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HomeMy WebLinkAbout16-17923� . � ' � CITY OF ZEPHYRHILLS 5335-8TH STREET � (813)78o-oozo 17923 BUILDING PERMIT ' PERMIT INFORMATION - LOCATION INFORMATION Permit f�umber: 17923 Address: 39380 B AVE 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: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: Improv. Cost: 14,000.00 OWNER INFORMATION Date�lssued: 11/17/2016 Name: CITY OF ZEPHYRHILLS Total Fees: 157.50 Address: 39380 B AVE Amount Paid: 157.50 ZEPHYRHILLS, FL 33542 Date Paid: 11/17/2016 Phone: Wor',k Desc: REROOF METAL � CONTRACTOR S APPLICATION FEES JK JOHNS ROOFING & SHEET METAL REROOF COMMERCIAL 157.50 � � � i � II Ins ections Re uired RY IN RO F INSP TAPE JOINTS ROOF INSP FINAL �I II �o I �\ ' \� � V REINSPECTION EES:(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 property that , may b�e 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 impriovements to your property. 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. II NO OCCUPANCY BEFORE C.O. N �� � �'C NT ATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER H : �I 13-26-21;0000-00100-0011 � Pasco County Property Appraiser Page 1 of 1 � ; �; i Mike Wells Pasco County Property Appraiser , Data Current as Of: Weekly Archive- Saturday, November 12, 2016 ,, Parcel ID 13-26-21-0000-00100-0011 (Card: 001 of 002) ' Classification 89 - Other Municipal " Mailing Address Property Value � CITY OF ZEPHYRHILLS Ag Land $0 � 5335 8TH ST Land $71,450 j� ZEPHYRHILLS FL33542-4312 PhYsical Address-See All 3 Building $41,077 � addresses�Fi�csnow�� Extra Features $184 39320 B AVE �� ZEPHYRHILLS FL 33542-5243 Le4al Descriation (First 4 Lines) 7ust Value $112,711 PART OF ZEPHYRHILLS AIRPORT Assessed (Non-School Amendment 1) $112,711 PROPERTYLEASED TO ZEPHYR - ENGINE BY LEASE DATE 12/15/94 • DESC AS COM AT NW COR OF SEC Taxable Value $112,711 7urisdiction Citv of Zeohvrhills Land Detail (Card: 001 of 002) Line Use __Description Zoning Units ; �Type ( Price�Condition Value ^ 1 � 2000 AIRPORT OAP2 �178,625.00, SF $0.40 ; 1.00 , $71,450 Additional Land Information —��_.�—, -- �----- FEMA �_ — � Acres f 4.10 Tax Area ! 30ZH Code Commercial Code IZAP6CA P I ! __�_� ».� � Buildina Information - Use 20-Airports (Card: 001 of 002) ' ;Year Built 1965 Stories 1.0 Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None �toof Structure Flat Roof Cover Built-Up Tar and Gravel Interior Wall 1 Masonry or Minimum Interior Wall 2 None Flooring 1 Finished Concrete Flooring 2 None Fuel Gas Heat Convection A/C None Baths 1.0 �___ Line �_ _ _ �� _ Descri tion � S Feet I Re I. Cost New p ___� __.______..___4• ___�1----p-- 1 � FST 4,880 ; $41,236 ` �2 � v� CAN��� 120 � $608 Extra Features(Card: 001 of 002) _ Line Description Year Units Value -- 1 i-- f M~�uCLFENCE � 1994 4���mm�-- -��-408��—��--� $184 ��_� Sales Historv Previous Owner: N/A Month/Year Book/Pa e ;---___._��_______._ __ __.___9 .�_.__�__Type DOR Code �Condition j Amount � 05/1947 4 � 0139 / 0137 � ���Quit Claim Deed �� ; Vacant � $0 � I; http://appraiser.pascogov.com/search/parcel.aspx?sec=13&twn=26&rng=21&sbb=0000&... 11/17/2016 ____---- ,�.,,. ; �," ' ,. � " �'��� '�i'•�R". ,.' a�� '",p: ,4v n �� . . .. `iG+,�d,'..'���`1."��;1..�'y�`'i+y,. .� t' w .. .µ ,�" ,�- � 'Li�.' ,. �i'�k� � � . �, -,;; ` � , . _ «..Y ``�-_5^��4, _ ""�' ,«.h . , `3G� +°°'"�"�'`��'��� +:,�� S�P .�,...."`�'a.�".,ia y� ���"'�ar��g'�'",y��� �5.�'`"'�" .� '�'' . > � ,F',{ `t' `�} �,�'�, Q'`r�az�+�he+�`� ''" c �`."�'"c"" '�+„"-,." .. ;1Y�,..::c-..seanc.- s�=.��.waa+�':-me���� � � �, F •'•". .. 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' � . �_ «Y T;ta �' �NkEi Kr`. �n � �` ,E' v�` � �- t� . j -` - .1' _ _ . „ , - , ,. - . ` ' _ _ - ' � -- .. . ' - - '`_Fj�,',,- -�,,�;x;"K�;�Y�;. do - .� " • ' ' _ ' , ,_ - , ` .' .. [.: u , ��'� .�� ���s��r�?� s�h '� .. .. - . . , , . _ .,� . . �Y�V _ , , n ��1�-�t��� � r � ` " r `,.�.`�'.;A. ,� `a, x ,.�c., x�. - - . ' - " , � _ .. ., _ �, z,?w.�,"; '�.!l',4�� �'i•- `?t�`v„r;p,'.5 y�3�,*�"°", m.. a v.�: - ^ t � ; ' , � ' � � .. ' , v . c . . " * �i"Yi�f��. t ,'t�ti�•�y�.� 4.-' .. - . ` . ,���...�'^"" y � �t� ��7 ��� 1. DESIGN CONFORMS WITH 5th EDITION 2014 FLORIDA BUILDING CODE (BUILDING & RESIDENTIAL DESIGN CRITERIA FOR 140 MPH WIND FORCES PE ASCE/SEI 7-10 MINIMUM DESIGN LOADS FOR BUILDINGS AND OTHER STRUCTURES 2. WOOD No. 2 GRADE SOUTHERN PINE OR BETTER. 3. RISK CATEGORY II 4. INTERNAL PRESSURE COEFFICIENT f0.18 ENCLOSED 5. EXPOSURE 'B'. 6. CHAPTER 30 COMPONENTS/CLADDING (C&C) , s,, .�e PART 1: LOW RISE BUILDING f25 PSF e ��Y��� A, �� �.�f� �,�C.�••,.�C E/V� ��,L`�°� e-` �, S�C`° 'S' °s �=� � PJ o ? � �`' �a 8317 � ._ � a� � _,� a m a.�y ° ���'� �r'�"o S Tf1 T E p F o �� " ,n•, �, �r:: � e �,<CJ�� p R•�p 4;,•�`30�� o •`. . �� �. �>,s,a 9�'t, L C Q�,�,``° ��/��` �Q G���4 � � F�• �'�L 813:aao-ooz� City of Zephyrhills Permit Application Fax 813-TSO-0021 � . Building Departrnent � Date Recelv��tl .%� Phone�Contact�for Permtttin � — 3 � Owner's Nar�e J 6/1� 1� W�R�1 EA� Owner Phone Number g�3'7$�'3 3a� Owner's Add���� � I�3 2� � ��e Z �(,,'G ��3' y2 Owner Phone.Number I . � - , Fee Simple TItleHolder Name ' � Owner Phone Number i 1 . Fee Simple Titleholder Addres� ° JOB ADDRE S �� � !?+!G �e .��,,�l� F�L 3 3 s�z. �oT# � SUBDIVISIO PARCEL ID# 13 �Z� ' `z�-- �(�DO-Q(�l�O— �0! 1 " - , - , (OBTNNED FROM PROPERTY TAX NOTICE) WORK PROPOSED ,= NEW CONSTR ADD/ALT Q SIGN Q 'Q DEMOLISH �B, INSTALL 8 - REPAIR � . PROPOSED>USE � Q SFR [� 'COMM Q �OTHER "- TYPE OF CO STRUCTION - Q� BLOCK " Q FRAME Q `STEEL Q _ DESCRIPTIO OF WORK' I 2Mb V� elG;f�;N M�T�n:a� �- e /�}c� �J tTp� n�'G IS BUILDING SIZE ��� _x �: ,7, I SQ�FOOTAGE � S�a , . ;HEIGHT� �Z � � QBU��LDING $ VALUATIONhOF-TOTAL CONSTRUCTION ^ 1 1� ��'�. �a. QELECTRIGAL $ " AMP SERVICE - Q 'PROGRESS ENERGY [� W.R.E.C. QPLUMBING ' $ -- ' f�f /,.�� Z 2 � �� � ✓ � / �� v � QMECHANICAL $ - VALUATION OF:MECHANICAL INSTALLATION ` r �� �C� i � J QGAS � ROOFING Q SPECIALTY Q OTHER� FINISHED FLIOOR ELEVATIONS FLOOD ZONE AREA QYES ;NO I � . 3 �UILDER � �� . '�Z� COMPi4NY' �K JO�it�S /�v��'f1 �"JfIE'�'/i"`P�I .�ylG SIGNATUItE REGISTERED Y/ N FEE CURRE� Y'/N Address 33/�� /�uS���s �� ��_/lSvi`/�C �I✓yY��'� Ctcense# GCC'/3� �G�2 ELECTRIC . . .. ' :COMPANY� ' ' - - SIGNATURE "' REGISTERED Y/ N FEE�CURRE��"� � 'Y 6 N" Addre�s � . , � . _ , License.# . • ° PLUMBER � . A COINPANY� .. � � SIGNATURE' � ' ` � ; �_ReG�S�REo. Y./�-N ,FEECURRE�- ' Y:/N -• ' Address � License,# � ^ MECHANICAL „ . • . ' ° - COAAPANY ` ' ... ' SIGNATURE�I � � � '� REGISTERED Y.,/ N . _ FEE CURRE� Y/N Addres�lP:::. - � _ , . . ,. ,n _ ' , '. - ' . , License# OTHER ` ' , � . , , `� - ';COIIA�PANY _ . - . � . . . . �F � SIGNATURE -}:��.�'��� ""�: �%'` "`r; ' . ' " '` REGISTEREO ' , 'Y/ N�._ . ' • FEE CURRE�• Y/N Addr�ss�l . •�.h _ , � - �' , � ' Cicense#• ' , � RESIDENTIAL�.� .-.Attacfi;(2).PIotiP;lans;:(2)setsiof'Bullding'�Plans;(1)set of.Energy Foiiqs;R=O=W Permltfor new construction, " " ` � �;�Minfmum:tenr(:1;0)wor141ng days,aRer submlEtal date`.Requlred onslte,•:Constructlon Plans;-Stormwat'er Plans w/Slk Fence lnstalled, Santtary Faclllfle.s;&;:1:�,dumpster,,-Slte°Worfc�,P.>ermit foc subtlivislons/large p'roJects,_: �;;`..,':: ' ` �� • - `� �- I :• �::.,.� ,.._, _ COMMERCIF►L Attach(3)complete sets'of Bullding``Plans'plus a Llfe Safetji�Page;(1)set of Energy Forms.R-O-W Permlt for neW construoUon.' Minlmum ten(10)woiicing days zfter submtttal date. Required o�site,Constructlon Plans,Stormwater Plans w/Silt Fence Installed, Sanitary Facllltles 81 dumpster.Site Work,Permlt for�II neiiu�projects.All commerclafrequlrements.must meet compllence � ' �. . , QIGN PERMI I Altach"(2)sets�ofEnglneer.edfiPlans:;.,•:".�;- ... , ; � = � - : -• � •"'PROPERTY SURVEY regulred for all_NEW cons.truction... � ��� � ��� � Dlrectlons: I� .. .. . _- - ` . .., , FIII out applica8on completely: Owner&IContractor slgn back of appl(catlon,notarized � � - , � If over 5�500,a Notice of Commencement ls required., (A/C upgrades over 57500) � �1:. .y:.,y;... " Agent(foil th�e contractor)'or Powe�of"Attorrmey�(fo�the owner)would be someone with notarized letter from owner authorizing same . DVER THE COUNTER.P..ERMI'RING-� --,-(Front of-Appllcation Only) Reroofs If shingles Sewers,.,a.�._6:.Senrice_Upgradas.A/C,_._�Fences(Plot/Survey/Footage)_ _ _ , ...�... __ ._..-.:k,;_;: ..�. ,_.;, �- Drlvewa lya-Not over CounterJf an,public roadways:.needs�ROW s� � , , . „ , ti�!'; .,_. . ,�,. , i , r; ' ' i• � �', � -,. , , , I , .;� . ;'3 ':f? , ,, li".. �. .. ,� � , , . _ � I `,,' ,�.j ` .,ji`I(;P -V 1„ �1�� . � , ' � ` •',i' _.'....4 ;h�lil!�i:�. - __ _. � ' .� +-,_ - t�a-�'y.{�T- I � .� ' • - . �/ryG�� . , `Y ' - ��.::-p _,;.� :- :. NOTICE OF DEED RESTRICTtONS:. The undecsigned,under�tands��th�t:this:p�Rnit�.may.be,subjecfitto,;�eed":restrict[ons -_ ,_,, ..,�. which may,be�more�:r.est�tctNe=the�t Countq�regrllatCons.=The undersigned"a§sumes��responsibiltty`��for"compliance with'any ' `� }'� applicable:deed_restrictlons. .,.:..:,�- .._ ; ::. • . • , ., ,.. .n ,. ._�.. . `- .� .� � ,.� UNLICENSED•CONTRACTORS AND CON�RACTOR RESPON8IBILITIES: =�If=tfie�owner�has��hiredT�a�°contractvr or contractors to undertake work, they,may:b,e;c.e.quired�#o.:be,llcensed=ln_accordance:with state.and,local:�gulations:�tif the� -' � � contractor�i's�noti�Iicensed�as requlred.;tiy taVi(, tiotti�the owner�and cont�acto��may�be�°ctted•for�a��misdemeanor violatlon under state law. If the owner or Intended;,contr,a.cto�:are;uncertaln as to what Ilcensing:requlrements,'�rr�ay-�eppty��ior�.the�+-� ••� •- . ,. .,., :..,:�... . . .___. _. ,. ,., _ � _ _.. Intended"work,they are ad'vised to contact the_Pasco County;Bullding;Inspection:Divlslon-Licensing Section at 727-84T- 8009. Furthermore, If the vwner'ha�'hired a conUacto�'or contracfors, he is advlsed to have the contracto s ,,sign. , . K.,)_.., . portions of the.�"contractor Block" of this_application for,which.they.wilLbe�tesponslble.-.If-you�.as,#he.own'er"sfgn�as the`� " '� contractor, that may be an indication that`be=is•not:prope�ly�licensed�antl`�is'not'entitied to pemiffting priulleges In Pasco County. , , -. : . : .-;.:,.. �-- TRANSPORTATION.IMPACTIUTILITIES-TMPAC7 ANb RE,30U�tCE RECOVERY•FEES:��7he undersigned understands that Transportation Impact Fees�and:Reco.urse.Recovery;Fees,may�%apply��ta tf�e:;canstruction of�new bulldings,?change-�of���•������ �=' use in existing bulldings,�or�expar�si��rr o�ezistin�'�buildings, a§ specified.in Pasco County O�dtnance number 89-07 and 90-07, as amended..,�;�'he undecsigned also;understands, that'-such fees�°;as��majr�e�:due;kwlll;�be identtfied at the�°time°'ofr'�'r �T�=� '` permitting. It Is ftir'tNer understood that Tra�spo�tation Impacf Fees and�Resource:Reco�ery-Fees.must be paid prior to receiving-a 'certiflcate.of�occupancy" or�flnal�powerretease.• :If the.project,:does;not,involve�a=:certfficate of occupancy�o����-�z-"�`•"'� "� flnal power:release;,the=,fees mas�t tie paid pelor to;permft Issuance. Fu�thermore;ff:Pascv;;Countyi'INater/Sewerflmpact� -� �����•�� fees are due, they>must be;pald�prior to permit_-,Issyanee=.in accordance with�:applfcable Pasco�-�County-'orclinances. • CONSTRUCTION"LIEN�LAW�(Chapter 773,-Flor�da Statutea�as amended): If valuatlon of work is$2,500.00=,or more,..l�� �: = -._. certify that I, #he applicant;.-have-been provided with=a=copy of�the "Florida-Construatton` Lien-Law-liomeowne�'s Protection Guide" prepared by tFie FloFida Depa�menC of Agriculture and ConsumerAffairs. If the applicant is soineone� . . other than the"owner", 1 certifyt-th�t I;h�ve:.:obtaJned�a�eopy.ot the°above.described ilocu�ent�and.pror�ise::in,good�faith.to , �E deliver It to�the.'owne�'=pi�ioc�to�cornmencement:-'° . , ' . -= • - - . CONTRACTAR'S/OWNER'S AFFIDAVIT: I.certify�;th;at-ail�.the��inf.ormation::in�thi�appilcation,is accurat�and that all work will'be done in compltance with all appllcable laws regulating constructlon� zoning and�land°development. Application is hereby made to obtain�:a permit�_.to do.;wor.'k�;and Instellatlon as indicafed:->��'I. certify that no work�'or Installafion Fias - , commenced p�tor to Issuance of�a permit`"and that.all work w(II be pertormed�to meet_standards�of ali laws regulating- construcNon, County and City codes, zoning regulatiQns, and land development regtalatlons=tn the,Jurisdiction.• I:aiso . _ �� certify that I understand that the regulations of other government agencies may�apply�to the.intended work, and that it is my respons(bility to identify.what.act(ons I must�take:to bedn.compllance�:S.uch agencles�include but=are.not Ifmited to: � - DepaRment of E�v(ronmental:�Protectton=Cypress`Bayhead�, V11eHand Areas and Environmentally Sensttive Lands,WateNWastewater Treatment. � - Southwest �Florida W�ter Management=.District-VVells;' �Cypress.� Bayheads;- Wetland Areas, Altering Watercourses. - � • ,.� ..� - Army Corps of Engineers-Seawalis�`Docks,Navlgable Waterways. - Department of_.Health_,.8 .Ret�abllltaflve:,;ServiceslEnvfronmental�-,Health Unit:Wells, Wastewater�Treatment, � Septtc Tanks...`_ ` � � ' . � - � - - - - : - US Environrtnental Protection Agency-Asbes4os abatemen� Federal Aviatlon_Aul�iori,ty;;Runways: � - I understand.that the.following..�esUictions apply to tfie use of flIL•• II - U�e offill is not allowed in:Flood Zone"V"unless expressly permitted. � - If the�:flll�materfal=is to-,b.e usetl:`�In �Flood Zone. "A"� (t. Is understood that a drainage plan addressing a "compensat(ng volume"will be submitted at#ime of:permttting which is prepared by a professional engtneer - iicensed by'�h�State of Florida: � - If ih� flll mate�lal�is to be used In Flood �bne 'A" In�connecfion�with�a�permitted buflding using stem wall � consttiction, I certify.that.fUl:wall:b.e used only.to flll the area wtthin�the�stem�wall: - � - If flll material Is to be used in any area; I certify that .use. of such flll will not adversely affect ad)acent properties. If use of fill is found�to adversely..�ffect ad)aEent�presperties�.the owner may be cited for viol'ating, ' ' the�condNions_of the buildtng;permit Issued�under the�attacNed_�ermit �ppltcatlon,_for�lots�less than one (1) acre which ere elevated�tiy flil,a�r engineered drainage plan Is required. . •� If I am the AGENT FOR TME OWNER; I�pr"omise In good falth to inform the owner of-the perrriltting condfttons set forth in this affidavit'prtor to commer�cing construction: �I understand thet a-separate permlt may be requtred for electricel work� „ plumbing, signs, wells, pools;. air condttiontng,.gas� or otlae� Installaitlqns nol.spec�teally Included-tn.the appifcation. .A permit issued shall be conshued to`be�a�license�to��:proceed with'tNe�work and not�as authodty:to,violate,�:cancel; alter, or . set aslde any prov(stons of the.technical codes;�nor shall tssuance�of a.permit.prevent the Bulidirig Of�icial from thereafter requlring a conection af errors in.plans; construction or violatlons cf-any codes. Every�penrilt issued�shall��become invalid unl�ss the work authorized.by such permit:�s-cotnmenced�withfn sfx.months of�permit issua�ce, or if work authorized by the pe�mlt is suspended�or.aba�doned�f,or:a;period;of six=EB)montFis:after_the�time the�work�is commenced. An extension may be requested, In writing,from the.Building,Official for a pertod-not>to-exceed"ninety�(90) days and�viiill demonstrate justifiable cause for.the extenslon� If work ceases..for n(nety.(90)cons.ecutive days;..th�job�Ps considered aba�doned. � ' __ —!l�AI�MENG TO-OViFF�E�:—Y�UR=�AILUItE:TQ.,REC.OttD A:MOTICE OF:-COMMEMCEMENT;NFAY�RESULT IN YOUR PAYING TWICE;FOR�IMPR01lEINEN�S�Tfl.X�OUE��:PROPER�TY.�•IF°YO.tJ�IN�'�ErVD�TO'�BTAIN�FIN941�E1NG;�.ONSULT WITH Y9UR LEND�R�OR AN A�TORNEY�tFOR��R�OR�IpC��YOUa'MO'FtC�'O��CO�YIII�IENCE'A�IENT' ' FLORIDA JURA��(F.S:1.17.03} " � - � � " OWNER OR AOE , CONTRACTO Subscrlbed and swo ;o(or�� rtned)before me this Sobscrlbed'and' �to�t,ffl �fore me tFitg.� ��—LO�LCa by �-+� �by � o-h Who is/are personally k wm lo.me or�haslhave produced Who is/are p.ergonallyknown•to.me�orhaelhava-produced • � �v 1..�`� � aa Identlflcetlqn. � - L A ' , as IdentlBcaUon. �otary Public �� Notary Public. I Commisslon No: mmiselon No. I, Name of Notary type p��d'd�j•�tamped � R Name of Notary d,,R�tm eE�vs atampe • ;�°„ ,`�; Notary Public-State of Florida ;z°,�,'o; Notary Public-State o1 F,lorida 5•;�:•=My Comm�.Expires Jun 10,2017 _•: : •;My Comm�. Expires Jun 10,2017 =;'�' `a": Commission#FF 025888 '?9� ���� Commission#FF 02b888 qr �, �. Q,�. �°'%°������� Bonded Through National Notary Assn. �''�°���"� Bonded Through National Notary Assn. _ � N Q!T I C E O F CO M M E N C E M E N T this space reserved for recorder �, THE UN�DERSIGNED hereby gives notice that improvement (II�II��II(�If I�+Illl�lll�lllll�ll�llllllllillllllllllllllll will be made to'certain real property,and in accordance 2016+179600 �� with Chapter 713, Florida State Statutes,the following informa�tion is provided in this Notice of Commencement: Key No.�; Permit No. 1. Descri,iption of Property: Parcel No. � —2(,�2/ — Q600 — 0010 a — ao �� Legal�descrlption of the property anc��street addreprtsy�/s if a aila p7�/�3 Z S� 3 �-�,G 7 L 1 7 [ riL 3 3 r v�i7'��!�r�l G 0 /�^�^ !!' �I Lr�i Y `{r i'�� {r�J 2.General Description of Improvement: Re-Roof 3a. Own;er Information: Name: `J d�i� � d,�(A�itite� Ze � -.e�a�� �.v ;.,u�s..dr�` Address�! �3�3 2 0 � ,A�d e. City: ZQ � �,-�G State:.� Zip: 33s`y2. 3b. Interest in Property: Name of Fee Simple Titleholder (If other than owner): • � ' Address1 City: • Stafe: Zip: 4. Contractor: Name: JK Johns Roofing&Sheet Metal,Inc. Address�' 3323 Mustang Dr. City:Brooksville State:FLA. Zip:34604 Phone: ;352 7548600 Fax:352 7548604 Email: Roofing@JKJohnsRoofing.com 5.Surety: Name Address�# City: State: Zip: Amount��of Bond:$ Phone: Fax: , 6. Lende�r: Name ' Address�� City: State: Zip: Phone: �� Fax: Email: 7. Perso��s within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 7i�13.13(1)(a)(7),Florida Statutes: Address';; City: State: Zip: Phone: �� Fax: Email: 8. In adc�ition to himself or herself, Owner designates of to receiv�a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Phone No.of person or entity designated by owner: 9. Expira�ion date of Notice of Commencement Date: (the expi�ration date is 1 year from the date of recording unless a different date is specified.) WARNING TI O OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OFTHE NOTICE OF COMMENCEMENTARE CONSIDERED IMPROPERPAYMENTS UNDER CHAPTER 713,PART 1,SEC 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTSTO 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 WITH YOUR LENDER ORIAN ATTORNEY BEFORE COMfVIENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. �� � ' X: ignature of Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Title/Office I ***Signature Required by same person below by'X:'mark*** STATE !� F: Florida COUNTY OF: Pasco I The foregoing instrument was � O-� Day Of ���e� 201�O�aBy �� 1� ��rYe� acknowledged before me this ��/ As II e c.�► C�,e �r For 2 �l (�ype of authority e.g.,o ' e,trustee,attorney in fact) (N me of party on behal Print,Type or Stamp Name of Notary ;zo;"�P"���; Notary Public-State oi Florid x' « :•:My Comm.Expires Jun 10,20 7 Si ur �of Notary =;;; "o:= Commission#FF 025868 Personall�l�Known Or Produced Identification ✓ Type of Identification Produ d:�''����� nde Thro gh ' nal Natary As n. Verification pursuant to Section 92.525,Florida Statutes:under penalties of perjury,I declare that I have read t e oregoing an that the facts stated in i�t�are true to the best of my knowledge and belief. X: II �Rcpt:1814886 Rec: 10.00 \ � Signature of Natural Person Signing Above DS: 0.00 IT: 0.00 11/10/2016 E. M. , Dpty Clerk PHULA 5 0`NEIL,Ph D PF�SCO CLERK & COMPTRGLLEk _ 110R BK 1����m PG ���� _ i� ,� , ' I; 0 � � F ��q. -� ,i `� =�.;��', �� - =t�,; _ �,i � �,,-� . �.:: ,� ,,..�.�.��,;�;.. City of Zephyrhills �� BUILDING PLAI�T REVIEW COMMENTS " ,�� � ,,.-� �, \ � 1/ � �� f� ����� ; Contractorl.�Iomeowner: �✓ /�- ��S , �- ����-+ Date Re i)ived. /y/ " —T. slt�: � � ��� � � Permit Ty,pe: C.. � Approved wlno comments: Appraved withe below comments: C1 Denied w1#he beIaw comments: ❑ �� � �) �� I �I I� �� I I II I� I� ; This connment sheet shall be kept with the permit andlor plans. . ,; �, _ - ���� �alvin witzex ans Examin;er Date Contractar andlor Homeawner �C {R.equired when connments are present} �� i) i, o . i I� Physical,Addresses � 13-26-21-0000-00100-0011 � Pasco County Property Appraiser Page 1 of 1 'I MIICE'W@IIS PascoCounNProoerlvAaoraiser il . � Physical Address List for Parcel: 13-26-21-0000-00100-0011 i' I, Displaying 3 records View in groups of: 10 25 50 S00 500 5000 I �I Street Number Street Name f Unit 39320 B AVE , 39380 B AVE � 39403 B AVE I I I � I �' � http://appraiser.pascogov.coxn/search/parcel-physadd.aspx?parce1=212613 000000100001... 11/17/2016 i� — - — -- �, ; �; . -,� , �, � � , _ , �-, _ ,t . . :,�. :� _ ,.:: ��;� -� �� � ,x: :�, ;,� I "� "�� �j ��� � ��� �� ��� ������� . AR �� HtTEG�"�.1R�L S�-1E��1" hr1ETRiL P'�OFES� IOl�4AL5 • c �� _. _ . _ � __.._. _.. _ . _._------- --- I, ��'�-� � J�1i�is of �� �a�hS /tidc��t-���R �'"f�e.e�" ����. -�lx�, � Contractpr/Qualifier's Name Florida Shate Corporation,L'uru Partnership Compaz�y or Trademark Name hereby I ant authorizatian to � Y f`� c"_' to act in my behalf with The City of Broaksville as Authorized A ent's Name 0 AC'TIl�'G AG�NI'-Nd RESTRICTIONS or L�ACTZNG AGENT FOR PERMIT#: (only} for the�Building Division. These actzvities sgecifically include signing all documents requiring signature of"cantracta�"and is to be considered an agent of my business, and therefore,the signature of said agent is binding and causes me to a$sume all responsibilities conmect�ed to or associated with the signature as they may relate to rny contracting business. As said contractor,I also agree ta.relieve the Cit� of Brooksville Building Division from, any and aIl responsibility, cIaims or other actions arising from or related to the Buitdin'g Division's acceptance of the above agent's signature for permit-related activities. I further understand tha.t it is my sole responsibility to grant and tennin�tte any such authoriza#ian and to ensure that the Building Division receives timely notice of any such $f3t1�Of,�j�8LII11ri1t1QII. JI �'L.. � il Si of Contrae#orJt�ualiSer's Name Signatune a Agent � C �C 1 �� �� .� � State Certification or Registrstion Number , � **PI..EASE NOTE: BO'T�I SIGNATURES MIjST BE NOTARIZED"¢ Notarv or Contractor 3ieuature State of��lorida County of f�/t�n a�/l0 The fore�omg was acknowiedged before rne this � � day af Nd+''', ,24I6,by_ ��'1"� �� ,�I��f 0 1 knawn to me o wha produced as idea�catiou. II _ � ( � 1 N4TARY STAMP: �,t�Y'A;�:;�., •'..`_ �oriN�Ur,NS � ;�,o� ,,; Noia�y Pubf�c-State af ftOtiG� ` Notary x ignuture � _ '� • - Comm�ssion#FF 983274 � ��` V��� '-�. �4 `�`: M y C o m m.Ex pires ARr 18,2020 � ot for A A ent �'��;;;+;��� gonded through Nationai Notary Assn. State of Florida County of - ..�.�*►��=«-.�. . _, --.::�'•� ,I _ 'The for�I aiffg was acknowledged before me this �� day of ���''• 2016,by !v � a k �P i 01 E j .a�rbo is p�I anallv knawn to me or who produced _ _ i � tification. I4 �\�IYF�R�i� JQNNJONNS �� , �4, Notary PubUc-State ol florid� NOTARY STAMP: ', , •s Commlt�ion+M FF 9t327� I� Notary c S` hue !►ty C+o�lilli�tpE�ii Apt ti,2020 �n IlOfldld*"'�w�.lqdO�qFNpqt��iii. '� *?7te original of this a,�'idavit should he kept in the possession af the abave designated"AuthariZerl AgenP: T7tis uffiduvit need rmty hL ptnduced to the G'iiy ojBrooksville Building Divis+ian when signing dacumemts irr the preserrce of a perrtat represemative, Wl:en you sign a permit at' appl�c�on be prepmed to produce this affidavit,it will be copied and placed with ihe appropriate per»ut application'" 3'*The�ui�ng Division,at its�scretiar�,rr�ay require a cantractar or license-hvlder to persvrratly aFFjY.far vr ohtuin u huildang pe+'mit not►vithstanding any authorization allmving anMher person to applp for ar obtaiit arry permit on behalJvf a cvntraetar,qualiftc�,or licens� hoJder: Rev.12/2013 i � , i�.-,:e.�:�F._.:. �.,V,...__.r,.,�_. ___ �_ —