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Home My WebLink About20-1118 r F'�Ofl1U'fl City of Zephyrhills PERMIT NUMBER+ 5335 Eighth Street Zephyrhills, FL 33542 BGR-001118-2020 Phone: (813)780-0020 Fax: (813)780-0021 Issue Date: 11/25/2020 Permit Type: Building General (Residential) Street�Ad ;' Property,Numbed '. :- 12 26 21 0040 00500 0150 5322 23Rd Street ' , ANn�erinformatios`', Permit.lnformation - Contractor Information ..sy_F, -, �.- Name: ROBERT&JANET KUSTRA Permit Type:Building General(Residential) Contractor:A. BARTLETT ROOFING & Class of Work:Reroof CONSTRUCTION SERVICE Address: 5322 23Rd St Total Valuation:$9,338.00 ZEPHYRHILLS,FL 33542 Total Fees:$130.03 Phone: (267)348-9300 Amount Paid:$130.03 Date Paid:11/25/2020 10:56:35AM L � v "I'll Dal l Pr ject`Desc�rptionh°,"`�; ey'4: I REROOF TPO&SHINGLE Building Plan Review Fee $43.34 Building Permit Fee $86.69 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. CONTRACTOR SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813a80-0020 City of Zephyrhills Permit Application Fair-813-780-0021 Building Department Date Received _ t Phone Contact for Permitting .Ella[a E a E a E E■ Owner's Name Robert&Janet Kustra Owner Phone Number 267-348-9300 Owners Address 15322 23rd Street Zephyrhills, FL 33542 owner Phone Number Fee Simple Titleholder Name I Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 5322 23rd Street Zephyrhills, FL 33542 LOT# SUBDIVISION PARCEL ID# 12-26-21-0040-00500-0150 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR B ADD/ALT = SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR = COMM = OTHER TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = DESCRIPTION OF WORK New TPO Roof w/Insulation 4-OCLO Shin le l2ocyc u.)1Tear O;F BUILDING SIZE SQ FOOTAGE HEIGHT -ccccz-r'ccc-s-rsz-crca-rrctr�-r�t�cc>�ccccc>t c-sccrc-;-c�-s-cc�'cc�-r-�-rcq-cccrrrs'><s�-r =BUILDING $ 9,338.00 VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E . =PLUMBING $ =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION =GAS ® ROOFING 0 SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE F REGISTERED I Y/N FEE CURREN Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y/N Address I License# PLUMBER COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y/N Address I License# MECHANICAL COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y!N Address License# OTHER COMPANY A BBartlett Roofing&Construction Services,LLC SIGNATURE X REGISTERED I Y/N FEE CURREN I Y/N Address 38408 3rd Ave Ze h rhills,FL 33542 License# I CCC 1331965 ie�a>f[tec��[e�t®fa��o�®ea[o�eeet�rfeti�a�aa®er�att�i��Eta�®[[® �assil 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,Stornwater Plans w!Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsllarge 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/Sllt 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(PlottSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW 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 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'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-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 CO ENCEMENT MAY RESULT IN/YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INT TO OB AIN FINANCING, NSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO FLORIDA JURAT(F.S.117.03) / OWNER OR AGENT CONTRACTOR Subscribed and swom to(or affirmed)before me this Subscribed and sworn to(or a ad)befor a th g by by CO v Hannev Who istare personally known to me or hasthave produced Who[stare personally known to me or hasihave produced as identification. _ � as identification. 1 Notary Public �'V Y�_(- Y V��. l ./LCs�/�V Notary Public Commission No. Commission No. GG211065 Tina M Prater Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped R Notary Public State of Florida Tina M PraterMy Commission GG 211065 Expires04/25/2022 INSTR#2020197834 OR BK 1 0220 PG 1616 Page 1 of 1 11/20/2020 11:50 AM Rcpt:2229505 Rec: 10.00 DS:0.00 IT:0.00 Nikki Alvarez-Sowles,Esq.,Pasco County Clerk&Comptroller Permit No Peroel ID No I a A6 Al'CC 40 Dy 00 01.5-0 NOTICE OF COMMENCEMENT state of Florida County of Pasco THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property and in accordance with Chapter 713 Florida Statutes the following information U provided in this Notice of Commencement �,�1 I.� 1 Descnphon of Property Parcel Identification N la1'a(o Al C J *(qD �oo 0 1so Street Address 5 3 a►a a 3'� s-+ Ze0hyirh1 1 IS F- 3 3sq a 2 General Descnpbon of Improvement 3 Omer Information or Lessee information a Lessee contracted for the Improvement erg Za el KUSAYtA- 53 a a =ed S4 Address CItyV j State Interest in Property F KJYI FP L7t)O n Name of Fee Simple Titleholder (If different from Owner hated above) 4 Address tor A Bartlett Roofing &Construct obi Services LLC s,�a Name 38408 3rd Ave Zeghyrhllls FL Address City State Contractors Tetephcme No 813-782-5585 33542 5 Surety Name Address City State Amount of Bond $ Telephone No a Lender Name Address city State Lenders Telephone No 7 Persons wrthm the State of Florida designated by the owner upon whom notices or other documents may be served as provided by Sechon 71313(1)(ex7) Florida Statutes Name Address City State Telephone Number of Designated Person 8 In addition to himself the owner designates of to receive a copy of the Lrenors Notice as provided in section 71313(1)(b) Florida Statutes Telephone Number of Person or Entity Designated by Owner 8 EWrabon date of Notice of Commencemerd(the e*iretron date may not be before the completion of construction end final payment to the contractor but will be one year from the date of recording unless a different date is specified) 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 1 SECTION 71313 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 I declare that I have read the foregoing notice of commencement and that the facts stated theMn are true to the best of my knowledge and belief STATE OF FLORIDA COUNTY OF PASCO Sr o Owner or Lessee or srs or Lessees oozed CrDrroclor/PaMer/Manager Home Owner Signatory's TNe/Olfice The foregoing instrument was acknowledged before me tfva day a��' 20Laby k 1 r�-- as Home Owner (type of authardy e g officer trustee attorney in fact)for _ (name party on behalf of aWm t was awcuted) Personally Known❑DE Plodu(gidlIdentrfieabon® Notay Signature -�1�✓LO�� 1 Type of Identification Produced 1 rT Name(Print) 15�8 ash'-`1 40 Notary Public State of Florida $ Tina M Prater ' My Commission GG 211065 p tti Expires 04125/2022 wpdauubcs/noscecommencenen(pc053 W 8 State Of Florida,County Of Pasco ,�; s. y,j`•�� This is to certifiy that the foregoing is a r t•t. _f. true and correct copy of the document ^•,�s; �:�,� or, r�,:;;ar of puk�!�c record in this office. �4�- ,5 Witness my hand and o ficiL.i sE,,ii ,,his Nikki kiva(Z-Snwies,Esq.,C' :rk&Comptroller PasC ou)sty,nonaa L9 �?F By irW uty Clerk Business & Professional Reciulation rig BCIS Home I Log In I User Registration I Hot Topic Submit Surcharge Stats&Facts Publications i Contact Us I BCIS Site Map Links Search Florida r Product Approval 0 USER:Public User Gram Product Approval Menu>Product or Application Search>Application List>Application Detail FL# FL5293-R42 Application Type Revision Code Version 2017 Application Status Approved Comments Archived ❑ ALL WORK SHALI COMPLY WITH PRE—VAII_li Product Manufacturer GAF CODES FLORIDA BUILDING 00013-1 Address/Phone/Email 1 Campus Drive NATIONAL ELECTRIC L COVE, Parisppany,NJ 07054 AND THE CITY OF;FP I l Fear'ILI.8 (800) @gaf.c11 ORDINANCES c�mstieh@gaf.com Authorized Signature Robert Nieminen Ireith@nemoetc.com NOVREVIEWDATE 2 � Technical Representative William Broussard CITY o��EPI"I� Address/Phone/Email 1 Campus Drive H RHI Parsippany,NJ 07054 PLAN EXAMINER (800)766-3411 Technica[QuestionsGAF@gaf.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Single Ply Roof Systems Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer ❑ 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 12/16/2022 Validated By John W.Knezevich,PE O Validation Checklist-Hardcopy Received Certificate of Independence FL5293 R42 COI 2020 01 COI NIEMINEN.odf Referenced Standard and Year(of Standard) Standard Year ASTM D6878 2011 FM 4470 2012 FM 4474 2011 TAS 114 2011 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 08/11/2020 Date Validated 08/11/2020 Date Pending FBC Approval 08/19/2020 Date Approved 10/13/2020 Date Revised 10/22/2020 Summary of Products FL At Model,Number or Name Description 5293.1 EverGuard TPO Single-Ply Roof Single-ply,thermoplastic polyolefin roofing systems Membrane Systems Limits of Use Installation Instructions Approved for use in HVHZ:No FL5293 R42 II 2020 08 10 FINAL Al ER FL5293-R42.Ddf Approved for use outside HVHZ:Yes Verified By: Robert Nieminen PE-59166 Impact Resistant:N/A Created by Independent Third Party:Yes Design Pressure:+N/A/-502.5 Evaluation Reports Other: 1.)The design pressure noted in this application FL5293 R42 AE 2020 08 10 FINAL ER FL5293-R42.Ddf relates to one specific assembly in the ER Appendix.Refer to Created by Independent Third Party:Yes the ER Appendix for all systems and associated max.design pressures.2.)Refer to ER Section 5 for Limits of Use Back NeM Contact Us::2601 Blair Stone Road,Tallahassee FL 32399 Phone:850-487-1824 The State of Florida is an AA/EEO employer.Copyright 2007-2013 State of Florida.::Privacy Statement::Accessibility Statement::Refund Statement Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.*Pursuant to Section 455.275(1), Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public.To determine if you are a licensee under Chapter 455,F.S.,please click here. Product Approval Accepts: ® 0 ® rAlhe'ck �~.Credit Cards I Safe D City of Zephyrhills n 5335 8"St _ Zephyrhills FL 33542 (813)780-0020 • ROOFING I TION AF DAU1T Per itNo.:��'COIIi$—a,0a.C7 I, Corey Hanney licensed under Chapter 468, Florida Statutes as a(n): Contractor-X Engineer_Architect_Building Inspector_ License No. CCC1331965 On or about November 25, 2020 did personally inspect the: Check: Roof Deck Nailing___X_ Dry in X Flashing and Drip edge X Check which was used: 30#felt X Peel and Stick X Other(List) At the following address: 5322 23rd Street Zephyrhills, FL 33542 Based upon that examination, I have determined the installation was done according to the Hurricane Mitigation Retrofi nual (Based on Section 553.844, Florida Statutes). Signature: STATE OF FLORIDA COUNTY OF PASCO Swor to and subscribed before this day BY: c �VILO� r U l Notary Public State of Florida �,�ANNotary Public State of Florida Tina M Prater y My Commission GG 211065 �1j« Expires 04/25/2022