HomeMy WebLinkAbout20-239 fLUNIUfl City,of Zephyrhills PERMIT NUMBER
- - 5335 Eighth Street
Zephyrhills, FL 33542 BGR-000239-2020
x Phone: (813)780-0020
•
Fax: (813)780-0021 Issue Date:
Permit Type: Building General (Residential)
Property Number Street Address
1126 21 0010 07900 0125 38905 9Th Avenue
Owner Information Permit Information Contractor Information
Name: MATTHEW ZAMBRANA Permit Type:Building General(Residential) Contractor: PROTECH ROOFING
Class of Work:Reroof(Shingle Only) WSERVICESAddress: 38905 9Th Ave Building Valuation:$0.00
ZEPHYRHILLS,FL 33542 Electrical Valuation:
Phone: (813)713-5661 Mechanical Valuation:
Plumbing Valuation:
Total Valuation:$0.00
Total Fees:
Amount Paid:
Date Paid:
Project Description
GARAGE REROOF SHINGLE ONLY...PART OF BP201
Application Fees,
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 subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit 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 add fee 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.
ajav*v-orl
CONTRACTOR SIGNATURE PE IT OFFICE
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 Phone Contact for Permitting —
r�
Owner's Name CL 1-l UAQ 7.a- hb ram Q- Owner Phone NumberOwner's Address 3 -1 c)5 9 Ave. Z Owner Phone Number
Fee Simple Titleholder Name I I Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 38905 of th AV2, -2 e—joky r(Li I15, F&,, 3354 LOT# 12/ i3,l�l, lS
SUBDIVISION PARCEL ID# 11—-2(.—2.1 d 0 1 0 ' 0 7 9 00 —' U 12.
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH
e INSTALL B REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL =
DESCRIPTION OF WORK at aU4x1.a/'1+ AE74'CHED 6/tIZ O L (FLi 0 o `f-
BUILDING SIZE I I SO FOOTAGE HEIGHT
BUILDING $ ' (O�1 Q VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ T AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
=PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY {'(� l Jv` �Q 6
SIGNATURE REGISTERED I Y/N FEE CURREN LY2
Address I License# C E (p
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/N FEE CURREN Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/N FEE CURREN
Address I License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address I License#
OTHER COMPANY
SIGNATURE REGISTERED I Y/N FEE CURREN Y/N
Address License#
ttit'itttititittititiitIItiti its vital ffiiiiiittiiti lag gifts iii-iili.i.iii
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1),set of Energy Forms;R-O-W Permit for new construction,
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
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 understate 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 1,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 f 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 worts,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,WaterNVastewater 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.
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 ATTORN Y BEFORE RECORDING%ff%l 10 NQ=--E OF COMMENCEMENT,
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirmed)before me this Subscribed and swom to(or a rmed)beforA me this y•d ci" o f
by J kv1L by
Who is/are personally known to me or has/have produced Who is/are p or has/have produced
as identification.
JOSEPH PCHELKA
MY COMMISSION#GG 219781
22
Notary Public ",�, oQo: EXPIt��S PFU Der
}y b�Q�{�erwriters
Commission No. Commission No. GG a'L9"r g I
PROTECH
N
ROOFING SERVICES , LLC
OFFICE: (352) 601-0799
Florida License No. CCC1330964
BUSINESS INFORMATION
June 2nd, 2020
Re: City of Zephyrhills
5335 8th St.
Zephyrhills, FL 33542
Please see below information for our roofing business:
Business Name: Protech Roofing Services LLC
Mailing Address: P.O. Box 1114, Brooksville, FL 34605
Business Phone: 352-601-0799
Business Fax: 352-608-9690
A_ UTHO.RIZED_AGENT
AFFIDAVIT
I Joseph Mignoli hereby grant authorization to Ashley Mignoli
(Contractor) (Authorized Agent)
to act in my behalf with the City of Zephryhills Building Division while conducting activities related
to obtaining permits. These activities specifically include signing all documents requiring signature
of°contractor".
Ashley Mignoli is to be considered an agent of my business and
(Authorized Agent)
therefore the signature of said agent is binding and causes me to assume all responsibilities
connected to or associated with the signature as they may relate to my contracting business.
I Joseph Mignoli relieve the City of Zephryhills of,
(Contractor)
and agree to hold the City of Zephyhills Building Division harmless from, any and all responsibility,
claims or other actions arising from or related'to the Division's acceptance of the above agent's
signature for permit-related activities. I further understand that it is my sole responsibility to grant
and terminate any such authorization and to ensure that the Division receives timely notice of any
such 77rmination
4
14% '1/ Lr��.-
Signature o Contra for Signature of Agent
State Certification or Registration Number
N(h
County Certification Number(if applicable)
"PLEASE NOTE: BOTH SIGNATURES MUST BE NOTARIZED"
Notary for Contractor's Signature: Notary for Agent's Signature:
State of F 1 County of hki A rw%a o State of Pi County of l t t r n a^J-
The foregoing was acknowledged before me this ywd The foregoing was acknowledged before me this ZAJ
dayof Jv.r4 voyo , 3y1 by day of jL*0%-� , .. by I% sklc.j m;Onoli
k�tph nn:61owlc who is personals known who is personally known to me,or
lryme,or who produced as who produced as
identification. Identification. ,
Notary PiSlic Signature Notary ublic Signature
Print,Type,or Stamp Name of Notary Print,Type,or Stamp Name of Notary
FF
!!ye JOSEPH PCHELKA �i3!+►ghc: JOSEPH PCHELKA
_ MY COMMISSION#GG 219781
*: MY COMMISSION#GG 219781
EXPIRES:May 20,2022 =�� a� EXPIRES:May 20,2022
Bonded Thru Notary Public Underwriters -OR F�°P' Bonded Thru Notary Public Undervrrtlers
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Ph g Phone Contact for Permitting
OwnePs Name M a�l 1 W� Z 06M by Uhl a Owner Phone Number
Owner's Address 359 o5 qtK Ave. Zt h rhi lkS I Rw• Owner Phone Number
Fee Simple Titleholder Name I Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS3gq0S qf>< vf. 2,eph rkiRS/ 1=L• .33S42- LOT# I2,13,1y�J
SUBDIVISION PARCEL ID# 1 1 26-ZI -0 O 10 -019 0 O• O 1 225
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR R
ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR 0 COMM = OTHER
TYPE OF CONSTRUCTION Q c BLOCK Q FRAME = STEEL =
DESCRIPTION OF WORK `Z�OT ��l�.l' -n'(' CFLIOb7�•1 +(FLl?9?�• 1
BUILDING SIZE SQ FOOTAGE 15 3 mo di ft e d HEIGHT
=BUILDING $ t l'W40 VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
-P-z
=PLUMBING $ dl Cpt,lS���M
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIONI cv
/Vl
=GAS E2" ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER 'COMPANY ro c k ap c�
SIGNATURE REGISTERED Y/N FEE CURREN LXLN
Address License# e C L co
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address I License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address License#
THER COMPANY
MATURE REGISTERED Y/N FEE CURREN Y/N
7\191ress License#
'[ �f # 11� I � lilEt{ [Iti �� ll-i-ilfii� ll� i [ � Itii [ ! i[�iE�# iit_� IE # Ii �iE111tIt1Elt� # i,f Ia1t1I ��i
nITIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
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 understate 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'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
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.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"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 YQUR LENDER OR AN ATTORNEY BEFORE RECORDING 12 K1 f-f%A"fi0L1J*-
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and ssylo�n to{or affi ed)b b efore IM 1 this
by z jff'"'
Who is/are personally known to me or has/have produced Who is�/aare p9rrsonally known to mp or JpSEPH PCHELISA
as identification. �PAEation.
:t; MY COMMISSION#GG 219781
j a'• o� EXPIRES:May 20,2022
Bonded ThN Notary Public UnderwritersNotary Public
Commission No. Commission No.
INSTR#2020083.384 OR BK 10107 PG 1 934 Page 1 of 1
0512712020 09:41 AM Rcpt 2165100 Reo:10.00 DS:0.00 IT:0.00
Nikki AlvarezSowles,Esq.,Pasco County Clerk&Comptroller_
Peril No. Parcel ID No 11-26-21.0010-07900-0125
NOTICE OF COMMENCEMENT
State of Florida County of Pasco
THE UNDERSIGNED hereby gives notice that improvement Wit be made to certain real property,and in accordance with Chapter 713.Florida Statutes.
the follovring information is provided in this Notice of Commencement
i. Description of Property.Parcel identification No.11-26-21-0010-0790D-0125
Street Address: 38905 9th Ave Zephyrhllls FL 33542
2. General Description of improvement Roof replacement on main house&detached garame
3. Owner Information or Lessee information 6 the Lessee contracted for the Improvement:
Matthew Zambrena
38905 9lh Ave.Name Zephyrhilis FL
Address City Stale
Interest in Property: Owner
Name of Fee Simple Titleholder. NIA
(II different from Omar listed above)
_ _ _ _ .--Guy _ _ _— _-_ Stale
4. Contractor. Protech Roofing Services LLC
Name
P.O.Box 1114 Brooksville ♦=L
Address City Slate
Contractofs Telephone No.: 352-601-0799
5. Surely: NIA
Name
Address City Stale
Amount of Bond:$ Telephone No.:
6. Lender.N/A
Name
Address City State
Lender's Telephone No.:
7. Pawns within the State of Florida designated b owner y the upon whom notices or onto documents may be served as provided by
Section 713.13(p(a)(7).Florida Statutes:
Name
Address City Stale
Telephone Number of Designated Persom
a. In addlion to himself,gre owner designates of—
to receive a copy of the Llenor's Notice as provided in Section 713.13(1)(b).Florida Statutes.
Telephone Number of Person or Entity Designated by Owns:
9. Expiration date of Notice of Commencement(the wpimfion date may hot be before the completion of construction and final payment to the
contractor,but will be oneyear from the date of recordimf unless a different date is specr7edr
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.SECTION713.13,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
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,)declare that I have read the foregoing notice of eommencermnd that the fads stated therein are We to the best
of my knowledge and belief.
STATE OF FLORIDA
COUNTY OF PASCO —r
Signature of Owner r Le .or Ovmer's or Lessees Authorized
Oificar/Dire_Uor/P anger
k rum /Signatolrys Tdie/Office _/
The foregoing instrument was acknurwfedged before me this�day of 1 �7 20�tby �'ti�� � 10 L�4 A /-C,11 C
as __(type of authority.e.g.,officer,bustee,attorney in fact)for
(name parry on be1Wf of v4i m i�nstrume/rf executed).
Personally Known 0 CRR Produced Identification❑ Notary Signaturryg'�0;- �L�- /J' I _
Type of Identification Produced Name(Print) !`o n a
RONNIE H.IRVIN
h1Y COt1MISSION#GG 084521
EXPIRES:Ap10 k 2021
wpdatalbcsmaticacommencement_pcOW016 -~Wt4:i�R:•`-96nded TNU Nitliq Putft Undenwdtan"
Business & Professional Regulation
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USER:Public User
Product Approval Menu>Product or AgPlication Search>Aoolication List>Application Detail
FL R1
ALL WORK SHALL COI1li1�LY-WITH PREVAILING
Application Type Revision
# FL CODES FLORIDA BUILDING CODE;Code.Version 2017: NATIONAL ELECTRIC CODE
,
Application:St atus Approved AND THE CITYOF ZEPHYRHILLS
ORDINANCES
Comments
Archived El
Product Manufacturer Owens Corning II Ip1 0-7 �o�o
Address/Phone/Email: One Owens Corning Parkway REVIEW:DATE .
-Toledo,OH 43659 v l
(740)404=7829 CITY-OF ZEPH i RHILL
greg.keeler@owenscorning.com PLAN EXAMINER
Authorized Signature Greg Keeler
g reg.keeler@owenscorn i ng.com,
Technical Representative Greg Keeler
Address/Phone/Email 2790 Columbus Road
Granville,OH 43023
(740)321-6345
greg.keeler@owenscorning.com
Quality Assurance'Representative
Address/Phone/Email
Category Roofing
Subcategory Modified Bitumen Roof System
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed'Florida
Professional Engineer
O Evaluation Report-Hardcopy Received
Florida.Engineer or Architect Name who developed Robert Nieminen
the Evaluation Report
Florida License PE-59166
Quality Assurance-Entity UL LLC
Quality Assurance Contract Expiration Date 08/25/2020
Validated By John W.Knezevich,PE
❑� Validation Checklist-Hardcopy,Received
Certificate of Independence FL19979 RI COI 2017 01 COI Nieminen.Rdf
Referenced Standard and Year(of Standard) Standard Year
ASTM D6163 2008
ASTM D6164 2011
FM 4470 2012
FM 4474 2011
Equivalence of Product Standards
Certified By
Sections from the Code
1,
Product Approval Method Method 1 Option D
Date Submitted 10/10/2017
Date Validated 10/11/2017
Date Pending FBC Approval 10/15/2017
Date Approved 12/12/2017
Summary.of Products
FL.#.. Model,Number or Name Description . .
19979:1 Dec kSeal Modified Bitumen Roof Self-adhering,SBS modified bitumen roof systems
Systems
Limits of Use Installation Instructions
Approved.for use in HVHZ:No FL19979 R1 II 2017 10 FINAL Al ER OC MODBIT NOW
Approved for use outside HVHZ:Yes HVHZ FL19979=R1.Ddf-
Impact Resistant:N/A. . Verified By:,Robert Nieminen PE-59166
Design Pressure:4-N/A/ 135 Created by Independent Third Party:Yes
Other:1.)The design pressure herein pertains to one Evaluation Reports, .
assembly.Refer to ER Appendix for all assemblies.and max. FL19979 R1.AE 2017 10 FINAL-ER OC MODBIT NOW
allowable design pressures..2.)Refer to ER;Section 5 for HVHZ FL19979=R1.pdf
Limits of.Use. Created by Independent Third Party:Yes
- Contact Us::2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824
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►mot.„ City, of Ze h rhills
- p Y PERMIT NUMBER
5335 Eighth Street
Zephyrhills, FL 33542 BGR-000201-2020
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 06/19/2020
Permit Type: Building General (Residential)
Property Number Street Address
1126 21 0010 07900 0125 38905 9Th Avenue
Owner Information Permit Information Contractor Information
Name: MATTHEW ZAMBRANA Permit Type:Building General(Residential) Contractor: PROTECH ROOFING
Class of Work:Reroof SERVICES LLC
Address: 38905 9Th Ave Total Valuation:$11,640.00
ZEPHYRHILLS,FL 33542 Total Fees:$98.20
Phone: (813)713-5661 Amount Paid:$98.20
Date Paid:6/19/2020 12:1POPM —
I;
Project Description
REROOF SHINGLE&MODIFIED 5 SID
Application Fees
Building Permit Fee $98.20
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 subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit 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 add fee 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.
4 CTOR SIGNATURE PE IT OFFICE
ERMI EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER