HomeMy WebLinkAbout11-11887 CITY OF ZEPHYRHILLS
5335-8th Street
(si3)�so-oo20 11887
. ELECTRICAL PERMIT
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Permit Number: 11887 Address: 7326 GALL BLVD
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRICAL MISC Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Contractor: M&P SMITH INVESTMENT INC Book: Page:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35-25-21-0010-08800-0000
Improv. Cost: 2,500.00
Date Issued: 5/19/2011 Name: TOWNVIEW RETAIL LLC
Total Fees: 75.00 Address: 725 CONSHOHOCKEN STATE RD
Amount Paid: 75.00 BALA CYNWYD PA 190042102
Date Paid: 5/19/2011 Phone: (610)667-5800
Work Desc: INSTALL 17 CAMERAS / FRNT DOOR DENINTERVENTION SYSTEM � �'IG�
ELECTRICAL FEE 75.00
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ROUGH ELECTRIC ,
CONSTRUCTION POLE � �
PRE-METER �
FINAL �"- `� � '`��
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 inspection 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."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes a dinances.
. �--�- �-
� ' C TOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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Invoice
M& P SMITH INVESTMENTS nvc Date Invoice #
8217 Vassar Circle
Tampa F133634 5/6/2011 4189
813-667-0508
Work completed at:
Bill To
ADT SECURITY SERVICES TT Ma�oc #1194
7326 Gail Blvd
ACCOLJNTS PAYABLE -MAILSTOP 2 Zephyrhilis Fl
14200 E Exposition Ave SC#7071069 AC#319297
AURORA CO 80012
Requestor:
Kevin Reynolds 66996 Sensormatic Contact Town #0985 Dept. # 410 Vendor # 163429
Tom Jones
Description Qty Rate Amount
Install 15 fixed cameras, 4 pvms, 2 digital Dvr, 1 j-box, 2 office 1 1,555.00 1,555.00
monitors, 2 power supplies and 1 touch tracker
MATERIALS 1 I50.00 150.00
PERMTI' 1 225.00 225.00
Subtotal $t,93o.00
Sales Tax (7.0%) $0.00
Phone # Fax # Total $1,930.00
813-667-0580 813-884-2603 Payments/Credits $0.00
Ali work is complete!
Balance Due $1,930.00
s�3-�ao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
. Building Department
Date Received � l.�/ Phone Contact for Permittin l� � 0 � – C� /�
Owner's Name dGr��✓ l�/ G�✓ �e /�/J`/ L G� C Owner Phone Number �( ���o �? S�G �
Owner's Address � S (�r/�✓ G�✓ oCY�(�"� �f ��Y Owner Phone Number �—
Fee 5imple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ��.0 �/,/ L✓�/ �' �/� ✓l �/� '- LOT # �
SUBDIVISION PARCEL ID# � S�� J�� d�/ � D�r �OG d�G G
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR 8 ADDlALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER —
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK /'�S ��// / � G���2.✓,f �j.Q� � d .p f ��OlC ��j?L� y/� ia-� � S/'l�/ � �
BUILDING SIZE SQ FOOTAGE� HEIGHT f�J I' ` a � /'"
OBUILDING $ � 0� VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ � ( �� �
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
OGAS 0 ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
� / / /
BUIIDER � � � COMPANY �1� /v�� ��'�✓/� �- e-
SIGNATURE / �'� �` �fY/4 �/ REGISTERED Y/ N FEE C RRE� Y/ N
Address � / !/�.�s� �l �''''� ���C /,/ �� �� License # � ��� 3 Z
ELECTRICIAN 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
SIGNATURE REGISTEREO Y/ N FEE CURRE� Y/ N
Address License #
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
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 ansite, 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 iiays after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities 8 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. (AIC upgrades over 57500)
** 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 (PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTtONS: 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 buiidings, 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 finai power release. If the project does not involve a. cer#ificate of occupancy or
finai 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" prepare�l 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 ta commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: i certify that ail the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone "V" unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction, I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
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 YOUR N CE OF C NCEMENT.
FLORIDA JURAT (F.S. 117.03)
� �
OWNER OR AGENT CONTRACTOR'^�
Subscribed and swom to (or affirmed) before me this Subscribed and s (T� t or flirm e e me
by J bY^1.�./j�./ /�'!/ .
Who is/are personally known to me or haslhave produced Who Islare per qnal� nown to me or has/have produced
as identlficatlon. �� CC��SJ�-�� as identification.
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Notary Public Notary Public
"""'"' JACQUELINE BOGES
Commission No. Co ' sion N.�� s
:*; _
�' F.�cpirres December 12, 2014
Name of Notary typed, printed or stamped Name of Nota ` � 7019
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
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Contractor/Homeowner: � / l �._.��"l i � �v�" LL
Date Received: ��1� ���
Site: 7.�� (L/� l � ���..,J
Permit Type: �� �/'� ��°/'-� �S� �� �'rl
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
This c mment sh et shall be kept with the permit andlor plans.
,��-/9 //
alv' tzer — Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
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11-17 -2010
`'�4 4E � `�
AIEX SINK STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
** CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKBtS' COMPENSATION LAW *�
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Woricers' Compensation law.
EFFECTIVE DATE: 11/17/2010 EXPIRATION DATE: 11/16/2012
PERSON: SMITH PATRICK F
FEIN: 550864751
BUSINESS NAME AND ADDRESS:
M& P SMITH INVESTMENTS INC
DBA M&P SECURITY
8217 VASSAR CIRCLE
TAMPA FL 33634
SCOPES OF BUSINESS OR TRADE:
1- ELECTRICAL WOitlC 2- CONSTRIJCTION
3- SECURITY SYSTEMS
IMPORTANT: Prrsaa�t to CMpter 440 . 05(14►, F.S., a� ofFicer af a corpontio� w6o elects exawptto� frow Mis cMyter by filisg a certiHcrte al electioe ���er tAis
seciioa esy wt recorer be�efits or coopensaUo� ua�er IMIs cMapter. Prrsu�n m CM�pter 440.08(121, F.S., CertiHatas of alecHo� �o Ae ezswpt... ayply ealy witMi� tpa
scepe a( IAe h�si�ess or tn�e listei ea tke notice of eleMia� ta be exewpt. Pwar�At �o CY�pter 440.051191. F.S., Natices of eleqiae to 6a exa�pt ui certific�tes af
eleetio� to be exeapt sMall be s�bject to revoetlioe il, a[ �ay tiwe �fter Ne fili�g of tAe eotice or lMe isau�ee af t1e certilicNe, Ue persa� name! oa Ne wtice or
certificate ao longer seets tMe reqeireme�ts ot tMis sectioa for issrwce of � certtficate. The dap�rtee�t sMall revoMe a certi(icate at asy [iwe for f�ilers of tMe persoa
na■ed on the certiFicne to weet t6e reqriremests of t4is seaioe. QUESTIONS? (85D) 413-1609
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLOttIDA IMPORTANT
DEPARTMENT OF FlNANCIAL SEtVICES
DIVISWN OF WORKERS' CoMPENSATION F Pursuant ta Chapter 440.051t4), F.S., an ofticer of a corporation who
WNSTRUCTIQN INCUSTRY � elects exemptiai from this chapter by filing a certificate of election
CHtTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA L�der this section may not recover benefits or compensation under this
4YORKERS� COMPENSATtON LAW � chapter.
EFFECTIVE 11/17/2010 EXPIRATION DATE: 11/16/2012 H pursuant to Chapter 440.05(17a, F.S., Certificates of election to be
PERSON: PATRICK F SMITH exempt.. �ply only within the scope of the business or trade listed on
FEIN: 550864751 R ffie notice of election to be exempt
BUSINESS NAME AND ADDRESS: E Pursu�t to Chepter 440.05i131, F.S., Notices ot election to be exempt
M& P SMITH INVESTMENTS INC and certificates of election to be exempt shall be subject to revocation
DBA M&P SECURITY if, at any time after the filing of the notice or the issuance of the
8217 VASSAR CIRCLE certificate, the perso� �ned on the notice or certificete no longer meets
TAMP/� FL 33634 the requiremeMS of �is section for issuance of a certificate. The
department shall revoke a certificate at any time for failure of the
SCOPE OF BUSINESS OR TRADE person named on the certificate to meet the requiremerrts of this
1- EIECTRICAI WORK 2- CONSTRUCTION section.
3- SECURITV SYSTEMS QUESTIONS? (850) 4�3
CUT HERE
+� Carry bottom portion on the job, keap upper portion for your records.
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
CERTIFICATE OF INSURANCE ISSUE DATE 2/14/2011
�1 71i1S CER'i1RCATE IS ISSUED AS A IMAT�ER OF INFORMA710N ONLY AND
PRODUCER �� 1 CONFERS NO RIGHiS UPON THE CE�i1FlC/�►7E HOLDER. TFNS CERTIFICATE
CanneMa Insurance Services, Inc. � � NOT AMEND, EXTEND, OR ALTER TI� CONERAGE AFFORDED BY 7HE
� 1220 S. Dale Mabry / � ��� ��
Tampa, FL 33629 c�, r� (,�►.� COMPANIES AFFORDMIG COVERAGE
U ��
COMPANY A Voyd's of I�On
LETTER
INSURED LETTER B N/A
M� P Smith Investrnent, inc COMPANY
8217 Vassar Cirde �� C WA
Tampa, FL 33634 COMPANY wA
D
COMPANY E WA
LETTER
COVERAGES
THi3 IS TO CERTIFY THAT THE POUqES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSt1RE0 NAMED ABONE FOR THE
POLICY PERIOD INOICATED. N07YYITFI3TANDING ANY REt�tMREMENT, TERM OR CONDIi'ION OF ANY CONTRACT OR OTHER DOCUMENT VYITH
RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSI�D OR MAY PERTAIN, THE INSURANCE /►FFORDED BY THE POLJCIES DESCWBED
HEREIN 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIGES, UMITS SHOWIi MAY HAVE BEEN REDUCED BY
PAID CI.AIMS.
CO TYPE OF POLiCY POLICY POLICY LIMITS
LTR I URANC NUMBER EFFECTNE DATE EXPIRATION DATE
A GENERALLIABILI7Y �E006062 11/10/2010 11l10/2011 GENER/LLAGGREG/►TE 2,000,000
PRODUCTS-COMI�OP AGG. 1,000,000
PERSOtrAI. & ADV. INdURY 1.000,000
EACH OCCURRENCE 1,000,000
DAMAGE PREM RENTED TO YOU � pp�ppp
MED IXPENSE (Any one Pe«) 5,000
B PERSONAL LWBII.ITY COMBINDED SINCiLE LIIYpT
MEDICAL PAYME1ffS TO OTHERS
C F�CESS LIABIUTY EACH OCCURRENCE
AGGREGATE
D
E PROPERTY �1���
CONTENTS
LOSS OF USE
DESCRIPTION OF OPERATIONS / VEtIICLES / SPECIALTY ITEMS
Waiver of Subrogatan, FJectrical Work wifhin buildings, Contradors suboontraded wwic - build'mg aor�strt�dion. repair of one or iwo familyY dv�ngs
niis iNSUw►� �s �ssu� PuRSUa►r�rr To r� �owa► su�us u�s u►w_ �RSOns �su�� �r suR�.us uNes
CARRIERS DO NOT HAVE THE PROTECTION OF THE FLORIDA GUARANTY ACT TO Ti� EXTENT OF ANl( RIC,HT OF RECOVERY
FOR THE OBLIGATION � AN INSOLVENT UNUCENSED INSUI�R.
SURPLUS LINES INSURERS' POLICY RATES AND FORMS ARE NOT APPROVED BY ANY FLORIDA REGULATORY
AGENCY_
sur�us uNes Ac,�r w�wn c. PrnwPS uc�ses azo�es�
�asn �rrri�sour+n or�ve Po eox ��ogs c�►r�ww�R, �owo�► ��ss
CERTIFICATE IiOIDER � �„ �� �„� �
Poicies be canoeled before tl�e e�q�iation de�e,
COLIANT SOLUTIONS compery 9t�eN e►ldeerOr b rt� 30 deys wlilbn nolioe �D 111e aertilk�e holdef
2703 BRICKTON NORTH QR. n��ed b tl�e le�k but tai�re.to me�l aua� nauoe ahell :npome no onips6or, or fedlKp
BttFotd, GA 30518 �M � W� 1�e oamParry. its a9an�. ar iepreaen�6ves.
UTHORIZED SIGNATURE
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1940 NORTS MONROS STRFLT32399-0783
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M&P 3MITS INV'SSTMSNT3 INC
T�A ASSAR CIRCLE FL 33��-
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Cw�graiulatio�s! With this lic�ense you becortte one d the nearly o�e frril�on __� I}g�1���_ BUSI�$#S A1�D= -_ `
Fbridians ace►�sed by the Dep�trr�nt of Business and Prc�#�sional Regulation. -_. c _ =�.t}��SSI�: &3�G�A�ION.
Our profiessionals and bus�r� range fran �s �o yacht brokers. fran � _ _ � .- , ,,," _� _ ? _-- - '
boxers to barbeque restawac�s, and they keep Florida's ec�r�onry sUvr►9- `. �._ �G13�4t�-3�Z'� `�=����U6� z� -�E!_001�5�fl `
Every day we woric tio improve Uie way we do busir�ess in or+der to serve you better' ;= -, _- .
Fa inforrrration about our s�rv�oes, Please l09 0�o www.myfloridalioense.00rn. � F _ C$ItT- Ai.�2 S�� £�N�tACT�R II
T h e r e y o u c a n fi n d a � o r� e i n f a m a ti o n a b o u t o u r divis�ons and the r� r► s that :}_ °=_ Sl►�I�'$-; :_-�.?��RZ4�'°�'�:�: •, . .
impad you. subscxibe to departrnent nerrslette�s and ieam more about the -M&P �T-l� -,_- 3�`.^ I N C;_
DeparhneM's initiatives- : -_ ` _ _ -
Our mission at the Depart�nerrt is License Eff'ic '�entlY, Re9ulade Fa�riY- We _= _ -
co�sta�ny stme to se�e yo�, n�r So mat y«, �, �r,+e y«.� �. � zs ._c�r�� ,m� �. P�•i�� of Ch .489 �S
Tha�k you far dang business in Florida. and oongratulations on your new lic�nse! :;--_. �srat� a;� Ave 31.� Zo1.2 �:�oo7osox3s2 �
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