HomeMy WebLinkAbout16-17509 CITY OF ZEPHYRHILLS
5335-8TH STREEf
- ' (813)780-0020 17509 �
►
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 1'7509 Address: 6034 12TH ST
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: OAK PARK
Est. Value: Parcel Number: 02-26-21-0050-00000-0060
Improv. Cost: 6,300.00 OWNER INFORMATION
Date Issued: 7/12/2016 Name: KIEPER JAMES& RHONDA&CROOK IRL
Total Fees: 70.00 Address: 4853 17TH ST
Amount Paid: 70.00 ZEPHYRHILLS FL 33542-6023
Date Paid: 7/12/2016 Phone:
Work Desc: REROOF SHINGLE
CONTRACTOR S APPLICATION FEES
SCOTT BLACKMAN ROOFING INC REROOF RESIDENTIAL 70.00
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Ins ections Re uired
DRY IN ROOF INSP
TAPE JOINTS ROOF INSPd
FINAL `�7 ���'C�
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
, first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this properly 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 BEFORE C.O.
� NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE PERMIT OFFI R
' PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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Scat# Blackman Roo�in , Inc. � !
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P O. Box 1188 !
i � 5an Antonio, FL 3357fi ����b�� � �
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SOLD Td SHlP TO ;
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CUS.TOMER OR ER N4:�� - . -,�SOLD:BYr . � . TERMS _ , ,. . F.O.B. ' DATE
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e��-�ea-aozo City of Zephyrhills Permit Application Fax 813aso-oo2�
Bultding Department
Date Recetvad � . �� `Phone C6ritactrforPermlttin '`,',,• . - � .
Owner's Name �:� , �jr'�o �- . . . . t3wnet Phane Nnmber . . . -
Owner's Address b S 3 (�� � �S"�' j S Clwrner-Phone Idumber � �
Fe�e Slmple�TlNehalder Name � ° ' � Owner phone Number ' � .,��
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Fe�Stmple Titlehalder Address ' -
JOB ADDRESS � � � �'P 4 � �^-�~ s I v L--, �f 1 G" � �.aT# ��
su�o�vistoN �- �� PaRc��i� � �3 Z� 2� � —2.i — DoS G �oo�o �-- o�o
, � •(OBTAINEDFROM�PROPERTYTAX'NOTICE) �
WORK PRt�POSEp ,. NEVVCONSTR��.� ADDIALT •C� S1GN [� ` Q DEMOLiSH
- -� � e INSTALL 8 ��� .REPAIR �
PROPOSED�USE Q:, �SFR �' Q COMM' Q OTHEft' ' .
TYPE OF CONSTRUCTION,' `Q� ' `BLOCK�' '[� "'�� FRAME � STEEL. Q; �
DESCRIP710P1`OF WORK �b- tl� � +�✓ 11 �� I��.�•ti�ta•1��•• t � .S.: . �
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St11LD1F1C,�SiZE.'`'�- SQ.F,QOTAOE � ,.HEIGHT � ., 4 - f
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._.. [�Bt1t�DING $ , �'--� -�,::�,:A,=� .._.s=,�,..,_,_..'' , ` - . .
C �Q�5� � � �. I; VALUATION`aF'�TOTAL GONSTRUCTION . ,.
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QE�ECTRICAl. $ AMP SERVlGE Q PROGFtESS ENERGY Q W.R.E.C. ,.
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�PLUMBING $ � , - ���
QM�CHANICAt. $ ' VAt.UATION;OF.MECHANIGALf[NSTALtAT10N �� �� �1��`V��
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QGAS :� . E�OOFlNG,._{Q SPECIALTY'� OTNER� ' ��jJ�
FINISHED FLOOR ELEVATIONS FLOQD ZONE AREA �YES: NO
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BUILDER COMPANY � � ' �
SIt3NATUPtE REGISTERED Y/ N. FEE GURRE�`., "Y LN.�: �
Address ' "� � . License'# I ' � I -
E�.EC'�RICtAN�:�. . > ,, COMPANY � , - ; �. �. �.
SIGNATURE M ftEGISTERED Y/ N FEE GURRE� '"Y/M .
Address , ' , , ":Ucense`#;I ' � - � —���
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Pl.UMBER GO[dlttP�1N'l� .` � ,> °` :. - � ., `° '
SIGNATURE " - .., . �REGIS�TERED � �� .%.�Y,/«N . , .FE�:GuttRen' . Y/N:- ,
�ddres� . .- .� , I- , ,l:icense,#:.I , - ' � ' I �
MECHANIC,AL`: ' " ' . . � � _.GONIPJ�t�1Y. � _ _ _ � _ , ,
SIGNATU�tE ' ". ` ' . RE�� o , Y;/���N;,. .1;FeE cu�n� ,Y./N:•-°�.:
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Address�- , ' . ,� ., . _ , Ucense#.� , -' •-I� ,
o�e� � - „ _ _ 'co�r�amr t� :r`f:,d3j��G�.�.�. ;:°�''�'�.o� �r�f:, . .�c�.� -
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SIGNATURE ' � . . .�i��GisteaEo � _ Y/. N--�. , ��GuR�n� . :Y�I:N:<.:, ,
AdtiP988 'C3��� ����; •ca�, `l9�,1�=�;;;�G :,��:�,G:33 :�t� � .. ,uce�se#'.:C'�`�v;�'7 y�'� � � `
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RESlDENTIAt.:._ :Attacti�2;P1ok'Pians�:2 :sets:of>Bul�il�n°�`�'Plans::1�.aetiaf,�Ene� �Fariiis:=R�0�1N..Permit:foi��sew;.con�tru�tlon,.:. � ,.
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,:;Minir�u'm,ten�(1�Q)�worltln.g;days,:�after�'s"ubmittail�dafe:�Requlr.eil o,'ns(te;%ConsErucBon�Plans;^Stortriwate�'Plens w%"Sllt Fenc,e.installed,.
'�� ��Sanifary Facj�4Ues&€+1 dumRster,Slte�Wortc�Per,mit�or'sutidlvl'slnrisllarge`p_ncJ+actsl: �,,�. i:":.:°:.� �:_ _ . ' , .� _` ..-
---- COMMERCiAt At�ch(3}camplete'sets 6f Bu'ltiting F'lans ptus a l�fe Safetji page;(1j set of Energy Farms.R-O-W Permitfar nev+t aanstcuctlon.
Mtnimum ten(1Q)working days'after submlttel date. Required onsite,,Construcdon Plans,Stormwater Plans.w/Silt Fence installed; • ,
Sanitary�FaclliUes.&1�dumRster..Sfte.Work_Permtt for all�new`piojects:All,comrt►erclai.requlrements-musfineet comp!lance , ,-
SFGN PERMlT Attacti(2)"set�af`Eng,i`�iiaeredj,Pi'8ns¢.,;anrr��`...;}: j �, � , , , , , •
"•••PROPER71f SURVEYrsgulred.fur all_NEW:construcdon..,. _ „ -. �
� <Dlrections: ",t'�.. . . .. . • ,..., -- - _. »_,___._ �
Ffll out appltcadon completely.
Owrtier&Coatrac�r sign back:of appltca�on,notarized
If over 52500�a:Notice�ofCommencement is requiresl: (A!C upgrades over ST500).._ , �.� �
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Agent,(for ttie contractor�:or'Fa�fver of Attomey`(fo�#lie�owner)�woulcl.be_some�one with notarized letker from owner authorizing same
OVER�THE'COUN.T.�Rr�PEFtMIT11NG�= '-�:��(fiont:ofi-App�ication�Only}�� ,� _ ` . -� -
Reroofs if shingles Sewers Service Upgrades,AIC�� . Fence`s:_(PIot/Survey/Footage) - •
Drlvewrays-Not over Counter if on;publlc roadweys:�:needs ROW., 4 ,
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�T10E OF�EED:RE�'1'RICTI��IS:-The unde�rslgraed�untler:stands��.#h�$ft#��s:;p,��ps,ccnt�;;r�ay.,b.e,,:sub�ect;ta,;:deed;:.�restcf�tio%ts:V.
.w,s . .` . . ..u,y. } ' - ' - ]aro �T ' e ir���.� ��,..� �r s �';'�'+1 ti"f:w=.lk.t '' '4�L d .�v.
ich may;be�r�or�e�res#�ict�re.�t�iei�ri�Co`unty c��latf��is The`�.underslgneitl�as�u►ries rre►sp�n�Ibilttj�foc comp4ance=with�any � �
�!lcabfe�deed:restrtc#lons,` - �,f;:-x=,;;$,_ ;,4_���'_- � • _ �,._,. - _: . ,-
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ILiC�NSED���.CONF �'��C':TORS�AND�.CONTRAGTOR RESP,OhM�SfiE�i �. .�. ,. - ,, •��,.�-.�._
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I�Itt�S��;;,�;�if�-�he�ow�ner'�fi�a�`htre�l.'a�;`�i�i'itractor•.or`'..,:' �
Ytractors io.undertake wark,.they-:may�bewre�qui,red�to.;�s��ltcensed��in.�accordance_with�,.state�and��loEal�� ulatlons:°<°�If�'ttie�.���==:�=s��: ,
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�#ractar;:is;iiot;lic�nsed`;as�:requir,ed�tiy law,:bot#y #�ie".owner an+�=�contractc"r�rnayy�be:�clt�d for�-� mts�,`emeaaot uiolatian ,
ier state law. If the owner or lntended��c�ntraetor�ei�er:uncertaln as.ta.what`(tcensin8:r.equirecnents:imaY±���epPlj�fia�::t1�e�;5:.�.�:_`��,=f;::�
anded.workr�#he =<arie:atfecfser�to:e:tiritac�t'tt`te�Pasco=Cou�i Buticling:liis"�ecttonRQtutslort,-=l:li�r.tsln_..Secflon:�C727=647 ,
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)9. Furthermiore;::if�,:#Fie~cirivFier�has'�iiir�ii�a`�coritractq� cir'cort�iractors;�lie'�js'adviseiT`to�tiave;.the ,contractor(s)�4sIA�.:•.- . ;;
w a x��.:_,x;;,.,;.... s ;.�K w r,_;;.�;�R-;•;=.s
tlons of the� contrecbr Qlock°..of�this�appllcation�fur.._whichrthey.;vvill,.;be�respo�slale.��•if.ynu;�,as'.the"oviin�r��itgn�as'ttie�� - -
�#tac#ar;:`that�,maj►be�a�t Iridica�ori�fh�#�he is�'iiat•-.propetij,r�llaense�`�`and ls tr'rit�entftled`�tar pernil#fing�pit�triNeges'1r� Pascv ��
A SPOftTA'TiQNtIMPACT/UTl�1�'IES�I�'IRl���'-At��?��ESO�l�CE�R�C�VE�tX�FEEB:`�'�It��nid'er�igrte�`�und�rstands, . �'. ' f+ �
t'Transportat1on Impact Fees:and.Reco.urse Recov.,e.ry.Fees maj�;apply<#a�tite consUuctlon„of..n�nrrbupdtngs;:ichan�e��.of;;;r�'�::���::'-�`�;�:` y;; =
� in exisHn �buildin's;<.��'Aex h�t�n:�:of�existi`:,."�cill`�N�i� s; as�s ecifleil.in PascQ�Coun }Ordinance numb�r 89=07 and "� �
9 9" .w. Y Pe� � . � 9 ` _� P kY
0�, as amende;d..,�'t�7a�.anderslgned �lso.-unde�stands� tits�t�such fees;;as,ma����:�:due;,r�r��:I�e �ae��ttea at tt,8=tirrieaof�'',�.,';'�`�;;;'� ' ;
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mitttng. It Is fiirtlier unde�stood that Tra�i�portatlan`Impact��Fees and�;R�sour�':FtecoveiynFees�-mu�ti be paid prlor to . •
e�ving a;"cet#i��fe�of�=occupancy"-4or#ina���r�.celease.�_If�the.pro��;does:tio��'Involve;;�-.CBT�C.Bt@ O€QCCU�t1Gjf--flt:':,;�';�;;=%. ,
il power.�release�._the��fees=.mu�t.�tie`�paid`�.pctac,to.permR Issu�nce. :F��tkier�more,�>ff::Pas,c,���Counqi::Vllater/Sewer�lrinpact�,��, �� . �
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�are du�;they;must be;p�ld.-pitor to;permit-l�suance:in.aaGordance.wltf�;aPpllcatite•Pasco County`onitnances. � -
��tSTRUGT10N�tiEN't14NV'{Cti�pter 713; Ftorttla�tatute���a�mendedj; i#vaiu�tiora af warlc is�2,SOO:Q.O:,or�more;>:IF,_:F> ;N:,=....
ttfy that I, -�he_.appllcant;,.::haye.:�ti�een.,.provitled�wfth-a,copy-of',�the;,"Florida��•Constivt�tion�`LIen�Law�Homeowner's
rtectlon Guide� prepar+ed�by;�fl��`�Ftoi�d�'Dep�t!#inent'of Agrtculti�re and�Cons�m�er.:.Affalrs, #�#he appticant#s sorrieone; �;_� .,.-;F, •
er than the"awner", I certlfy,;th�f�l�have.oqtatne���?cqpy;of:the�aboye:descflt�e�tl�t�ticiiiii�nt;,and°prgml.si�:ln.;g�od�faltfi:to�; .
Ever It tt��the:'ow�e�:°pr�o��:to�coir`iit�encemerit.` . .> �,�',_ . �` � � �,. .. -- . ` :; - � . :.' . °v. �.,_: � . , - - •
�P�TRACTOR'S/OWNER"8"AFFIDAVIT: I.cdrtiEjr.;:t�t�ka11:,#h�-;inforrr�atirm•:1n�;thls:applfcaNe�n is aacurat�.and thet all'work
'be done in compllance.wlth all.appllqable'laws�regulaNng con�9cuctlon, zonlns anduland°development. .Appticatlan is
eby made to,, abtain�;�_;pecmit�:ta.rd�t,,�:wofik:,;and.'=i�lstap�#lon as indtCefetl:�:::1,.certity.`tfiat rio uuoriC�:or instattation�.has ;
nmenced�p�lor to`Is'suanc�of a permilt�and that:all"wvrk wfll be pertarmed�to meete;standgrds<of_all laws regulating-
�struciton, Coun�j+ and City codes, aoning-reg�latlans, and land devetopm�#:reg�tatlonsAln'tti�:3ur�sdtction.Y.>:1�`a1sa�.
kify that 1 uaderstand thaE the regulatlons of ather�gavernment agencles may�apply�to.,t�e,,tntended,work, and that it is �
responslbllity to ldentlfy.what.actlons l.must:�teke:to be.4ln:;cor�p!lar�c��..,S.uch,agencles�tr�ciade�bu#=are:nat limited.to:. �, �
- Departmen! of Et�vironrr�ental��'FrotectiTin'�jGjipress�'Bayfi�ad�;r1lVetl�rd-Aineas and Envlronmentally Sensttive �
Lands,Wat�aNVNasteHrater Treatment. � , �� � � � ` " r '
- Sauthwest Flortd� Water (V�anagemeri��:.:C�tstrict We�ls� �Cypress. ;8ayi��aels�► .'Wetland Areas� Ai#ering ' �� ,
OIVVa#ercourses. . , � . .. . .. � ;�. �
- Army Gorps of Englneefs�Seawalls;;Docks,Nevtgabte Wateravays. � y
- Department,;of_:Health;.&;..Ret�atiltitafive>..Servtces.lErntrc�nmen#al.H�altti;Unit:Wells,�W�ste.water���Treatment; '
Se�tic Tanks:':-, � _ ._ , . . r;__. .. - �' � � � _
- US Env�ronmental Pro#ec�on Agency-Asbestos��afement.;;..
- . Federal Avlatlon:Autlio�:ity-Runway�:: �-, -� ` , .
�derstand that:the;follow�ng:r_est�lct�oris�apply`to�ttie tsse of fllt:•
� . .,.. -
- Use cf flll.ls not allowed:in'Fiood;Zone"V"unless expre�sly permlttgd.
- If�-the flll�'Materlal,�ls�to'';;b�<}�used:�:ln„f.lood.Zone. 'A", It"!s�undersfnod�that-� dralnage--plan�addtess(ng a
"co�pe�saElrig volume"wlll be submitted �##ime'of permitting wfiicM is prepared by a professionat engineer�
Ilcensed by:_�he�;�tate�of�•Flotlda: , -�..�= . � ,
- t#th�:ftll.:mafer`lal�i�,ta>:be=used�In �lood �or�e 'AR irn connec#lon��v�►�h:���piartt�ltt�d bail�ing using stem wail
conatrucNon�,al,certifiy.that ftll;w�ll-be-Wsed.only•to..f111 the:.area.wlthln�the�.stem:wall.. -
- If fl1l=ifmaterlat-=�l�`ryto��6er used°�°In�.any°area;=`�I'�certlijr t#tat .use. af auch"#ill�wltl:not�adversely affect...ad�acent
properties. if use:�f fi[I,is foc�nd.to advers!et�r�,aft'ecf°aidJaEerit��praipertles�,the owner may be ctted far vlola#Ing , .
the condwnns��.of'tFie:ti�iUaing'��p�rmft�!§suecl��:utider tlie"�t�acM�id„�ermlt_�pp!lcaQto�; for•:lots less than:one {7)
acu�whl���are=eteva#e��tsY;�l;.��ter�gtneer�ed draln$ge�ptari`ls ieqiilted. , .. `
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�m the AGENT:.FOR,THE.,OWNEI�;`I,�iiromise'In goad falth to�lniarm�the owner.of�the.p�rmitting condltlons.set forth In � :�
atfidavlt`prtor to��acmmencing constructt�in:...# undecstai�d=tliat a�.s�p�arete permtt may be requlred for�fectrical work,: � ;��
nbing, s#gns� welts,t,paats� air,condttioning�.ga;s, or„ottiec tnsfa�l 8"�icns�nd�.spec�l�at�y included�ln.the appllcation. .A• ,- . > '? i�
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n f t Issue d s h�l l�be�con s t t t r ue d to�b�;e':I lcense>to;prorcee d with'the virortc and no.t;�as:_authorlty 4M;vlolater aancel� al#e�, or
asEde any provistonsr�f�#lie:techiilcal',cod�;�nor sha1C Is�u�nce•of'a:pertn�t.pr�iient#he Bulldirig t�ctal from therea#ter
�Iring a correctton._of errors.ln.:pla�s�;'�ristructbn.or vlolatlons�of-any.�codes.���very}p�enYo(t.l.ssued��hall�become�invalid " 'i� ,,
�ss the wo�k aatnoi�zzed�by,such pei�rialt:��s.co�imenced•'wlNiln s�c�nonths�of:.�perm�t Issu�nce, ae If�vark autharized by s �
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perrrtit is suspended„or..abar�donedfoe:a:�etladraf>eiar:(�).�montFis,.afteF`the.tlri�e�the�work��ls commenced. An extenston _ � '�' ;_
� be re uested, In wrltln ;:;irom.the Bull"dln ;Oi�clal�for�a erl''od not to.exceed,:nlrie" :�9p r�l� ��� ,��
q 9 9 P tY{ � Ys:a�id vvlll denianstrate s: ,,
fiabte cause`fioc�tl�e�fenslo�: If bvork:ce�ses.for nlne#y{�0}cons�cutt�e:day.�,_the:�ob=is�cansidered abandoned. -
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RN1NG TQ�OWNEl�:�"'Yt�UR`.,FAIL:iJRE:�t'J.�;R�E:Q�ni4xsN�'�1,'l',�.QF,-CbMME1�I�EME1atTaMAY:RESU�T}IN'Yt]��iR _�
�iNG TWiCE:FOR;�MP,R01�'EMEN��`T�b`.YOt1��:P�'QPER�TY.v,;1��=YO.tJ�l�i1�'.�D"TO;+C�B3''AINi�FINi4pEtNG��ONSULT ���
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Is/are perscnally kttown to.me or•haa/have produc�d VVho I's/ere,p : 'na�y � ���r m�:o�.:i,�nav�r�mai��ea, • _
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s ot Motary lyPed,printed cr stamped Name ot�lotarY tYP z,, �rr smber 92,2018
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07I1112026 J. R. , Dpty Clerk
1V�TICE OF CONIlViCNCEMEN7C
PeTmit Na.
�� r���ey za���aenxo. �2-2�•-21 � e t��'� - v r�a�v- o o�o
TFF�UNUERSICrNED haebq give informs you that the improvement wi11 be mede to certain real Pmperty,end'm accordance with
Sec6on fi23.i3 af t6e Ftorlda S�Wfes,the faItowiag infotmetlau is provlded#n tiz£s NOTICE OI�COM2tSLtKCEiVIENT.
1.Descripdan ofproperty(lcgal deser on) �?Z"�-(o " 21- b d s O^O 6 0b 0�^Q c9 (o a
� 8}5'tIDEt i��LiSB:_jO l7� 1 Z- <. ._�P l31+'t c..r .'{ � Y"'�'�
� 2.4enerat drscriptioa of improvements•�r�rrv_fa w �_� i. ..w• !�e' i A�t
3.Owner Infotmation .
�I a)Nemo amd aediaxs: ���'�i C�,'r••�k 5��'f"`� l7�'`' Sfi 7 eat��-i,.%1!,�f�r 3 3�yZ
b)Neme aind address of fee s' le Mleholder(if othei than owner)
c)Tntcsrst in F�P�?'
d.Gon�ctirr Infom�aa /� /� n ,/ ,�+ �,,j�—�L
s)Nemeapd8ddress: o" �! GrG�:M.n''1 /�G+u/'i:�t ./'b l��"x I(��'" ci�, {Qiz,'ti'r rv,�,l`�
b)Talephone Xo.: 2— !c>b.'S _ Feac AIo.{Opt.)��S `i?�--�--
S,Suretylnformetion ` — �
e)1Vame epd addresss
b)Amonnt ofBond:
; c}Tslephon�No.: ' Fax No.{Opt}
I 6.Lender
a)Neme and eddress:
Phone No.
7.Identity of persoa within the State o£Florida deaignated by owner�o�wLom notices o�pttter docrmnents map 6e senred:
a)2Vame and address:
b)TclephanoNa,: FaacNb.{Opt.)
S.In addition W himsel�owneTdesignates tfi�foilowirig ptrsoa to receiva e copy ofthe I.ienor's Notice es�provided in Section
713.13(1)(b�,Florida S�h�v: .
a�Nama and sddress: "
b)TeIephomeNo.: � .gaxNo,(pp�) . �"
�i�k n date ofNatice of+Commencemont(the expirakion date Lv one yGar fi+bm the date af cecordfing�mless a diffeimrt dato is
WA.1tiYIlYG T'U OW1�It: A,NY PAXM�P7TS t4lAD8 BY TAE OWNitlt AFTER THE�XPiRliTIOPt OF THE PtOTICE OF
GOMNiENCEMENT ARE CONSID�RED�ROPER PAYMEl�T5 iTNi3ER CSAPTE3t 723,PART 7,SECITOlY 713.23,
FL;ORIDA 5TATDT�S;AND CA1V RESULT IN YOUit PAY1t+'fG TWICE FOR I144IPROV�MENI'S 1`O YOTJit PRQPERTY:
A 1VOTICE OF COMMENCEMENT MU�!'BE RECt��tD$D AND POSTEb 41V THE JQS S1TE�EF4�TR�F�RST
INSi'ECi701Y. IF YO[TINT'ENA TO OBTAIiY RINAN'CING,CONSUI.T YOtTIt LENCfER OR AN A.TTORNEY BE�'URE
, GOIV�MENCllYG WORK Olt ItECORDYN�XOIIR 1�iCITICE OF COMMENCEMENT. ,
� SFd'TiE QF FLO$IDA �
- COUNTY OF PASCO r �I
Signem�e f or er'e " _ O�csr/DJ�eehu/Pctnc/M�mnac I
G�•Y y1st�
Frint �
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The�'oiegofng instiument was acla�owled�befone me Uu's�__day of_;�;,�.�V�"� . .20�!p,,by / `�'r`/ __ ���
es �^'"��-�,.--- (tYPe of nutho:ity,e.g.offiaer,fivstee,ornay
ia fact)for (neme of party oa bchalf of w inslx�eat wag executed).
Pessaaslly KnaFva 1�ORProduced IdeatifcatTan_ Notary Signainre s1��� �1�'t""�"�---_.._
Type af Idwtification Pradueed Name{prmt}
Sc,� ff"- (" �C��1�..,...�...-
Verificatian pursvent to 5ecdon 92.525,F2orid�S1�hites.IJnder peaehies af perjury,I decJare that I have read the foregoiag snd ihai
the facts stated in it are true ta the best of my imowledge sad betieE
Sfg+tattuso Pels 3�gNngAbove
FOWM�!^NOC,Md7LP7 ,
____—___` iA��iw��i
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ppULA S 0'NE I L�Ph D PRSCO CLERK & COMF7ROLLER� - ,�� ��.�..�,1 $CpTt C BLACKMAN
07J 11l201��0,�9�n m 1 ���� s` '��1y C��tm.fitptnut Oet 15�2Q18 '.
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P.O. Box 10263
Brooksville, Florida 34603
Voice: (352) 796-0229 Toll Free: (800) 580-0229
Fax: (352) 754-4558 Web: www.lre si.com
COMPLETION REPORT RECEIPT /ACKNOWLEDGEMENT
May 25, 2016 Job#: 5442
RE: Heather E. Peterson
5230 2nd Street
Zephyrhills, FL 33542
CITY/COUNTY: Zephyrhills/Pasco PERMIT#: ,�0� ��j�''��
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I acknowledge receipt of the above referenced completion report as required for the
2 ���
termination of all permits or a request to have any inspections needed to terminate such
permits.
SIGNED: �-`�—�"" '" � DATE:
PRINT:
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May 13, 2016
Ms. Heather E. Peterson
5230 2nd Street
Zephyrhills,Florida 33542
Reference: Monitoring of Installation of Stabilizer Piers
&Develop As-Built Drawing
Peterson Residence
5230 2°d Street
Zephyrhills,Hillsborough County,Florida 33542
RE&A Project No.: 2828-15-058-ER
Dear Ms. Peterson:
A representative from Ramos Engineering and Associates, LLC (RE&A) monitored the layout
and installation of six (6) Smart Jack crawlspace stabilizer piers, on a full-time basis on August
' 17, 18 and 19, 2015 (3 days total). The stabilization work was performed by L.R.E. Ground
Services, Inc. (LRE), to address concerns with foundation system stability and structural distress
� due to distresses observed in and beneath the foundation of the structure, during our site visit of June
19, 2015, and as proposed by Ramos Engineering and Associates, LLC, RE&A Proposal No.:
FE-15-110-ER,dated July 14, 2015.
The work was completed by LRE following the finalization of our monitoring services, due to
lack of authorization from the homeowner to expend additional monitoring days. LRE
proceeded to also replace and install approximately 384 linear feet of 2"x6" wood foundation
framing, 16 linear feet of 2"x8" framing, and new hangers for all of the new joist and girder
members. The framing was remotely and verbally specified by RE&A to LRE at the time of
construction, and then reported to RE&A by LRE following completion. Elevation changes due
to installation and jacking of the new smart jack piers were not recorded.
2�2�et�er�uteraraea I:�ree4 ler.�e�6Am,�a flor�i�a�3�17-J5G4g[e6sorae�ti3-�953-04135 fax�73-�53-179�
��77 vYe6�iS9��4iim85�Y�eGY�9�ECH:o���
1
; , �.
' : • Monitoring of Crawlspace Stabilization RE&A Project No. 2828-15-058-ER
Peterson Residence Mav 13, 2016
Smart Jack Installation
Six (6) Smart Jack crawlspace stabilizer piers (SJ-1 through SJ-6) were proposed by RE&A for
the crawlspace of the structure. A total of six (6) Smart Jacks (SJ-1 through SJ-6)were installed
by LRE.
The piers were installed in accordance with industry standards. For specific da.ta and pier
locations as built, please refer to the attached As-Built Foundation Stabilization Plans (Sheet
AB-1 &AB-2).
After the final lift, pressure was applied and the system locked into place on their respective
installation date. All of the piers were mechanically jacked to ensure that they all remained
loaded. The crawlspace was stabilized through the pier installation process at those locations
where the piers were installed.
It is our professional opinion that with the above stabilization of the foundation the structure
should continue to perform as designed. Should additional movement be observed, additional
stabilization may be required.
It needs to be noted that the above remedial process does not seal off the top of the karst
limestone or minimize the ability of the overlying soils from raveling into the limestone, nor
does it inhibit any shrink/swell activity in underlying highly plastic clay layers. Also, the Smart
Jack installation only address the foundation system at those locations that were supported.
2
' . .
: • Monitoring of Crawlspace Stabilization RE&A Project No. 2828-15-058-ER
Peterson Residence Mav 13, 2016
It is our professional opinion that cosmetic repairs on the structure should not commence for a
period of 30 to 120 days after the stabilization process is completed. This time frame is
important for the structure to readjust and find equilibrium.
RE&A appreciates the opportunity to be of service on this very important project. Should you
have questions and or need additional information, do not hesitate to contact us.
Very truly yours,
Ramos Eng'beering and Associates,L.L.C. �`�`\@11 I�I ll�%�
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Copies: (1) Client /��'j0`��iON,``�\\��
(2) L.R.E Ground Services,Inc.
Enclosure: As-Built Foundation Plan(Sheet AB-1)
As-Built Foundation Framing Plan(Sheet AB-2)
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LEGEND
0 SmartJack crawlspace stabilizer pier with
compacted No.57stone footing 1'-4"deep
(6 total)
`''�� � � 2825 Minuteman�ane PETERSON RESIDENCE AS-BUILT FOUNDATION SCALE: AS NOTED SHEET NO.
�,�"�`+': ° '��`�. arandon,Florida 33511 PLAN DESIGNED BY'
=.�y�_:.::>..,.._-_.s,,, A B- 1
;�; i�i-. � , p:(813J 453-0935
� DRAWN BY: W V.
�. " f:(813J 653-1792
` � ' www.ramosengineering.com 5230 2nd Street CHECKED BY: pQ f g:
�„'—�,.. Zephyrhills,Florida 33542 PROJ.NO. 2828-15-058-ER Mat 18,2016 i
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SJ-1 I� SJ-4
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LEGEND
� SmartJack crawlspace stabilizer pier with compacted NOTE
No.57stone footing 1'-4"deep(6 totai) Single 2x6 joist hangers used at each joist to girder
connection in kitchen (30 total)
New PT 2x6 wood joist @ 16"o.c. (312 LF total)
New 2 PT 2x6 girder(72 LF total)
—•— New 2x8 PT sistered to existing girder full length (16
LF total)
LJ New 2-2x6 girder to girder hanger(4 total)
_____= Existing girder
��''� �� � 2825 Minuteman Lane PETERSON RESIDENCE AS-BUILT SCALE: AS NOTED SHEET NO.
.;�';���-,�'; '`'_'�: Brandon,Florida 33511 FLOOR FRAMING PLAN DESIGNED BY:
$- : AB-2
, : :...� ,. ',�,
;j..- ` , p:(813)453-0935
j' .r DRAWN BY: W.V.
�.�� ', f:(813�653-1792 CHECKED BY:
a G www.ramosengineering.com 5230 2nd Street Date:
,_„��. Z@phyfhlll5,FlOfldd 33542 PROJ.NO. 282&IS-058-ER Mat 18,2016