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Name: PHILLIP MICHAEL INC
Address: Po Box 2590
ZEPHYRHILLS, FL 33539-2590
Phone: (813) 780-6101
Building Permit Fee
City of Zephyrhilis
5335 Eighth Street
Zephyrhills, FL 33542 BGC-002691-2021
Phone: (813) 780-0020 Fax: (813) 780-0021 Issue Date: 08/20/2021
6951 6949 6945 6943 6947 6953 Gall Blvd 03 26 21 0010 00100 0011
Permit Type: Building General (Commercial) Contractor: PRO LINK ROOFING
Class of Work: Reroof SYSTEMS INC
Total Valuation: $73,500.00 1
Total Fees: $447-50
Amount Paid: $447.50
Date Paid: 8/20/2021 10:39:08AM
$447.50
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Wmaye TOund in the PUDIIC reCO!"CIS Or MIS Coun , an r I j fe alallional Aerma reAllreCl "Frornik-UP-77.FFM 0-1,
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
/7
A/-
-CONTRACTOR SIGNATURE PE 6FfICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIOK
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department 7
Date Received phone qc�.ntauctjor Permitting
al-11144014 'laws* WW%*WWW4WAM1C
Owner's Name Owner Phone
Number
Owner's Address 9x Z. 5-10 0 Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS
�q �51
G l6I\-Vb
C. WJ0_VKL0' eu 335q*L
LOT #
SUBDIVISION
PARCEL ID#
[03 —2,s _14_MIO— 00100— 00%%
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
NEW CONSTRF7
ADD/ALT = SIGN DEMOLISH
e
INSTALL
REPAIR
PROPOSED USE
SFR 0
COMM OTHER
TYPE OF CONSTRUCTION
BLOCK 0
FRAME STEEL
DESCRIPTION OF WORK
F_mCQJE—a,
(711PO
BUILDING SIZE
SQFOOTAGE = HEIGHT
It
�L k IL IL
=BUILDING
swo-�' VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL
1$
AMP SERVICE PROGRESS ENERGY W,R.E,C,
=PLUMBING 1$ 1
=MECHANICAL 1$ 1 VALUATION OF MECHANICAL INSTALLATION
=GAS IF4] ROOFING = SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY P9,0-WilioK 900fikli
SIGNATURE REGISTERED YIN FEE CURREN
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED L_11_N _J FEE CURREN L N
Address License #
PLUMBER COMPANY =
SIGNATURE REGISTERED Y/N FEE CURREN L_LLN J
Address I License #
MECHANICAL COMPANY =
SIGNATURE REGISTERED Y/N FEE CURREN L_Y / N
Address I License#
/OTHER COMPANY =
SIGNATURE REGISTERED Y/N FEE CURREN I YIN
Address License #
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 wl Silt Fence installed,
Sanitary Facilities & 1 clumpster; Site Work Permit for subdivisionsfarge 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 (P[oUSurvey/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 1, 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.
CONTRACTORSIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance Wth
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 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.
It'll U06ITT46140 ZL30
FLORIDA JURAT (F.S. 11 7,03L---
; NER OR CONTRACTOR OWej� *
Subs and swom to or affirmed) before me this Subscribed and swoalito (or affirmed) befo? me this
by fq,0_PVL0 111C 111VA A 0S
Who is/are Personally known to me or has/have produe Who Ward personally known to me or has/have produced
as identification. as identification.
Notary Public s" L Q_ Notary Public
r �1, son 4N.-� 0
Commission No. 0 6
Name of Notary typed, printed or stamped Naffie of Notary typed, Ormted or stamped
JENNIFER A PASH
Notary Public - State of Florida
Commission 4 GG 146050
My Comm, Expires Dec 12, 2021
. . . . I I I I I I . I
Notary Public Stale of Florida
INN,
Jennifer S McCall
�,_\f My Commission FIH 005083
of Expires 08/28/2024
INSTR#2021178417OR BK10420 PG3695 Page 1 of 1
08/20/2021 11:24 AM Rcpt: 2342495 Rec: 10.00 DS: 0.00 IT: 0.00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller
R'ermitNo. N I OTIfE OF fQNNLENCEMENT
Property Identification No. 0.3 -A 46 Z 1 -00 10 C9
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in the NOTICE OF COMMENCEMENT. pp
'�C — e z I
1. Description of property (legal ifescrlpfion:) A SSC -�5<CJ I rl 2l(II30J+l(,
a) Street Address: q Gok -ei �vd I—e- LIk jr- S
2. General description of improvements 9QQF 9- e C r, v �r C-C(10�
3. Owner Information li N li I I, r c- :3 3S 3
a) Name and address: ArLd f)
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4. Contractor Information AA P,(L 3,0 21 0"L T pijk-�- k &J, in (Zat 'U Sfe24,1
a) Name and address: ' e'(- i,- i tj `6 222
b) Telephone No.: 2 9 W 3 - .31) 7- (0 Fax No. (Opt.)
5. Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6. Lender
a) Name and address:
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served;
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713,13(l) (b), Florida Statutes:
a) Name and address;
b) Telephone No.: Fax No. (Opt.)
9. Expiration date of Notice of Commencement (the expiration date is 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 713.13,
FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IPROVEMENTS 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOU NOTICE OF COMMENCEMENT.
OF Owner or
Print Name
The foregoing instrument was acknowledged before me this — day of 20
as (type of authority, e.g. officer, trustee, attorney in fact) for
(name of party on behalf ofwhom ins ent was executed).
Personally Known OR Produced Identification Notary Signature�=
-V—/
Type of Identification Produced Name (print)
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I d ve read the fore of the facts stated
in it are true to the best of my knowledge and belief. of pe"Ury" I d ve �read the �Iore 0�i the facts stated
FORMS/N0C,rvsd2007 me Signature Of Na-W-W Pletson Signing Above
JENNIFER A PASH
Notary Public - State of FIOH&
-ja
State
1 0
46
So
Commission a GG 146050
OF My Comm. Expires Dec 1Z 2021
IM
VI
State of Florida, County Of R scO
This is to certify that the foregoing is a
true and correct. copy of the document
on file or of public record in this office,
Witness nay hanlaofficiai seal this
A
day of
I Nikki Alva re,, -Sow t ., Clerk & Comptrraller
f.
';4o
Pasco County, R ld�
Deputy Clerk
City of Zephyrhills
5335 81h St
tewWhills FL 33542
Elff
Permit No.:-BC'C' - Doz("CA i - -zaz- `1
1\90'j4n dlicensed under Chapter 468, Florida Statutes as a(n):
Contractor_& Engineer —
Architect_ Building Inspector
License No. CC C I 3-L -7 � �- ?-
On or about--n - 3 - -70 2- 1 did personally inspect the:
Check: Roof Deck Nailing_ Dry in Flashing and Drip edge_
Check which was used: 30# felt— Peel and Stick— Other (List) T130
At the following
address: (rq5"11, 6941j ft q V 7 6",1,5- 9 6"Ii:
Based upon that examination, I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on Section 553.844, Florida Statutes).
Signature: ��
STATE OF FLORIDA
COUNTY OF PASCO R Cody Von Zente
Notary Public
Sworn d subscribed before this day State of Floridamm#
k CoHH043370
BY- 'EA Expires 9/16/2024
Public
c
Nota Public State of Florida