HomeMy WebLinkAbout18-19941 CITY OF ZEPHYRHILLS
E� 5335-8TH STREET
(813)780-0020 19941
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 19941 Address: 4768 SILVER CR
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: CHALFONT VILLAS
Est. Value: Parcel Number: 15-26-21-0180-00000-0360
Improv. Cost: 6,000.00 OWNER INFORMATION
Date Issued: 7/17/2018 Name: KYLE GARY L
Total Fees: 70.00 Address: 4768 SILVER CIR
Amount Paid: 70.00 ZEPHYRHILLS FL 33541-6515
Date Paid: 7/17/2018 Phone: 352-457-5416
Work Desc: REROOF SHINGLES
CONTRACTORS APPLICATION FEES
RESTORATION SPECIALIST REROOF RESIDENTIAL 70.00
V
i:�`�12UZ
DRY IN ROOF INSP Ins ections Required
TAPE JOINTS R F 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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021✓
Building Department
Date Received -7— r Phone Contact for Permitting ( 01-7 -
t�'
-rrl-iT-7 t-I-
Owners Name (�GCc 1// Owner Phone Number ''/S
Owners Address ! r ivy 'C t r . 5`I Owner Phone Number
Fee Simple Titleholder Name SCvM. Owner Phone Number
Fee Simple Titleholder
+Address 5Q4.
JOB ADDRESS "fCe Jr I`fit r�C,rr, El 335q I LOT#
SUBDIVISION I�Rr f�t� �i�IQS 1`7Rl_ PARCEL ID# I -c2 I"6 I5O'OCC0 - 'OR
Z�
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL =
DESCRIPTION OF WORK r &4 eMAlfttiT
BUILDING SIZE 305(ifC SQ FOOTAGE HEIGHT
rrrrrrrrrrrrrr�-rr-r-r-rTrr�-rr-rr-r-rr'r'r'r-r-*-rrrrrrrr-r-rrr-rTrr-rre-r-�-rrrrrr�
=BUILDING $ !_®�. C) VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ lQ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
=PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS �< ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER < ., r]�( �„ COMPANY � t`ic�?fSn S QQ-I6t'i
SIGNATURE Q1J /��- (�J-.,1S1 L1�-X>L� REGISTERED�7 Y/ N FEE CURRE Y I N
Address O��7 1 + TM✓C a,F)39 ( License# Q JT O 3
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpsler;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
• PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
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
contractors 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 contractor 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 entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,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,will 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"certificate of occupancy"or final power release. If 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—Homeowners
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner', I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"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 applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work 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 performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government 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 include but are not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater 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-Welis, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone W"unless expressly permitted.
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.
If fill material is to be used in any area; I certify that use of such fill will 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 fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically 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 permit 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 work 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
justifiable cause for the extension. 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_ 13A"v2 r
Subscribed and sworn to(or affirmed)before me this Subscribed arrk�sworn to pr ffirmed)befo me this
by 7—�Z_J by "F`.eu_Z I�0^�LQ!-
Who islare personally known to me or has/have produced Who iS(;3re pe nally�}cnown�°rp_e„o�r�as/have produced
as identification. [, f�r(�i W+Xes identification.
e
Notary Public Notary Public
Commission No. Commi Sion o.
Name of Notary typed,printed or stamped Name of Notary type
o4�Y•erB-, JACQUELINE BOGIES
Commission#FF 150422
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STATE OF FLORIDA
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R)ESTORATION SPECIALISTS
"Oood People To nrn Tex"
Goneml Connmtors-State Certifted-Lieeneo#COC 04216S
244 N,W,9tb Surat,teat%Ftartda$4475•(352)732-2322 F fox(352)73M950
23 15 Griffin Road Unit 3,Lmbvr$,Florida 34748•(352)787-4223-Fax(352)314A320
7.24 t1X Ath Avoaup,,gvitc B•Gnlncovi 1c.PIwida 3201 (352)37"721•Fax(352)373.0341
36 W.QuINo Lake HighwAy.Lau,eto.Florida 34461•(352)744.467E-Fox(342)746-d120
q division of Pro0slcr&Aesoelater.,Ino, 13419 Chftbord8t,•Arookavdie„FL 24613•(352)754.114.7.•Fax(352)597.4090
144 SW Wotorlbrd Ct,#107+LWo GStA FL 32025•(386)487.0297• Fox(386)715-2726
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WORKAITHORTZArION
Insured Name 1'T�-'I aq Home Phone
Loss Address 1t—T Co , - i r (� �It�U *Phone
Residence Address t Cell phone
Temporary Address Alternate Phone
Email Address • Birthday,Month Day Only
Insurance Company ( Claim# �
Agent Name ` Lt r' Adjuster Name ;
Mortgage Company Phone#
Address Loan#
We,the property owner,the insured,or their agent(insured)a chorine Restoration Specialists(Contractor)to perform the work-outlined below to our property at the
shove address The damage was caused by an ar about - ?--�zU ysigning below,the Insured agrees to all
111k m9 and Conditions"on the front and back of this authorization.
* The Contractor agrees to proceed witti the work as described in the original estlmate and my supplemental m t liter which Are incorporated herein by
reference,plus any change orders approved by the Insured and Contractor. Duo to the nature of the work,no contple(ion date is specified.
• The insured hereby gives authorization to the Contractor to proceed with the work and appoints the adjuster or Insurance companyas their agent for all work
4 covered by insurance.
Th e Insured authorizes the Insurance company to pay all proceeds due COtltrattor payable under Insured's policy directly to Conh actor.If Insured's nAme is
included on the payment,Insured agrees to promptly cndorsc and deliver said payment to Contractor,
The insured fully understands that he,/she has the right to select a contractor,and in doing so,Restoration Specialists is aciingsolely for the undersigned and
not for any lasut'ance company or any third patty,
• The Insured understands that the price of,%vrk will be bored on the ewsting quality of Items to be repaired or replaced.
• The Insured thoroughly understands that payment in full is due and payable Immedlotely upon substantial completion. The Insured agrees that any
payments not made In Accordance with this agreement Shalt be considered delinquent alter 10 days from dtte date, Default interest will accrue at the highest
rate allowed by law on any delinquent payment,
• The Insured agrees,when the Job exceeds$8000,that the Insurance company will be requested to Issue"draws"so that payment may be issued to Contractor
under the schedule of 115 upon commencement,1/3 midway through►he job,and 1/3 within 10 days of substamial domptetion.
The In red agrees to pay the deductible portion of$_t at tfie time of signing this contract.
LT 9 IS AN iMFORTANT DOCUMENT—PLEASE-READ ITBEFORE-SIGNINO IT 01.1"
Insured,or r1th6r blKlaIllo—rins trtsured,or Atldiorizod Agent fox lmureA
Authorized Contractor.signature
WORtt PERFORSIED BY Restoration 5pvclai1s>r IS GUAItWMED FOR THE PERIOD OF ONE(I)YBAR VROM TIIB DATC OP COMPLETION PROWDED PAYMENT HAS
BEEN MADE IN A TIMELY MANNER. MATERIALS gE WAMMEED AYTl1E MANUFACTURER ONLY.
Comments
ANY CLAIMS I'OIt CONSTRUCTION DEFECTS Albs SUBJECT TO THE NOTICE AND CURS
PROVISIONS OF CHAMR 555,) MI)A.Sie['I'U'Ci3S
NadudBJti rsrzs
r Tt�s>`axx�t> ta�t Specxl%ats�--�' aas&Coindx�rofxs
GENERAL(Cost.inid -,)
1. Us work BAZU herein relates to the specifications on the front page of this contract,the estimate,supplements,change orders and related documents,and does not
cover preexisting defects unless stated otherwise.
2, Aft mateftaia used will be standard stock malortals,unless otherwise spadilad,and wits match existing materials within reasonable tolarshce as to color texture,•d"19n,
eta.Wood Is a product of natom.Natural products wits have some variations in graining or color,watch is consldeted-amptable condition of wood condition,
S. Ali palming of aklsting surfaces Is Intended to retum oxlstinq paint surfaces to t1a same color.Any changes In color or type of material will be done at extra coat to the
insured by written change order.
4. The contract price Is based on completion during normal working hours and the insured's agree to provide access to the Job seta as required for the completion of the
work. Insured's etectrielly,water,and toilet arc to be made avallabts to the contractor's personnel during the course of work.
5. Anywork deleted from this work authorization and paid for by the In6rance company must be agreed upon by both the Insured and f Contrad4r In writing and the
Insured wplU reftumed fci such work In an amount equal to the Contmetoea projected cost of seed work upgrades and rttsngos will be done only by a rlgned.dwange order,
6. The Contractor Is not maponslble for the that disappearance or,or the damage to jewelry,an objects,sliver,gold,Suns,monies,antiques,ar personal items unless these
Rams are removed and Inventoried by the Contractor's personnol and stored in the-Contractor's faclillu;s,
7, AI I materials used are covered by the warranties or guarantees provided by the manufaeturaror supplier only.
5. Contractortras no responsibility for additional work or services contracted between fhs Insured and the workmen orlmdesman or or the Contractor,
9. Insured shall cooperate with Conlractorand agrees to execute any and all documents required-by any insurance company including,but not Ilnwlted to,release and hold
harmless agreements.
REMEDIES FOR NON-PAYMENT BY INSURED(Gust.in
In the event of default by the Insured,Restoration Spe iallNtsmaLYL its right to any remedy allowed bylaw and any of tho following remedies;
1. Construction Lien on the property In socordance with Florida Statutaa,-Chapter 713.
2, Insured grants to Contractor a Ilan on the Insursd`s rest property,being repolred under this contract for all work performed on insumd'a contents pursuant to this contract,
The lien amount may be included In any lien claimed by Contractor pursuant to Florida Statutes§713 at seq.
3., Referral 4f account to outside collection agency,and report the account to an national credit bureaus.
4. Racaver collection costa Inourred. Collection cam will include Internal eoliection costs Incurred by Contractor,such as documentatt time spent by collectian swat a rate
of$55,00 per hour,express courser costs,title and credit raaeeroh.lien Bing costs,etc.
S. Affomsy fees. In any litigation arising out of this contract,the prevalnrg party shall bo entitled to recover their aft may foss,Inoluding attorney fees on appeal.
AddifTohally.Insured shall be responsible for all le al fees and costs Incurred by Contractor if this matter Is-fumed over for collection and enforcement prior to Mahon,
SPECIAL NOTICE-INSURANCE CHEC0(Cult,En
Restoration Specialists is agreeing to perform work on your property based solely upon your agreement to make payment for the services rendered as set out In the provisions
of this agreement.The normal procedure for the meting of such paymem is to endorse any and all Insurance check(a)recoived for the restoration worts done and
send or give such check directly to Restoration Specialists. The deductible will usually be payable by the Insured over and above any insurance checks,payable at the
signing of this agreement.
FLORID EMMERT tON��idGTION l2ECbVERY FUND�PAYMENT MAY BEAVAILABLE FROM`t'HE''FLORiDA'HC)MEOWNERS'CONSTRUC.
TION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,WHERE THE LOSS RESFI4 'FROM SPECIFIED
VIOLATIONS OF FLORIDA LAW BYLICENSEDCONTRACTOR, FOR INFORMATION ABOUT THE RECOVER;FUND-AND FILING A CLAIM,CONTACT
THE FLORIDA CONSTRUCTION INDUSTRY LICENSING 50ARD AT THE FOLLOWING TELEPHONE NUMBER AND AUDR�SS:1940.N,Monroe SL,
Teliahasses,Florida$?.399.2202;(850)4871195
ACCORING TO FLORIDA'S CONSTRUCTION LIEN LAW{SECTIONS 713.001-713,37,FLORIDA STATUTES),THOSE
WHO IIII'ORK ON YOUR PROPERTY OR PROVIDE MATERIAL'S AND SERVICES AND'ARE NOT PAID IN FULL HAVE
THE RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY THIS CLAIM IS KNOWN AS
A CONSTRUCTION LIEN. iF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS,
SUB-SUBCONTRACTORS,OR MATERIAL SUPPLIERS,THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO
YOUR PROPERTY FOR PAYMENT,EVEN IF YOU HAVE PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY
YOUR CONTRACTOR,YOUR CONTRAGTOR MAY ALSO HAVE ALIEN ON YOUR PROPERTY, THIS MEANS iI:A
LIEN iS FILED,YOUIR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR,MATERIALS,OR
OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE-FAILED TO PAY, TO PRO-
TECT YOURSELF,YOU SHOULD STIPULATE IN THiS CONTRACT THAT BEFORE ANY PAYMENT IS MADE,YOUR
CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR
COMPANY THAT HAS PROVIDED TO YOU A"NOT-ICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW IS
COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY
,
K, City of Zephyrhills
S335 8'"St
,.. ,:-:•. :.: � Zephyrh1llsFL33942
(813)780-0020
'cjrwrw:+:7irihrnit.i;::-:.
J4x_
(� ] ROOFING INSPECTION AFFIDAVIT
Permit No.; k l 1
licensed under Chapter 458,Florida Statutes as a(n):
Contractor"Engineer Architect__Building Ins _pector
License.No.��c.� �_ H.
i t
On or did personally inspect the:
Check: Roof peck Nailing ✓ Dry in &'--- Flashing and Drip edge
Check which was used: 30N felt Peel and Stick_Other(List)
At the following 11 !
address: "f
Based upon that examination,'l have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual(Based on Section 553.844;Florida Statutes)..
Signatur .
STA OF FLORIDA
COUNTY OF PASCO
Swo�n o and subscrI before
;•';++•Do'•.. KRISTIN ANN HOSFELD
N.Uy Public-Stk,&Fiarie�
BY: ? CommPffion a GG i 2446
:;, •. My Comm.EiDms� Ju116,201i
Notary Public State of Fl a �J�QIfR Y�AipYdlA}i,Ayr
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