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Home My WebLink About11-12115 , CITY OF ZEPHYRHILLS 5335 - 8TH STREET � � ' (si3)�so-oo20 12115 BUILDING PERMIT Permit Number: 12115 Address: 38700 GRANGER LN Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: Improv. Cost: 4,950.00 Date Issued: 7/12/2011 Name: COLTON STEPHEN Total Fees: 60.00 Address: 38700 GRANGER LN Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542 Date Paid: 7/12/2011 Phone: Work Desc: HVAC CHANGEOUT PACKAGE UNIT ��7J� �`d�`�J' ��t°C�-�-(L �0 -�( -� f"� I /OD/7 ^�� l�a bI l�� --�-� ,1 �1 __� � DUCTSINSULATED 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 aonstruction 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 of commenceme " r , r' ! r/ �\ I CON OR S� ATURE PERMIT OFFI R PERMI CPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER t,i:aso-ooze City of Zephyrhilis Permit Apphcat�on raX-eisasaooz� Building Departmeni Date Received � -� Phone Corttact for Permittinc I ' —� __ ' �axem�rx�.� - -=--,�-- S vc. ff /� � Owner's hame Owner Phone Number CJ I�J -' fpg "��d� � Owner's Address j 3 7�J /' ��j'� �. -��r Phone Number � Fee 5imple Titleholder Name �— _.. � Owner Phone Number �— � i Fee Simple Titfeholder Address � I �os aoorxESS �AD �rrrqer�rt•�tQ �,G•tdu,�uNS -r—' 33�� L I �or# � SUBDNfS�ON �---� pARCE D#L 1 i pZ - zh ' Z! -OOI C-obci� °� L$O �OBTAINE� FROM PROPERTY iNX NOTICE) WORK PROPOSED NEW CONSTr^ ADD/AL � � SIGN � MOVE � D�MOLISH � WSTALL REPAIR PROPOSED USE � SFR � COMM � OTHEF TYPE OFCONSTRUCTlON � BLOCK J FRAM= Cj STEEL � OTHEF DESCRIPTION OF WORK �` � �� r BUILDING SIZE SQ FOOTAGE � i HEIGHT � � - , �:r::�s�a:tp�.�r.sa�,� �� 3UILDING � � VAWATIOtJ OF TOTAL CONSTRUCTION I � � =�ECTRICAL �5 � i AMP SERVI�E � PROGRESS ENER3v C W.R.�.0 � '! UME3iNG �--� ��%� ,�f \'w r j IAECHANICAL�' S � ��j� ' VALUNTI�N 0� MECHANICAL INS?4LLATION � � / /� � '�AS �'�.- -J�36riNL-'� � S°ECIALTY U OTHER � � � i=1NISH�D FLOOR E:E�'aTIONS FLOOD �ONE AFcf. �YES �N,. f I �� 3 , .. . . . �..}: �«.�.«:«k�.,�...�., �,,.,�,. � «.,,�� _� - - _� BUILDER I � COMPAN� � SIGNATURE REGISTEREC � Y� n j FE'cCURRENi � N� Address J License# i � ELECTRICtAN � � f _" ` �/L ► f �_.�,,,�C j COM?ANY � (�pp� �.+� -�- SIGNkTURE �'� 4;Joerf � � REGISTEReD N F CURRcNT / rv � Address � License # � O � Q � PLUMBER �— _� COMPANti � � SIGNATJRE 1 R2GISTERED Y i N T — T — � I F��CURREN' �� Address ucer.se # � I MECHANICAL �! COMPANY I +y/ �,r�/'G� SlGNATURE „/� � s REGISTcREC Y/ ' FEE CURREhT ; N Hddress ( �—� License # pTHER COMPANY I � SIGNA7URE RcGISTEREC Y� n FEECURRENT Y' Iv Address � � License� C RESIDENTIAL Attach (2? Plot Plans (2� sets of Building Plans, (1 t set of Energy Forms. R-O-W Permit for new constructior. M�mmum ter. (�0� woriung days after submittai dafe Reqmretl onsite. Construc6on Plans. Stormwater Plans wt Silt F,ence installed Sanitarv Facilities & 1 dumpster Site Work Permit for subdiwsions/large pro�ects COMMERCfAL Attach (3y complete sets of Building Plans pWs a Lrfe Safety Page: (1 } set of Energy Forms. R-O-W Pertni; for new conswction Mirnmum ten (10) work�ng days after submittal date Required onsite Construction Plans Stormwater Plans w.' Silt Fence instalied. Sanitary Facilibes & t dumoster Site Work Permit for all new pro�ects. Ali wmmeraal requirements must meei comobance SIGN PERMIT Attach (2) sets of Engmeered Plans ""PROPERTY SURVEY reqwred for all NEW construction Directions: � � � - - - � -- � - - � ' Fill out applica!ion completely Owner 8 Contractor sign back of apphcat�on, notanzed If over 52500, a Notice of Commencement is required. (A/C upgrades over $5000) '" Agent (for the coMractor) or Power of Attomey (for the owner) would be someone with notanzed ietter from owner authonzing same OVER THE COUNTER PERMIT7ING (Front of Applicatwn Onlyi Reroofs Sewers Sennce Upgrades A/C Fences (PIOVSurvey/Footage) DrivewaysNot over Counter if on public rcadways .neeCs ROV�' , 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 RNQ CONTRACTOR RESPONSiBILlTIES I° 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 ficensed as required by law, both the owner and contractor may be cited for a misdemeanor violation unde� state iaw If fhe owner or intended contractor are uncertain as to what licensing requirements may apply for the inlended work. they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- 8009 FuRhermore if the owner has hired a contractor or contractors. he is acfvised 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 privdeges in Pasco Countv TRANSPORTATION IMPACTIUTILfTIES IMPACT AND RESOURCE RECOVERY FEES. The undersigned understands that Transportatio� fmpact Fees and Recourse Recovery Fees may apply to the construction of new buildings. cha�ge o` use ir, existing buildings or expansion of existing buildinas, as specified in Pasco County Ordinance number 89-07 and 90-d� , as amended. The undersigned also unders;ands, that such tees, as rnay be due will oe 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 appl�cable Pasco Counry ordinances CONSTRUCTION LIEN LAW (Chapter 713, Fforida Statutes, as amendeda I` valuation of work is �2,500 00 or more ! certifv that I, the applicant. have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide" prepared by th2 Florida Departmen, of Agncuiture a�d Consumer Affairs If the applicant is someone other than the "owner" 1 certify that I have ob:ained a copy of the above described document and prom�se in good faith to dehver it to the "owner" prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVfT I certify that ail the information in this application is accurate and that all work wili be done in compiiance with ali applicabfe laws regulating construction, zoning and land development Appiicatior, is heret�y made to obtain a permit to do work and installation as indicated. I certify that no work or irtstallatior; has commenced prior to issuance of a permit and that all work will be performed tc meet standards of ali laws regulating construction County and City codes, zonmg regulations. and land development regulations in the �unsdiction. I alsc certifi� tha; I understand that the regulations of other government agencies may apply to the mtended work. and that it is my responsibifity to identify what actions I must take to be in compiiance Such aoencies include but are not limited to - Department of Environmental Protection-Cypress Bayheads, Wetfand Areas and �nvironmentalfy Sensitive Lands, Water/Wastewater Treatmen; - Southwest f=lorida Water NEanagement District-Welis Cypress Bayneads. Wetland Nre2s Alterine Watercourses. - Army Corps of Engineers-Seawal!s, Docks. Navigabfe Waterwa��s - Department of Heaith & Rehabiliiative Services/Environmental H�alth Unit-Welis, Wasfewater Treatment Septic Tanks. - US Environmental Protection Aoency-Asbestos abatement. - Federal Aviation Authority-Runways. f understand tnat the following restrictions apply to the use of fill: - Use of fill is not allowed in Fiood Zone "V'� unless expressiy permitted - If the fill material is tc be used in Flood Zone "A" it is understood thai a drair,age plan addressing a "compensating volume° wil! be submitted a; time of permitting which is prepared by a professio�a! enoineer I�censed by the Staie of Flonda. - If the nl! matenai is fo be used �n Flood Zone "P," in connection with a permitted building using stem wall construction, I certify that fil' will be used only to fill the area within the stem wali - If fill material is to be used in any area, I certify that use of such fill will not adversefy affecf adjacen� properties. If use of fill is found to aduersely affect adjacent properties the owner may be cited for violating the conditions of the buifaing permit issued under the attached permit application, for lats less than one (i, acre which are efevated by fill, an enqineered drainaoe plan is required. if i am the AGENT FOR THE OWNER. I promise in good faith to inform the owner o'the permitting conditions set forth in this affidavit prior to commencing construc?ion I understand that a separate permit may be required for efectricai work. plumbing, signs. wells, pools. air conditiornng, gas, or other installations not specifically induded 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 as�de any prov�sions of the technical codes nor shall issuance of a permit prevent the Building Official from thereafter requiri�g a correction of errors in pians, 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 bv the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extersion may be requested in writing, from the Building Officiai for a period not to exceed ninety (90) days and wilf demonstrate justifiable cause for the extension If work ceases for ninety (90j consecutive days, the �ob is considered abandoned. WARNtNG TO OWNER: YOUR FAILt1RE TO RECORD A NOTICE OF CdMMENCEMENT MAY RESULT fN YOUR PAYING TWIGE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU i END TO OBTAIN FINANCING, CONSULT WITH YOUR LEN R OR ORNEY EFORE RECORDING YOUR !C ENCE NT. F�ORIDk JURAT (F. 11 .03 � OWNER OR AGENT CONTRACTOR scnbed and swAt� o(pr affirm Qr me this b nbe and sworn t or affi e re me tyis 7 by �JA+�ie� i32u.!(lu� ,��bv 17oti+J�� Urerw�YL� are persona y known o m r has/have producec' aJn e persona y nown o me o as/have producetl as' e i n as �dentificahon. , ��'��a % RYAN HOERLE � V P ��NIIII/ :r°� `�+= `�''`�'"4i°� RYAN HOERIE . c Not��ygi,� State of florida ; ip �i ; My Comm. Expires Sep 23, 2013 �� • State oi Florida Commission No :� S,o No. � �? My Comm. Expires Sep 23, 2013 .,, � # DD 9 �.��, � Commfasion #� DD 927156 �„�,�� • .� '��n.aa Name of Notary ped, nn sta pe Name o No ary typ d, pnnted or stam � n W a o o n n D o D v+ �� o - y � ,� m c 3 � m � . �'n' � v� o x�� R c, ci -� o�i N F' �; O 2 D 'O n ` � C �� j� '� a Q' � m m D =� p D � Z P f� m � o n� "c o, � O� � ' J � �^ -i m\' A m � o ('`� X a= ��.'^ o a �� 3 c �� '�" � y �+ „ o °' o - Q' o a [,'1 rp o�, �» � � p � N ,^ m ° V` m Z � � � � � � o x � nm � � �\ A - � � °-' � � � 3 " � c 3 = D D . 2 m A � a m � c� v iv m �' •, - � a � », Z � j a �� s r y � T�e �t < • � m o a ` y "' �� N / m ^ �. � 'v � � ' = 7�� - i � o G � N y {�� '\ v+ D A D (� ? n� d m l0 � � O A m d � F 1 .�» J < H� _ p N � r p �n y O D � � C N p� N •`% �0 .L � ,{-_, -� � R.�i S r�+ Q H L/ \ R � � �o m° N r f � n� o � � o�. o � 1_ D m � o ° c � � � ? fD �. � m �' Z < � ° � , � o f° � s - f a � � " � m � s � < ,` r � � m� c aT�ps=m m N F N fD � �p Oi � O d � � vi � m -I W �\ � d � _ �( � � � � � � 3 � o; � �l g�� f D Q �'� a r � n m��^ �o �+ m m m m a m � a R' � �i < ,- � N n � � a � � � m ? 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' 1� � s� ��D�mD�° w I m � � a O O < � •,_ � m y ��r� ��, Z � m m� � ^ , 1 m � SO ��m��0o O � I n n 3 D U7 � o_^ �zD?� r ^ , � o � p � z QZ m�� Z <y . � I � xc � L1 � c, m D n <p � o • �c = �pp�OCD � G� I ^ \ � t� < N m�=?CC D l o� p � �•� c � `n�mz�� S � I D , 3 � �. z o � r�c S Z�DnO�' fD a X 3 � Z � m 00� � m v X � \ � c� Z � .a �� OpZm.. s O � f • , � ° � � T n n � � ,°» � z � m'^O0"�Z y � ae � � � � � D m �'y � N Np O� d m f1 N v 7� j - n D a� ��_Imv o � n � � i^ 4 ' r S I� � m On00� �c °� p � 1 , m al0 N� C��N=� � s= _ � O O O C Z �lo o - paz<�z �„ a� _� � � Z � � s �^'00�� I 1 \ O D m O P.+ T O m D m � ,�D., m � l / 1 � � D � ,� �; 'O oi � m D r -{ A a T� m � � � 1 I � O Q!'1 r-<C � O � G m o z m � m�� a o D D D � �I "O oi � r L'1 m � m co 1 m �^ DG1Dm03 � O O �' � z � o � ��DA�z re �' � � r .-"�,.� �p-{^"^�., a � p z �. �o ,• � � � c m .o ��p�,z � � a • v� 2 ° �`* =D Znz c D v � n � �^ -i � .� ry r �r� m =m0 <! C `3 C Q p � �` � W Z a 3- v i m�"'� - � i < c m y � y � o ' ['`} G '` =iZ� � `-' � Z z • ? 'UlF .. � � � � m ��z'�� a 0 3 � CO a � �m�" ` 3 � m � - a � • ` �v l �m �2m C _' � -1 C O n �. � m� D �c 2 � T a� y =�� 00 '^ ° c r X � D m � • � N 7 Z- T t n=� m � Q ', O n �n o p � � � = z = = p o ,�» `' '�',D � 3 � � � - w � ,i rnnt rrevieu�. WorkUrderInformation �� a� Page 1 of 1 - - � --� S� �S (} �� b� - - - - -_.�06 ys-- Service Line/T � �� Work Order: 5306081 ype: HVAC/Residential AOR Branch: ARS TAMPA BAY �"1 � ---- -- - ---- - -- --- - — -- ---- - -- - -- - Customer Information ��"�'� Customer Name: STEVE COLTON %�� Address: 38700 GRANGER LN City: ZEPHYRHILLS State: FL Zip Code: 3354� ��' Primary Phone: 813-469-8906 Secondary Phone: ��, Mobile Phone: � Contad First: Contact Last: � Acquisition Type: N/A AR Status: COD Only Map Coordinate: -- ------------ ------- __6'�=.�v_- Z �� -_ cm� - ao� �- a � a Work Order Information Activity Type: Sent Sched. Start: 6/23/il 10:30 AM Sched. End: 6/23/11 2:30 PM Location and Symptom Description: Air Conditioning / Replacement Estimate - HVAC Co-Pay Amount: $0.00 PO Number: Primary Tech.: ROBERT Morris Secondary Tech.: Payment Type: � Completed On: Invoice Number: O Unverified Amt.: $0.00 Invoice Amount: $0.00 ��G�� Agreement Recognized Revenue Amount: $0.00 Arrived Time: Completion Time: �� gj'1C^"-`/� Completion Activity Notes: � � / Created By: BRIAN THOMPSON Created On: 6/23/11 10:21 AM Work Order Notes: Prob Loc/Sym:Air Conditioning/Replacement Estimate - HVAC 06/23/11 10:19 AM BThompson: tech lead from danny sipe 7-� - --- - - --- , � � - - -- ---- �-- - - -- �rM-� }�-� �� , J�- �- - -� - f - ----- -- - -- -- -- - � - ------ -- J ' � %3- Robert Hugues Enterprises Inc. 7510 Cypress Knoll Drive New Port Richey, Fl. 34653 (727)847-5806 Fax (727)847-5211 Cel Phone (72'�919-3304 rhugues(�a,tampabav.rr.com EC — 0001040 Date: JiJLY 15, 2011 To whom it may concern at CITY OF ZEPHYRHILLS BUILDING Department, I, ROBERT HUGUES, hereby authorize the following named person or persons to apply for, sign and purchase permits and/or licenses in the name of ROBERT HUGUES ENTERPRISES INC. This list is to replace all ot6er previously issued which are now to be considered null and void. AUTHORIZED SIGNERS: ROBERT HUGUES H220-765-42-012-0 EDWARD GREEN G650-232-68-364-0 MICHELLE HUMBERT H516-554-68-512-8 SHERRY TAYLOR T-460.781-45-518-0 KIM JEFFORDS J163-510-77-550-1 PAULA TIMMRECK T562-667-70-824-0 MONA BOYER B600-553-83-501-0 HENRY STEENE 5-315-38�65-448-0 JOHN WALSH W 420-472-63-327-0 DAVID BEWERI�TITZ B653-151-60-169-0 DAVID ORTIZ 0632-164-68-441-0 DAVID BOYLE B-400-161-49-172-0 KENNETH SWEENEY 5-500-513-76-416-0 LINDA DANA D500-526-62-564-0 NICK MARZOLA M624621-80-188-0 TONY ORLANDO 0645-006-59-06(�0 DAVID MCALLI 42-170-64-213-0 TIM SWAFFORD 5163-810-79-427-0 y-' '. ,� ,�r•" ,� " ,._._�:-�'' ` � EC-0001040 ONTRACTOR STATE OF FLORIDA COUNTY OF PASCO The foregoing instrument was acknowledges before me this day 15 of JiTLY 2011 by _ROBERT HUGUES as PRESIDENT_ of ROBERT HUGUES ENTERPRISES INC._, a Florida corporation, on behalf of the corporation. He or she is personally known to me or has produced Florida Drivers License H220-765-42-012-0_ as identification and who (did/did not) take an oath. My Commission expires: NOTARY PUBLIC ,,,��,,,,, y ��.'"" ••; RYAN NOERLE Signed ' : : N�ar Public - State of FloMda p� �„ !-�C+r.rl 2 � �� My Comm. Expires Sep 23, 2013 � �'•, c„�.�`� Commisalon I� DO 927156 ��.�N� i ..�,..�.�...,w�..�..�.�,. .._,�.X_ . �. ., _._ � .._ .. ,� . .. _ �.. � �. , , } -- � � � "°�; � b' � a � � �k� � � .. , � t � ' „ �b � � � �m' � � S ' , - q :. , � '� ' ! �� ' . � ACCOUNT N0� 002395 ;. TYPE OF BUSINESS� , I SFC CODE� 1731.02 ��°°��°-�-��^"�°" ELECTRICAL CONTRACTOR I � + °' LOCATION ADDRE55� ROBERT E HUGUES ENT INC ,� 7510 CYPRESS KNOLL DR ; 7510 CYPRESS KNOLL DR NEW PRT RCHY I, NEW PRT RCHY FL 34653-3532 �= `"� y DATE RECEIPT AMOUNT �� , 07�12i10 586849 31.25 ' ��p�n�I�IIU�NI�ddr�hh�I��i�luli�P��h�i��ii��r•�� ;; . � � `� - - .,.,,..,�,w„as�„n,.F.,.....<..�. ,�.....,- .. . . ..�,...,.... -..,_m».m-..r,«,.r.,�,�...-. .,:..._�,�.�,..no....�..,.,.w - - - pII�IELLAS COU?1TY CONS'fRUGTION L[GfiNSiTKi SOARD — - - - - - _ �1C# a �1 � � ° � 3 �� _ STATE � F40RfDA ��rtEHnSa� � DBP�T�'r fl1 BUSIlTSTIO� T}iISCER'CIFIESTHAT - .� -�RQF.BSSIONAL'AS DBA Robert Hu&� �� InC -- _ +, _ - -.�ooi��04o -�/�� o�000000 = I�EG'0 pR ppF OF REQ�� l P1TR3�CTOR SfATECERT# C�3,tTIFIE�: � TR�C..1CL�4'� HAS FLl.BT� 1��ER LICENSG N(PENSAT[OTI _ R .,��'. -; LIABILITY AND WORKER � P.Y EE �� i f� $�,'�,�yS`S&� INC ` iNSURAI3CE �TH THIS BOARD. - -• > ^�;_;�'° �py�ber 30, 2�1] - i� {IV GOOD STAND[NQUtTI'[I- �� _ - _ - -- -- ,:_%__ - .- . DATE OF ISSI7ANCE I$.,CSRTIFIBD undK L� P=�isions ot _en.489 FS �i` �p3taciam iSrEe:..AII9 31r 2'0�12 =Ii3.Q062� � iz; - z , - _ _ ' _ 9 - '".� 07/15/2011 10:15 FF:OM: 72i2695462-TO: Contractor Lic@18137800021 Page: 1 of 2 Date: 7/15/2011 Time: 10:18:48 AM Pages : 2 From: Leanne Martin To: Contractor Lic Email: leannem cLDwaldeninsurance.com Fax:18137800021 Fax�72�8479544 Subject: Robert Hugues Company: Walden Insurance Network Confidential! comments: Certificate attached thank you Leanne Walden Insurance Network Inc This Fax Was Serrt Sf curey And Owcky Over The Irnemet 07/15/2�11 1C:15 FF;OM: 7272695462-T0: Contractor Lic@18137800021 Page: 2 of 2 OP ID: LM '` CERTIFICATE OF LIABILITY INSURANCE DATE(MMUDDflYYY) 07/15/11 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S� AUTHORI�D REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. : t e certi icate o er is an , t e po icy ies must e en ors . , su �ect to the terms and conditions of the policy, certain policies may require an endorsement A statemeM on this certificate does nat confer rights to the cert'ficate hol er in ieu of suc endorseme s alden Insurance Network, Inc �2�_gq�_9544 ' 7516 Ridge Road "� "O E'� : �ac, No�: Port Richey, FL 34668 PRODUCER H. Shelita StuartlA275613 INSURER(S) AFFORDMIG COVERAGE �� # INSURED RobertHugues INSURERA.MOflt ome InsuranceCom an 24074 Enterprises Inc INSURERB . 7510 Cypress Knoll Dr INSURER C. New Port Richey, FL 34653 INSURER D . INSURER E . INSURER F . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE IIMIT3 GENERAL LIABILITY EACH OCCURRENCE g 1,000,00 A x COMMERCIAL GENERAl. LIABILITY BL01253554125 06/26111 06126I12 pREMISES Ee occurrence S ��,0 CLAIMS-MADE � OCCUR MED EXP (My one pereon) $ � O,OO PERSONAL & ADV INJURY $ 'I,OOO�OO GENER,4L AGGREGAlE $ Z�OOO�OO GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ Z�OOO�OO POLICY PRa LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X.nNrAUro BA01253749282 06/2B111 06/26/12 �Eee`°�°em� $ 1,000,00 ALL OWNED AUTOS BODILY INJLK2Y (Per person) $ SCHEDULED AUTOS BODILY INJURY (Per eccideM) $ HIRED AUTOS PROPERTY DAMAGE $ (Per acadeM) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ W ERS COMPENSATION EMPLOYERS' LUIBILT' Y/ N TORY LIMITS ER PROPRIETORIPARTNERIEXECUfIVE $ OFFICERMIEMBER EXCLUDED? N/ A E L EACH ACCIDENT (Mandatory in NH) If yes, describe under E.L DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E L DISEASE - POLiCY LIMIT DESCRIPTION OF OPERATION3/ LOCATIONS ! VEHICLES (Attaeh ACORD 101, Addkional Rsmarka Schsduls, H moro spses ia nqWred) CTYZEPH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ACCORDANC WI H THE POLICY P OVISIONS. 2ephyrhill City Hall 5335 8th St AIJT►{ORIZE� REpREgENTATIVE Zephyrhills, FL 34248 � ,�..�-�+ta7�.. �"#��:�ew� O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 {2009/09) The ACORD name and logo registered marks of ACORD