HomeMy WebLinkAbout16-17520 CITY OF ZEPHYRHILLS �
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,� ' S335-8TH STREEi' !
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BUILdING PERMIT
PERMIT INFORMATION LOCATION INFORMATION (
Permit Number: 17520 Address: 5453 10TH ST
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABL.E Lot(s): Block: Section: �
Square Feet: Subdivision: ClTY OF ZEPHYRHILLS
Est. Vaiue: Parcel Number: 11-26-21-0010-11900-0070
Improv. Cost: 5,600.00 OWNER INFORMATION
Da#e Issued: 612 812 4 1 6 Name: 111[OREL JAMES I &J4YC� E TRUST
Total Fees: 65.00 Address: 5914 WILSON DR I
Amount Paid: 65.04 ZEPNYRHILLS FL 33542-7927 '�
Date Paid: 6/28/2016 Phone: 813-714-3388 I
Work Desc: REROOF SHINGLE I
CONTRACTOR S APPLICATION FEES
TRIPLE CROWN ROOFING I C REROOF RESIDENTIAL 65.00
Ins ections Re uired
DR IN ROOF IN P
TAi'E JOINT F20���
FINAL c -'"
REINSPECT�ON FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the
local government shai! impose a fee of four times the amounfi 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 property that
may be found in the public recards of this county, and there may be additianal permits required from other gavernmentai
entities such as wafier management, state agencies or federal agencies.
"1Narning ta owner. Yaur failure to recard a natice af commencement may result in your paying twice for
impravements to your property. If you intend to obtain financing, consult wifih your lender or an attorney
before recording your natice of commencement."
Complete Plans,Specifications Must Accompany Application.All wark shall be pertarmed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFORE CA.
NO OCCUPANCY BEFORE C.O.
�
GONTRACTO SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 M{3NTHS 1NITHCIUT APPROVED IN5PECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRUTECT CARD FRBM WEATHER
o,,�-,ou-vU�� City of Zephyrhills Permit Application Fax 813-�r8o-oo2i
Building Department
Date Recelved p�'�";�� Phone Contact for Parmitting �j A '3 — �����
Ow���'s Name c.,1���"" Q��;— Owner Phane Number �,�'"'7��" ��
Owner's Address �7�I� �l/��0� �" �'�'� �/`f J��.�Wner Phons Number _ ,_,
Fee Simple Titleholder Name �` � Qwner Phone Humber �
Fee S9mple Tltlehotder Address
JOB ADDRESS �7,✓� � G.S�� L.OT# �
suaa�vrsioN � � PARCEL iD# d�"��o�",I- �0/!1-��'�pc� - ,p o�O
(OBTAINED FROM PROPERTY TAX NOTlCE}
WORK PRQPOSED e NEW CONSTR 8 ADDtALT �� SiGN' CJ Q DEM�L.ISH
INSTAL� REPAfR
PROPOSED USE Q SFR Q COMM C� QTHER
TYPE OF CONSTRtlCTIQN [� BLOCK [� FRAME C� STEEL Q
DESCR�PTION OF WORK �¢� �D4'�'" /��G ,.S�i ,G �T� �.�t L'/t.�/Or.*4� � �'
BUILQING SiZE �� � SQ FOOTAGE�� HEIGHT C��
QBUILDING $ � � � VA�UATION OF TOTAL CONSTRUGTION
[�ELECTRICAL ($ --_� AMP SEF2VICE � PROGftESS ENERGY Q W.R.E.C.
�
OPLUMB�NG ($ —_�
L_ ,� ���
QMECHANICAL $ VA�UATION OF MECHANICAL lNSTALLATlON �� �
QGAS � ROOFING Q SPECIALTY � 07HER
FlNISNED F1.00R E�EVATfOP1S � � FLOOD ZONE AF2EA QYES NQ
BUILDER �� — ` CCIMPANY
SIGNATURE �_ REGtSTERED Y/ N FEE CURRE� Y/N
Address License# �� � �
ELECTRICIAN COMPANY
SIGNATURE REGiSTEREd Y/ N FEE CURRE� Y/N
Address Ltcense# �— i ]
PLUMBER � COMPANY
SIGNATURE REGtSTEREO Y J IV FEE GURREh Y I N
Address License# �` �
MECHANICAt. �� . CdMPANY
SiGNATURE ____`� REGISTERED Y i N FEE CURRER Y J N
Address License# � �
�l'H�R COiriPrgPlY �r/ ��C�y'o(,d/l�Odt�j�'•s '�iv, G � -
St6NATURE � REGISTEl2ED Y! N FEE CUftRE� Y I I�I
Address �^yQ ' �- �" �1 �'�?�'r�11 � ��;�,� License# ������1�e7l� �
RESIDENTIAL. Attach(2}Plot Plans;(2}sets of Buitding Plans;(1)set of Energy FoRns;R-O-W Permit for new conshuctian,
Minimum ten(1d}working days after submlttal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fencs instailed,
Senitary Facilities&.1 dumpster,Site Woric Permit for subdivisionsAarge projects
COMMERCIA� Aftach(3}camptete sets of Building Ptans plus a 4ife Safety Page;{1)set of Energy Famts.R-O-W Permit for new consfn�c8on.
Minimum ten(10}woricing days after submlttal date. Required onsite,Construction Plans,Siormwaier PEans w/Siii Fence instalted,
Sanitary Facitities&1 dumpster.Site Work Perrnft for all new proJects.All commercia!reqairements must meet campliance
SiGN PERMIT Attach(2)sets of Engineered Plans.
__ "'*PROPERTY SURVEY required for all NEW constniction.
Dtrections:
Fil{out apptication completety.
Owner&Contractor slgn back of appllcat(on,notarized
if over�2500,a Notice af Commencement is raqulred. (A!C upgrades over$7500)
" Agent(for the contraotor)ar Power of Attomey(for the owner)woutd be someone wifh notarized tetter from owner suthorizing same
DVER TNE COUNTER PERMITTING (Front of Applicatian Only}
Reroofs if shingles Sewers Service Upgrades A/C Fences(PloUSurveylFootage}
Driveways-Not over Counter if on public roadways..needs Ft4W
. � t
�10TICE OF DEED RE3TRICTlONS: The underslgned understands°that this.pprm(t.maybe.subJect to"deed"restricttons"
vhich may be.mare restcictive than County regula#ions. 'The�rnderslgned assumes rasponsibility for compliance with any
ipplicable deed restrict(ons. • ,
�NLICENSED CCiNTRACTQRS ANQ-_Ct3NTRACT{)R RESPONSIBILII'1ES: Ef the awner has hlred a contractor or
:ontractors to undertake work, they may be required.to be:l(censed in accordanee.with state.and�local regulations. If the
:ontractor is not lEcensecf as requlred-by law, both the awn�r and canVactar may be afted for a misdemeanor vtolatfon
mder state iaw. If the owner or intended contractor are uncertatn as ta what licensing.requiremenfs may apply.far fhe
�tended wark, they are advised to cantact the Pasco Gaunty Building Inspection Diviston—l.icensfng Sectton at 727-847-
1009. Furthermore, if the owner has hired a contractor or contractars, he is advised to have the contractor(s} slgn
�ortians of the "contractar Black" of#his application far whlah they wiil be responsible. If you, as.the owner sign as the
:ontractor, that�may be an indication that he fs not properly iicensed and is not enti#!ed to permitting privileges in Pasco
�ounty.
fRANSPORTATION IMPAC'CIUTILITIES IMPACT ANL1 RE30URCE RECOVERY FEES: The undersigned understands
hat Transportatian Impac#Fees and Recourse Recove.ry.Fe�,s rn�y.apply�#o the cons#ruatian of new buildings� change af
�se in existing buildings, or.expansion-of�existing'.buildings, as speclfled in Pasco Caunty Ordinance number 89-0? and
30-07, as amended. The undersigned also understands� that such fees, as�may�be�due,.wili be identified at the time of
�ermikking, It Is fuMher understood that Transpartation Impact Fees and Respurce Reco�ery Fees must be paid prfar to
•eceiving a "certificate of occupancy°" or flnal pawer. cetease. :If the project does nat involve a certificake o#occupancy or
•inal power re(ease, the fees must be paid prior#o permit issuanee. Furthermore, if Pasca Counfy VNaterlSewer (mpact
`ees are due, they�must be-paid prior to permit issuance°in accordance with applicable Pasco County ordinances.
CONSTRUCTtQN t1EN LAW(Chaptee 743�Flor�da Statutes,as amende�i�: If valuatia�of work ls�2,500.04 ar mare, !
�ertify that I, the applioant, have been provided with a copy of the °Florida Constructlon Lien Law—Hameowner's
ProtectEon Guide" prepared by the Ftorlda Department of Agrlculture and GonsumerAffairs. If the app!lcant ls someone
�ther than the"owner", I certify that 1 have�obtained a copy;of the above.described document and promise in.good faith to
deliver it to the°owner"�prior to>commencement.
CONTRACTOR'SI�WNER'S AFFIDAViT: i ce'rtify-.that ail the Enfvrmatlan in fhis appticatlan is accucate and that all wark
will'be done in compliance with all applicable laws regulating constructian, zoning and land develapment. Applicatian is
hereby macfe to obtaln .a perm�t ta da work..and instatiatlon as indteated. 1 certify that no work or instattatton has
�ommenced priar to issuance of a permit and that all work wilt be perFormed to meet standards of aiP iaws regulating
construction, County and City codes, zoning regulatir��s, and land development regulatians�In the jurisdictlan. I also
cerfify that 1 understand that the regulatians oi other gavernment agencles may apply�to the intended work, and that it is
my responsibility#o identify what,actions I must take to be�in.compliance. Such agencles inalude but are not limited to,:
- Depar#ment af Envlrvnmental Protection-Cypress.Bayheads, Vltetland Areas and Envlronmentatly Sensitive
Lands, WatedWastewater Treatment.
- Sou#hwest Florida Water Management District-We!!s, Cypress. Bayheads, Wetland Areas, AI#eri�g
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navfgabie Waterways.
- Depa�tment af Health & Rehabilitative ServiaeslEnvimnmenfal Neaith llnit Welts, Vhlastewater Treatment,
Septic Tanks. _
- US Environmental Protectlon Agency-Asbestos abatement.
- Federat Avfation Authority-Runways.
1 understand that the following.�estrictions apply to the use of flU:�
- Use af�tll is not altowed in Flood Zone"V"uniess expressiy permitted.
- If the fiil material fs to be used in Flood Zone "A", it_ is understood that a drainage plan addressing a
°compensating volume" wiiE be submltted at time af perm€tting wh�ch is prepared by a professionat engfneer
I(censed by the State of Florida. �
- !# the fil! materia! is to be used in Flood Zone °A" in�connection with.a permitted building using stem wall
� construction, t certiiy tha#fi1{�will:be used anty.to fitl the area within the s#em wal3.
- If fill material is to be used in any area, I certify that use. of such flll wiil not adversely affect adjacent
propertles. If use of fill is foc�nd t� adversely:affect adjacent properties,.the awner may be c#ted for vioEating
the canditions of the building.permi# Issued under the attaahed permit application, far Iots less than ane (1)
acre whlch are elevated by fl!!{an engEneered drainage plan is required.. �
(f I am the AGENT FOR THE OWNER, i,'�aromise tn good fatth to inform#he ownerof•the permifting conditions set forth in
thts affidavit prlor to cammer�cing construction. I understand thet a.separate permit may be required for electrical work,
plumbing, stgns, wells, pools, alr condittaning..gas, or other Ins#allat�ons nat•spec�f{catly included in #he application. A
permit issued shall be constcued to be a Iicense to praceed with the work and not as�authority ta.violate, cancel, alter, or
seE aslde any prov�sions of the technlcal codes; nor shall issuance af a permft.pcevent the Bulldt►ig Q#fJcia!from thereafter
requiring a correction af.errors in�pians, canstruction ar vtolations of any codes. Every permlt issued shati become invaiid
unless the work authorized by such perm3t.�is.cammer�ced^within six_mo�nths�f-permit-issu�nce,-or-if work auQhorized-by �-
��tne permit�s suspenciec9 0�abandon�#or a period of six{6)months after the time the wark fs cammenced. An ex#ension
may be requested, ln writing, from the Building,Official for a periad.not to exceed nlnety (90) days and will demonstrate
�ustt#iable cause for the ex#enstan: If wvrk ceases�for n�nety(90}consecutive days,..th�Job�is consEdered abandoned.
itVARNlNC 70 C?,,�t�CyUR �'A!lURE.TO,R�CC?RD A MO'TICE OF COMMENCEMENT MAY�RESU!»T IN YOUR
PAYiNG TWiCE.FOR iMPRC►VEM�NTS�TO YOUR-PROPERTY. IF�YCi.U�IN�'END`TO!{}BTAIN�FiNi�NCING;�CONSUlT
WIT R L NDE O AN A'T'I'OR � FOR � EC� �D G� O � C 'O E ENT
FLORIDA JURAT(F,S.t'f J.03} �
OWIVER OR AGENT CONTRAC'TO
3ubsctl6ed and swom fo(or ai�rmedj befare me fhls S bscrll� nd`swom�(or a�rmed)�b' ,ne me this� ,
- _- by ---- -. - �-� -
Who isfare personally k�own to me or haslhave produced Wha Is/ar rsonaUy ownto me or hasRrave produced •
as idsn�flcaUon. � as ldentlftcaflon. - �
Notary Pubtic Natary Public
Cornmisslon Na. �Q S��ri� •
��"PY I I���
Name of tdat2try tyfted,printed or stamped Name of Notary ty �?p t'`�r{��g��#FF 150422
:�;�,��o; Expires December 12,2018
�%.�y,pF��QQ' Bonded TNu Troy Fain Inaurance 800.385�7018
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. . I Illff I illfl Illlf illll Illli lilll fiif I ilif I iiill illll illl iill
�� 201fi07810�
Permit No. Parcet 1D No �t'�t0 f������/7uzJ^���Q7�
�..� N0710E OF COMMENCEMENT
Stnteof �i�//-�/4 cour+tyot �/t'S'CO
SN�UNDERSIGNED hareby gives notica that Improvement wpl be made la certain reai property,end In accordance wlth Chapter 7t3,Florida Stetutea,
the following intarmatinn is provided in this t3at(ca ot Commencenient:
t. OesctipBon of Ptogerty: Parce!identificatian No. •FZ,C � P � c.ei�qd,�.��3����G 8��yG P4
��BtA�d��: s �� -` � 3..rya //;�?aa21.�yIG�/��6
2. Ganerel Desc�iptfon of improvamant��j� /�Lf
- 3. Clwner InformaUon or lessee infortna4an iithe Lassea corrtracted for the impravemenY ,
, �,�f-r�e� /�'?t9�C�t_
�f� Nam�JlLSOit 1 JJ� Z.�"Ps+��/1�,+I,f1LC.S � ��`�2
• ae��sg 4�!,v'.J� °t�` scat�
Inten�st[n Properiy: .
Name at Fee Simple 7d1eholder. ��� ���
(If dtiferent finm Ovmsr isted a6o�e} � s.
61 m..
�wa�ss 1..L��.�� �_._.���Uo F�l�.��i /�L� stexe `�- F-
A. Contractor. m m.,'�'j�
� �l'LONam�/vt�,,�� ,�� ���1�/�.�.5 �^,,�,j�� dt A
Address Q' Cit�r State
ConUactots Tetephone No.: u �� � � �
6. Suraty: 3�,'p
Name A � •• �
1
Addrese CNy State .��"
Amaurrt o1 Bond: S Teiaphona No.: , t"'�N
K m M9
6. Lender. , n �g
Name � 19
AddFess C{{y 5ffite =
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Lende�s Te4ephone No.:
?, Persons within the State af Fiarida designated by the ovmer upon whom notices or other documents may he ser�ed as provided by •
Saction 713.13(1)(a)(7),Florlda Statutes: /,�
Name
qd��g C{ty Stete
Telephoi�e fSumber of Qes4gnated Person: �.a
D
& In additian ta himself;the ovunes designatss °t_,_ p�r�
to receive a copy of tho lienors Notice as provided in Section 713.13(i);b),Florida Stetutes. �m
N
Telephone Numher oi per�on or Entity Designated by Owner. ��o
�z
9. E�qiiration dale of Notice oT Commencement(Ihe e�iraQon deta may not be before tha canpletion p(construction and iina�payment to the `�+�'�
{�i/��
cm�traanr,but wilt be one year irom the date of recwding untess a dttferent date is sper.Ified}: _
WARNING TO QWNES2: AM'PpYMEl1i'S MAQE 8Y TFlE QWNER AFTER THE EXPIRATtQN OF TkE NOTiCE OF�OMMENCEMEMT ���
ARE CONSIDERED IMPROPER PAYMENTS UN�ER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STAI'U7ES, AND CAN
RESULT !N YQUR PAYING TWlCE �OR IMFROVEMEtSTS TU YC?UR PROPERTY. A NOTiCE OF C�MMENGcMENT MUST BE N�
RECORqEO ANQ POSTED ON 7HE JOB SITE BEFORE THE FIRST tNSPECTION. IF YOU iNTEND TO OBTAIN FiNfiNCiNG,CONSULT ��n
tM1'tH YOUR I.EFIDER OR AtV ATCORIVEY BEFORE COMMENC4NG WORK OR RECqRDlNG YOUR tJOTIGE OF COMPAENCEMENT. � �
U�dergenatry�pu�yury,l dedare that 1 have read the toregaing noUce af commencement and that tha faetc stated thereln are Wo to llre best � "
of my knowtedge and betief, , ��,,�
S7A'fE pF FI.ORIpA �i J��� , � ` �
G�!lNTY 4F PASCO ���'j �="- ' 'I�„dh pu
&i�iSire of r or�e ea,or t1HmePs or lessee�s`RDtf+eFaad ` ■
• !7fllcsdOi o arinerlMan er _ - ��+3
, �
-.�
,, ignatar�sTdlelOtflce � o
The foregoinq instrumsnt was acknowtedged betore me this dey:af' 2U�.by{�� �� � �� m
as �d�.,� (type o►authority,a.g,afficer,tnstse,attomey in tact}far
� � {n e of 'on 6e of.wh instrumeni S�ras executed).
Persanally Knawrr O$Produced]den#Efi�atian❑ ' Notary SignaWre
Type of IdenBfication Praduced � � .Nsme{PdnY} f�
SNARON B.SUMNER �
NOTARY pUBLIC•STATE�f��Q���A
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�� �., �G STATE OF �Lr��21DA,�C7UNTY 0��ASGO
��;�;`''��f_ • ,;�THIS IS TO CERTIFY THAT THE FORcG01NG IS A
� e• J:�;r`� :�,, RUE AND CORRECT COPY OF THE DOCUMENT
�"��1��'¢�r . # lN F#LE 0�'OF PUBLIC RECORC}1t�4 THIS{�FFIGE
�' � ��� j Q"' " 1TNES MY NAND A FFlCIAL SEAL THlS
�°.;r.,� `1� �" —s��C��.v�-DAY QF 2 �
,� ,:��:.,. �.
,g`��- � ��"�7 �� PAULA S 0'NEIL,CLERK COMP?ROLL
�"P'�`T � e o
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�����.�� SY �DEPUTY Cl.ERK
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TRIPLE CROWN ROOFING, INC. �
7140 ANDRE DR. � ZEPHYRHILLS, FL 33541
813-833-7720 w,�-�- :.�,
STATE LICENSE CCC049370 �/`"'" ii'�.-� l/' ��
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WWW.TRIPLE-CROWN-ROOFING.COM � LNAULT1963@AOL.COM`�1_
SPECIALIZING INALL TYPES OFMETAL ROOF SYSTEMS
NAME PHONE DATE
��i _ _ �i -�' "...��"' ,�(�
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' STREET%r�'_'`�` ¢r'c.'•i t-/t, -. . `
�l CITY� � /'f ! f���(;� STATE ZIP
_ ��� � ,r�� � �''� , ��-.� ��{.f; � ./1� �'�. � _ . �
SALESMAN � �' 1�� 'r �-
.G,1"4 ''� ,,��'✓u fJ�"
We hereby submit specification and work description: �
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,�,,,�o�t1 f��'i-� ,..� '" .� ,l. ��'�",,� ,� � _1 ,f --°�-•_
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THE ABOVE DESCRIBED WORK WILL BE COMPLETED ACCORDING TO SPECIFICATIONS, FOR�THE-SIJM�OF`
($ ). PAYMENT TO BE MADE AS FOLLOWS:$ .a``�f�;ft, AS DOWN PAYMENT ,
--�f f"'�`'�� BALANCE OF$ `�;� �> DUE UPON COMPLETION.
� "
***ANY ROTTED WOOD DISCOVERED WILL BE AN EXTRA CHARGE AT A COST OF$ •`-�"� PER 1/2"SHEET OF �
PLYWOOD$ �,�, S C� Lin. Ft. Lumber.
� NO ORAL AGREEMENTS HAVE BEEN GIVEN OR ACCEPTED. THIS WRITTEN CONTRACT IS THE
ENTIRE AGREEMENT COVERING ALL THE WORK TO BE PERFORMED AND/OR MATERIALS TO BE
FURNISHED. THE WRITTEN PORTION ABOVE IS THE ENTIRE CONSIDERATION FOR THE AMOUNT
OF THE CONTRACT. PURCHASER MAY CANCEL THIS CONTRACT ANY TIME PRIOR TO MIDNIGHT �
OF THE THIRD BUSINESS DAYAFTER THE DATE PURCHASER SIGNED THIS CONTRACT.
IT IS AGREED:
Contractor will do all said work in a good and workmanlike manner and in strict accordance with the ordinances, rules and requirements
of the city, Town�or Village, wherein the above mentioned property is located. If purchaser should cancel this contact after time stated
above, the Furcha'ser agrees to forfeit tlown payment paid. In the event it becomes necessary for Contractor to employ an attorney to
collect any sums due the Contractor pursuant to this contract, then the Purchaser shall pay all reasonable attorney's fees incurred by
the contractor.This contract shall not be binding upon Contractor until accepted by them. Upon such acceptance by said company, this
.--contract shall be binding on melus without any further notification to me/us. The undersignetl property owner agrees that this contract
�� may be assigned for the performance of the work and labor required by the description of the work to be performed. Upon assigned the
- parties hereto consent:to the performance of the work by and payment to sucfi assignee of the amount.of this contract.Any Alteration or
- - deviation-from above specificafions�involving ext�a�co`sfsEwiil�beYexecuted only�upon w�itten�o�ders'and�will.become:an_extra�harge over _ ..' -
and 'above the stated contract amount. , � . � ';
. ;
NOTICE TO THE BUYER : (1) Do not sign this contract before you read it or if it contains any blank spaces. (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 to obtain a partial refund of the time charge. Owner acknowl-
' edges receipt of a true copy of this CONTRACT. �r'�
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f'��� PURCHASE�� �bATE�� `" ,
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'" BY: Triple Crown°�Roofing, Inc. - " DATE PURCHASER DATE �
� This:contract is,enforceable only when accepted by management of Triple Crown.