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Home My WebLink About16-17739 CITY OF ZEPHYRHILLS � " 5335-8TH STREET (813)780-0020 177 BUILDING PERMIT �PERMIT INFORMATION. � - - � ' - LOCATIONr INFORMATION- � Permit umber: 17739 Address: 37347 NEUKOM AVE LOT 73 ' Per it Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: , Propo ed Use: NOT APPLICABLE Lot(s): Block: Section: Squ re Feet: Subdivision: GRAND HORIZONS ' � E t.Value: Parcel Number: 34-25-21-0090-00000-0730 Impr v. Cost: 9,276.58 - � ' ,- OWNER.INFORMATION ` � Dat Issued: 9/16/2016 Name: WRIGHT GLENN & MARY To al Fees: 85.00 Address: 37347 NEUKOM AVE Amo nt Paid: 85.00 ZEPHYRHILLS FL 33541-9320 D te Paid: 9/16/2016 Phone: 440-645-7637 W rk Desc: REROOF SHINGLE CONTRACTOR S - � " � � �APPLICATION FEES- � � � PERDE ROOFING LLC REROOF RESIDENTIAL 85.00 V � � �� ,� � ' ` � � �- � Ins ections Re uired � ' � � � � DR IN R OF INSP TAPE JOI TS ROOF INSP FINAL REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the local overnment 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. NOTIC : In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that may b 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. "Wa ning to owner: Your failure to record a notice of commencement may result in your paying twice for impr vements to your properly. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Comp ete 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. 9 t, � ✓ � i � ONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER : . u �� w : • - P�Perden =��=:�;�R O O F'I N G ��. �_._y_. Building Department, I, Kyle Perchalski, owner of Perden Roofing give Chelsea Hatton and Lance Tomberlin authorization to pull permits, Notice of Commencements and other permitting needs on behalf of myself for Perden Roofing. Thank you, Kyle Perchalski Owner Phone: 850-997-3638 Email: kyle.perdenroofincLCc�gmail.com www.perdenroofing.com Visit us on Facebook @ https://www.facebook.com/perdenroofing Cti'i-e,�S�e�t, u�-�� et�`YP°Bi. CHElSEAHAT'f�ON _ ' * ��••�' �MYCOMMlSSIONtMGGOtY811 ' o EXPIRES:Ntgust 8.202D .- ' � I �FOF F�°Q Bor�ded 7fuu Bu08e1►Jola�Y SeMcw , � State Certified Roofing Contractor#CCC1330433 I a�a-�eo-oozo City of Zephyrhills Permit Application Fax�1&780-0021 � Building Department Date Received ^ phone Contect for Pertnitting , �1�11'1 ��" '-frU -'��S- 7 �� Owner's Name � Owner Phone Number Owner's Address 3 3 y--] .�i�L � �' � l � Owner Phone Number I� Fee Simple TiBeholder Name � Owner Phone Number Fee Simple Tideholder Address � JOB ADDRESS 3`1 3 '-� -1 I V'�U-�� ` l ��' '1 V��'S LOT# � SUBDIVISION ^ 0 `l�� PARCEL IQIt ��t� ��I � �� I� — ��Du —u �� (OBTAfNED FK018 PROPERTY TA1C NOTICE) WORK PROPOSED B NEW CONS7R� ADD/ALT Q SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM Q OTHER � TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q DESCRIPTION OF WORK �-"C-�'�� BUILDING SIZE S4 F007AGE� HElGF{T � QBUILDING $ �f'1r•% VALUATION OF TOTAL CONSTRUCTION !i �o. QELECTRICAL $ AMP SEf2VECE Q PROGRESS ENERGY Q W.R.E.C.�` _,� yV\ QPLUMBING $ �, QMECHANICAL $ VALUATION OF MECHANICAL INSTALIATION � � � ��v QGAS Q ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER Iv �n COMPANY SiGNASURE � � REGIS7ERED Y! N �curu�n Y!N Address License# ELECTRICIAN COMPANY � SIGNATURE �GisrEaEv Y/ N �e cuar�n Y/N Address � License# PLUMBER COMPANY SIGNATURE r�Gi5r�n Y/N �curu�n Y!N Address License# MECHANICAL COMPANY SIGNATURE rx�cts�o Y/N �curu�n Y/N Address License# O7HER � COMPANY ` '�"`^�' �1�� L� SIGNATURE r�cisr�u / N �curux�n Y/N �d�� S� c-�re2� �� I � �"r. -j-c{ c,�, ��:-ee,�- ��se# �-cG 13 3 D 4-3 �.� � � � � � r � �:r.� r� � rrri �:�.r � rr� r� ri.�.� � � rr:� rrrc�.� � c� r-r� � � rr� r� r.rcrri �.r � r.� RESIDENTiAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects COMMERCIAL Attach(2)complete sets of Buiiding Plans plus a Life Safely Page;(1)set of Energy Fortns.R-O-W Pertnit for new wnstruction. �i Min'imum ten(�0)working days ailer suhmilFal date. Required onsite,Construciion Plans,Startnwater Plans w1 Silt Fence instalied, I San'dary FaciliGes&1 dumpsler.Site Work Permit for all new pmjects.All commercial requiremenfs must meet compliance ' SION PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required forall NEW consVuction. Directions: Fill out application completely. Owner 8 Contractor sign back of application,notarized If over SZ500,a NoUce of Commencement is required. (A!C upgrades over 57500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized Ietter from owner authorizing same OVER THE COUNTER PERMITrING (copy of contrac[required) Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) Ddveways-Not over Counter if on public roadways..needs ROW II 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 AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or conVactors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a conVactor or contractors, he is advised 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 entiUed to permitting privileges in Pasco County. TRANSPORTATION IMPACTNTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportatton(mpact Fees and Recourse Recovery Fees may appfy to the construction of new buifdings,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 Recovery Fees must be paid prior to receiving a"certificata of occupancy"ar fina!power release. lf 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 applicable 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 applicant, have been provided with a copy of the °Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the°owne�',I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the"owne�'prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all appficable laws regulating construction,zoning and land development. Apptication is hereby made to obtain a permit to do woric and installation 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 all laws regulating construction, County and Ciry codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other govemment agencies may apply to the intended work,and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies inGude but are not limited to: - Department of Environmental Protection-Cypress Bayheads, WeUand Areas and Environmentally Sensitive Lands,WateNWastewater 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 Services/Environmental Health Unit-Wells, Wastewater Treatrnent, Septic Tanks. � - US Environmental Protection Agency,Asbestos abateme�t. � - Federal Aviation Authority-Runways. I understand that the following resfictions apply to the use of fill: ', - Use of fill is not allowed in Flood Zone"V"unless expressly pertnitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume"will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone"A"in connection with a permitted building using stem wall construction,I certify that fill will be used only to fill the area within the stem wall. - ff fill material is to be used in any area, t certify that use of such fif( wilf not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating ' the conditions of the building permit issued under the attached permit application,for lots less than one(1) acre which are elevated by filt,an engineered drainage plan is required. lf l am the AGENT FOR THE OWNER,l Qromise in good faith to inform the owner of the permitting conditions set forth in ' this affidavit prior to commencing construction. 1 understand that a separate pertnit may be required for electrical work, plumbing, signs,wells, pools, air conditioning, gas, or other installations not speafically included 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 aside any provisions of the technical codes,nor shall issuance of a pertnit prevent the Building Official from thereafter requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid unless the woric authorized by such permit is commenced within six months of permit issuance,or if work authorized by the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate juslifiable cause for 1he exlension. If work ceases for ninety(90)consecutive days,the job is considered abandoned. 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. FLORIDA JURAT(F.S.117.03) OWNER OR AGENT CONTRACTOR � � �.u cnbgd and swo�n t jqr ' befo me i � S,u cri ed and sw�r� o(or�a� rmed befor�e m�e�his� q� � Ll by 1�-LI l-� �Q��t -1 �7 l.e by l�wl IL �-e�C�"C�n9t�S�t �h�s! re rsonally kn to me or has/have produced o 1 re personally to gat has/have produced 2--1r5 l�i c2.nS''�as identifica6on. 7�1��2XS 1,.i G � as identification. i // Noiary Public � Notary Public II Commission No. C �'I b I �� l � Commission No. ��+�� -`�1� Nam��1.:�..�ped,pri Name of Notary t�{�Hd(�ted or sta�$��{�QrJ . + MY COMMISSION�GG 01�17 * ,.•••,'+��ISSION#GG 019811 N��E�F F��po Bpfld�Q PTIMI BIWgBI Mp18I�S61VIC83 °'�s o�e� EXPIRES;AuguS19,2010 OF f�P BOf�d ThN BYdqNNolary S6tV(Cd� l �� Office Location:TarnPa, Proposal Da e 07/28/2016 Job Number 20795200 Sears Home Improvement Products,Inc. Customer N me /�' P.O.Box 522290 GLENN W IGHT � 'rs 1024 Florida Central Parkway � Customer's Home Phone Customer's Work Phone Home Improvement Products Longwood,FL 32750-7579 (aao) 6 5-7637 Phone(800)469-4663 StreetAddre s ESTIMATE AND PROPOSAL Contractor LicenselRegistration Number 37347 NEUKOM AVE FL(CGC012538,CCC1329316) City State Zip Code Roofing ZEPHYRH LLS FL 33541 Is installation within city limits? Installatio Address County PAsco (YeslNo): vEs Billing Addre s(if different from above) City State Zip Code Project Consultant Name&License No.(if applicable) JASON LESLIE Description of the Project and Description.of the Significant Materials to be Used and Equipment to be installed � - The work o be done under this contract includes the following(where checked): Specifications(0=Included ❑=Not Included) Pre arati n 1. 0 Tear off existing roof shingles down to wood deck on entire house. 2. Q Inspect wood deck for rotten wood. 3. � Replace any rotten wood found in the deck area at a rate of$ 3.oo per square foot. PLEASE NOTE:this amount is not included in the TO.TAL PRICE shown below. Customer and Sears agree that the TOTAL PRICE will be amended via a Contract Change Authorization form to add the costs of replacing rotten wood in the deck area discovered after existing roofing materials are removed. Customer(s)initials � NJ Installati n 4. � Fumish and install Exterior Shingle: TYPE: SUPREME COLOR: SHASTA WHITE 5. ❑ Fumish and ihstall PRo ARMOR underlayment over roof decking. 6. ❑ Fumish and install ice&water eave&valley protector. 7. � Fumish and install starter shingle on all eaves. 8. 0 Fumish and installlreplace any deteriorated"L"flashing. 9. 0 Fumish and install metal drip edge along rake edges and eaves. 10. ❑ Fumish and install skylight systems. ❑ Reuse existing 11. C�J Furnish and install new vent covers on all vent pipes. 12. 0 Fumish and install attic ventilation system(Check all applicable): ❑Turbines ❑ Power vents ❑ Shingle-over ridge vents �Off-ridge vents ❑ Soffit vents 13. ❑ Fumish and install.new flat roof E�erior Protection System: COLOR: Gutters 14. ❑ Furnish and install guttering: COLOR: 15. ❑ Dispose of old guttering. Clean•up 16. � Clean-up and removal of all job-related debris including excess materials. (Extra materials are shipped with each job to avoid dela s .Manufacturer warran will be sent u on com letion of installation. Sears rec�mmends that Customers have their chimney siding or mortar between brick,stone,or blocks inspected periodicall b a rofessional and tuck ointed and/or wa erproofed as needed.Sears shall not be responsible for chimney integrity other than Customer(s)initials h w replacing e flashing in conjunction with the installation of the roofing materials described above. Addltl0f18I WO�IC t0 b@ dOfl@:REMOVE AND REINSTALL SKYLIGHT Work NO to be done: Repairs and replacement of any damaged existing structural members. Interior repair to walls or ceilings including sealing, painting,and/or drywall repair. Removal and/or re-installation of items that may otherwise impede Sears'ability to install a new roofing system prior to installation. Examples include, but are not limited to, satellite dishes, solar panels, pool heating panels, gutter protection systems,TV antennas,HVAC systems,and weather equipment. SPECIAL INSTRUCTIONS: , All of the above check boxes, "Work NOT to be done," "Additional work to be done," and Customer(s)initials � l�� "Special Instructions"sections have been reviewed and explained to me. SRl-FL ( ig.) Rev 6/16/2016 Page 1 of 3 �� Job Number: Zo795zoo APPROXI�ATE START DATE and APPROXIMATE COMPLETION DATE: • The work will start approximately a-5 WEEKS (Approximate Start Date) It will be substantially completed by approximately a-s wEEKs (Approximate Completion Date) These dat�s are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears")or at any other time by mutual written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule t�e actual start date. ASBESTdS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs")that would be disturbed in the performan�e of the installation work. If upon further inspection by the contractor or others it is leamed that ACMs have to be disturbed to perform work,then Customer�nust arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary�asbestos abatement within thirty(30) days, Sears may cancel this contract upon Customer(s)initials ,� �nI written not ce to Customer. The TOTAL PRICE including all labor,material,taxes and any applicable discount is$ 9>z76.50 Contract Price µp $9,276.50 Initial Payment(not to exceed 30%of Total Price unless Special Order)$ 2,782.95 State Sales Tax( o.oo %) $ o.o0 Final Payment(balance payable upon completion ofjob)$ 6,493.55 Local Sales Tax( o.oo %) $ o.o0 The Initial ayment is due prior to Sears ordering products. Total Amount Due $9�z�6.50 The form�nd method by which the Customer(s)will pay is described in a separate Cash/Credit Card Pay entAddendum made a part of and incorporated into this contract by reference. Customer(s)initials �µ ,� NOTICE IO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH B SINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSA�TION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ADDITIONAL PROVISIONS Pro osal and A roval. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page andlor the attached sketches a d specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department. If this is a credit sale or a payment on comple�ion sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law,thi offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed are Sears�roperty and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT furnished�r arranged by Sears.Sears'installation contractor(s)will obtain all building permits required by local law.For homes located in historic or landmark zoning distI icts,Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract. Authorization. I authorize Sears to: (1) arrange for a contractor(licensed where required by law)to make the installation of materials; (2) issue a work order for this ins allation to a contractor; (3)inspect the installation; and(4)pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Dela s in nstallation.I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,govemment regulations or any causes beyond Sears'control. Oral A reements and Chan es in Contract.I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work � described;n this contract. Electrical�& Plumbing Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings. If the electrical a�nd/or plumbing service(s)tlo not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expen �e unless Sears has agreed in this contract to make the changes. Payment. will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty nformation.Appropriate protluct warranty documents will be given to me by Sears.Sears'Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the workmans ip(or application)of any Sears'arranged installation proves faulty within five years(Best),three years(Better),two years(Good)or one year(Limited) after prod cts are installed,then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you.If Sears determines that repair is n t commercially practicable or cannot be timely made then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights, and you may also have other rights that vary from State to State. SRl-FL Dig.) Rev 6/16/2016 Page 2 of 3 �� '�� Job Number: zo�g52oo NOTICE TO OWNER 1. DONO�SIGNTHEAGREEMENTIFANYOFTHESPACESINTENDEDFORTHEAGREEDTERMSTOTHEEXTENTOFTHEAVAILABLEINFORMATION ARE LEIFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. THIS HOME IMPROVEMENT CONTRACT MAY CONTAIN A MORTGAGE OR OTHERWISE CREATE A LIEN ON YOUR PROPERTY THAT COULD BE FOREOLOSED ON IF YOU DO NOT PAY.BE SURE YOD UNDERSTAND ALL PROVISIONS OF THIS CONTRACT BEFORE YOU SIGN. 4. YOU MI Y PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO A FUL�REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 5. YOU M�Y CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA, FIFTE NTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTIC OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT INTERE�ERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFI�ATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE S�LLER FOR YOUR RECORDS. 6. IT SH �LL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPO�SESS GOODS PURCHASED UNDER THIS AGREEMENT. I FLORIDA HOMEOWNERS'CONSTRUCTION RECOVERY FUND PAYMEN MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND, UP TO A LIMITED AMOUNT, IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR. FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA CONSTR CTION INDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS: CONSTRUCTION INDUSTRIES RECOVE Y FUND, 1940 NORTH MONROE STREET,TALLAHASSEE,FL 32399;TELEPHONE:(850)921-6593. ACCOR ING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO WORK N YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. I YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB-SUBCONTRACTORS, OR MA ERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN I� YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONT CTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY.THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SORLrD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBOONTRACTOR MAY HAVE FAILED TO PAY.TO PROTECT YOURSELF,YOU SHOULD STIPULATE IN THIS CONTRACT THAT EFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEA E OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A"NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX,AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY. L1/ o�/zs/zoi6 o�/z8/zois Customer's signature Date Customer's signature Date Accepte by Sears Home Improvement Products,Inc.("Sears")on o�/zs/zoi6 by. � Date Management Representative SRl-FL(Dig.) Rev 6/16/2016 Page 3 of 3 9fl/2016 BusinessTaxReq�rirements�Officeoftl�eTr�surer-Clerk UP�ATE: City of Tallahassee is worldng around the clock to restore customer services including elecficity.Thank you for your patience.For all information on current relief effor[s please visit our response and impact page. �City Of Taiia�ha�ssee Business Tax Requirements FrequenUy Asked Questions when starting a business within city limits: Who nee s a Tax_Certifizate and Why_?__ ._ _,.___., ______,___ _________. Any person or business having a location within the dty limits ofTallahassee that engages in any business activiry must pay an occupational business tax and obtain a Bu iness Tax Certificate. �( O O� ��J I � Business T x Certificates expire September 30 and may be renewed on or after]uly 1 of each year.On October 1,they are delinquent and subject to penalties each mont thereafter.New certificates are issued at any time during the year and are prorated April 1 thru September 30. A eusiness ax Certificate(formerly called occupational license)is issued by the City ofTallahassee Treasurer Clerk forthe privilege of engaging in any business,o pa[ion or profiession.Anyone providing merchandise orservioes to the public,evert a one-person mmpany,home-based ocrupation or web- based business must obtain a Business Tax Certificate.A City of Tallahassee Business Tax Certlficate does not replace or eliminate any other city or state requiremen s for taxes or licenses. Businesses that open and are operating for business prior to obtaining a Business Tax Certificate are subject to a 25%penalty on the assessed business tax. This penalty and the penalties for late renewal of the Business Tax Certificate is pursuant to the Fiorida State Statue 205.053,which states: 1.All bus�ness tax receipts shall be sold by the appropriate tax rnllector beginning]uly 1 of each year,are due and payable on or before September 30 of each year,and expire on September 30 of the succeeding year.If September 30 falis on a weekend or holiday,the tax is due and payable on or before the first workin day following September 30.Provisions for partial receipts may be made in the resolution or ordinance authorizing such receipts.Receipts that are not re ewed when due and payable are delinquent and subject to a delinquency penalty of 10 percent forthe month of October,plus an additional 5 percen penalty for each subsequent month of delinquency until paid.However,the total delinquency penalty may not exceed 25 percent of the occupational license tax for the deli�quent establishment. 2.Any pelrson who engages in or manages any business,oaupation,or profession without first obtaining a lool business tax receipt,if required,is subject to a penalty of 25 percent of the license due,in addition to any other penalty provided by law or ordinance. 3.Any pelrson who engages in any business,occupation,or profession rnvered by this chapter,who does not pay the required business tax within 150 days after the initial notice of tax due,and who does not obtain the required receipt is subject to civil actions and penalties,including court msts,reasonable attom ys'fees,additional administrative costs incurred as a result of collection efforts,and a penalty of up to$250. City of Tal ahassee Code of Ordinance Chapter 18 Sec.18-33.Business�x certiFcate required. Any perso who engages fn or manages any business,occupation or profession,for which there is a business tax required by this chapter or any other ordinance f the dty,must have a valid business tax certificate from the city treasurer-clerk or his designee.My sign,advertisement,building oaupancy, directory li ting or activity indicating that a business,plling,profession or occupatian is being conducted at a lootion within this munidpality shall be prima facie evide ce that a person is liable for a business tax certificate. • (Code 1984,§22-52;Ord.No.95-0-0007AA,§1,5-10-1995) Sec.18-3 .Separate buslness tax for each location and business activity. A tax certi cate shall be obtained for each location including branches of the business within the city as if the branch or location were a separete business, , unless pro ibited by F.S.ch.205.A tax certificate shall also be obtained for each unique and different type of business activity.W henever any business, oaupation or profession shall fall into more than one of the ciassifiqtions contained in the schedule set forth in this arti�e,such ocwpation,business,or profession shall be required to rnmply with the tax requirements and to pay the business tax imposed under or pertaining to each dassification or privilege. The city t asurertlerk or his designee shall have the authority to detertnine the dasslfication for each business activity.AII business activities shall be assigned t at least one ofthe approved classifications.Many of the classifications are general in nature,and a more mmplete list of the businesses contained in each Ga sification will be maintained by the treasurer-clerk. • (Code 1984,§22-53;Ord.No.95-0-0007AA,§1,S-SO-1995) I� How do__a_ppty_for_a Tax Certificate? The Appli tion/Declaration for a City ofTallahassee Business Tax Certificate can be obtained by: • Callin (850)891-6488 • Sendipg in a written request • DownCoading the Citv of Tallahassee eusiness Tax Certificate(PDF)and mailing the completed form to the below mentioned address: City ofTallahassee � , Reve �ue Division 300 S Adams St.,Box A-4 Tallah ssee,FL 32301 � • Visitin the C1ty's Tax and Revenue Section,which is located at: Renai sance Center 435 N Macomb Street,First Floor Tallah ssee,FL L httpsJMntiw IgovcoMtreasurer/treasurer-faq.aspx 113 � � I IIIIII IIIII IIIII IIIII IIIII IIIII�IIII Ilill IIIII IIIII IIII Iall " Permit No. 2016146448 Tax Folio No.�� J��~�-1 � �� L � ��C� C� ' � � 3� NOTICE OF COMMENCEMENT To Whom It May Concem: The undersigned hereby informs you that improvemeats will be made to certain real property,and in accordance with SecHon 713.13 of the Florida Statutes,the following iuformation is stated in this NOTICE OF COD'IlVIENCEMENT. 1. Description of prope�rtyil:�� O V��YLS �1 �0.S�Qi � 'C U�T ��S ��- ��T � � Legal Deseriptiom r � �,�,— � Street Address: .'3'—I 3 i-f-—I Q�l.� i1'1 ��(-Q� � (� Rcpt:1801238 Rec: 10.00 2. General description of improvements: ��' � � �l' �S: 0.00 I T: 0.00 3. Owner's Iaformation: Name: �)1��R � �Ir1C�� 09/15/2016 J. R. , Dpty C 1 erk Address: ?�'"1 � —1 f,l,l-�L-l� V Interest in Property: (�\nM�2�� Nam�$n�Address of fee simple titleholder(if other than owner): ��i� 4. Contractor Information: Name: p-Q�'(�-�1� ��(`}�c1'��.��1 �—`'�— a��e �� Address: `o S �2�Xl � �1�_ �G( Q �. Telephone No. ��O—�l�-1 ll� -" Fax No.(OpL) „ r � 3cp3� 5. Surety Information: Name: ��l Address: Amount of Bond: Telephone No. Fas No.(Opt) 6. Lender Information: Name: �' Address• Telephone No. Fax No.(Opt) 7. Identity of person within the State of F�da designated by owner upon whom notices or ather documents may be served: Name• � Address• Telephone No. Faa No.(Opt.) 8. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as Provided in Secdon 713.13(1)(b),Flor'd. Sta�: Name: PAULA S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER Address: 090R56K01�42�m PG 2'1�� Telephone No. Fax No.(Opt) 9. Expiration date of Notice of Commencement(the expiration date is 1 year from the date of recording unless Dif'ferent date is spec�ed) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13, FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCEING WORK OR RECORDING YOUR NOTICE OF CO NT. S' atu� o Owner or Owner's Authorized Ofticer/D'uector/ Partner/M ager I�-t�'1�2 ��rG�cc;I Sk-�` P' Name State of Florida County of Leon „y�_ r��,�b�� The Foregoing in trumenk was ck owledged before me this ��day of J ,20�_, by Q, ��-rGYl�l.�S�Lj who is personally known to me or has produced h� ,k s � ,l GP�i'� 'C- as idenHBcatton and who did/did not take an oath. BOB INZER,CLERK CIR ��gY PUB� CHELSF�HA�� Si ature of Notary/Depu Clerk _° ,....,7°��1Y COItt�11S�lON d GG 019617 C J� LC/l��. ��..�I I '`� � * �„ " E�?IR�g.Au�.st9.?020. `��° Printed Name 9ff oF P�? aondE,i 7n�.�u.:�at�Vu1�y S�t�� Veritication pursaant to Section 92.525,Florida Statutes Under penalries of perjury,I declare that I have read the foregoing and that the facts stated ln it are true to the best of my knowledge and belief. : Si ature of N 1 Person Signing Above NQTICE OF ELEC7'!ON TO BE EXEMPT lf.this a pl��afion c3ntains incomptete ar inaccurate intorma6on, i�may causa a t3eFay in the issuance of yac�r exemptic�n_An officer�lecting an exemption under Chapter 440, Flarida Statutes,is not eritilfied to benefits under this chapter. , Sectio 1: - , . APP41 ANT INFORRAATION Pirst i.ast Name: Dauglas F Ragers . State #rive�'s�icense Number: S`#ate iD Number. � State: F�' � - - ,. R2629�650330{l � Date � Birth: 9/90/9950 .. � � , Socia Security Number past four dig"rts): 5447 , Email�Add�ess: Rogers-elect�ic�hotmait.corr� Secti n 2: • . - - CONSTRUG"T'!ON INDUSTRY APPLiCANY($SO-EEE-REQUIRED) ` Office of a Carporation (Construction) �7"rtte: PRE$tDENT _ � ' �ecti�n 3: ; , :, ` 'fhis section shauSd be campleted wit�i mforrnatian specific ta y,aur corporatio�i or f+a the[icnit�ct=l`ia�iility,company in which you are , a mer�tber.The name of the corporation o�-Jirnited tiability company 1"�sted on this appticatian_MUST match th�name of the car�pa #ion or limited liabitify campany as tegiste€ed v�rith�tt�e-�loiida Divisian of Corporatiortis. �'1+N af Corporation or LLC: :Rogers Electric Incorporafed FEiN: 59-3006458 ,,,.!E YO NEED TO APP�Y FOR A FEtN,CLICiC HEf2E .. , : Businl Name(DBA}:-:Rogers Eiecfic tncorporated Phone: {352)583-56'f 9 � Appli� nYs Address.of Re+cord: 331&�Portage Path City Dade Ciiy _ State: FL. Zip 33523� CouMy: Hernando Click on tha arrow(s).next#o tFre#ext box{s}to view a iist of available 5cope classifica#ionsl#rades'For the form tYPe r�asen in Secti n;2.4''Iick on tkie appropriate-.scape�to sefect.lf you are unsur.e,as to_uyhich ciassificationflrade to choose,please contact yaur o�tc-ers;�c�i�pensation inst�ance'cariier..tfyou da nat have a usiottcei"s'cornpensafion irtsurance policy,con#act the •'Natio at.Council=on Compensa�ia��Insurance(NCCI)at 1-800-622.=4123 option 5 ta obtain a dassficafion code. S`cop�9: o00os LtCEtvSED ,-Scope 2-: � Scope 3: Scope 4: I <t EI:ECTRICAL . . f�' CQNTRACTOR .r!` -�'0114: _ :t: 'The rpora6on a#which.you are an o#f�cer or 3imited liabitrty campany of ufiich yc}ei are a�ember must be registered and in ACTlVE status witf� e Florida D'}vision'of.Corporafions.Applicants applying as an officer of a corporation must be listed as an officer of the Corporation with • the F orida Division of,Coiporations.List the documerrt number on file with the Florida Division of Carporabc�ns• ;�; = PO4._:m.0005923 ` S ��i�5: � - - � �' Pu�,'uanti�to>�Chaptelr-�489, F_S. (cantractor licensing law),list ce►tified or registered licenses related to#he scope of business or trad�tisteii�:in Section 3 held by the-applicant,::or the certified or regis#e�-+ed license numbers hetd by the qual�er for the corp�aration`ar limited i'iabii'i#y campany tis�ed on this appiication.The business name iisted an the ticense MUST match the name '� ' of the corpara�on or Gmited liabil'ity company as registered with the Flor�da D'rvision of Corporations and an this Notiae of Election to b�Exernp�. I EFt0012229 � i ' M '� � Sectian�6: If you h e submiffed an eiedronic payment fior this applic�fion,the transat�an t�firsr�ation number is listed in the following spaoe: � :onfirm�tion t3umber. �g�'��Q��$ Applic:�tion Nurr�ber: E40492492 aectio 7: NIA e you affiitated with any casrpara�ion or limi#ed liahility corr�pany o#her than the corporation or I�ited liabitiiy..company to which #his application appiies? Name: FEtN Name: FEIN Name: FEIN Sectio 8:CONSTRUCTIQN INDUSTRY AND NON-CONSTRUC�ION;tNDUSTRY LLC MEMBERS ON#.Y To be ligible for a construction industry exemption ar a non-consfr�acciion timifed liabitity carrtpany exemption,an applic�t must have e required ownersh�p of the carpora#ion ar fimited liability company. � 1 a�n a sharehotder owning at ieast ten percent{10�fo)of stack ofi the corporation iisted an this apRl�cation• Sectio`n 9: . , t cerfif r thaf any emptayees of the corpor4a#ion oc it�errf6ers af the fisrti#ed iiabiliiy corr�pa[�y listed in Sectian 3 are cavered Eay workers'compensa#ion insurance. Piease identity:the workers'compensatio�ins�rance carrisr!#�a#cavers any non-exernpt empto ees. � Carrie Name: My business does not have any nan�xemp#employees Se�ti n 10: FRAUD NC3TiCE A Any persan wha, knowingly and-with intent ta injure,ifefraad,,ar deceive fhe depar�ment or.any employer or emptoyee, insurance company or,ariy;other person,fites_a Notice of Etec�i6n to be E�cempt:cont�ii�ing any false or rrtisteading infarmation is guitty of�a=felony of the third d�g�ee:., B. At#estation of applicant—Sy provid"sng rny nairie below,1 attest that!have.re-acl;�understand and adcnowledge the fotegoing no#ice_ . " C. Acknowledge that ti�is No�ice of Etedibn#o be Exempt does not exc�ed limifs fior carporate afficers, including any affiliated corporations as provided irrSection 440.02, Florida Statutes. First�iame: Dauglas Last Name: Rogers Note Tt�e E)ivision has 3Q days ta�review y.our apglicaiion to determine if it meets the eligbility requirements for the issuance of an e,emptian.The Division wilE either 9ssue a::CierEirt�cate of Election to tie F�cempt or r�atiffy yau that yaur applica�on is incomplete. Ttte irrision reviews and processes exemptiori applicatians in ft�e orderthey are received. Fx. :>Ption inforrriation is reflected an#he Praof of Coverage database.tt�e day fo!!ow'sr�g the iss�ance of the exemption.Visit the Di ' ion's website at:�iftp:/lwww.my�oridacFa_com/wc ta print:yaur certificate. � ' . , i � .�