HomeMy WebLinkAbout17-19117� CITY OF ZEPHYRHILLS
� r 5335-8TH STREET
(813)780-0020 19117
BUILDING PERMIT
� ��� �- - PERMIT INFORMATION - = - LOCATION INFORMATiON � I
Permit Number: 19117 Address: 5825 19TH 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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-07600-0010
Improv. Cost: 8,000.00 OWNER INFORMATION
Date Issued: 12/11/2017 Name: QUESENBERY JUDITH
Total Fees: 80.00 Address: 5825 19TH ST
Amount Paid: 80.00 ZEPHYRHILLS FL 33542-4438
Date Paid: 12/11/2017 Phone: 813-997-3177
Work Desc: REROOF SHINGLE
CONTRACTOR S APPLICATION FEES
SCOTT BLACKMAN ROOFING INC REROOF RESIDENTIAL 80.00
� G
Ins ections Re uired
TAPE JOINT 00 INSP
FINAL �
,
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 property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications Must Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
,�„ � �-�c-z,�
��
�
w
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
• CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813aeo-oo2o City af Zephyrhills Permit Application Fax-813-7eo-oa2�
Buflding DeparUment `���
oate Rece�v,ed ,1",� f f :: �hane�Contact�for+Fermittin 1� � t –��J
� , r►r�
Owner"s Name 1 er..b4 Owner Phane Number � �;� r�,',,,�/ !-
Owner's Address aJ r"a� * 1"=�–�� �owrnar Phone Numb�r � �
Fee Simple�TMtleholder Name Y • Owne�Phone Number �
, �
Fee Simple�Titleholder Addresa
�
JOB ApDRES3 �� t �� � � �C��``� ��-��� 12-- LOT# �__i��
suBa�v�stoN � � PSIRCEL.ID# t`,�2�0 �- `�1�QC� C3 — 'r7G�--t��lt�3
. (pBTAINED F,ROM,PROPERTY?AX NOTICE)
WQRfC PRO,PQSED ,NEW CONSTR ADD/A�T � S1GN Q �Q DEMOLlSFi
� e. INSTALL 8, , REPAIR
PROPQSE[3_U$E . Q SFR Q COMM [� OTHER �
TYPE OF CONSTRUCTION Q BLOCK " [�` FRAME � Q_ `STEEL Q -
DESCRIPTIbN OF WCiRK � �++�-��-�=�`•� �'' S��� 1a ►�-�. ("c7c�wC� Go����,
; �
BUIIDING 81ZE` �� �'SQ�FOOTAGE C_� > ,NE[GHT �
QBUII.DING $��Q �+, �AIUATiOt�t�(3F T01'AL C�NSTRCICTION � , ,
QEL.EGTRIGJIL ,�—�� AMP BERVICE. ' 'Q PROGRESS ENERGY Q, W.R.E:C.
� �
OPLUMBING- ;�� ' �
i
; .. �. . - �
QNIECHRNIGAL ($ — � VALUATiON C?FiMECHANICAL,INS7"AlLA7101�f.
i - �„ ,_,,,�,,.
OG/!�S Q ROOFINCs .[�,. 3PECIAI:TY,,�_3; OTHER
FINISHED FLOOR ELEVATIONS r�� F�OOD zONE AREA QYES. NO
� ,., _
8U1�DER i COMPANY'� '
SIGNA►TURE REGISTERED Y/ N FEE CUi2REP Y/N
Addre�s � � Licsnse# � I
. � .
E�ECTRICIA{�1 , COIWPANY � � �
SIGNATURE � REGI3TERED Y/ N FEE CURREk�' Y/N '
Addre� ` • License# i - �
PLUMBER�? GOl4�PANY � , " = .:� , �
SIGNATURE �REGIS7ERED� y �Y/.N� ,-�FEE CURREA Y/N '
Address � . , ,,_ . . `� .License#� ._ �
�� . . ,, , . ,
I� l4AECHANtGAL' _ C{}MFANIt, ir � � ' �._.
�i SiGNATURE - ` tiEGiSTEREo � . Y./.N,., ; FEECURRE� Y�/•N
i ' . _ .
� Address� , � License# � M�
OTHER - . . ;.CONIPANl( ,����C.�-�Y-•- t� ��--n� �
SIGNATURE '' �` . " �REGISTERED Y/ N_... � FEE CURRE� ~ Y N
Cn��
t _,
Address :�:r� �t�• ii��►J+a �33.5� - - " -Ucense# ��S��S� "�`
, .4.... .. , e .->. . r. :. . . � '
RESlpENTiAL" :Attaoti�(2},RtotP..iaiis;..(2)sels�ofBulliltng�Pians;'(.1)setafiEriergy�Faiins;ftA�W;P_er�nitfornewconstrucUbn,
_ :,Minlmum;.ten;(�1.0);wortiing"days,after>"subr`iiittal'datet'°,Requireil onslfe;:Can§tiuctiori�Pl�ans;$tortnwateYPtan`s w/S11hFence lnstalled, '
� ' �~ Sani'taryFactltUes:&;;1;dumpste_r,_Site•Wq,tk�Permitforsutidivisions/large;projects` ' ,- � �. ��� �� •�°
COMOAEE�CIAL Attach{3)�asiz►'plete"sets of"Bailding f'lans plus a+l.if�-Saf�i#y Page;(1)s�t af Energy Fotms.R-C}W Permtt#or newr canstcuctlan. -
Minimum ten(10)woricing days after submittal date. Required onsite,ConsUucNon Plans,Stortnwater Plans w/Sflt Fence installed,
Sanitary Fadtitles&7 dumpster.Site Wprk Permik for ail new,projects..All commercial requirements_must meet compllanca �
S1GN PERMIT Attat�{2jsets of Engineer.ed�Plans.: . ,�; -` ," •-
••"'PROPERTY SURVEY reguirecl for all NEW cons,tructfon. -
Dlrectlons: • . . ;
Ffll out applicadon completely.
4wner&Contractor sign back of applicaflon,aotadzed
If ovar�2500,a Notice af Commencarnent is requirad. (AtC upgrades ovar�T500) ,
:� fi.,.
" Agent(for the contractor)ar Power of Attomey�(far tfie owner)woultl be someane with notarized letter from owner autho�izing same
OVER TtiE COUNTER RERMF'fTlt�G {Front af•ApplEcatEan Only)a �
Reroofs If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) ,
Driveways-Not aver Counter.if on publlc roadways..neads ROW - �• --° - • �` �" " ' �
�. i"i�J.,_..�. ...'1. — . � . .i. � .� ., . , . ..... ; .
� ,.. �c.'L` '`` ,f' ` , ` : ..`.. :v�: r .,c_..'�� ,. ' . `
f ' .-...��: .;. ., �.,...-i . .} . ' • ......_. _ .. •i `v� _, ' ... " ..i .. , . .. ...
�
r ?�' a c. r
� -, . . ._ ..��
IVOTiCE OF DEED ItE$TRICTIONS: The undersigned�under�tands�:th�t,thi�.�:p�rmif,�may;be;subJect_to"deed"__restrictlon's" _,_ ,:�..__.
which may�be�more-rest�ictive�th���County���egulatfons:�•The u�iderslgned�assumes�responsitiility.for^coriipllance witFi any ��
appllcable deed restrictions. . _ � � � �- -
UNLICENSED�CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: =-If'�the owner has°`htred �a`contractor or
contractors to undertake work, they may;be_requlred-:to.;be:licensed In:accordance.with state.and�local regulations: �-1f�the�� -� - �
contractor (s-not Itcensed�as�requlred-'�by law, both�the owner and contiUaator=may��be�cited�for��a�-misdemeanor violatton
under state Iaar. If the owner or intended>:contca�tor ace:uncertain as to what Iicensing.requlreRnents,�"may��apply�ior�tfie� � • �
intended work, they are"advised to contact the�.Pasao County Bullding'Inspection,.Division--Ltcenstng�Section at T27-847-
8009. Furthermore, It the ovmer'has'�hired�a con�ractor or contractors, he ts advised to,have �the contractor(s).:sign
. � _,.
portions of the_"cont�actor.Block" of this_appllcetton_for,whlch..they wlll.be:r,esponsible.- If:you,�as.#he owner�'slgn`as tiie
cont�actor;that•may�be an Indication that`he�is not":properly pcensed"antl'is'not entitled to permittfng p�ivlleges in Pasco
County. ° . • �: ,:_ _
TRANSPORTATIONfIMPACT/tJTIWTIE$�IMPAC7�A�1b-ItESAU1tCE REGOVERY�FEES:� The undersigned-understands �
thatTransportation Impact Fees and.Reco.urse Recove.ry.Fees mey:.sppiy��to�tf�e constructton_of new,.buildings,achange�'of'• �
use in existing buitdings,-oc:expansi�in��of�ezistin��buildtngs��as specifled.in Pasco County Ordinance number 89-07 and.
90-07, as amended.; The undersigned also;urtderstands; thaf:`such fees;��as•:may�be:;due;:will�:be idenftfled at the=time�of"� ���'•' '
permitting. It Is furtFier understoo'd that Tra�isportation Impact Fees and,Resource.:Recovery�Fees.mu'st be pald prior to
rece€ving-a "certfflcate�of occupancy"�or flnal=power,release: :If�the project�..does::not Involve�:a�.certfficafe of occupancy�o� :-•`={� ' "
- . .- ....
I flnal powec releaseA.the.--,fee"s"mu�t~tie paid:pc1o�to.,.permft issuanc�. Ft��thermore;if:Pasco,County`Water/Sewer�,lmpact - � ��~
fees are due,.they_must-be�pald:.prlor_to.permit.issuance°:tn.accordance witF��appticabte Pasco�:County�ordinances. •
' COtdSTRUCTION'LIEN'LAW'(CFiaptir 713� Flor�da§tatute�,��amended): If valuadon of work is$2,500.00.;or:more,:I ��,�_�
certify tFiat .I, the �applicant,-have_been..provided�-with-a-copy of the�"Florida���Const�titction� Uen "Lav�—Homeowner's
Protection Gutde" prepared by tlie'Flo�ida-DepartmenC of Agric.ultnre and Consum�r Aifair`s. If the appllcant is someone .., �: :;
other than the°owne�', I certify-that.:l_.have:optained=a<aopy.of.the.above..des.cribed�ocur�ent,and.pJo,rxiise:Jn;good':faith to
delive�it to:the�'owne�"�p�ior:to�ciommencemerit:'�` ` ` ' ' ` � � � � "" ' - ,
CONTRACTOR'SIOWNER'S AFFIDAVIT: I.certlfy:.tFiat�ail:.the�,lnf.ormation In-this application is accurate.and that all work
will'be done in compliance with all.applicable'laws regulating construction, zoning and:�land�development. Appltcatton is
hereby made to obtain,.a .permit�..to,;do=wor,'k::.and,ihstallation as tndlCated::.:�1. certify that no work�'or instailatfon ha§
commenced p�lor to issuance of'.a permit""and that`:all work will be pertormed to meet.standards of all laws regulating•
construction, County and City codes, zoning regulatians, and land development regulaUons=tn the jurisd(ction. (�ai'so .
certify that I understand that the regulattons of other government agencies may�apply�to the.intended work, and that it is
my responstbility to identify•what.act(ons I must�take.to be,in:.corrlpllance:�S.uch agencles include but-are.not iimited to: ��
- Depaitment of E�vironmental=Protection=Cypress.'Bayhead�; Wetiand Areas and Envlronmentaily Sensitive
Lands,WaterlWastewater Treatment.
- Southwest FloNda Water Management. .District Wells, Cypress.'�Bayheads; Wetland Areas, Alter�ng
VVatercourses.
- Army Corps of Eng(neers-Seawalis� Docks, N�vigable Waterways.
- Department of Health_;& ReY�abilitative,.Services/Environmental:�.Health Unit Wells, I�Fastewater�Treatment; •
Se�tic Tanks._.. '' ' - �. ; "
- US Environmental Protection Agency-Asbestos abatement. - ,
- FederaFAv,latton.Authority-Runways,:� , � - _
I understand.that the..following.restrictlons apply fo tfie use of flll:•
- Use of fill is not allowed in`;Flood�;Zone"V"unl�ss expressly,permitted. ,
- if the-flll"mate�laG•15 �to be used�in :Flood Zone "A", It. is und�retood that a drainage plan addressing a
°compensating volume" will be submitted at Ume of permiftJng which ts prepared by a professional enginee�
Iicensed bytfie��tate of`:Fiotida:. � �� �
- If ih� flll-material-.ts_to-:be used In Fiood Zone "A" irr connec�lon�with-a�permltted building using stem wall
� const�uction, I ce�tifjt that flll:�rall:b.e-used only.to.fill the area within�the�stem�wall. � �
- if flll material�is to be used in any area; I �certffy that .use. of such flil will not adversely af�ect adJacent
properties. if use of fill Is found to adversely:�ffect adJgEent�prc�pertles,.the owner may be clted for viofating
the�conditions of_the building-.permlt Issued�under the attached,.�ermit-applicatlon;:for:lots.less than one (1;)
acre wFiicFi a�e elevated'6y flll,a�r engineered drainage plan is required. . ;
If I am the AGENT FOIt_THE-OIMNER, I;promise In good faith to laform the�owner of�the�permitting conditio�s set forth in
this affidavlt`prior to�commencing construction. I understand that�a�separate permlt may be requlred for elecMcal'work,
plumbing...signs,,wells,,pools;. air condttioNng,-.gas� or otk�er install�ttons not.spec�flcally included-in.the application. .A
permit Issued shall be construed to'be�a'license°to'proceed with tFie wo�k and_not as:authoNty_:.to.violate;'cancel, alter, or
set aside any provistons of the.techntcal.c+odes;�nor shall Issuance�of a.permit.prevent the Bulldirig O�ficial from theceafte�
requiring a correction af eRors=ln�plans; constructioa.or violat(ons of any codes: Every p�ermit=lssued sfiell become invalid
unless the work authorized.by such permit:ls,commenced•withln sGc.months of permit Issuance� or iFwork authorized by � I
the pe�rnit is suspended��or.abandoned�-for�a�:period,;of�six��f8)montt�s after,the.tirt�e#he�wo�k�ts commenced. An extension
may be requested, In writirig,,from.#fie Building.Official for a perlod=�not-to exceed�ninety�(90)days and will demonstrate • i
justf�able'cause for.�the exfensior�. If work ceases.for Nnety�(90)cons.ecutive:days,..th�)ob�is consfdered aba�doned. � ',
1MARNING TO OYVNER: YOUR..FAIUJRE.•TO�,;R�EC;ORQ:Af;.R1071GE OF��COMMENCEMENT.NFAY�RESULT IN�YOUR
PAYING'11AlI,C,E;FOR.�IMPROVEMEN'1'S:TO:YOUF�:PROPERTY. 1�°YO.U{I�ITEpID�`T�'�OBTAIN�FINAt�E1NG;'C.ON3UL'�____�
WITH YAUR L�E�VDER:O'R�IN-�1TTORNEY�EFOREiRE�OR�IN���YAUR';�QTICE'O���Q�l�����1�l�l��':_ � -- --- -- - -
—FLOR(�7i!dUPtA�(F:S:9.97:03)-- - - ---- _ _ - _. . _,
OINNER OR AOENT �cr���� CONTRACTOR . •� `-- �-���
�Subs bed and swam�o(or aflirtned),�etore me thts Subsc bed and'swom�to(ot aflirtned)�befote e tFil&.
by S:cr�r-�./L/2�G���'.rrP1.J�. h . y... � 4.��ca.�i �n�rrl��
Who 1 are ersonally known to.me or haslhave.produced Who.(s/are•personally known•to me oc haslhave produced �
_.,��j��_G,(�T� � as IdenBflcatlpri. as Identlfication. - '
' Notery Public _ ��^� ,�Q, 9�L�� Notary Public .
Com sslan No: � � Commisslon.No._ G l ,�-�
� N�' V
�►�c. C��'t;�e �vF�( ��rA �lQ.c�.e. ��/I �
Name ot Notary Name of Notery
.t�':Y:�,�� DEBRA ELAINE RUFFELL 1>ar""'• DEBRA ELAINE RUFFELL
:ek �oi :a�'���;:=
� �;k:Commission#GG 045343 �, „Commission#GG 045343 -
.��. :;;��;:Expires November 7,2020 :� ��:Expires November 7,2020
'••F��;;°:'�� Bonded Thru Troy Fain Insurance BDO,�E&7019 ��:F��a�'` Bonded ihm Tmy fain Insurance BOa38&7019
5��� Proposal/C�ontract
` .�c�� Seacl¢��,�,r� � �'rzry, �rzc. �
_ . ._.,� ------ - . . _--- - --=- -•-3301-0-�SR b2- - - -- ----
_ P.O. Box-11-88 - ,
•
San Antonio, FL 33576 �'���- �
,� (352) 588-ROOF (7663) � (813) 782-1330 s �o�ded&
1-866-407-0559 • Fax (352) 588-9763 � ��au�ed
www.scottblackman�oofing.com
���� email: blackmanroofing@aol.com Datel�-��°� /y� �l�
G�GG 05795? � ._
PROPOSAL SUBMITTED TO � WORKED TO BE PERFORMED AT _
Name �� se �-r �e v . Street
Street���.� � � �� ..5�" City �
City � � v � -��.� � State- Zip
State ` / Zip Owner of Property
Phone Number Fax � Phone Number Fax
We hereby propose to fumish all the materials and perForm all the labor necessary for the completion of:
� ��►��V� .'.;,•�rY` i s�, a c ��r � �,�. � t�,�,�
� Jd� l �- �� L.1ov � � J lnr � ��
f _ /� / f f �� ¢7 c �i� �d �G �, � ,
�.d�t. .�F � .�r., � �it .
�►.... J � IO , // � � � � � o/� ��� I/� �-f�
��,� � �°o s�e�,� �c � s �o � . - ;
- - " , k� . - ,
/a% oQo�,�
All material is guaranteed to be as specified, and the above work is to be performed is accordance with the drawings and specifi-
cations submitted for above work and completed in a substantial workmanlike manner for the sum of$ ������d
with payments to be made as fo�lows: Payment due in full on completion, unless otherwise noted. Thank You.
Credit,cards accepted, additional 3% charge.
, ;
*Not responsible for satellite signal when satelite is reinstalled *Not responsible f C'8�electrical lines too close to roof decking
Any alteration or deviation frdm above specifications involving extra costs will be ��-
executed only upon written orders, and will'become an extra charge over and -
above the estimate.All agreements contingent upon strikes,accidents or delays Officer/Agent Scott Blackman Roofing
beyond our convol. Owner to cafry fire,tornado and other necessary insurance Note: This proposal may be withdrawn by us if not accepted
upon above work.Workers'Compensation and Public Liability insurance an above � u
work to be taken out by Roofing Contractor. Extreme cautlon should be used Within days.
during and after constructlon for debris and nalls missed during cleanup.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do
the work as specified. I have read the back of this Proposal/Contract, which contains Florida Statues 713.001-713.37.
Payment will be made as outlined above. Client gives permission to driv ,driveway to eliver materials.
' � )
Accepted Sigaature � f� �.�, .
T �,� � L, J-� r .
Date - -- � Signature_
-� ��
� ' �J