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11-11788
Zephyrhills
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2011
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11-11788
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Last modified
2/9/2012 9:02:55 AM
Creation date
2/9/2012 9:02:53 AM
Metadata
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
11-11788
Building Department - Name
EASPAS ENTERPRISES LLC
Address
5749 GALL BLVD
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..AC# �; ;�� � �, ;� � � ' ' - - . _µ �..�__ � - S�'i�'E ��?F FLORiDA :+ � ,�- - - _ : _.., _ � _ -=._ �:.__ ... r _... - - _. ._ _� _ �: _ <br /> _ °�' � �' � � - - — - - . <br /> - = - - � _- =_ - --- -- - � <br /> ` __ ;�:DEP�R:�z- - =-' OF B�JS , ;S��AN17 �Ri�FPS�;���L , - �'��G1�=- ' _ '_ _ ` <br /> = _ � - _ s_�TRII� =���U�_�R'�--�,� Chl�f'��N� � _ _ . = _ - - - <br /> _ - _ '` =_- - � - . ',- ����`�`-__ _ S�f� L� o. , <br /> fl .$S�0l�'1tT$2 <br /> �3'sNSL r��TBR'� _ '..-.:_. :- �, f - - ,. .-. __ -- =. <br /> - _ ; <br /> :.: :., �� <br /> 0$ 10 ZO10 1U8029125 C�059519 -� � �` `� "� '� - = <br /> F" ' -- F' : - <br /> � _ __" __" _: " _ - __ _ <br /> The B'ETILDTNG CQNTRACTOR :;, ;� _ _ - ._ �; . , , ` _--- ' � _-= ; , <br /> Named below IS CSRTIFIED�:_ _ '� _ - `__' ` ' -` _ <br /> _ �--- __ -> -, <br /> Under the pravisians of 'Chapte�r ��9 f FS.. � _- _ -- _-_ _ <br /> Expiration date: AUG 31,'2012�, � ` <br /> � , __ _ - <br /> SMITH, JOHN L k _ -= __- _ , � � ' _. = <br /> ` JOHN L SMITH CONSTRUCTI�N _ l ' _ _ ' _ _ ' =_ <br /> ( 4240 COATS RD <br /> ZLPBYRHTLLS FL 33b�41 <br /> CIiARLIE CRIST = -= - -_ _-=.��;� � <br /> G4VERNflbt = ° _=-- :-' �`��SECR�`,�`A�tY <br /> D[$PLAY RS REQUIRED BY LAVFf'---= =� -__- -- <br /> �71E � <br /> _ \ <br /> _ � <br /> l l . , � ; ��t = �3-22-2��� <br /> � M� ��� <br /> JEFF ATWATER STATE OF FLORIDA <br /> CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES <br /> DIVISION OF WORKERS' COMPENSATION <br /> �� CERTIFICATE Of ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW �* <br /> CONSTRUCTION INDUSTRY EXEMPTiON <br /> This certifies that the individual listed below has elected to be exempt from Flarida Workers' Compensation law. <br /> EFFECTIVE DATE: 03/22/2011 EXPIRATION DATE: 03/21/2013 <br /> PERSON: SMITH JOHN L <br /> FEIN: 270071702 <br /> BUSINESS NAME AND ADDRESS: <br /> JOF#V L SMITH CONSTRUCTION INC � <br /> 4240 COATS RD <br /> ZEPHYRHtLLS FL 33541 <br /> SCOPES OF BUSINESS OR TRADE: <br /> 1- CERTIFIED BUILDING CONTRACTOR <br /> IMPONTANT: Pursuant lo Chapter 440 . 05(14), F.S., an otficer ai a corporatioe wqo elects exemp[ion Irom Ibis chapter 6y filipg a certifica�e oF election under this <br /> section may eoi recorer benefits or compensalion under [his chapter. Purseant to Cbap[er 440.05112), F.S., Certiticates of election io 6e exempt... apply only within the <br /> scape ot Ihe busiaess or trade listed on Me rtotice aF election to be exempL Pursuant to Cqapler 440.05(131, F.S., Nmices ol eleclion ro be exempt and certifiwtes o( <br /> election [o be exempt shall be subject to revocation if, at any time aftet the filieg ol tAe nolice or tbe issuance of the certilicate, the person aamed on the notice ar <br /> certificate no longer meets the requirements oF this section for issusnce of a certiticate. The department shall revoke a cerliticate at any time for failure ol Me person <br /> named on Ihe certiticate to meet [he requirements oF this section. <br /> QUESTIONS? (850? 413 <br /> OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVtSED 01-11 <br /> PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE <br />
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