Loading...
HomeMy WebLinkAbout19-21984 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 21984 BUILDING PERMIT -PERMIT INFORMATION LOCATION,INFORMATION Permit Number: 21984 . Address: 5629 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: 11-26-21-0010-10900-0100 Improv. Cost: 8,800.00 OWNER INFORMATION Date Issued: 10/29/2019 Name: F AND R BLOCK HOMES LLC Total Fees: 85.00 Address: 35246 US HIGHWAY 19N Amount Paid: 85.00 PALM HARBOUR Date Paid: 10/29/2019 Phone: Work Desc: REROOF SHINGLES CONTRACTORS APPLICATION FEES MY ROOFER LLC REROOF RESIDENTIAL 85.00 ri ► ,1 Ins ections Required DRY IN ROOF INSP TAPE JOINTS ROOF 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. C PRACTOR SIGNATU E PERMIT OFFI R PERMIT EXPIRES 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-MO City of Zephyrhills Permit Application Fa"l3-780-0021 Building Department Date Received -�^�.,((,�'� Phone Contact for Permitting Owner's Name l V_ (.7(.�L I hps Owner Phone Number Owner's Address i�( u 5 HW X q fU Owner Phone Number Fee Simple Titleholder Name I Owner Phone Number Fee Simple Titleholder Address Q� {�� JOB ADDRESS 1 `fin LOT# SUBDIVISION l/ p l J PARCEL IDf/ 11 -a(0 al - `U1 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR 8 ADD/ALT = SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR = COMM OTHER TYPE OF CONSTRUCTION = BLOCK Q FRAME = S,�TEEL Q , DESCRIPTION OF WORK O V_e I O S/" ( y/ 0 C BUILDING SIZE I SQ FOOTAGE a a HEIGHT =BUILDING $ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ �JJ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. =PLUMBING $ =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION =GAS r 3 ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO BUILDER COMPANY 1 �� SIGNATURE REGISTERED I Y FEE CURREN L11N--�J Address ( l-1 I License# C .tT ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address I License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y!N Address License# 1111111111111111111111111111111111111111111111111111111111111111111 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 dumpster,Site Work Permit for subdivisions/large projects COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortes.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—Homeowner's 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'SIOWNER'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-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. 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 Y END TO OBTAIN FINANCING,CONSULT WITH YOUR&9_NDbkW0R AN ATTORNEY BEFORE RECORDINJrYOUR NOTICE OF COMMENCEMENT. FLORIDA JU T(F.S.117.0 k OWNER OR T CONTRA $ubs 'be an sv(o to ed) efore th' CA$4bs nd wom t or ed before me i� ho istare personallyfto o me or hasve h produced 0 isla a or has/have ro as identification. WI as i en ica Public on Notary Public Commission No. Com iory� Heather D Strouae oriC ywrre a • r Ouse Name ar P 07/24f2021 My Commission GG 127560 Expires 07/24/2021 Permit tvo. Patcel[D No `+ tt'— �._' '✓C J� "' � � i i_�t• State of county of Hozlsec> THE UNDERMGNED.hereby glyes nonce that improvement will be made)to attain renal property,and In accordance With ChVer,713,Florida Statutes;. the following information is provided in this Notice of CamtpencJement:' 1,: Descriptlon,of ProperCty._'Parcel idepfifccaGon No.I t— StreetAddress: .r.E7: ' `�✓ ' t 2., "General Description of trnpmvemenf ' -i1'V I tOlac ,3. Oiiwr ,lnformatigr,on ' e information if the Lessee contracted.for the improvement,. .. ffCity State tnteiest in Property: _ >1 �e l;— Name pt fee Simple Titleholder. (if differentfrdm Owner listed above] Address 9 City State Address /./� �/ State,-. Contrarrtor s Telephone No: r7�� �lL" 5. Surety: Name Address INSTR# 20191 5911 BK 9997 PC. Amount of Bond.,.$. 10/29/2019 10:49am Page 1 of 1 6. Lender Rcp t: 2103666 Rec: 10.00 Nan'e. DS: 0.00 I T: 0.00 Address _ " - Nikki Alvarez-Sowles, Esq, s lendar :;ere,hor;allo. �Pasco County Clark & Comotroller :.Z. Persons.-within.the',State of,Fidridi designated,by,the owner upon wham nofices or other documents may be served as provided by Section 713.73(1)(a7) FlotldaStetutes: Name: Addresg City State `Fetepiiono.Number of Designated Person: a., ln,addition to hi self,the ownevdesignates. Of to receive a copy of fie Lienoes Notice as prpvided in Section 713.13(7_)(b),Ftorida'Statutes: Telephone Number of Person or Entity Designated by Owner 9, Expiration date of Notice of Commencement(the expiration date may not be before the completion of-crorstnrGion_arsd final payment to.the" contractor,bpt will be one year tram the date of recording unless a different date is spedied):.. WARNINGTO.OWNER: ANYPAYMENTS MADE BY THE,OWNER AFTER THE EXPIRATION OF THE.NOTtCE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS:UNDER CHAPTER 713, PART 1, 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 Y FiRST.INSPECTION, IFOU.tNTEND TO OBTAIN"FINANCING;CONSULT VjnTkl YOUR LENDER OR AN ATTORNEY BEFORE.COMMENCING WORK.OR RECORDING YOUR NOTICE OF.COMMENCEMENT. Under penalty of,pei ury,[,declare that I have.read.tha foregoing notice of commencement and that the facts stated,therein are true to the best of my,kricwledgo and belief: STATE OF FLORIDA `n C COUNTY OF P1k569:f W(`� SigSignatureOwner or.Lessee,or s r Lessrffeswed OfiScedDirector/PadnedmanaS4 5ign�talrys TitiefOficgo "' 7hb foregoing instnirnon2 vr5s:acktiovtledged before maethi§�✓li.-y of it's�13.�}by_�Sr/ .Lil�� � I f (type of authority:o g.,officer trustee,.adomey in fact)for (name of P�of a1r of v✓h m trument was executed). Personally Knomm( ORProduced tdaniicah Notary Sigrr�ture Type of identtliaation Produced'_ C/ Name(Print)__ �/� . C/ V iKARI PETTAWAY y ��y� Notary Public,State of Florida Commission#GG 259545 My comm.expires Sept.17,2022 wpdatalbcsJnohce=nmencernent_ico53M D City of Zephyrhills -onwe 5335 811 St Zephyrhills FL 33542 (813)780-0020 • ROOFING INSPECTION AFFIDAvrr Permit No.: ?`C A r LCCJ 0 4, 71 licensed under Chapter 468, Florida Statutes as a(n): ContractorXEngineer_Architect_Building Inspector License No. On or about C did personally inspect the: Check: Roof Deck Nailing X Dry in X Flashing and Drip edge_ Check which was used: 30#felt_Peel and Stick Other(List) At the following address: ailQ;�'q 101 GI—(/ tee' ill L,�1�1 i 1 j S I Based upon that examination, I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual(Based on Section 55$.844, Florida Statutes). Signature STATE OF FLORI COUNTY OF PASCO Sworn to rand subscribed before this day Notary Public Stat o r �., Notary PL&m stoW or Fbrkla Heather D srmm y .. AAy commission GG 127560 p'�oc Expires 07rrzM2o21 D, City of Zephyrhills AIDA 5335 811 St Zephyrhills FL 33542 (813)780-0.020 0 ROOFINGINSPECTION AFFIDAVIT Permit No.: I, f/IY1 . �.�C ('� . 21�P/1 licensed under Chapter 468, Florida Statutes as a(n): ContractorXEngineer Architect_Building Inspector License No. On or about did personally inspect the: Check: Roof Deck Nailing X Dry in- Flashing and Drip edge C Check which.was used: 30#felt Peel and Sticky Other(List) At the " following , .� address: � �yt (D 1 0 - �r/ �•t_LLS-4 Based upon that examination, I have determined:the installation was done according to the Hurricane Mitigation Retrofit Manual(Basetl on Section 553844, Florida Statutes). Signature STATE OF FLORI COUNTY OF PASCO Sworn to and subscribed before this day Notary Public Stat r a t WWA xvHeather D Strouse My Commission GG 127560 M:!i 0711M2021 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 2601 BLAIR STONE ROAD COD qrg `.. TALLAHASSEE FL 32399-0783 Congratulations!With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services,please log onto www.myfloridalicense.com.There you can find more information about our divisions and the regulations that impact you,subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can serve your customers.Thank you for doing business in Florida,and congratulations on your new license! STATE>sO.FF—LQR1pA;DEPARTMENT ;'' ROF BUSINESSAIjID;�PROFESSIONAL.:�.:' z "RE-UL'—A- ROOFING:CONTREICTORt °r} KOLODZIEJ;JNNIFER-tYNNi "��" � z .p..t.-..•, .i WY:ROOFER=LLG LICENSED"LINDEICHAPTER 489 F_L'ORIDA_',ST x: EXPIRATION. NIJGUSI41; •�ae tea ' JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that-the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 2/26/2019 EXPIRATION DATE: 2125/2021 PERSON: JENNIFER KOLODZIEJ EMAIL: MYROOFERDAN@GMAIL.COM FEIN: 264242664 BUSINESS NAME AND ADDRESS: MY ROOFER, LLC 11804 PINE FOREST'DRIVE NEW PORT RICHEY, FL 34654 SCOPE OF BUSINESS OR TRADE: Licensed Roofing Contractor IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scrape of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 �aGV/6 JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 8/4/2018 EXPIRATION DATE: 8/3/2020 PERSON: DANIEL H STROUSE EMAIL: MYROOFERDAN@GMAIL.COM FEIN: 264242664 BUSINESS NAME AND ADDRESS: MY ROOFER, LLC 11804 PINE FOREST DRIVE NEW PORT RICHEY, FL 34654 SCOPE OF BUSINESS OR TRADE: Licensed Roofing Contractor IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt..apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a, certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 >TASCO- COI7NTY BUSIl FSS;-"TAX R C�IP,T 2020, i f . { p, 1 ty, �v, -Expires,�• Se tember,.30th', Issued u�suant and sub ect.to,Florida Statutes and Pasco Coun Ordinances.`Issuance iJoes not certi ,. p {''`. .Y% compiiance`wlth zoning_-off other�laws`Thi'This re must be posted conspicuously in place of business. MIKE IFASAN®, %,11' .'%ACC,OUNT`#:'r ` •-89687,/' `�, `. TYPE CiF:BUSINESS ;'ems "TAX COLLECTOR 1 QR ROOFING CONTRACTOR SIC ODE: ' "" �-1761`,00 `NSTATE LICENSE'# PASCO''COUNTY.FLORIDA. , {i CCC1329139 , OWNER/QUALIFYING�AGENT. f T: ,KOLODZIEJ JENNIF,ER LYNN MY ROOFER LL"C, „ LOCATION•ADDRESS:, /11804 PINE FOREST DR 11804 PINE FOREST DR. ; `. NEW-PORT RICHEY,FL 34654-1412 NEW PORT RICHEY,-FL 3,4654-1412 ' f` ,'DATES,:° RECEIPT,, AMOUNT' i .. 07/18/2019 .. 19-1-116462 pry. c ------------------------------------------------------------------------------- Dear Business Owner: Your 2020 Pasco County Business Tax Receipt is printed above. Please detach the receipt and display it in a place that is visible to the public and available for inspection. The Pasco County Business Tax Receipt is in addition to any other license or certificate that may be required by law and does not signify compliance with zoning, health, or regulatory requirements.The Pasco County Business Tax Receipt is non-regulatory and is not meant to be a certification of the holder's ability to perform the service for which it is registered. Business Tax Receipts expire September 30th.Annual renewals are mailed in June to the address of record at that time. Please contact our office if there are any changes to your business name, ownership, physical address,or closing of your business. Thank you for allowing us to serve you! MIKE FASANO PASCO COUNTY TAX COLLECTOR EAST PASCO GOVERNMENT CENTER WEST PASCO GOVERNMENT CENTER TAX COLLECTOR BUILDING DADE CITY NEW PORT RICHEY GULF HARBORS CENTRAL PASCO GOVERNMENT CENTER COMPARK 75 BUSINESS PARK LAND O'LAKES WESLEY CHAPEL CALL CENTER:MONDAY-FRIDAY 8:30 AM-5:00 PM (352)521-4338 a (727)847-8032 • (813)235-6076