HomeMy WebLinkAbout21-2715City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
I mmmam
BGR-002715-2021
Issue Date: 08/23/2021
��l 0111- -r-jVlW0rAlL"rVm
umi M=-
EEA���
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
1 (J6�I b0c, ft of pf,
llq -- lAla��
CONTtCTOR SIGNATURE PEfAIT OFFICE[)
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
11171.rm�,I
Building Department
1110M
'*hone Contact for Permitting -.0w
X117, 17-6-1 ;2 � 1-5-
-7-Al V Z/ R 0
Owner Phone Number' JU- -73bO
Owner's Name I' Jwidk'Tu(qbu11
Owner's Address [55:4i:! bqA 54 owner Phone Number
Fee Simple Titleholder Name Owner,Phone Number
Fee Simple Titleholder Address
JOB ADDRESS
I A ,
SUBDIVISION I Ul�
WORK PROPOSED
PROPOSED USE
TYPE OF CONSTRUCTION
LOT #
PARCEL I ID# (OBTAINED FROM PROPERTY TAX NOTICE)
ADD/ALT SIGN MOVE 0 DEMOLISH
REPAIR
r
SFR COMM OTHER
BLOCK FRAME STEEL OTHER
n-_AL�i4 f:14)01414.1 nPS14Q+fdC UUL
DESCRIPTION OF WORK eaf 0a wroof—
BUILDING SIZE SQ FOOTAGE HEIGHT
f zHifts
Manzi=
a
4444444444-
BUILDING
rS "" �
VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL
A . MP SERVICE
PROGRESS ENERGY
. W.R.E,C.
$�I
PLUMBING
MECHANICAL
VALUATION OF MECHANICAL
INSTALLATION
GAS
ROOFING
SPECIALTY
OTHER
FINISHED FLOOR ELEVATibl\!S
FLOOD ZONE AREA
rYES =NO-7
+H-h4"-HH-H+HH+"
BUILDER
F
COMPANY
SIGNATURE
REGISTERED
Y/ N FEE CURRENT
Address
License # E:==:=
ELECTRICIAN
COMPANY
�/N
;N N �=
SIGNATURE
REGISTERED
Y FEE CURRENT
Y
Address
License #
PLUMBER
COMPANY
�Y/
SIGNATURE
REGISTERED
NFEECURRENT�Y
N�
Address
License # E====
MECHANICAL
COMPANY
�CURRE�NT
SIGNATURE
REGISTERED
Y / N FEE
Y / N
Address
License #
E:=:==
2 An Tfic
1-2 1 C/
OTHER
COMPANY
-CO
SIGNATURE
REGISTERED
Y/N FEE
N��
Address I IXA(3
License#
Len La556t),
Sg sq
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, Sto.rmw,ater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL, Attach (3) 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 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 $5000)
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 (Fropt of Application Only)
Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
Public
Public
1 1. NtLLI 13, HYMAN
Notary Public -State of Florid
Commission # GG 348302
MY Commission Expires
July 30, 2023
am
",A,y P KELLI B. RYMAN
W-T ,
t�rNotary Public -State of Floridi
Commission # GG 348302
My Commission Expires
July 30, 2023
INSTR#2021176504OR BK10419 PG1335 Page 1-fi
08/19/2021 08:12 AM Rcpt * 2341720 Rec: 10.00 DS: 0.00 IT: 0.00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller
Parcel ID No — --------- -
ParmItNo. — --
['10 flt;L. CIF COMMIENCE-11j) Ai I
Stare ac�-
provp property, and in Flarida"t"lotes,
'rI-jE UNDERSICNP-D gives notire 11181 IM: 11lailt vVil be made to cotlain rest
the fo*icvt'*nq iriformallOn !"' provided in ills Notinn nr Comma Llfi'" bol b
assliwt"011ofproperty: P'l I Ide iff
Street Address-_ W,
General D 05 c(ifil fni i of I no p rovprn 0 1; 1,
co 0 T
formation or Less If the Lessoo cer�fi Octed (Of 010 — -----
Mniec"itt 7WA bu 1( --
4
Ve I
Address
interestinproputy.
Harna of Feet Slin"I" Titlehol&r;
-(If different from C emir listed EbOVI)
City
Addre s ifiTAC
Ka
contractor's I'cleplr011- NO-:
Nal, 9
�k( dr �11'1 City
Arnountemcnd* $ ---
6. Lander: N
Name city
Address
7, Persons within Ilia suite of Florida doAgnataa by the avvner upon whom;latices or other documents may be, served as prolvided by
Florida Statutes:
8 ta, G,
Address
8. [It add to himself, the ovmer cicsigna(es
to n-)c.ejka a ropy oftho Lianais Notice ar, provided in Section OcricieStat-jiss,
Tplepho,lo rJURII)Of G- PaysDll Or Entity Dusignaed by OW11sr:
9. rxphalton data of 1`10110 Of commenrament (the expo 3tfan dato may not lin be the coinpleithin of corl I It' I I ont to 1hp
` 'r r""' �jo( losi Pay"
,,,P, diwnrdirig, - s , diff�,rent dnia is spedriad):
be ore year fiern ibe d, -viles
V,1ARN;^10]'o OWNER: ANY PAYNIFNTS MAP F BY -IHE OVJNF.'-� AFTFR THE EXPIRATI N OF THEN �TJCI� OP CL)jVrVFNCEMENT
AR� GON&DERED IMPROPER P"(,JENTS UNDER CHAPTER 713 IIAR'P I -ECTION 713A3, FLORIDA GTAI-6TEg, AND CAid
ESUI
-0 YOUR PROPcRW A'NOTIC-E OF GDW4ENCEkjl-r,jL p,jjjqj' BE
-EBFF0P,,L--. 1HEFIRS-l'iKSPECTION. IFY(-I)tl.r,4-iLf�,f')TOOL3TAI,%IFI,�)ANICIM1IG,Co�4SLII-T
-T IN YOUR PAYING TWICE FnR IMPROVEM17NTS I
RE F r) ON - l�lGtjVopi(oRr�ECORDINUYOIJRt4OT�GEOFCOMMENICI-�ML f.
,cORDED AND pos I IHEJO�Sk C N
wi rH YOUR I.ENUFR OR AN ATTORNEY BETORE CONINIE-N Ilia Lest
therein are Wait,
ofjyjVknowledge and Gal Pf
0
ED E-Spo oVj Florida
STATE C' v
f,OIJNT -d
poblIc
lIniss 0 1 Officer Na'Co Ex iTes
N4Y Co ()9 ?. 0 e�'
f,eb r
I pint
-'0regoing Ira thjp�/'�-��'Jviyuf
I ho_ Listairrient Was aGj(jjok�jsd9ed belare
trustee, aj[ora8yjrl Lea) for
---- — -------- Z"
F1o)s-n-a1JVXOO-Vn ODE Ploduced ldentifjcairon i'fs:c)
_, / �� :)fou (Print)
'I-yrie of I dwilifles' ton F(Oduced
pcO-51(148
ME
PoKoy#
Inc.A Division of Rymon Construction,
pnone\o/3q /o2-ou9*-Fax y,/a/'oo'o''o -'
1-855-3c~Ryman(1-855-467-9626)�Lic.#CCC1325505
vmmwRymanRonDng.uom
Servilng a19 of Central Flodda
Insurance Company:
Mail toAddress:
Momet� ���-778-7860 Qa I|#
[7lComplete tear off nfexisting
hi 1
one laver included
C�Secure all loose roof decking aeneeded according
toFlorida Building Codes
Roof dried inwith Peel and stick
C�
[-/j install new
va|�ym�a|wdgal
vanized
0|n�U Install 6 ^ drip edge color:
�� Install new lead boots
k1 install all new generalroof vents
install n�� ^—~Shing|e [—�K8�a| [:]Tile
0 Mod�edButi� �� --�n TPO
F—1
�4 Manufacturer (smnule.metal urtile)
Manufacturer (rpo"rMod. n/mmen)
0 Color: (8hing|o.MeteiorTi|e)
Color: (TPOorNlOD,Bitumen)
All roof related debris removed hnmjob site, pick -Lip loose
nails using commercial grade magnet
C�All materials, labor and permits 'fuminbed
labor warranty
Provide o � nr�
Additional Items:
Payment Method: �—lCheck #F—lCash
Q Credit Card #
Down Payment: $
PaynntTe
ERICAN
ISA
mo:
5% fee for credit card processing.
Proposal #
O024OO
E�me�#Job
City: Zephmrhi||S zip: 33542
E-Mail Address:
Business�
Additional Notes/Special Concerns: Includes
Install new GAF Timberline HDZ 30 year lifetime Ltd.
di mansion al/architectu ral shingles
1�e�isto peel and stick underlayment
_11p to 'two sheets of plywood includ�d
Permit and scheduling of inspections
10,903.00
BasePr�e°*
��
| |Finamdng
Amount Financed: $
35% down and balance upon completion
!mmmme Claim
CC|D#
Approx. Monthly Payment: $
*Base Price does NOT include unforeseen costs asdescribed below unless indicated in"Additional Items" above
dent1��pkmvoodnap� . ataoos of per in�oxnof�e@.wh�hindudea|abor&m�*ha|n.A||���'
na|labor, such as, but not limited to, xaUeyrebuilding, m#arre�aooment. 1xdecking, et�vxUibemrate of$l��L__per |meo/motpmame
4w o �oo r Va d -
cost ofmaterials.
THIS BECOMES AB|ND|NG CONTRACT N DGE8RECEIPT OP© OFTHIS GD03RACT
WP�
| ACCEPT THIS PROPOSAL ANUNDERSTAND THE PROVISIONS UFTHIS CONTRACT,
Date: 8/10/71
� �� Ed
Purchaser: Estimator'.
City ofZephvrbUb
53358mSt
2ephy[hi|bFL33542
INSPECTION AFFIDAVIT
Permit No.'
licensed Linder Chapter 468, Florida Statutes as a(n):
Contractor 1,,"Fng|Peer___Arohitec1____Building Inspector_
License
Onnrabout did personally inspect the:
- T'Zi
���
Check: Roof Deck Naj|in Dry in Flashing and Drip edge______
[heokwh|chvvasusod: 304fe| Other(Usd
Atthe following D5 1U
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).
STATE OFTLORIDA
COUNTY OF PASCO
/�
,~/�
Sworn,,to and subscribed before this day
RMNotary Pt-jjc - State of Florida
Bonded through National Notary Assn,