HomeMy WebLinkAbout15-16166 CITY OF ZEPHYRHILLS
� � 5335-8TH STREET
(si3)�so-oozo 161 6
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16166 Address: 4616 WISTERIA DR
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: WHISPERING OAKS
Est. Value: Parcel Number: 15-26-21-0160-00000-0400
Improv. Cost: 7,980.00 OWNER INFORMATION
Date Issued: 4/10/2015 Name: ROYAL, GARY �
Total Fees: 75.00 Address: 4616 W ISTERIA DR
Amount Paid: 75.00 ZEPHYRHILLS FL 33542
Date Paid: 4/10/2015 Phone: (813)783-2911
Work Desc: REROOF SHINGLE i
CONTRACTOR S APPLICATION FEES '
TRIPLE ROWN ROOFING I REROOF RESIDENTIAL 75.00
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Ins ections Re uired
DRY IN ROOF INSP
TAPE JOINTS ROOF INSP
FI NAL
:
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when e�ctra 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 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.
"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 Must Accompany Application.All work shall be pertormed in accordance with
, City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CONTRACT R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
' PROTECT CARD FROM WEATHER
a„-,��,��U Gity of Zephyrhilfs Permit Applicatian Fax-s�aaso-oo2�
i Buitding bepartment
Date Recatved ,/ ""� �'�3 �3-3 — ��z�
�y— I(� —/S Phane Contact for Permitting
Owner's Name L'�'g�`/ �a Yf�L_ Owner Phone Number �r_
Owner's Address �W� � �/A' �. Owner Pho�e Number �_
Fea Simpte Titleholder Name �� �� Oa►ner Phone Number
I Fee Simple Tittehatder Address
� JOB AQDRESS �/G IJiST�`�C�A � . �ar# �D
susoiwsioN �i/h�s �r•n ��--�5� PAF2CEL ID# 1�'�b - �/ -f•�1GD — L�OOdD �D�'d�J
(OBTAINED FROM PROPERTY TAX NdTICE►
WQRK PROPOSED e NEW Ct�NSTR� ADDlALT � SiGN Q Q DEMOt�ISH
iNSTALL REPAIR
, FROPOSED USE [� SFR Q COMM �� OTHER
i i'YPE 8F C01V5TRUCTiON [� BLOCK [� FRAME [�� STEEI. Q
DESCRIPTIONQFWORK �w✓ D'�� .S�l.,n'!� 1°�' ,,'�si� l� �vs,�ih G"�/�F/�lrrrvnsre.,u�
BU1Ld1NG SIZE � � SQ FdOTAGE �r+'�a HEIGNT ��_,� � r ryr f��
C]BUti.D4NG $ � � � VALUATION OF TOTAL CONSTRUCTION
QELEGTRICAl. ($ — � AMP SERVIGE ,[� PROGRESS ENERGY [� W.R.E.C.
�_—
OPLUMBING ��
QMECHANlCAL $ VALUATlQN QF MECHANICAI.INSTALLATION
[�GAS RdOFiNG L„] SPECIALTY � QTHER
'INiSHED FLOOR E�EVATtO S �� � FLOOD ZONE AREA �YES NO
3U1l.DER � COMPANY
�IGNATURE REGiSTERED Y J N FEE CURRE� Y J N
Address License# � � �,
i
e1.ECTRiCiAN COMPANY �
'siGNATURE REGISTERED Y J N FEE CURRE� Y I N
Address License# �— ' �
�LUMBER � � COMPANY
�lGNATURE REGiSTERED Y I N FEE CURRE� Y I N
Address License# � ��
�ECHANICAL � CQMPANY
�IGNATURE REGISTERED Y/ N FEE CURRER Y I id
Address License# � � �
iTHER �,"�' COMPANY ��P`"e �ro'�.� �i�' s �a' L
�IGNATURE '� � REGISTERED Y/ IY FEE CURRE� Y/N
Address t�7� !�l�2C l�2• �� t� ��,;ti 5 �3).s"/i License# �G � �`�g � ?G� ��
:ESiDENTtAt Attach(2)Plot Plans;(2)sets of Building Plans;(1)set af Energy'Forms;R-O-W PetmEt for new construction,
Minlmum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/SAt Fence instaited,
Sanitary FaoiltUes&1 dumpster,Site Work Permit for subdivi$IansAarge proJe�ts
'I OMMERCIAL Attach(3a complete sets of Building Plans plus a life Safety Page;(1)set of Energy Forms.R-O-W Permit for new canstrucNon.
Minimum ten(10)working days after submlttal date. Required onsite,Constnictlon Pfans,StoRnwater PEans wt Siit Fence instafled,
Sanitary Facil(ttes 8 1 dumpster.Site Work Perinft for aA new proJects.Alf corrtmercfal requtrements must meet compiiance
IGN PERMIT Attach(2)sets of Eng(nee�ed Plans.
•"'•PROPERTY SURVEY requlred for aA NEW consiruction.
irections:
FIII out application completely.
Owner&Contractor sign baok af applicatian,natarized
If aver�2500,a Notice of Gommencsment ts requ9red. (A/C upgradas over S75d0}
Agent(for the contractor)ar Power of Attomey(for the owner}would be someone with notarized(etter from owne�authorizing same
YER THE COUNTER PERMlTTING {Front of Appficatlan Oniy)
eroofs if shingles Sewers Service Upgrades A/C Fences(PIotlSurveylFootage}
Drlveways-Rtot over Counter if an public roadways..needs ROW
. �
NOTICE OF DEED RESTRICTIONS: The unders(gned under.stands°�that this:p�rmlt.may be subJect to"deed"restrictfons"
which may be:more restrictive�than County regulatlons. �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
cantractor is not licensed as required-by law, both the owner and conUactor may be cited for a misdemeanor violatfon
under state law. If the owner or Intended contractor are uncertaln as to what Iicensing.requlrements may apply��for the
intended work, they are advised to contact the Pasco County Building Inspectton Divislon—Licensing Sectton 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 appllcation for which they will ba responsible. If you, as.the owner sign as the
co�t�actor, that may be an indication that he Is not p�operly licensed and is not entftled to permitting privileges in Pasco
County. �
TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The understgned understands
that Transportation Impact Fees and Recourse Recove.ry.Fees may�apply to the construction of new buiidings, 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„wlll be identified at the time of
, permitting. It is further understood that Transportation Impact Fees and Resource Reco�ery Fees must be pafd prior to
, receiving a "certificate of occupancy" or flnal.power release. .If the project.does not (nvolve a certificate of occupancy or
final power release, ihe fees must be pa(d prior to permit issuance. Furthermore; if Pasco County Water/Sewer Impact
fees are due, they must be paid prlor to permif�issuance-In accordance with appl(cable 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 applicaht, have been provided with a copy of the "Florida ConsUuctton Lien Law—Homeowner's
Protection Guide" prepared by�the Fiorida Department of Agriculture and ConsumerAffairs. If the appltcant 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'SlOWNER'3 AFFIDAVIT: I ce�tify that.all the information in this application is accurate and that all work
', will�be done in compliance with all applicable laws regulating constructlon, zoning and land development. Application is
hereby made to obtain .a permit to do work.and installatlon as Indicated. 'I certify that no work or installation has
commenced prior to issuance of a permit and that.all work will be pertormed to meet standards of ali laws regulaking-
construction, County and City codes, zoning regulations, and land development regulations-in the jurtsdtction. 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:.compllance. Such agencles include but are not limited to:
- Departmenf of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WatedWastewater 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 Serv(ces/Environmenfal 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 flll:�
I - 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" wilt be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
` - If the fiil material is to be used in Flood �one "A° in�connectfon�with a ermitted buildin usin stem wall
P 9 9
construction, I certify that fill.will:be used only.to.flll the area wlthin the stem wall.
- If flll material is to be used in any area, I certify that .use. of such flll will not adversely affect adjacent
properties.- if use of flll is found to adversely affect adjacent prope►ties,-the owner may be clted for violating
the conditions of the buiiding.permit Issued under the attached permit application, for lots less than one (1)
acre which are elevated by flil, an engtneered drainage plan is required. .
If I am the AGENT FOR THE OWNER, I,.promtse in good falth 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, afr condttioning,.gas, or other installatfons not speciflcally included-in the application. .A
permit issued shall be construed to be a Iicense to proceed with the work and not as authority to.violate,cancel, alter, or
set aside any provisions of the technicat codes, nor shall issuance of a permit prevent the Bulldirig Offic(al from thereafter
requiring a correction.nf errors in plans, construction or iriolatlons of any codes. Every permit issued shall become invalid
unless the work authorized by such permit�is-commenced�withtn sGc months of permit issuance, or if work authorized by
the pe�mit is suspended or.abandoned for.a period of six(8)months after the time the work is commenced. An extensio�
may be requested, in writing, f�om the Building.Officiai 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 abaFldoned.
WARNING TO OWNER: YOUR FAILURE�TO..REC.ORD A NOTICE OF COMIIAENCEMEMT MAY RESULT IN YOUR
PAYING TWICE FOR�IMPROVEMENTS TO YO.UR�.:PROPERTI(. IF YOU�INTEND`TO'OBTAIN�FINANCING;�CONSULT
' WITH YOUR LENDE O AN 14TTORNEY�B FORE�RECO �DI G�YOU O � C '.O E C ENT
FLORIDA JURAT(F.S. 17.0 , _ _
OWNER OR AGE �� CONTRACT � _---_'_ �
Subscrlbed and t or aflirmed)bef re me thls Subsctlbed� swo to(or aflfrmed)�b fore me this
by �by •
Who is/are personally known to ma or haslhave produced_ Who Islare personally knovm to me or has/have produced
as identlflcatlon. as IdentlficaUon.
Notary Public . � Notary Public
Commisslon No. Commisslon No.
Name of Nolary typed,printed or stamped Name of Nolary typed,printed or stamped
- IIIIIIIIIIIIilllllllllllllllllllllllilllllllllllllllllllllil
. ' 2015056143
ParcellD No �5��('�'?�"�I�O "�O�Od
Pertnft No.
NOTICE OF COMMENCEMENT
State of
�LO�Z/1JL1' Counry of PI�$Cb
THE UNDERSIGNED hereby glves nolice lhat impfovement wili be made to certain real propaAy,and in accordance with Chapter 7t3,Florida Statutes,
Ihe(allowing intortnation Is provided in lhis Notice of Commencement:
�. Descrip6on of Property: Parcel IdentlficaUon No.41hKOt/i•a�s�S ���y P�86 ��y� �� YDSy/��s�7��
5�G/6 6✓/ST�2if+ D2 ��v�w2K�c�5 . F` �z-r'�2
Slreel Address: i
2. General Descripdon of Improvement RG���o�
3, Owner Information or Lesse�e Infortnation ff the lessee contracted for the fmprovemenl: � � Y
X �r L. l�oa� ) v� z� � w
Name +� �17�ivr�'fiJlf �1 33.��� �'���� � � U
X H b/6 Gs�ii�`�°/�'et-_�n'K' City �— � state GJ 7 �
Address �'�c � — C.7 EY3 J�0 �
fnlerest in PropeAy: 0 E� ���� � �� a
N �� rJ7� Q- �
Name of Fee Simple ruPholder ,
(if diHerent from O er isted above) - . � � _? �
Clty � Stale °y- � F Q — O
�Ad dress T�P� C�eow�J 00`//� 1��- '°" L.lJ � p['t�� U U
a Contractar. � S Q U � Y
'Il �iiT[�eE D2 T�PN�lRidll65 �` 33Sy� � F- >-
City S1ate � t-- O �
Address $I�^�32�7�� U = U � - w
Contractors Telephone No.. � --�
KL � I-- -9 U
s. surery: � i� w � Z o �
Name � F-• � a- <( � —
Cily State Q [� �,' �y = ¢ W
Address "'� � � G' � O J
Amount ot Bond: S Telephone No.: �- U U �
� O Q O .
g. �ender: Rcpt:1674121 Rec: 10.00� w � Q J Q
Name DS: 0.00 IT: 0.00
�- � WI.�,
Address ��ry 04/10/2015 E. M., Dpby Clerk
Z —
� H-.
I.ender's Teiephone No.. fn H � � � �.. �
7 Persons within the Stete of Flarida designaled by the ovmer upon whom noUces or olher documenls may be served as provided by �
Sectlon 713.13(1)(a)(�,Florida Statules:
Name
PPULR S 0'NEIL�Ph.D PRSCO CLERK 6 COMPTROLLER
C(ry 04/10/2015 02:35 m 1 of 1
Address OR BK 917� P� 900
Telephone Num6er of Designated Person: � �
ot__. j,�/ �
g. In addition lo himselt,lhe owner designates . ��
to receive a copy o(lhe Lienafs NoUce as provided in Sectlon 713.73(1)(b),Fiorida Stalules. � •0 ��
`,�` e • 'e�' ��a
Telephone Number of Person or EnUty Designated by Owner. ,mf _c,��1/.� �y
g, Expirelion date of Notice of Commencemect(the expiralion date may not be before lhe campletion of conswctlon and final payment to thel��, c`� � ,'� L� m�
eontraclor,but wili be pne year from lhe dale o(recording unless a ditferenl date is specifie�: ',__ d .� �. �
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRAT{ON OF THE NOTICE OF COMMENCEMENT �u j ��` : �
ARE CONSIDEREO IMPROPER PAYMEN7S UNDER CHAPTER 713. PART 1. SECTION 713.13, FLORIDA STATUTES, AND CAN,.a ; ��" �
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BF� H J
WITH YOUR L ND R OR AN ATTOR EY BIEFORE COMMENCING WORK OR�RECORDI�NG!YOUR NOTICE OF COMMENfCEM NTSULT
ad lhe�fore oing nolice of commencement and that lhe facts staled lherein are true to the best�y,:d•a e ��
" Under penally af pe�jury,I declare lhat I have re 9 �.:�9� � 0 .
of my knawiedge and be11eL _ • � ,
i ���� *
STATE OF FLORIDA X ♦
COUNTY OF PASCO Signature of r or Lessee,ar O r's or Lessee's Authorized
OHiceUDireGodPaAnerlManager �
Pr
Signatary's TillelOKce
1 R �
The foregoing inslrument was acknowledged before me this�day ot�.A..l�..Z��by _
as nl lll`Q,l —(�YPe of autho ity, .g.,officer, rustee,etlomey in(acq for
�I A (name o arty on b aI �f vfio instrumenl was executed).
Personally Knovm�OR ProAUCed Identilcatian
Nolary Signature
Type ot Identfficatian Produced_��-�2
Name(Print)
�;,a�e., CASEY S.HAWKINS
. ;i�. .�� Notary Publie•Stale ol Florida
; ; My Comm.Ezpires Nov 3,2015
%;?,;o"t,o,�' Cammisslon I/EE 143612
Bonded Throuph Nalional Notary Assn.
wpdata/bcslnoticecommencement_p c053048
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TRIPLE CROWN ROOFING, IN�.
� ��� �s��. 7140 ANDRE DR. � ZEPHITRHILLS, FL 33541
cj���.�c��= 813-833-7720
�,_ STATE LICENSE CCC049370
WVVW.TRIPLE-CROtjVN-R{�4FING.CQM � LNAULT19b3C�AOL.GOM
SPECIALIZING INALL TYPES OFMETAL ROOF SYSTEMS
NAME . PHONE DATE
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STREET CI7Y STATE ZIP
/(f��� ���/��-l�-7 ��F'T T t�!'f��� /f„
SALESMAN $f�
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We hereby sabmit specification and wark description:
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�t'�A��1!� �'�ly-/��" ��'C,�I/t�C7 �t/���/ f r.
.I��f�-G� ��Q �J�o�ca /� �4,�14� ��'��=`' Y�i2�c�,'� ��[.o� .
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'�/U`..5�}-4.� ,ti`�'�./ �/�' �l�l�� h�i/�C�� 1/�'r� L�',r�-�J �3�d'� � ��i�d✓
-��1`Gt� I��`L���S ,�'..�t��' ,/sfiA=f�t�i-G.� ("���"�t—�,e ,�3�sr-o �o� �'�2�-r�
.��-,�-�5 �f��'��'�s � ��✓�° ����' �
'`fHE ABOVE DESCRIBED WORK WILL BE COMPLE7ED ACCORDING TO SPECIFICATIONS, FOR THE SUM OF
{$_ 7,'�R C? }. PAYNIE�IT TO BE MADE AS FQLLOWS:$ � `�c�t� AS DOWN PAYMENT
BALANCE OF$ �C7� DUE UPON C MPLETION.
� ***ANY ROTTED I,NOOD DISCOVERED WILL BE AN EXTRA CHARGE ATA COST OF$ � PER 1I2"SHEET�F
PLYWOOD$ ,'�� �in. Ft. �umber.
Nt� ORAL AGREEMENTS HAVE BEEN GIVEN OR AGCEPTED. THIS WRITTEN CQNTRACT 1S THE
ENTIRE AGREEMENT COVERING ALL THE WORK TO BE PERFORMED ANDIOR MATERIALS TO BE
FURNISHED. TNE NIRITTEN P4RT141�ABtJVE 1S THE ENTIRE CONSIDERATIaN F�R THE AMOUNT
4F THE CONTRACT. PURCHASER MAY GANCEL THIS CQNTRACT ANY TIME PRlOR TC? MIDNlGHT
OF THE THIRD BUSINESS DAY AFTER THE DATE PURCHASER SIGNED THIS CONTRACT.
IT IS AGREED:
Contractor will do al!said work in a goad and workmanlike manner and in strict accardance with the ordinances,rules and requirements
of the city, Town or Village, wherein the above menfioned property is located, 1f purchaser should cancel this contact after time stated
above, the Purchaser agrees to forfeit down payment paid. In the event it becomes necessary for Contractor to employ an attorney to
collect any sums due the Cantractor pursuant to this contract, #hen the Purchaser shaN pay all reasonable attorney's fees incurred by
the contractor.This contract shal!not be binding upon Cantractor until accepted by them. Upon such acceptance by said company,this
cantract shall be binding on melus wifhout any further natification to melus. The undersigned proper#y owner agrees that this contract
may be assig�ed for the performance of the work and labor required by the description of the work to be performed. Upon assigned the
par�ies hereto consent ta the performance of the work 6y and payment to such assignee af the amaunt af this contract.Any Aiteration or
deviation from above specifications involving extra costs will be executetl only upon written orders and will become an extra charge over
and abave the stated cantract amaunf.
lV��lC1E Ta'�HE BUYER : d1��3��s�#sign thes von�ra�t be��re y�� r��d i#�r�#it cantai€��a€�y.b[ar�k spa�es. �2}You
are entitled to an exact copy of the contract you sign. (3) Under the law you have the right to pay off in advance
the full amount due and under certain circumstances ta abtain a partial refund o#the time charge.Owner acknowl-
edges receipt of a true copy of this CONTRACT.
�� - , J� tr � �o�',!
- PURCHA D E
. ���_f� �
BY:Triple Crown Roofing, I . DATE PURCNASER DATE
This contract is enforceable only when acceptsd by management af Triple Grown.