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BUILDING PERMIT N~
0779
36 . {)<J
BUILDING
CITY OF ZEPHYRHILLS
(81"!fi 38,,66 t1
'~O..oao
Permit
Date J..( - :J. 7 - to (
Property Owner:
Job Address:
Parcel 1. D. #
ELE~AL
1Yl ovrt', t'\ i
6...J, II ; o'fh
?,SING
(J Asso~
-ST.
ME~L
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s;
Zoning:
Description of Work
En~e:
Qe-
Radon Gas:
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
(!;
Valuation or
Contract Price
:;J. L{~
~5
Permit Fe~,,~
~ignatu~ ~~
Company
Address
)<:TelePhOne/(~2lCS(O 7" 6!5FJrf)
City License Registration # ;;J 8 ;;;l..
State Certified License#
S e. h~fJlf ~1I;'d
BUILDING
ELECtRttAL
,/'
PLUMBI~
./
MECH~AL
.r
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Twenty Five and 00/100 Dollars ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
OWNER'S NAME
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DBPARTMENT 5335 8th STREET ZEPHYRBILLS, FL 33540
Phone:813-780-0020 Fax:813-780-0021
DATE RBCEIVED
PLANS REVIEW FEE
PHONE CONTAC~ \ 3- ~S~JoQ(
D\\\S
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # \ \ -2~'l \' CJC)\ D- \~<1 00' ()C)\ C)
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
o COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
o MOBILE HOME
o OTHER
PROPOSED USE: DSGL FAMILY DWELLING
DMULTI - FAMILY
0# OF UNITS
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK ~~ ~
BUILDING SIZE SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$'2~ CD'
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA 0 YES
o NO
BUILDER
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
******************************************************************
ELECTRICIAN
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
PLUMBER
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
******************************************************************
MECHANICAL
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
OTHER \( ()~~"''''HHHHH::~::'''HH.~~~'''H.H
STATE CERT OR REGIST #
SIGNATURE' ' 0- - ~Y PROCESSING # 2
************~-***************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to ~deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. 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
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of ~Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify 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.
E. 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, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental 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 Regulation-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
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or ~A,etc.", it is
understood that a drainage plan addressing a ~compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
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 code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2 0 IN VALUE DO NEED TO RECORD AND POST A ~NOTI OF COMMEN E T".
SIGN E:
STATE OF FLORIDA ~ CJ:)
COUNTY OF
The foregoing instrument was ack~dged
Before me this ~() day of\nJ)ll'f'~ , ~
by . 0\
(name of person acknowledged)
[1ho is personally known to me, or
STATE OF FLORI~ C\ c..D
COUNTY OF ~
The foregoing in,!;Lr:wnent was acknowledged
Before me this ~ day of t00.XJ--\..'QQ.y-~ I
'-z..oo
by
(name of person acknowledged)
~ho is personally known to me, or
o who has produced
(type of identification)
and WhO~~id ::~ take an oath.
l
Signature of person t~ \lIlUlM\~~(iigement
j~ u.. CQmm\$$I00 CC87
* *'"" I 25. 2003
, if ill41I...s oclotle
Name typed, printe'l!l." r stamped
Dwho has produced
(type of identification)
~iQ not take an oath
Name typed, printed or stamped
'::0~~<~~~:V:'"rt;..
if':: S(!flAPER ~OOF1Na. 'Nt!
, tt 250 S. !I'IIY. 98, Dade City, FlQrida 33525 Phone: '352-567-8580 Fu: 352-567-7073
JTATE <.."EP.TIFIED BUlLDING AN"D ROOFIN'G- CONTRACI'OR 1# CC-C0S8134 CB-C05817
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T erna Summers
Date: _11/t4/01
,4;
~31'3. St..'
Z.~..JL 33~..t
Phone: 788-13'9
city! Coaaty: _city
P~i #:_Proje~ roofSJ1l10tl1 St ZepbyrbilIs. FL 33540
J
We hereby prl}pOS~ to funusiI materials and labor necessary tor the completion of;
Two iayer retU" uff
Shingie Reroof _' ",
1. 'For the tlhmgied portIons nftile hom~, remove oid roofing mat~ais to dry-in. taking
pr~cm.1rions to !'I'otect the building and the lanescapiitg. Gt"oo~ me deck mid reset existing
deckin'J nails. _
~ Repiace oad wood odler man herein agreed for at ..:..$36.00 _ per man-hour pius marenais
1l111rlred Ul) a _25'~/(t _ contractor' 3 tee, .' .-~': . I !
~ Install _lNhite _ ~av~s drip \O\O;th all ~dges ;sealt:?d with piastic ceillent.
t. Install _1 & Z _lnyer(sJ ofASTM 15 lb. Asphalt shingle underlayment
~ In...qfail ~vani.:.-ed valley metal for tbe length of all valleys. Valleys will be closed
6. Instali new lead boots over vent pipes and replace metal vents with new.
7. Cmillflliles snarrf)estruCtnoa~surtrproper sfiiDgJe expostire. fustall_Z5..-year Royal
Sovereil!l1_ Class A sett:sealing fimgus resistant fiberglass shingles. SL"t l"QI" c'orrosion
re~stant natls shall be insta11ed per manufacturers ~jctions~ t..V? A7<.
&. Shingle Mnuufactures: _OAF calor T c.//f ,./ r G /"t.R...,..,,.....v
9. Hurricane nail the deck to the rafters option to meet current SBCCI code. See price section.
10. Install _nla feet ofaluminmn rjrige vent See pricing BstiOn.
Written HeMeation 1
tWO Layer dry-in required 4111 the 3/11 pitch POrtiOD Gf the roof. R.efiash cbimDey if'required.
fnstntl auto canik fur electric.
.
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seHAPE~ ROOf'NG, 'Nt!.
11250 S. Hwy. 98. Dade City. Florida 33525 Phone: ,352.567.8580 Fax 352-567.7073
3TATE CER...."'1FIED BUILDlli'G.AND ROOFlNO CONTR..Al.'"'TOR # CC-C0S8134 CB-~9817
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· CONTRATOR WAlilJ~lY
Upon completion of the work aDd payment oC aJlmemes ow~d. Contractor shaD issue a _'J_
year1f'arralltY iOf1f'9rirmllmDipiiDiked to 'leaks C2l1!ed by any c9IIIponeilt InstaD by the
~oDtradOl'. S~e mamu-acturer shan provide a _~S _year iimited ....arnmty.
. '
Geaer.u Coaditioll
\H WOfX shaH be carefully supervised and completed by worlcmen skilled and knowledgeable in
methods needed to produce hil!h quaiity work. The job site shaH be kept dean daily for the duraiion
.)fthe job:md ~ ~omlds shall be left dean ofall roofrelated debris afler completion. The yard
.; snail be sweut Wtth a ~et Cullel.1ion costs ifany. togeth..~ with interest shall be added to the
conlfn,t.'t price lip3yment defulllt occurs. C3l1cellation of tile cootrnct after the 72-bOl.D" grace period
:Joall inCllT a uominnl tee. Pennil workmnn compensatiolL 3l1d genern.lliability insurance shall be
provIded by the contractor. Cm-nootry. ~otj..-ed chnn~ orden andworlt. which is not covered
under the !cope of W1JrK outlined herein.,' shall be performed 00 a time' and materials basis unIe~s
otherwise agreed upon. l:
CGntract Base Priel?
Visible T &. M tomi
;';hin~e reroof as describe herein,
HtitTiClJ11c; nnit th~ ~vood deck
lUd~ v~nt .~p(i.)o
.. .'$ ~o:oo allowance
') 2.10000
S _n1a
S _nia
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A~.eed ~on price. labor and material fi S 2.400.00
~ C> v'-( /( ~.Y r 7.-"" ~ CJ ,..4'h_~.
TE&.\fS. _$lt)O~)O down. 5ou.'... at commencement.. balnnce WPn r~re.
I(er:. /trI. - I'J'''/O' ~ (/
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Schaper Rooting Warc lAiter
Price is good for tb.i.rty days.
[ :ICCeI.'[ dle :Wove !lore mId tenDs: you m-e mnhorized to begin work;
Signea: \ ~ Q -^- ~~ ~~ 0 J J)- P!10 ~ c:y lrJ>-:
Signed:
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