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Home My WebLink About11-11946 CITY OF ZEPHYRHILLS 5335 - 8TH STREET � , . �sis)�so-ao2o 11946 BUILDING PERMIT Permit Number: 11946 Address: 6748 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: 02-26-21-0010-02500-0020 Improv. Cost: 170,000.00 Date Issued: 6/23/2011 Name: FLORIDA HOSPITAL ZEPHYRHILLS INC Total Fees: 1,166.95 Address: 7050 GALL BLVD Amount Paid: 1,166.95 ZEPHYRHILLS FL 33542 Date Paid: 6/23/2011 Phone: (813)783-6189 Work Desc: INTERIOR RENOVATION 1,500 SQ FT • 5. SEALANDER CONTRACTOR SERVICES PLUMBING FEE 104.25 MECHANICAL FEE 72.98 DOUBLE M ELECTRIC FIRE PLAN REVIEW FEES 124.44 MASSEY METALS CO �✓ �, � � " /� / �/- `/ / f � � _ - ��--_.:� -- � � ` -,. _ � �� y�� /l. , i '�l. � _ � � �;St USC�,� 2-(i' � / - . ,�,/� � 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 � 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 fnancing, consult with your lender or an attorney before recording your notice of commenceme " CONTRA OR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER l��l�`�;; � s�4�r1�;, �.� � (�s� k; �!R _ „ ��c'fR� • arwP"` � � . � .vx : � `1:.�• 4' �.�.ti i � Y City of Zephyrhills BUILDING PLAN REVIEW COMMENTS # Contractor/Homeowner: � ��-� �� Date Received: � � `� �— �I site: � 7 7 � �,�-i/ /�� '''_' � � Permit Type: �/J�2� � jCE�p ' Approved w/no comments:❑ Approved w/the below comments:�` Denied w/the below comments: ❑ � 0' L� I c fM 4t �/ c� , Yl , �� :,' P ��i%f V S �'C i < L�,r'/ � �i f A � + t�i t � � L> / �r' �� ..� G � � � �/ 1� � ��2 ��Y f �' �' ��v j 1 ('? � � This comment sheet hall be kept with the permit and/or plans. _, ., _ _.�""�'s`"�/ �� , , alvin er — Plans Examiner Date Contractor and/or Homeowner (Required when comments are present) Jun 1411 03:29p Sealander Contractor Serv 813-788-4028 p.1 '� � CERTIFIGATE OF LIABtLITY #NSURANCE °"'�`""�°°'"'�"' s/i�/zoii TItIS CERTIFICATE 13 lSSUED AS A MATTFR OF �NFORMATiOli ONLY AID CONFERS NO RKiNTS UPON TlIE CERTlF1CA7E HOLO�t. T1�,4 CEIiTIPlCATE 60ES MOT AFfilGIATNEIY OR NE6ATIYFI.Y AIAEfd. p(T�p ap �y,� THE COYER/�GE AFFappEp BY 'TME ppt,IpEg BF10W. TFpS CERTIFICATE OF NSURANCE OOES NpT CpN8TRU7E A CONTqACT BETM�EN THp 15�11� REPRESENFATNE OR PRO�tJCER. ANC 7HE CERT/�7CATE HOLDBt �1. AUTHORIgD IMPORTANT: / tl�e atrli('ialr hold�r ie an AODIf1�NAl IN�URED� 1he pollcy(ksl muat be �ndo�sC. ■ SUBROGATIOM IS WAIV�. aup�eet ro the Iemie and co�ilb�c oi the ppllq, artaln polides may nqiqre an anppr�a�e�, A shbmeK oa tNS C�RIyeaEr do�s not epif�r rlOhfs !n tfy aRMleale Aoldor b Ilw W such Mdo�naR�s� PROOtR�R LEEREEDENSURANCE � Miiler PO Box 908 � � {813F782 5502 �.� �813)788-1996 Zephyrhilis, FL 33339-04D8 �aore�ss andy@leereedins.com �I AFFOMDMO cOYERAaE rwcr wa��. Southem-Owne►s Insurance [ompanY 10�.90 �"S�"EO Sealander ContractorServices, Inc. waur�a a : 5305 Camberlea Ave NSUqgt C : 2ephyrhills, FL 33541 �� o M{6'JIER E INBUREN F: COVERAGES CERTIRCAIE NUM6ER: REVISION NUA�ER: 7WI5 t5 TO CgiY�Y TFiN7 7HE POUCIES OF Mi3UW4NCE USTEO 86LOW MAVE BEEN ISSUED TO THE t�QUFEO NAt�ICp AgpyE FpR 7HE POUCV Pg'tpp W WCAi�. N071N17'FISTANDING ANY REOUIREIYE[�17'. TER610R CONDITiON OF ANY COMRACT OR OTHER DOCUNEM' WfiH RESPFCT TO VIlHICH THIS CERTIFICATE MRY BE �SSUED �i YAY PStfRN. 7HE �ISt1RJWf£ AFFOR[IED BY THE POUdES DESCRtBED HEHEIN !S SUBJECT TO ALL THE 7EftM15, EXCLUSIONS AND 004ORIONS OF SUCH POlIf1ES. LNAITS SHOWN MNY WNIE BEBi R�D BY VAIO CUI�l,4 �wn i� TrPE CF N191XIAUrE � wW POUCY MJMBg1 ��F � � G6NERAl 4A61LI�Y EACIi OOCtfdiENCE • Z�QQ�� x couuHrcw. cEx�w,� �usurv «,w�.� x0 � ? �•� � � aoo 000 � M��,��,.�.�� io,000 i 0723I2-20699636 9/18/I(I 9/18/11 oeasow�s�wvxu,rar i 1,000,000 � oer�tx �cort�w� s 1,00O,OOU CENL ARRREOATE UMIT APPLE$ PEIR X voucr E� �� , weooucrs.carwovrcc s 1.000,000 �uraiomsF �u�eiun ' t N+v�wro � �. de.r � : 1,OOU,000 A � �� w�v 072312 20699636 /18/30 /I8/21 wni�r euunv sn.r w.o„1 s - . X HIFIED MffOS � J( NOMOWNED SOOILYINR/C1'(p�r�ep�J s � �ums rn aarr s �otlurtt IA�AELl/� l6b S OCCIR � � i FXCESS 14�8 CWYSMADE AGp�.11l'E j �ED RE'[EFRION E WORMBiB CONPENW17p� i AND EMPLOYEAS' Ubt�flY Y�N TORYTU1tIi'i 014� �wr ewofwErcw�rutl�pimg �'''� � o�Mm4M�WEP OGUOSO� 1 I M!A E L° AGCI�!(T : �� i . If yw,��crip��r E.L D16EAEE . EA FJ+IPLOY� � t DESCRIP�AN OF OPSiA710N8 e�w et o�wse • Poucr uw► z oEaearvno►r oF oaou'noNS r �oranais rvgeaES t�noa �cao �w. adarar a.�wa se.+�� um. �.a k,. CER7IFICATE MIOtDER CANCELLATION City of Zephyrhills 5335 8th Street st+aua �wr oF rHe �eove oeaaaaeu voucies eE c�u.ea e�oaE Zephyrhills, FL 33542 ��r� p^� '�+E�. NoTic� wa� eE oa�v�o iN �ccoaaanrcE wrtx te� roucv as�ovs�,. � Ml►hARQED NEP11E7EN7KIVE � � ORA7101Y. Allright,teserved. ACORD25(?A10/06) 'The ACORO name and logo are reyLstere.W r�arks of ACOR� Jun 13 11 04•32p Sealander Contractor Serv 813-788-4028 p, � 3 �� AC# "' � '�. �'°`:2'� � .. _ .. _ _ _ ... ...- ---� ---- -- _- ...._..._..r._ _. ... ._ _ - --- - - -- -.. __ , ___._ , =,a _ ,.s . ..: �� .. _ - _ STA�E-O��FLl7R�DA -�---- ----- _ -- - .. - . .- --._ : DEPAR : �-, '=�:: :' =�:;;:,;.�' ;° . T�. OF� Bt732�+�S3S �D PROFLSS-3QNAL RgGiT�,,ATION `'''� `' � . _ CONSTRIICTI I�!7Df3S3'RY - t =�:�'-' �~`��`' ;;','.�.;= - �N '�ICE�T3ING $OARD �--- . � .y�'� � " SCE'� Ll`Q��7Z8JQ5:+4'90 � =:r - - • . .. i - LICEAT3E NHR � __- _ -- ._ .. - - i . . - .. � 47 28/2010 ].U0.047651� CG�15I469�. .. - . _ . ; ! The GENER�.�.� •- " .' : - - � -, - - : �,- - ' - i Named.- be1'.ow:�'Z�' �CF3�'IFY- - ' - .. . - , . _. _ . � _::: - , , i �o- �D •�,=; p Uncler ��is pravis;i:'ons df- Chap�er �,4�g ��'5,.: " --.- . . � _?� _ - , , Expiratio�a date : AUG 31, 2012 �' • , � �� , � - � " SSAT�IrAND$12, _ GARI� L;. ~= � - � ' - - - . - ' . ..; •- �•; . ,-;�:�' � • . � �t. CONTRACT4R�_ STR'f7ICSS ZN�-._: - ° �� ,.; � _ -- - : 5�3 0•'S��: CADQRERL'EA xvE ` �� i ZSPHYR,HILLS � FL 33541 ' .. •- ' ' ,- � ` , , - _ " -- '-- - _ . _ ' .. ' _ - . _ . •.- ._ - ' � ' �CHARLIE: CIt=S� _ - - °• CSARLI .', LI�: . :; ,� � � ' C�VS�I�TOR : - - -' - .INTERIM �C12ETA�.2Y - -i� j �-� - - _ . . "'D1�PLAY AS REQUkRED BY LAVir ' � . �aC� ;'� _.� ; r�; :'.F . . ...._. _ ; - ---- - - -- STA�E OF FLORIDA. - - __...- . - - � - �'�EPA.RZ�1ii�'- Ol? SIIS,INE3�=. A1�iD PROF}SSu�'IONAIi� �$GULp1T�ON ' __ " -;.-;�.- �` - -, , -- ,. CO B�Ra'CT30N �DII3TRY :=LI�EN3INCL _ _ - : ': : : ` - - . . , • - � - SE L� � , :=�:; C�# oo�ra�+��3s 'I;ICEN38 � NBR' - . = =, � , - a7 2 B. �.��.a 0 �;�D 4.t3�7575. ; � CFC14274F:8 � � � _ � . _ t. - The PT.iJMDING.�.GOi�I'�RACTO$._ . . .. - ==-�s, � _ • �bTamecl� be�:�w= 7S ��R'�IFIFD � - - " ' "--`'' ' ; -- . �Uiider -,t]ie pr.o'viszons of�:_Chap.Cer•.4.89 .FS.. � _ .- - � . ' _ - ::�� - 'M _ "' Expi�ation date: AUG 31, 2012 - � � - -" • ' , _ SEALAIITDSR, , ° CARL E , ; - r.: �� t " - . ,�� - SEAI+AND$it ��NTRACx012 SLRVIL'SS INC . - ,:'- � . ' - 5�305 `CAI�lBR�EA AVS -- _: - - . 2EP$YRHII;LS FL 3 3 541 � ' �� ' - • � - ',CKi�£LL3:E. CitTS� � � � - - _ . � _ -_ :� , _ -.� ; _- - Gt�V$ANOR - - - . : . CHARL�I$ LIffiri �." ._ - -.. ' � - DISPLAY AS�-REQUIRED BY LAW - " �:`�;!INTI�RIM SECRET'ARY _ ,_. �,�(� "`-' ' �,J �� Jun 1311 04:36p Sealander Contractor Serv 813-788-4028 p.1 �� : �� _ ___ ___ __ ___ _.. ___ _ _. . . . ____ .—_._ - _._ ___ _. _. _ - �. .� �s . `- - � . �. - _ � � i 1 ' " • ' --'• .— �li_„_ � � � ' • ' -._ " . . .... j i ACCOUMT NOs 073843 :� SYC CODE� 1711.03 TYPE 0� BUSINESS= PLU�fHING CaNT�2ACT0it ; � SEALANDER CONTitACTOR SERVICES L�CA7ION ADDRESS� 'i 5305 CAMBERLEA AVE 5305 CAMBERLEI► AVE J 2EPHYRNILES FE, 3354I-261� ��I�RS ! ; DATE RECEIPT AINOUNT � '�II�II!',��I�Isd��ll��'�11�1�l��1'I��1"�t��i��y�l��ul�l� O9f�Q/jQ 596004 31.25 ' ,; ' .; � _.. . � ------- ...---� ---_ -- - -- --- ---------:__. i _ a ��-� . � �� - � r �____- -- -- __ � ; � , ��. � 1 1 At�') iq t. `�; � 1'fl t+ W O ,.r ;� � j � ONr C!G ; ,� : � C7 RI OZ Y cn � M�H (7� ''d ' � .id �l � -i�+Z3 171 �R�-� i � -Ctf� •• Z . — rn rn o _ _ �: ; �' - �v � . '; � � i � = '�'1 7G 4t o� ' � � e� fr f+�0 � . �.� '' � n W � � W o .L� , i � W N � '' � � � � � � r, ' � � ,. <r. - v , , � N , � N ...z:�'° s ,, . - � si�� ° rKrs' � �3�• . � � � ... �- = ��` r ,�;�i �s �' 4 � • � . . � �.��:' R � � �� .--�. � \ IsOO r-( ` �� o a ty � c� rn'� ` f ��' ; o. s rn�-+ a c'� rn ,-:' ,"' ;�` ,�r�. s � f�it A�H �O - i o H70O N'Tt fa e� :<�,; i j --1 r-� Z A �� .:. , i �C aW "�= , �n rna r-c �,:, �°� ; � oo �v �oti vi :` �; � , u�+ n �o� oz �''�-� � `'' ± V i��i � N —1 N �'� r; �� i � � N 7DV! :�a : i � » a « .. � �, # , � - .= �� : $ o �.� � � . i r 3 � ` ffi � � j • O � ,�. x � � N C �' �A g � � ~ � I 1 0 � � � __ _,._. _,-°-.. ._...._,. ._ _._ _. _ __ _ _ __- --. _ .__- ---. _ _ _ _� •__.,. �..rnv��»^ --:'�-�� +:. _Y:_3e.,�' -= � = _ ;� - = _ °__ n : -==-= _`= _=�f�.L��xH a � � iO z R+ � N � - _ ' � C� Y- 8> i9 - �� C��ti .-1-t H�"i t'i R+C � _ oi��:�J C SB E� __ :.�,3 = n �� t�! i-i cr ft t� tji � _� .'� C #'- �' 48 fl p - c�sr�= � � O tD t--F y �,,, - ;� . a�i - n z�� o�r o �r� . �-r�H� � r� �u f r-� � � = y� �css c�. �t c� a _ =,,�- : ��- �t��;rt�c�rS �r a - _ ; ��_ _ � �Hy��{� �' _ _ � y_ Q Ks O r�- �s Q a d - �D��fl !�z � - �JC� G}H °Q = �, - � ��yQ� �� . _ � � ty w O +r � ,,��'' - F-► (1 � t-i r� t=! H� � - : _ >_ xor- �o « - �-�i y r N'*S` d� Y R � - - t�T Q �t0 ; � - �' n� n �� '�`,, � - w `� _ _� � a�i Z � o x �� - �_ ='- - = N G� C � � � ` -{ _ - __' _ _ =_ t-i c� �'- - = _ --_._. - x � � � —! - v �=-> �_-' = ;�. = - Hrn = tt�t = . m ;C�==_-_-__-__ �� '�� Q -� Ft3_�� ,,,� • �}�=�_=a.; _; '1i n c_`� = ' _ �7_ _. _-_ __ `, �' � � � t� _ x m,=_�-_= , _ -- � � �,� !p - m t ?== �= � f � �1 m aa�:-=_-_- �' � t�0 _ � - �� _ p __ D - ��x - 3> � � � � �- i = � r { � _ . _ -_ t ' �� _ � _ _ � � � _ -H _ - _ { � � � - i �' - � � _ � i- r o �� - � � z - m L=1 H � � - Hc� - � � _ _,;�� = r ° � _ �_� - � -- __° r � - _' _ `7 ° > Q _ '_ ,_ __ _ __ _ � _' ' _ °_ _ = _ _ pt-- - - - -= - �i ' � lilllllll�ill�i�lllliliilllliliiillllll!!!llllliilllllllllll 2P111075643 ASSESSED IN SECTION 02, TOY�II�TSHIPR26 SOUTH, � N: PASCO COUNT'y, FLORIDA R�GE 21 EAST, TRACTR25L LyII 1 G L EAST C OF�US Y 301 L�DS PB 1 PG 55 NORTH 1/2 OF LESS WEST 160 FT OF NORTH 1/2 LYING AST US 301REOF & OR 8021 PG 206 Permit No. Parcel ID No 02-26-21-0010-02500-0020 NOTICE OF COMMENCEMENT Rcpf, :1368030 Rec : 10. @0 DS: 0.00 IT: 0.00 State of Florida County of Pasco 03/ 17/ 11 C. Cook , Dpty C 1 ark THE UNDERSIGNED hereby gives notice that improvement will be made to ceRain real property, and in aocordance with Chapte� 713, Florida Statutes, the following information is provided in this Notice of Commencement 1 Description of Property: Parcel Identification No. 02-26-21-0090-02500-0020 Street Address: f748 Gall Bivd.. Zenhvrhills FL 33541 2. General Description of Improvement Irlterior renovation in rior walis eledrical HV C and olumbing PRULA S 0'NEIL,Ph D PqSCO CLERK & COMPTROLLER 3. Owner Information: Fi9rida Hosoitaf Zeohvrhifis Inc 0g�17/11 �1�Spr� 1 of Name OR BK 5� PG "l�r71�] 7050 Gall Blvd.. Ze�hvrhllls �� rJ+ � Address F � City State interest in Property: { Name of Fee Simple Titleholder. (If other than owner) Address City State 4. Contractor: Sealander Contractor Services Inc Name $305 Camberlea,Ave Zephyrhilis FL Address City State Contractor's Telephone No.. 813-548-7295 5. Surety: Name Address C�ty State Amount of Bond: $ Telephone No.: 6. Lender� Name Address City State Lender's Telephone No. 7 Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)(7), Flo�ida Statutes: Mike Gardner Name 7p50 Gall Blvd. Ze�Mvrhills FL Address City State Telephone Number of Designated Person: 813-783-6189 8. In addltion to himseif, the owner designates Carl Sealander of Sealander Contrador Servioes Inc to receive a copy of the Lienors Notice as provided m Section 713.13(1)(b), Florida Statutes. Telephone Number of Person or Entity Designated by Owner. 813-54�7295 9• Expiration date of Notioe of Commenoemerrt is one year irom the date of recording unless a d'rfferent 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 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A'tTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PASCO ��.rEcLV ��`i�/L��'LO-�.c.��. ��yna4ure of Owner or Owner's Authonzed OfficedDirectodPartner/Manager Signatory's TitleJOffice The foregoing instrument was acknowled ed re me this �day of , 2(�,(_, by �Q QY t� � � ( of authority, e.g., oificer, trustee, attomey in fact) for (name o arty on behalf ' trument was exec ted). Personally Known R Produced Identfiqtion ❑ Notary Signature ' Type of Ident�cation Produced Name (Print) Verification pursuant � i S t s U e aRies of perjury, 1 declare that 1 have read the for oing and that the facts stated in it are true to the best � "iYil�l t. � �r►+�e • �a..ra�ne�. �'�/,;,��i��r.��'�-� � ��_�'�= Signature of Natural Person Sigmng Above M�I�I �w;tlfl� wpdata/bcs/bcs form n STATE OF FLORIQA, CQUN7Y OF pA5C0 THIS IS TO CER7IFY THAT THE FOREGOfNG IS A TRUE AND CORREC7 COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE JdITNES MY HAND A �FFICIAL SEAL THIS � " / DAY OF 2� PA . A S O'NEIL, L�2�OMPTROLLER ,' � ` DEPUTY CLERK Zephyrhills Fire I�escue l,t)O7 1)air_y IZcr.�c1, /_cph��rhill�. f�l ;;�� I ire Marshal kei 13arnetl �;us (x I_i ) 780-O04 I (�a� (81 ;) 780-UU4�1 ._.�.____..__._..___ _..... _..__. _. _ �,-mr.�il.lcharne;tt�u;.fire.icrhyrhiliti.il.us n. .... .._. .. .. _,_ an Review #: 1 I -070 .... ._ ..._. ..._... _�.._ . ..... _._ _..._ _. ___ v. Project: Building Rehab (Renovation) Number of Pages: 33 May 31, 201 I 1 have received and reviewed the plans for the building rehab (renovation) located at 6748 Gall Blvd and will allow this project to move forward. Paying for permit, contractor acknowledges to the comments listed below. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. 1. Ensure safe practices are used during the construction process in accordance to NFPA l. 2. If at any time the fire alarm and/or fire sprinkler system is to be down for more than 4 hours this authority shall be notified. 3. The cover index page is wrong. There is no page A-2.2 in the plans. Pages A-2.3, P-4.1 and P-5.1 are in the plans but not listed. 4. Separate plans will be required by the contractors making modifications to the fire alarm and fire sprinklei• system in order to obtain permits to conduct that work. Ensure all details, calc, cut sheets, details, ete... are submitted. 5. Ensure east exit door in corridor 108 has panic hardware. 6. Ensure duct detector is installed and tied to FA system. 7. Ensure fire extinguishers are located within 75 feet of travel distance. Inspection Required: 1. Final r KERRY B ETT, 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. 1t 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 examinaUon or site inspection reveals areas of non-compliance, rt shall be the contractor's sole responsibility, at their sole expense to brmg [hose areas in compliance The City asswnes no responsibility for the contractor's failure to be in compliance with all applicable NFPA codes and local ordinances. � ' Z��-��IL�S FIR� L�EP'�4��'11�EN`� 6907 Dairy Road, �ephyrhilis, FL 33542 �ere Chi�f Keerh V1lifii�ms Bus (�13)780-Ot�41 F�x (813)"180-00�1� FIRE SERVICE USER FEES Occupancy No.: � Plan No.: �-- Contractor: ��,r /�� Business Name: � Billing Address: ,�J _ "(� ��,c� BusinessAddress �� " �,Y,-�►+-��'��..�,��,, Bus�ness Phone No • Billmg Phone No.: � Business Fax No Billing Fax No.: Contact- Contact. PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE SitePlan /C Annual N/C Sprinkler $50 1stAlarm N!C ulti-Family/Commercial O6 sf tst Re-inspection N/C Standpipes $50 2nd Alarm N/C � Minimum Charge $25. 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C v� Plan Revisions DBL 3rd Re-inspection $250 Hoods $SO 4th Alarm $�pp J 4th Re-Inspection $500 Fire Alarm $50 Sth Alarm $150 SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Atarm $200 0- 25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- oe� �nk $5p STANDPIPE SYSTEM Hydro Undergrounds �445 Sparklers $�pp � Per Riser $50 Hydrostatic Test $65 Pe� system Fire Works $5pp FIRE PUMP Acceptance Test $45 per system Camp Fire $25 � Per Pump $100 Hydrant Flow $75 ConUolled Burn $100 FIRE AIARM SYS7EM Hood/DuCt $5p 8 0- 25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $SO Annual 26 plus Devices $100 System Acceptance a50 Fire Protection �� SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $50 nnnua� Wet $50 OTHER Waste Tire Storage $50 Annual Dry $50 Fire Wall/Smoke Wall $15 Pe� wan Generator < KV1I g1 pp CO2 $50 LP Gas $25 Per��k Generator>30 KVU 150 Other $50 Natural Gas $25 per system Bio-Hazard Waste a100 qnnual KITCHEN EXMAUST Fumigation Tenting $50 � Hood/Ducts $50 Tent 10'x10' or greater $15 pe� te�t Torch PoUApplied $50 OTHER Fire Pump $45 Haz. Materials $100 qnnua� LP Installation per tank $50 Fire SUppfeSSiOn $3Q Fuel Tank Installation $50 System Acceptance (Per Tank) $50 8 Exhaust Hood/Duct $30 � Nalural Gas Installation $50 Re-inspeCtion DBL ( Per System ) (other than annual) � Spray Booth $50 � Inspection scheduled DBL 8 and cancelled less than 24 hours Construction Insp. N/C Emergency Vehicle Ac� $50 FALSE AI.ARM PLANS TOTAL� /' ��SPECTION TOTAL �I PERMIT TOTAL �- I TOTAL I-- - I GRAND TOTAL e Comments Date � Ins��ctor l�' �£ � �w^)�� 6748 Gall Blvd. �l� �`�� y 7 L � S SQ. FEET PRICE MAIN OR LIVING: OTHER AREA UNDER ROOF: - OTHER: - $ _ VALUATION $ 170,000.00 FEE SHEET $ 695.00 ADDRESS DRIVEWAY BUILDING: $ 708.90 ELECTRICAL: $ 156.38 PLUMBING: $ 104.25 MECHANICAL: $ 72.98 SUB-TOTAL $ 1,042.50 buildin surcha e $ - TOTAL S 7,042.50 SEWER: WATER: IRRIGATION: $ - TOTAL: E . WATER METER: IRRIGATION METER $ - FIRE DEPARTMENT FEES PLANS TOTAL: INSPECTION TOTAL: PERMIT TOTAL TOTAL: ; . PUBLIC SAFETY IMPACT FEES POLICE FIRE 5% TOTAL: E - SUB-TOTAL $ 1,042.50 PARK IMPACT FEES E - SIF'S: $ - 100.0% $ - 1.0% $ - TOTAL: S - TIF'S: 99% 1% $ - TOTAL: $ 1,042.50 813-780-0020 City of Zephyrhills Permit Appiication � f� � Fax-813-780-0021 Building Department � �'� Date Received /� � � � � � ' � Phone Contact for Permittin — Owner's Name � ` Owner Phone Number 3— f 3—G/ Owner's Address �i'JU �G Owner Phone Number Fee Simple Titlehoider Name �-,c..e� ;�',.,, ,tj, :.feL ..J/�. Owner Phone Number Fee Simple Titleholder Address �� ,�, j �'� JOB ADDRESS � LOT # C� SUBDIVISION . PARCEL ID# d _p (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR � ADD/ALT 0 SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR � COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK � FRAME �� STEEL Q DESCRIPTION OF WORK , _ � , � `, � BUILDING SIZE SQ FOOTAGE HEIGHT �BUILDING $ VALUATION OF TOTAL CONSTRUCTION �D aoo , QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. OPLUMBING $ /; ��S �� v �../ �� S-1 7— (1 k�i Jyc v OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � N�� ✓ �GAS Q ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �� BUILDER � COMPANY ��f C � SIGNATURE REGISTERED / N FEE CURRE� N Address ..�.� D j License # �ly L� /� S GNATURE N / �� COMPANY � �v�� (�- / �7 �= �� ( C � REGISTERED Y/ N FEE CURRE� Y I N Address fU �1�� /� � �ffl��: L ( � � ' License # PLUMBER �/ COMPANY �,q o „� �,Q��. � SIGNATURE REGISTERED N FEE CURRE� / N • Address Ucense # / MECHANICAL COMPANY ,SS s� � �p, SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � Address License # SC 6 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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisfons/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, Stortnwater 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 1s 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 Fenc�{��i�r�� o age�' Driveways-Not over Counter if on public roadways..needs �� , t t �rA �t; ,� � 3ftfx� 00 � �pl� .Mil� N �NIIN INMw NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County �egulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBtLITIES: 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 regulativns. 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 Counry. 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 finai 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 fimited 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 fi►I 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 t� vialate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued 5hall 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 NOTICE OF COMMENCEMENT. FLORfDA JURAT (F.S. 117.03) �? �,,; ) > �� OWNER OR AGENT `�'�—' CONTRACTO '` C/ '� '�'°`� S b and swo (or afflnned r me hi � � sc bed and swam�(�r r ed or ��s� ��p�, �r , �r o is/ re ersona known to or has/have produced s/are ersonally known me or has/have produced as idenHfication. __ as idenNfication. � % • , " °� l',(,�� r Notary Public CC.� Notary Publlc ti.��r Commission No. Commission No. \~ � a ed, printed tamped n Name of Notary typed, p ed or stamped � s"� . wc.�...��».�: o...�wr. r eo nt��: wr +�r �. 06/23/2011 8:4�:47 AM -0700 FAXCOM PAGE 1 OF 3 Total Pages: 3 � r ` Enterprise Fax To: From: cyberpd1 Fax: 813-780-0021 Phone: Phone: Date: Fax Number: Re: * Comments: NOTICE: CONFIDENTIAL AND PRIVILEGED INFORMATION - This fax may contain confidential and privileged material for the sole use of the intended recipient(s). Any review, use, dist�ibution, or disclosure by others is strictly prohibited. If you are not the intended recipient (or authorized to receive for the recipient), please contact the sender by telephone and destroy all copies of this correspondence. If you no longer wish to receive faxes from us, please contact the sender of this fax and we will remove your fax number from our list. Please allow us up to 10 business days to update our records. 06/23/2011 8:49:47 AM -0700 FAXCOM PAGE 2 OF 3 Commeraal Lines - (813) 6393000 Wells Fargo Insurance Services USA, Inc. 2502 N. Rocky Pant Drive, Suite 400 Tampa, FL 33607 T0: Kalvin Switzer FfOR�I: TanyaAlvarez(813-636-5307) FaX : 813-780-0021 SubjeCt: Certi6cate of Insurance Comments Per your request. Tanya Alvarez Wells Fargo Insurance Services 813-636-5307 tan ya.alvarez�wellsfargo. com This mesaege may conte�n canidenoal andla pnv�leged mbrmanon If you are not Ihe addresaee a authonzed [o rece�ve thia fa 6�e addreasee, you must not uee, copy, diaclose, a teke any ecoon 6eaed on thia message a any infama0m he�n If you have rec�ved ihis measege m erra, pleese eMise Ihe s�der �mmedie0ety by repy fax and dele[e this mesaege Thank you fa yourcooperanon 06/23/2011 8:4'�:47 AM -0700 FAXCOM PAGE 3 OF 3 �,,.�„ ,a3e� A�� CERTIFICATE OF LIABILITY INSURANCE °"'�`��'°°""""' �,,.r 6/23/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA71VElY AMEND, EXTEND OR AL7ER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERIIFlCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE'iWEEN THE ISSUING INSURER(S�, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CER7IFlCATE HOLDER. IMPORTANT: If the certiTicate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS W/UVED, subject to the terms and conditions of the policy, certain policies may requKe an endorsement. A statement on this certificate does not confer riphts to the certificate holder in lieu ofsuch endorsement(s). PRODUCER � Certificate Department Commeraal Lines - (813) 6393000 Wells Fargo Insurance Services USA, Inc. �� E,c : $13.639.3000 F � No : 813.639.7180 E•Ma� clw_certre ues welisfar ois.cam 2502 N. Rodcy Pdnt Drive, Suite 400 nooaess: q �@ 9 INSURER�S) AFFORDINO COVERAOE NAIC • Tampa, FL 33607 INSURER A Hartfard Casualty Insurance Company 29424 iNSU�o Massey Metals Company, Inc. Massey Fabricetars, Inc. �sur�a e. Zenith Insurance Company 13269 P O Box 89297 INSURER C. INSURER D INSURER E . Tampa FL 33689 INSURER F . COVERAGES CERTIFICATE NUMBER: 2901152 REV1310N NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTUVITHSTANDING ANY REQUIRETAENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUAAENT 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, D(CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE LTR POLICY NUMBER MIDDiYYYY MIDD LIMITS A GENERALLIABILITY 21UUNUT4163 11/01/2�� 11/01/2011 �CHOCCURRENCE $ 1.DOD.000 X COMMERCIAL GENERAL LIABILITY PREMISES Ee occurrence S 3 �•� CLAIMSauIADE � OCCUR MED EXP (My one person) $ 10,000 PERSONAL &ADV INJURY $ 1,00O,OOD GENERAL AGGREGATE 5 2.�00.000 GEN'LAGGREGAiELIMITAPPLIESPER PRODUCTS-COMPlOPAGG � 2.000,000 POLICY X PR � LOC S /.� AUTOMOBILELtA81LITY 21UUNUT4163 11/01/2010 �1/01/2011 �aec �p�� X ANYAUTO BODILYINJURY(Perpeison) $ AILOWNED �SCHEDULED BODILYINJURY(Peracddenq S AUTOS AUT0.S PROPERNDAMAGE NON-0WNED HIREDAUT0.S I AU7O8 erecciden[ � i � A X UMBRELLALIAB X OCCUR 21RHUTT9000K3 11/01/2010 ��/�1/2011 EACHOCCURRENCE y 3,000,000 EXCESS LIAB CLAIMS�IADE AGGREGATE y 3,000,000 DED x RETENTION 10 ,� y 1NORKERS COMPENSATION x WC STATU- O7H- B ANDEMPLOYERSLIABILITY yrN Z830729821 3l31/2011 3/31/2012 ANY PFZOPRIETOR7PARTNERIIXECUTNE 1.000.000 OFFICEWMEMBEREXCLUDED� � N1A EL EACHACCIDENT y (M�daOOry In NH) E L DISEASE -EA EMPLOYEE 5 ��•�� Ifyea, deecnbe under DESCRIPTION OF OPERATIONS belax E L DISEASE -POLICY LIMIT � �•�•�� DESCRIPTION OF OPERATION51 LOCATIONS I VEHICLES (Attadt ACORD 101, Addidonal Ranarks Schsduls, if mors spaes is roqufrod) Proof of Coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of ZephyfiillS 7HE EXPIRA710N DATE THEREOF, NOTICE WILL BE DELNERED IN Attn Kalvin SYvitzer ACCORDANCE WI7H THE POLICY PROVISIONS. 5335 Eigth Street pUTHOR12E0 REPRESENTATIVE Zephyrhills, FL 33542 9� �- The ACORD name and logo are registered marks ofACORD m 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)