISEASE - EA EMPLOYEE SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS BUILDING CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL CITY OF ZEPHYRHILLS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO BUILDING DEPT THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 5335 8TH STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ZEPHYRHILLS , FL 33542 AUTHORIZED REPRESENTATIVE 5,( ` FAX@8'13-780-0021 ��, d � � �'��/ ACORD 25 (2001/08) QF �O ACORD CORPORATION 1988 ..AC# �; ;�� , ;� � � ' ' - - . _µ �..�__ � - S�'i�'E ��?F FLORiDA :+ � ,�- - - _ : _.., _ � _ -=._ �:.__ ... r _... - - _. ._ _� _ �: _ _ °�' � �' � � - - — - - . - = - - � _- =_ - --- -- - � ` __ ;�:DEP�R:�z- - =-' OF B�JS , ;S��AN17 �Ri�FPS�;��L , - �'��G1�=- ' _ '_ _ ` = _ � - _ s_�TRII� =��U�_�R'�--�,� Chl�f'��N� � _ _ . = _ - - - _ - _ '` =_- - � - . ',- ��`�`-__ _ S�f� L� o. , fl .$S�0l�'1tT$2 �3'sNSL r��TBR'� _ '..-.:_. :- �, f - - ,. .-. __ -- =. - _ ; :.: :., �� 0$ 10 ZO10 1U8029125 C�059519 -� � �` `� "� '� - = F" ' -- F' : - � _ __" __" _: " _ - __ _ The B'ETILDTNG CQNTRACTOR :;, ;� _ _ - ._ �; . , , ` _--- ' � _-= ; , Named below IS CSRTIFIED�:_ _ '� _ - `__' ` ' -` _ _ �--- __ -> -, Under the pravisians of 'Chapte�r ��9 f FS.. � _- _ -- _-_ _ Expiration date: AUG 31,'2012�, � ` � , __ _ - SMITH, JOHN L k _ -= __- _ , � � ' _. = ` JOHN L SMITH CONSTRUCTI�N _ l ' _ _ ' _ _ ' =_ ( 4240 COATS RD ZLPBYRHTLLS FL 33b�41 CIiARLIE CRIST = -= - -_ _-=.��;� � G4VERNflbt = ° _=-- :-' �`��SECR�`,�`A�tY D[$PLAY RS REQUIRED BY LAVFf'---= =� -__- -- �71E � _ \ _ � l l . , � ; ��t = �3-22-2�� M� �� JEFF ATWATER 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 Flarida Workers' Compensation law. EFFECTIVE DATE: 03/22/2011 EXPIRATION DATE: 03/21/2013 PERSON: SMITH JOHN L FEIN: 270071702 BUSINESS NAME AND ADDRESS: JOF#V L SMITH CONSTRUCTION INC � 4240 COATS RD ZEPHYRHtLLS FL 33541 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED BUILDING CONTRACTOR IMPONTANT: Pursuant lo Chapter 440 . 05(14), F.S., an otficer ai a corporatioe wqo elects exemp[ion Irom Ibis chapter 6y filipg a certifica�e oF election under this section may eoi recorer benefits or compensalion under [his chapter. Purseant to Cbap[er 440.05112), F.S., Certiticates of election io 6e exempt... apply only within the scape ot Ihe busiaess or trade listed on Me rtotice aF election to be exempL Pursuant to Cqapler 440.05(131, F.S., Nmices ol eleclion ro be exempt and certifiwtes o( election [o be exempt shall be subject to revocation if, at any time aftet the filieg ol tAe nolice or tbe issuance of the certilicate, the person aamed on the notice ar certificate no longer meets the requirements oF this section for issusnce of a certiticate. The department shall revoke a cerliticate at any time for failure ol Me person named on Ihe certiticate to meet [he requirements oF this section. QUESTIONS? (850? 413 OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVtSED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE Bobbie Swetland From: Bobbie Swetland Sent: Wednesday, April 13, 2011 1:10 PM To: Kerry Barnett Subject: Revised floor plan for Contr John L Smith job at 5749 Gall Blvd Good afternoon Kerry, John L Smith just submitted a revised floor plan for his job at 5749 Gall B1vd. I'11 put it in your box with a copy of this email. As always - thanks! Bohbie Bobbie Sharon Swetland City of Zephyrhills - Building Dept 813-780-0020 ext. 3512 813-780-0021 Fax bswetlandCu�ci.zephvrhills.fl.us 1 q � �� x City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contrac r/Homeowner: , 1 ,. Date Received: �-' ��-//�—// Site: -��?' � �J�.� ' �..Q�, . � Permit Type: � �}2 �lo � Approved w/no comments: j� Approved w/the below comments: ❑ Denied w/the below comments: � ( This comment sheet shall be kept with the permit and/or plans. �� Kal Swi — Plans Examiner Date Contractor andlar Homeowner (Required when comments are present) _ _ — _ _ _ — — _ , ..,. s� ..�.rv.�z :z.�,_��a�a a�ia.:u�r.x.��m .ss�asw:u��.;��n�+ � � � � '__"_ .._..' ."_ __ ....._a , . ,��sa�a�.ae�+cwe+ea�...v�a..:z�.:,�.-_- �,.-_.,.� - -- � �_ "". __ __-.. -. . � � � _ � k - �� - � � .F , :� � � � � � ec,. � . _ �� . �'k . - s - , -r. . � � � t"�a:< _ `{ „� : , � . � ,;'�' i �< v. . .;� ACCOUNT N0� 002799 , TYPE OF BUSINESS� ` SIC CODE� 1541 BUILDING CONTRACTOR LOCATION ADDRESS� JOHN L SMITH CONSTRUCTION INC 4240 COATS ROAD 4240 COATS ROAD ZEPHYRHILLS ZEPHYRHILLS FL 33541-7144 DATE RECEIPT AMOUNT % 07/12/10 586882 31.25 ��1�11��1'lll'll�l�..l.�. `9�R'IYY:ST.ih��'�£H�8`�M4'v'ae,�AGx-.wsY'h.�• "� '�Y��_ a- � .•�_ `. � Jacqueline Boges From: Jacqueline Boges Sent: Wednesday, April 27, 2011 2:27 PM To: Kerry Barnett Subject: RE: closed permit Okay thank you will notate in permit . From: Kerry Barnett Sent: Wednesday, April 27, 2011 1:49 PM To: Jacqueline Boges Subject: RE: closed permit Thanks, Also the final inspect was done for the John Smith project (I believe 5749 Gall). It was approved. Kerry From: Jacqueline Boges Sent: Wednesday, April 27, 2011 11:24 AM To: Kerry Barnett Subject: RE: closed permit YES WOULD NEED TO RESUBMIT BEFORE ANY FURTHER INSPECTIONS WOULD BE DONE. From: Kerry Barnett Sent: Wednesday, April 27, 2011 8:55 AM To: Jacqueline Boges Subject: RE: closed permit Ok, does that mean for the room they started to buildout, plans would need to be re-submitted? Kerry From: Jacqueline Boges Sent: Wednesday, April 27, 2011 8:08 AM To: Kerry Barnett Subject: closed permit lust wanted to let you know that the permit for 5117 gall blvd the pasco turf has been close the permit has expired. Jackie Boges Code Support Specialist e�. 35i3 1