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Home My WebLink About11-11849 • CITY OF ZEPHYRHILLS _ 5335 - 8TH STREET (si3pso-oo20 11849 BUILDING PERMIT Permit Number: 11849 Address: 7248 GALL BLVD Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35-25-21-0010-08800-0000 Improv. Cost: 6,021.37 Date Issued: 5/09/2011 Name: RADIO SHACK Total Fees: 70.00 Address: 7248 GALL BLVD Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542 Date Paid: 5/09/2011 Phone: Work Desc: REPLACE THE EXISTING UNIT 4 TON ROOFTOP PKG . � � ,�� -1 l ., �� DUCTSINSU � �� - � �' 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 � 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 commencement." r CONT TO SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER PdiAY/06/2G? i/FRI �.�. �5 AM P, 008 ; I; I l I'I �l� �� 'I �'�'� ' �I ��' i��I�! �� ;� � ; � � ��;�,, , ;, � � � w ' �I� il� I;�; n"il,'�' i I� �' I�� + i� � ��. �, ��I', �� k ��I � �I II� �i � � ��C � � 1 I I I�; I� i �I ��11�� I i� I: o � °� o � � (l : . � ; -�; i , ?'j;�� I , ;;� ;� � � ;� �� M ; C; ��,,�I. C,; �� 1��,,�� i � �� ob� i.�� ; �� ;�i� ��I�� i ' � � � � �'! ► (� I�I ' �' +' '; I m �� '� ,—. .I � ''� � � ! ��^, I� li 'I � ! i '� ; � � � � � ��;�' ; i a ,!� { � ��;; �I I; j . � �i �' =1 ' ' � � ,,� ; ��,, ,I , - �; ;� � � 1 �,�. �. ; � � � I � �, � I � II I� I : ITI� ' � I �� j� r � w �' {� � � I� ( I � �� I � Tr� E ' a I �=�� "!� ', �� I � ��, �I�� , ; _ � �� ,�,� ( �,� �'� �� ,�;�;��. � � ; � � .� ; ;i i � �' � � � ' j) �� ' � , , ��tm, , � � ' ; I� ' i�� ' i , � � �' � � � , ► � � , i ;► � � , , � �: �� . i� . ! ;I i (�i �i ,� � i� ) �I �. � i.', ' �: ' j � � (.� ; I I i II � � � � �� ,� � � . � . ! i � � � � ; � � I i I� ` '� � , � � I � � I' !� � � li� � !��, � , ( . �i, Q�� , �' . .� f � .; �_, � 1 � � i �� .� � I. � � I f i �� i) ,� �� ; ; �� I �, �� : ; W �,.� t � ; � I �� ! .�. �� I ! ; �, � �.� �,, �,�� , ��-�� I, � !I ��; � �;� � ; � . ; , � �� : � � � i � � ; ; . o � , � �� ; �, � ; � � � � � � � � . o �. ` � � ii�iii� ( , eis-�eo-oo2o City of Zephyrhills Permit Application Fax-813-780.0021 Building Department Date Received Phone ConWCt for Pertnitting - i - rTTr Owner's Name �� Owner Phone Number � Owners Address Owner Phone Number �— � Fee Simple TiUeholder Name Owner Phone Number Fee Simple TiUeholder Address JOBADDRESS (- i � �� LOT# � SUBDIVISION PARCEL ID# � (� p �� (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEw coN57R e ADD/ALT [� SIGN Q � DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q DESCRIPTION OF WORK � � �P S BUILDING SIZE SQ FOOTAGE HEIGHT � QBUILDING $ VALUATtON OF TOTAL CONSTRUCTION QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ QMECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION QGAS Q ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE REGISTERED Y! N FEE CURRE� Y/ N Address License # EIECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # PLUMBER � COMPANY � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # MECHANICAL � COMPANY � � (,I' SIGNATURE REGISTERED N FEE CURRE� N Addre 'j� License # OTHER COMPANY � —� SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # �--� tlillllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fortns; R-O-W Pertnit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Ptans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Woric Pertnit for subdivisionsAarge projects COMMERCIAL Attach (3) comptete sets of Building Plans plus a Life Safety Page; (1) set of Energy Fonns. 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 Pertnit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. "*`PROPERTY SURVEY reqwred for a�l NEW construction. Direcdons: • Fill out application completely Owner & Contractor sign back of applicat�on, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over 57500) " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizmg same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs ff shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) Y ' Driveways-Not over Counter rf on pubfic 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 773, 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 certiTy 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 wili 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-Seawalis, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone "V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electricai work, plumbing, signs, welis, 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 UR PROPERTY. IF YOU INTEND TO OBTAIN FINANC , CONSULT WITH YOUR LENDER O AN A OR EFORE RECORDING YOUR NOTICE OF COMME NT. FLORIDA JURAT (F.S. 117-. OWNER OR AGEN � CONTRACTOR S b 'bed and or �y efore me this Su ' d andf i e or� me this l / Who is/are pe onallY to me or has/have produced Who is/are ers e or has/have produced as identificat�on. as identification. ( A Q � p— �� V� Notary Pubhc (�A � 0�,.. Notary Public Commission Na(� 7 2 �� OY Commission No.� 12 � Z�� J t P._'P � �S_ 0LS! t � �(P�-, _��_r � Name of Notary typed, printgd gr�� ame o� ol��yped, printed r stamped #.`1 "'�',�!`��.heP..ra�.,�r"., {�'�I'tit�,i+r`t�.,'4.dr.+°�hP��'.��.'�r'` ,�{xY pU �votary Pubhc State of Rorida _° �� Eiieer� C Rispoh =o �nr °o� Notary Pubhc Stata 7r �y�r,da � t��ly Commission DD72�286 � EilOer !� Rispoh �v� e' �x ires 09i3012011 ,a ` � h.'y Comrnissior. !��D720286 OFT'�� D 9�,OfF��'4 �"X�ffP.5091`3f!1�011 . � � ' ' aY.�'s{�^�d�.�•d•�,:4.-, Pasco Count�� Parcel: 3�-'?�-21-0010-08800-0000 001 Pa�e 1 of 2 Data Current as Of: Weekly Archive - Saturday, April 23, 2011 Parcel ID 35-25-21-0010-08800-0000 (Card: 001 of 018) Classification 16 - Shopping Center Community Mailing Address Property Value TOWNVIEW RETAIL LLC Ag Land $0 C/O STOLTZ RE PARTNER LLC Land $2,162,595 725 CONSHOHOCKEN STATE RD Building �1,290,939 BALA CYNWYD PA 19004-2102 Phvsical Address - See All 21 addresses (First Extra Features $133,656 Shown) `_j�_Ir', �p�(Q Market Value $3,587,190 7252 GALL BLVD � �� ZEPHYRHILLS FL 33541 Assessed (Non- 1)hool Amendment �3,587,190 Lecial Description (First 4 Lines) ZEPHYRHILLS COLONY CO LANDS PB Taxable Value $3,587,290 1 PG 55 POR TRS 73 8S & 89 & POR OF LOT 8 PASCO MEDICAL ARTS CENTER PB 23 PG 24 BEING Land Detail (Card: 001 of 018) Line Use Description Zoning Units Type Price Condition Value � 1600 SH �R G OOC2 5.00 AC �285,000.00 1.00 �1,425,000 � 1600 SH �R G OOC2 3 98 AC $285,000.00 0.65 �737,245 � 1600 SH �R G OOC2 30,000 00 SF $0 O1 1 00 $300 Additional Land Information Acres 9 67 Tax Area 30ZH FEMA Code � Commericai Code SITE2C2 Buildinq Information - Use 16 - Shopping Center Local (Card: 001 of 018) Year Built 1990 Stories 1.0 Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 Common Brick Roof Structure Steel Frame or Truss Roof Cover Built-Up Tar and Gravel Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Carpet Flooring 2 None Fuel Electric Heat Forced Air - Ducted A/C Packaged Roof Top Baths 2 0 Line Description Sq. Feet Repl. Cost New 1 FST 480 � 14, 851 2 SDA 2,320 $143,562 3 CAN 320 $5,940 Extra Features (Card 001 of 018) Line Description Year Units Value �- 1� SPRNKFP 1990 2,800 � 53,325 � 2 PAV ASP 1990 2Z9,400 $46,454 3 CLFENCE 1990 4,353 � $1,535 � 4 DWC 1990 C 12,579 �4,717 5 LIGHTDM 1990 6 �4,320 6 LIGHTSM 1990 3 $1,913 7 126W 1990 720 $1,110 8 PAV CON 1990 11,200 �4,200 � 9 �- SWC 1990 4,290 � $1,609 http://w�� R.sbb=0... 4!29/?O11 ' Pasco Count�� Parcel: 3�-?�-21-0010-08800-0000 001 Pa�e 2 of 2 I Sales History I Previous Owner ZEPHYRHILLS RETAIL LLC Year Month Book/Page Type Amount 2007 09 7642 / 0342 WD $0 2005 06 6462 1 1940 W D $0 1988 12 1765 / 1282 WD �0 httpJ/�� ?1&sbb=0... 4,�?9/?011 Page 1 of 2 James Pickren From: Kristi Lowery Sent: Thursday, April 28, 2011 5 32 PM � � 5 9 To: James Pickren, sales � �� Subject: FW� Quote Approval for Store 018898 WO#735991 - HVAC REPAIR Issue Kristi Lowery Operations Manager Advanced Mechanical Services 1-888-246-0595 From: )ennifer.Carrazco@radioshack.com [mailto:Jennifer.Carrazco@radioshack.com] Sent: Thursday, April 28, 2011 5:40 PM To: Service Email Cc: 018898%posmemo@mhsgate.radioshack.com; 010911@radioshack.com; jholmel@radioshack.com Subject: Quote Approval for Store 018898 WO#735991 - HVAC REPAIR Issue RADIOSHACK FACILITIES DEPARTMENT APPROVAL TO PROCEED DATE: 4/28/11 STORE: 018898 WORK ORDER NUMBER: 735991 OK TO PROCEED $6021.37 DESCRIPTION OF WORK PROPOSED: UNIT REPLACEMENT - replace existing Carrier unit with a new Carrier M#SOTCAOSA2BSOAOAO SEER 13.0. CONTRACTOR SHALL CONTACT THE STORE WITH THE ESTiMATED TIME OF ARRIVAL(ETA). Contractor sha!! submit before and after pictures of all HVAC unit replacements, compressors, heat exchangers, and coil replacements prior to payment of invoice. HVAC unit information on al1 HVAC units for the store must be submitted on the invoice. Contractor shall coordinate with the store manager only. The contractor will check in with the store manager upon arriva/ and upon each departure. Contractor shall have store manager's signature on the tech report confirming technician's arriva/ and departure time on all trips to the store. Tech reports confirming the contractor's hours on site must accompany alI invoices. Invoices not supported by tech reports wil/ delay processing. This approval is subject to the terms and conditions of the Purchase Agreement for Goods and Services Verv Important Contractor Billing Information' RadioShack agrees to pay the proposed amount upon completion of the described work. If the total labor hours required to complete the job are going to exceed the number of hours proposed, the contractor shall call the RadioShack Facilities Department for approval of the additional hours before completing the work. 4/28/2011 Page 2 of 2 Approved by Director, Store Services Kathy Frentz Approved by HVAC Service Manager� Debbie Newberry Thank you, RADIOSHACK FACILITIES SUPPORT 817-415-5544 4/28/2011 ADVANCED MECHANICAL SERVICES 2475 Regent Ave. Orlando, FI 32804 Ph. (888) 246-0595; (877) 590-4527 Heating & Air Conditioning Commercial Refrigeration Florida, Georgia, Alabama, Tennessee, North Carolina, South Carolina �.etter of �ut�jori�atior� Date 5/5/11 To Whom It May Concern: I hereby authorize Joe Ferreira to pull mechanical permits in City of Zehvrhills , FL in my place for the air conditioning replacement to be performed at Radio Shack #18898 Located at 7248 Gall Blvd, Zeph,vrhills , FL. Sincerely, _�, % � Je . . Sharr, President ADVANCED MECHANICAL SERVICES OF CENTRAL FLORIDA, INC. State of: FLORIDA County of: ORANGE Sworn & Subscribed before me this �Q th Day of ��QU , 20 I). .T �°�_��?�� e-e�. Notary Public ,rA. ° • Stamp ro �Y °�q Notan Pubiic State or Flonda , Edeer ^ Rispoh � _ 4 ° �'iV Commission UC��t7288 '? �cs � xn�res 09l301'1��1 r b�°� �;'�„°�e'�.+"+I4,/��.,�'� ADVANCED MECHANICAL SERVICES 2475 Regent Ave. Orlando, Fl 32804 Ph. (888) 246-0595; (877) 590-4527 Heating & Air Conditioning Commercial Refrigeration Florida, Georgia, Alabama, Tennessee, North Carolina, South Carolina Fax Cover Sheet � Date: 5/5/2011 To: City of Zephyrhilis FAX# �,3 ° - j �"[? � �o �l' Company Name: From: �i[��.c ' ' �ermit �e�artmettt Re: Contractor Register Number of pages including cover sheet: � If ou do not receive the amount of a es listed,please call our office. Message: , �+�n . i��; � �- �C,� � � � �.,� � I ► c� �.� - �;� �, �- ►J�,� , Z� �a��l:.� C�l.1ti'�1 i�QY�� `��"�( C � � C u1��YC�C� �L�te�r'�� Q{� C�0}�'aC�a� l� � r� (� � /Z 1�.� Y �� 1 `�'f U r ) - � Y \J 6 �=- � � t( . � � rti u�- �� r �� ,� � __._�� `f `� 1e.c� �- �.1 I ��-n �� F.��XE� ADVANCED MECHANICAL SERVICES 2475 Regent Ave. Orlando, Fl 32804 Ph. (888) 246-0595; (877) 590-4527 Heating & Air Conditioning Commercial Refrigeration Florida, Georgia, Alabama, Tennessee, North Carolina, South Carolina Fax Cover Sheet Date: 5I5/2011 To: City of Zephyrhilis FAX# ��.�' ° �(1 ° C�c=� �� Company Name: From: �.:Lcc.�. � ' ' �ermit �ep�rtment Re: Contractor Register Number of pages including cover sheet: If you do not receive the amount of pages listed,please call our offic Message: ��.� L l �� 1�c��-, Gr-�t c� G�o �c..��,�- -� , ,�'e.�rc.� _ , , �� Lt1� l( ��oc� . � �� ` ��S �" OP ID• NS �� `��{�� 1 E VF ��'tLil�� Ei�t��.i��l�.�E AtiTEIMMlDO/YYYY) osrosi� � THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER. TNIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLlCIES BELaW. THIS CERTIFICATE OF lNSURANCE D�ES NOT CONSTITUTE A CONTRACT BENVEEN 7HE ISSUfNG INSURERjS), AUTNORIZED REPRESENTATIVE OR Pi20DUCER, AND THE CERTIFICATE HOLDER. IMPORTANT• If the certificate liolder is an ADDITIONAL INSURED, the policy(ies} must be endorsed. If SUSROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not �onfer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 407-644-8689 CONTACT NAME: Cooper, Simms, Nelson 8 Mosiey 407-644-9934 PHONE Fnx 271 West Canton Avenue fAIC, No. Eztl: A1C No : P 0 Box 1480 E Winter Park, FL 32790-1480 ADDRESS. _ James R. Havron, Jr CUSTOM�R ID ri: ADVAN-4 INSURER(S AFFORDING GOVERAGE ' NAIC p INSURED Advanced Mechanical Services INSURER k Hanover American Insurance Co. 36064 of Central Florida, Inc. DBA INSURER B Hanover Insurance Compan ,222g2 Advanced Mechanical Services INSURER C Bridgefield Emplo ers lns. Co. 10701 2475 RegentAvenue Orlando, FL 32804 iNSURERD, I INSURER E INSURER F � COVERAGES CERTIFICATE NUMSER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE B�EN ISSUED TO THE IhSURED NAMED ABOVE FOR THE PQLICY PERIOD INDICATED NOTWITHS7ANDING ANY REQUIREMENT, TERIJ� OR GONDITION OF ANY CONTRACT OR OTHER pOCUtv1EN7 WITH RESPECT TO WHICH THIS CERTIFICATE MHY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUEJECT TG ALL THE TERtJIS EXCL�SIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN (J�AY HAVE BEEN REDUCED BY PAID ClAIMS INSR � 7YPE OF INSURANCE ADDLiSUBRi I POUCY EPF POLICY EXP LTR 1 POLICY NUMBER , IMMIDD/YYYY Idfv7fDOlYYYY) � LIMITS i GENERAL LIABILfTY ' I EACN OCCURRENCE �' S 'I,OOO,OD A X� COMMERCIALGENERhLLIABILITY i i ZZJ461383201 O'I/O'II'I'I O'I/O"I/'IZ �AMN6�T R� ENTcC . 'IOO,OO � PREMISES IEa occurrence i CLARdS-MADE [� OCCUR ( � i � � fi1ED EXP (Nny one persont £ 5,�� PERSONAL E ADV IhJURY :, $ �I �OOO,OO ! I � ' I � GENERALAGGREGATE '5� 2,000,00 ' GEN'� AGGREGH?E LIMIT .4PPUES PER � � �� PRO� �— � I PRODUCTS - COIvIF10P AGG : Z,OOO,OQ � POLICY '' 7 I ❑�T LOC j E � AU70MOBILE UABIIITY � � I COMBINED SINGLE LIMIT �,OOfl�OO � � (Ea acaoenit A I ' X nr,� AUTO � � IAZJ453533s01 ovolit� I D1/0V92 1 � � ALL OWNED ALITOS I � j ( ' BODILY INJUP.1' (Per person� £ "—' BODILYINJURY(Peracadentj S SCH�DULED AL'TCS � I �I � i ; �I ( � j PROPERTY DAMAGE y X' HiRED AUTOS i � (Per accitlenq X NON-0WNED AUTOS ( i � I I ' 1 � I i 5 x UMBRELLA UAB X pCCUR i I I EACH OCCUP.RENCE � g 4,ODO,OO � EXCESS LIAB � CLAlIdS-MADE AGvREGATE S 4,000,00 B • ; UNJ460405401 01101/11 01/Dil12 I DEDUCTIBLE X RETENTIOtJ � 'IO,ODO � I � WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y � N ; ; I � X 7 T lf?T, ' �� ( �Y PROPRIETDRlPAP.TNERI�XECUTIVE � 83029592 � 01101111 � D'I /O�/3 Z _ �.L EACH ACCIDENT � 5� '� �0��.0� I OFRCERltdEMBER EX,CLU�ED� � I N I A � � . i IMandaiory in NH) . � � o � � EL DISEASE -_A EM LOYE..I 5 'I.OQO,OO � If ves descnbe untler - � CESCRIPTION OF OPERATIONS befow : ( E�S� - POLICY LIA91T I; 'I,OOO,OO i I I ➢ESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES �Attach ACORD'101, Atltlitional Remarks Schedule, if more space is reqwredJ CERTIFICATE HOLDER CANCELLATION CITYZ-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICiES BE CANCELLED SEFORE City of Zephyrhills THE EXPIRATION �ATE THEREOF, NOTICE WtLL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIDNS. 5335 8th Street Zephyrhills, FL 33542 AUTHORIZED REPRESEN7A71VE � ��, �� G 1988-2009 ACORD CORPORATION. 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Businesses are sub�ect to regulation of zoning, health and other �ful authorities.This receipt is valid from October 1 through September 30 of receipt year Delinquent penalty is added October 1. '"'*ORIGINAL"* 2010 EXPIRES 9/30/2011 1804-0075663 1804 CONTR-HARV $70 00 35 EMPLOYEES� 5000 BUSINESS OFFICE $50 00 35 EMPLOYEES� TOTAL TAX $120 00 SHARR JERRY J PREVIOUSLY PAID $120 00 TOTAL DUE $0 00 ADVANCED MECHANICAL SERVICES OF CENTRAL FLORIDA INC 2475 REGENT ST 2475 REGENT ST ORLANDO FL 32804-4205 U - ORLANDO, 328�4 PAID $i20 GO 59-456534 7/7/2010 �rl K. Wood, Tax Coliector Local Business Tax Receipt Orange County, Florida , local business tax receipt is in addition to and not in lieu of any other tax required by law or municipal ordinance. Businesses are s�bject to regufation of zoning, health and other ful authorities. This receipt is valid from October 1 through September 30 of receipt year. Delinquent penalty is added October 1. *`"ORIGINAL"" 2010 EXPIRES 9l30l2011 1804-0075663 1804 CONTR-HARV �70 00 35 EMPLOYEES� 5000 BUSINESS OFFICE $50 00 35 EMPLOYEES� ��E CpC� �� TOTAL TAX $120 00 O � SHARR JERRY J PREVIOUSLY PAID $120 00 TOTAL DUE $0 00 ADVANCED MECHANICAL SERVICES OF CENTRAL FLORIDA INC 2475 REGENT ST 2475 REGENT ST ,� � ORLANDO FL 32804-4205 U - ORLANDO, 32804 �� PAIO $120 00 99-456534 7/7/2010 This receipt is official when validated by the Tax Collector. � _ ' - r,�; ' ; - , -. - I�n 1n�,J �� .