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HomeMy WebLinkAbout02-1086 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N2 1086 (813) 780-0020 Date :!-15-/);L. BUILDING ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Property Owner: Job Address: Parcel I. D. , ;J/h.o.yf~ 7)/-e~L Y71)~ &:1~v-e- sr: o Water Meter: T,I.F.'s: Zoning: Descriotion of Work Energy Code: Re - f6wf Radon Gas: ~/ .s/~.Lc.. ?1'7 111 ~hY~, FINAL -I/,;}- NO OCCUPANCY BEFORE C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector City license Registration # State Certified license# Perm;' Fee -l:.' ;><-Signature ~ ~ Company - - - v. N ~"-..- ~S'" C Address iO 9 ~ I 7 s';tA 57 C.4~ (0) rt 7377/ /Te'ephone# 7~ 7, c;,"cy 5- - Ie ~ C> Valuation or Contract Price J-( /._(=3 5' () V J:nrl''''0ii-e flS5(x' .JP1C SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compres r Final BUILDING Ftr. Pre SLB lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final L 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 I S NAME ,I)t. A'-t?- R 'i A JOB SITE ADDRESS '-190 'I CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMBNT 5335 8~ STRBET ZEPHYRHILLS, PL 33540 PhoneI813-780-0020 Pax:813-780-0021 DATE RRCEIVED '3 - t S - 0 :;L PLANS REVIEW PER DId JI t. (~7,rAGC PHONE CONTACTe/3 'If] '1-87G 'I J J S -<1/ " tl.hAJ/'64 S /1/#/ Br Z rG,o/-I-itA HU,L..f J /L " , LEGAl. DESCRI PTION : LOT (S) BLOCK SUBDIVISION PARCEL 10 f# j /1 'J / J , ~ '" ,~ ( , ~ 000 ()t!)D(~ WORK PROPSED: DNEW CONSTRUCTION 0 ADDITION o ALTERATION (OBTAIN FROM PROPERTY TAX NOTICE) ErP:EPAIR o INSTALL DSIGN PROPOSED USE: ~L FAMILY DWELLING o MOVE D DEMOLISH OMULTI - FAMILY 0# OF UNITS o MOBILE HOME o OTHER o COMMERCIAL o INDUSTRIAL o SWIMMING POOL c:J RESTAU~T & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK jl4?~()C1r /.b./:r,t:, Snu wc..-G fi~ y ~& hi t!3;{JJQ",16 , r _ BUILDING SIZE SQUARE FOOTAGE :e ~.:J . K 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 $ LIt.( 5,s-..CJ <( VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING o MECHANICAL $ o GAS ~OOFING D SPECIALTY VALUATION OF MECHANCIAL INSTALLATION o OTHER TYPE OF CONSTRUCTION: 0 BLOCK D FRAME o STEEL o OTHER FINISHED FLQOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO SIGNATURE ~.~ COMPANY "'fPP,tWc-/ BUT STATE CERT OR REGIST f# CITY PROCESSING # t€~ ~~ 1 C;'1 t:J BUILDEll ****************************************************************** ELECTllICIAN SIGNATURE COMPANY STATE CERT OR REGIST # CITY PROCESSING # ****************************************************************** PLUHBER COMPANY STATE CERT OR REGIST # CITY PROCESSING f# " " SIGNATURE MECHANICAL ****************************************************************** COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** OTHER COMPANY STATE CERT OR REGIST f# CITY PROCESSING # SIGNATURE ***************************************************************** 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, Cypl:ess 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 $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT". SI~~ _._ . ..... l-."~,,..__.__a SIGNATURE: OWNER OR AGENT acknowledged 19_ STATE OF FLORIDA /:.:;) COUNTY OF " // a.~ <!J ) The foregoing inst~ent was a~~wledged , Before ~his /5 ":''':''~y of ~:.~ ' ~.;2~.;Z by \.DfJ(.nl./ /~ ~ _0-,-- (name of person acknowledged) [Lho is personally known to me, or '~WhO has STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _ day of by (name of person ackno~ledged) Dwho is personally known to me, or o who has produced (type and whoD did Ddid not of identification) take an oath. ancr Signature of person taking acknowledgement Sig~~re person acknowledgmen ,'-;;'~'~:J", Bobbie Swetland 4~'i MY mMMISSION # ((893160 EXPIRES Name t =. : = intedebrllCl'YJt1a d -",'i!...,., BONDEDTHRIJTROYFAINI~C~ INC "',,9f.I~r\\\ Name typed, printed or stamped PASCO COUNTY BUILDING PERMIT APPLICATION CENTRAL PERMITTING OFFICES: SHADED AREAS FOR OFFICE USE ONLY · Dade City: (352) 521-5144 FAX (352) 521-5149 13852 17th St., Dade City · New Port Richey: (727) 847-8126 FAX (727) 847-8901 7530 Uttle Rd., Rm. 210 New Port Richey · Land O'Lakes: (813) 929-1266 FAX (813) 929-1307 4111 Land O'Lakes Blvd. (US 41), Land O'Lakes THIS APPLICATION MUST BE TYPED OR PRINTED IN INK AND IS VOID IF NOT PERMITTED WITHIN 6 MONTHS --------------------------------------------------------------------------------------------------------.- IS THIS APPLICATION THE RESULT OF A STOP WORK ORDER OR NOTICE OF VIOlATION? Y _ N l:l OWNER'SNAM~<"'~~~ PHONE. (.l2'L::L) ~~ -.'7f'r6'1 9 JOB LOCATION: _ 9. CJ __ __ e _---!- SUBDIVISION: r;u;;:; ~_ _ m PARCEL 10#: S . T ~ R SU BLK J2a!q,OT ~~PROJECT' TAl _ LOT SIZE _X_ i OWNER'S PRESENT ADDRESS: </90 q ('I'J 'nAt.J,G 3T: CITY: Z~IJ#,VR II/~ STATE: Fe... Z1P~.3 S-q / o FEE SIMPLE TITLEHOLDER'S NAME (rt other than owner): VA address (rt applicable): CITY: STATE: ZIP: ~~~~~~~ -~~;;~~:- R~ p,,-;:: - -;;;;~~ - :~~ ~-; -;;;/1 ~ y;U-;-;;' -;;;; ~ -;;; - -- - - - - - - - -- - -- - - - - -- - --- -- --- --. ~ UVING AREA: PATIO: GARAGE: . ENTRY: TOTAL UNDER ROOF: B&.::l L c:;- 9 , BEDROOMS - , BATHROOMS -- _ lYPE CONSTRUCTION: 0 BLOCK 0 FRAME 0 OTHER: m Fill Y _N_ ~ IF MOBILE HOME OR RV-~E YEAR SIZE ~ WORK cooeOe(,-- PLANS ON FILE? 0 NO 0 YES PRE-PAID PLANS FEES: $ ffi f' MODEL NAME C ' VALUATION $ ~<I ?5": tJ t/ RECEIPH: --------------------------------------------------------------------------------- BONDING COMPANY: /IIa. ~ ADDRESS: o ~ ARCHITECTIENGINEER: ;C;Qet'J c:. ..Jt1)~6S , I?~ a: ADDRESS: t.//~f3 //;l7A r;r. {7; CITY: E. E'LLe-""'-"eJ/\.- STATE:.a ZIP: 1~!l.2-:2 w S MORTGAGE LENDER: ,,/ A ADDRESS: CITY: STATE: _ ZIP: ------------------~--------------;r-----------~---------------------------------- COtmW:fOrt tJrit:r~a-vv'~"NcE ~~~. LK' , SIGNATURE: PHONE' ( ~ ) .6:L.S.. - I Boo ~ ADDRESS: 10' . ~ ? 7 CITY: Z 4-,12 ~ 0 STATE: .EL ZIP: ~ 577 ') 8 STATE UC, (rt applicable) t: ec tJ493 67 PASCO CO COMPUTER IOf: ""75"'j{ 7 ...J m g ELECTRICAL CONTRACTOR: o SIGNATURE: ~ ADDRESS: ~ STATE UC , Qf applicable) o POWER CO: CllY: STATE: _ ZIP: PHONE' (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 101: SAWPOLE: AMPS: MECHANICAL CONTRACTOR: SIGNATURE: ADDRESS: STATE UC , Qf applicable) o NEW 0 ALTERATION VALUATION: $ PHONE' (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 101: (Required) PLUMBING CONTRACTOR: SIGNATURE: ADDRESS: STATE UC # Qf applicable) # FIXTURES: SEPTIC PER , PHONE' (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 101: SEWER: WATER: WEll: OTHER CONTRACTOR: SIGNATURE: ADDRESS: STATE UC , Qf applicable) lYPE CONTRACTOR: PHONE' (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 10#: VALUATION: $ --------------------------------------------------------------------------------- OTHER FEE lYPE: AMOUNT: $ RECEIPT': --------------------------------------------------------------------------------- JOBS UNDER $2,500 IN VALUE DO NOT NEED TO TOTAL BUILDING PERMI RECORD AND POST A "NOTICE OF COMMENCEMENT' AIM' ". $ c.jI , """prcve~ . ....NOTlCE.... BOTH THE OWNER AND CONTRACTOR OF RECORD (Ucense Holder) MUST READ AND SIGN THE REVERSE SIDE OF THIS APPLICATION (pennit fOllTll0191) EDITIONS OF THIS FORM RELEASED BEFORE 1191 ARE OBSOlETE AND W1Ur NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF PC930430321G . (OVER) A. NOTICE OF DEED RESTRICTIONS The undersigned understand that this permit may be subject to "deed restrictions" which may be more restrictive than County regulafions. The undersigned assumes responsibility for compliance with 8Ily 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 regu- lations. 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 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 thd owner sign as the contractor, you are indicating that you, rather than the contrac- tor, are responsible for the work. If the contractor wishes you to sign as contractor, that may be an indication that he is not proper1y licensed and is not entitled to permitting privileges in Pasco County. C. TRANSPORTATION IMPACT/UTILlTIES IMPACT AND RESOURCE RECOVERY FEES The undersigned understand that Transportation impact Fees and Resource 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 numbers 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/SewEll' Impact fees are due, they must be paid prior to permit issuance. In accOldance with applicable Pasco County ordi- nances. D. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended) If valuation of work is $2500.00 or more, I certify that I, the applicant, have been provided with a copy of "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. 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 con- struction, 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 commended prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating constriction. Coooty codes, zoning reg- ulations, 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: . Deoartment of Environmental Protection - Cypress BayheadS, Wetland Areas and Environmentally Sensitive Lands, WaterNlastewater Treatment. . Southwest Florida Water Management District - Wells, Cypress Bayheads. Wetland Areas, Altering Watercources. . Army CorDS of Enaineers . Seawalls, Docks, Navigable Waterways. . Deoartment of Health & Rehabilitative Services Environmental Health Unit - Wells, WastewatEll' Treatment, Septic Tanks. . US Environmental Protection Aoency - Asbestos abatement. . Federal Aviation Authoritv . 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 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 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 provi- sions 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 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) consec;utlve 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ~~ OWNER OR AGENT ~ - DATE tb tl.Jl!h t l./ I 7 ~ L SIGNATURE SIGNATURE ~ r1~ CONTRACTOR MY COMMISSION EXPIRES 14VcJ. , 7DDZ NOTARY AS TO OWNER OR AGENT ~ NOTARY AS TO CONTRACTOR 1.0, MY COMMISSION EXPIRES The CASH CONTRACT PRICE for all labor & Materials (including any applicable discounts) is $ ~/,Y ~ Terms: /VCash 0 Credit (Subject to the approval of the Credit Sales Department) UJ saiNI ax $ 4i:Y1.J If this ilaCish transaction, the purchase~ paid as follows: ~ ~/J /) :.J.r t',/~ ~ Cash down Payment (Minimum 33%) $ - Balance Payable $ , r t/~ ' Tota ce $ , . r:>"5- If this is a credit transaction, the agreeme t for credit is contained in a separate documen hich is incorporated herin by reference a ma&l a part t eof.'1 · l!We the undersigned are hereby authorizing INVINCIBLE ASSOCIATES, INC. to verify and review my/our credit record with an independent credit reporting agency and release them from all liability incurred from inadvertent omissions or errors. Verbal understandings and agreements with representatives shall not be binding, All understandings and agreements must be set forth in writing in this Contract. ADDITIONAl PROVISIONS ARE STATED ON REVERSE SIDE AND ?RE. PART OF ~~CJt -, IN WITNESS WHEREOF Purchaser(s) have hereuntcl signed their name(s) this . L day of L 20 fi ~ and acknowledges receipt of a true copy of this Contract. UNLESS OTHERWISE SPECIFIED, IT IS UNDERST~~MNER(S) IS/ARE READY FOR THIS WORK TO BEGIN, THE PURCHASE PRICE QUOTED ABOVE WILL BE HONORED ONLY UNTIL '" , Purchaser(s) understands and agrees that if this agreement is cancelled after the recission period, the Purchaser is liable for twenty five percent (25%) of the total sales price as damages to the Contractor, In the event this offer to contract is not accepted by Contractor, any payment made hereunder shall be refunded to the Purchaser(s) and this proposal shall be null and void and of no effect, Contractor is not responsible for existing structural defects, dry rot or other factors beyond our control. No repairing, plastering, painting, carpentry, or decorat- inQ is included unless specifically charged ~ r and specified in writing herein, If Installation is not completed, Purchaser may withhold a maximum of 10% of Total Pnce until m t . T ere 'nder of tal Price is due upon install 'on or as otherwise specified, r- - ----- -----_______~_----- , I ~ I I I ACCEPTED BY:Authorized Signature for Contractor Date ACCEPTED BY: Purchaser Date I L______________________________________~ ,0 ~~I!~~:~ ~INVINCIBLE@~ Q SYSTEMS INVINCIBLE ASSOCIATES, INC. 'IlIt_,.__ 1093175THST.. LARGO,FL33777. 7271545-1800. 800/937-6635. STATE CERTIFIED LICENSE #CCC049367 MAKING THE SUNBELT A BETTER PLACE TO LIVE SINCE 1987.., ONE HOME AT A nME Ph!!{~ :J -- (W) /'. City: ~county State: El.. ZiP::iJ5J) Loti: I Nama(a): tlf.i /lL8{~ P.V:IIL . MaJling Address: tfi flNCO!fJ!Lt 57 " (If Applicable) MHP: U '" liP. Alternate Address: h'p. City: State: _Zip: _ Phone: l!We, the owners of the premises described below, hereinafter referred to as "Purchaser" offer to contract with INVINCIBLE ASSOCIATES, INC., herinafter referred to as "Contractor" to furnish, to deliver and arrange for installation of all materials necessary to improve the premises located at: Jobslte Address: according to the following specifications: City: State: _ Zip: ~~~~~~~D: Jl!l-<< IN\IINCIBLE" ~ SUPER ENERGY-SAVING WHITE MEMBRANE o OTHER (specify): 1. PROVIDE INVINCIBLEIl SUPER ENERG~- AVING Ifi~~~lED WATERPROOFING SYSTEM FOR THE FOLLOWING AREA: ,1J M t1J.~dC. 2'iCLUDE ENERGY-SAVING DOUBLE-F I FACED INSULATION AS INDICATED: ELUXE 1-1/4" 0314" 0 NONE 3. CLUDE NEW SPUN ALUMINUM VENTS: 'Z SMALL ..,z LARGE 4. INCLUDE UP TO 100 SQ. FT. OF NECESSARY DECK REPLACEMENT. ADDITIONAL DECK REPLACEMENT TO BE INVOICED SEPARATELY AT $2.00 PER SQUARE FOOT. 5. INCLUDE ALL REQUIRED PERMITS. 6. CLEAN UP AND REMOVE ALL JOB-RELATED DEBRIS FROM JOB SITE. 7. MAIL OUT LIFETIME, NO-LEAK, NON-PRORATED, TRANSFERABLE WARRANTY FULLY COVERING ALL LABOR AND MATERIAL, INCLUDING ALL STORM DAM- AGE FROM RAIN, LIGHTNING, HAIL AND WINDS UP TO 170 MPH. 8. ADDITIONAL INFORMATION: 9. IT IS UNDERSTOOD THAT THE FOLLOWING AREAS WILL NOT BE INCLUDED IN THE COVERAGE AREA PROVIDED BY THIS ~~W~~~lng at Right): / OTHpi:J!JESf;tt/l1~Nr L!K.~172- SHOW ALL AREAS OF HOME. DRAW ADDITIONS AS NECESSARY. WRITE "YESM IN AREAS TO BE COVERED. WHITE "OMIT" IN AREAS NOT TO BE COVER EO. ;14/tJ ;I/}HE' LIt'S c7tRP~& oiiiT 15lIiTJ y II D . CUS~OMER INITIAlS NOTE: RETAIL SALES TAX MUST BE CHARGED UNLESS THE CUSTOMER SIGNS THE FOLLOWING: I certify that I own the land on which the structure I am improving is perman.ently affixed, Furthermore, I have filed a declaration with the Property Appraiser requesting the structure be assessed as realty and it bears an "RP" decal. SIGNATURE: AJt 'C) \) ~ ~ ~ ~ ~ ~ \:) \0 ~ '- ~ ~ d ""'" ....,.." c _ ()~ ~INVINCIBLE~ ~O~K'g~~~ Customer 11;:s. 1tL8E:f!711 DIeHL MHpjJ/tJreR6 Job Address 'I'1tJ~ C:C//-At/'E 5r City ;l-LPllyRHILL.S Zip 339// Phone (613 ) ?tf:J... #}/:/ SYSTEM: <<ULTRA GOLD-l-l/4" Insulation 0 Silver-3/4" Ins. 0 Bronze-Membrane only VENTS: Small g Large f! STUFFERS: Quantity tJ Size: ,- A. SKYLIGHTS: Quantity tJ Size: -==- X -= GABLES: Quantity -a Size: @ SHOW ROOF PROFILE HERE! Show Ridges, Drops, and Flaps INCLUDING Dimen~~onsl ( ///~ ( 1/ '('" (1') I ~L 1(3' If roof is a Double-Wide, (()'I)C~~~:: show width of EACH half! I <<< FLAP DIMENSIONS Must include Over-Seals, Ridges, F~S smd .Drors'll Home: S x 3'1:(, FI. Room: - x - Carport: - x Other: -- x 86f,5 ROOF DIMENSIONS: Show all Lengths and Widths to be covered, includin~ Over-Seals of 6" each Side and 6" Front and Back. If Main Home is Double-Wide, Show Width of Each Half! Main Home INCLUDING Over-Seals: NOTE: INDICATE SOFT DECKING o l-W!cle W!dth = Tftt" J )"/ 1/ I'~ 1;'/' AREAS WITH "X"S ON DIAGRAM! t 2-Wlde Widths =/..LL + ll.L + ~ f 72'/ " ength =.:;A.l..IL.. f< 53'! II >{ 7f Ilk" <<FRONT CAf!.f(JRT dr.l/,.",- ,t fllEl 1.,1 fAN ' (1!'1IT Type of existing roof: J1~l Should a Tear-off be considered? IJ{J Is there soft decking that may need to be replaced? /1/1.1 ,V tJ2; SPECIAL INSTRUCTIONS: DIRECTIONS TO JOBSITE: -15 - tJ fl\J~R 71J t lJl! LEFI It Co/771~ fr j}/>f #rlPt/ It) /ltJl1 EA /5' 1'/0 t:..A/(e ALL WORK DONE TO SATISFACTION Customer Signature:, Date: COD Amount: $ ,~ LJtJ tf..f.J. Crew Leader Signature: Work Order Submitted By: Date: :3).;;)2 10/1 0/97 TO BE COMPLETED IF CONSRTUCTION VALUE EXCEEDS $2,500.00 Permit # 111111111111111111111111111111111111111111111111111111111III 2002040493 Tax Folio # Rcpl: 573e01 os: 0.00 03/14/02 Rec: 6.00 IT: 0.00 Dply Clerk OFFICIAL NOTICE OF COMMENCEMENT State of Florida Countyof ~5eO JEO PITTMANA PASCO COUNTY CLERK 03/14/02 0:11 : 49am 1 of 1 OR BK 4888 PG 72 THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in the Notice of ' Commencement. "'- I. Description of property: Jk,,.,..,,, ~c.4r4"''<1 Ar 'I9~/I (h;r/'1(;C7 Sr: 7p/H,Y~ hI/~~.s J ,.rc ./l1-Rct9~ # It{ :l~.:ll lIO eJo;J.t!)o ~oao ~ 357'-// I 2. General description of improvement: .;J:.f~~p- ~h ~t.. Sn'h'~;"s ft"v ~G/17,B~/Q/I/ P \. 3. Owner Information: A. Name and address: ;/L.lJG/fLTA- B. Interest in property: ~W.uG '€. C. Name and address of fee simple titleholder (if other than owner): A.J A- ~ lAp #L q.9~~ IJ,hl9~G 5'7: .7~h~.vR ;l-llt<) FL ~5.!>'Y) R 4. Contractor name and ~ddress: &/~ ~t/5.9h/Uv/n..Jc / ~L.C A>,$'oC'.:z:Nc . 1..It9-' I -?~ ~>- /~ LI ,-~ -, _ ' , (v :> f ..b~~, ~~,., ~.~GO; .-~, -'Ii /""""__,_ '.,,_ ..; .. .. 5. Surety (if required) A. Name and address JU.a B. Amount of bond $ 6. Lender name and address: flI.4 7. Persons within the State of Florida designated by Owner upon notices or other documents may be served as provided, by section 713.13 (1) (a) Florida Statutes. Name and address: 8. In addition to himself, Owner designates Mt//n,.JC / 8~c,- ffis c;:JC, to receive a copy ofthe Lienor's Notice as provided in Section 713.13 (I) (b) Florida Statutes. " 9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is specified) ,20_ .- Q:,-.-".' _.~'). ..,...- - to. ..L.....:....1o . -,. UI5,,,J:U...<? "'~..... W""V'; ....r I ~!.o...""'HZ('!- .'"l.gt.,.. YO~4d~~ ~ """'1. Shirl A H "1/. ~ ey n. unter Canm1aldoo f# DO 012555 ExpIree M8)1' I, 2005 , AiIu STATE OF FLORIDA COUNTY OF PAS'CO THiS IS TO CERm~y THAT THE FOREGOING IS A TRUE AND CURRECT COpy OF THE DOCUMENT ON FILE OROF PUBLIC RECORD ;f'J THiS OFFI~ESS MY HAND Ad14Z,L SEAL 2T~~ DAY OF JED PI, , CLERf, OF CiRC T COURT BY 'DEPUTY CLERK . Swore. and subscribed before me this 1L:._dayof M~,~ , 20~L r a'IWINClIILF 1 Making Florida a better place to live since 1987... one home of a time. '~ Contractor's Letter of Authorization I hereby authorize the below named individual to act as my agent to obtain all necessary permits for residential roofing work for: Owner 4A6~ 1lf IJI~ /It::.- at this location: 490<1 (), 7rAc;G ,57,: ZeAfi.YA #'a~ I,cL ~'J.,.,t/ / This person Is also empowered to obtain, complete, and sign all forms, applications, registrations, and Clocumentatlons, with this lim- ited power of attorney, on behalf of me that may be required to accomplish the issuance Of onv C'ormit, thnt may be required in any JuriSdiction throughout th~j :;~r]~e "f F/Clri'-kl Authorized Person:. ~A!O A.J A/-I~oc;<...J/---' Aufhorized Person's Signature: ~ ~ Brian Stover State License #CCC049367 .. ,a"..Y.~;IB(lo MONA L. BUTLER '.. MY COMMISSION # CC 961647 '* * EXPIRES August 16, 2004 BonUt~r.j Budget Notary Services INVINCIBLE AS:;OClArr:S. INC IC93175THST, . lARGO.FLJ3777. 72//5/15.1800. aOO/937.66J5 STATE CERTIFIED LICENSE II CCC049.161. CRCOl5276 (INVINCIBLE] State Certified License # CRC015276 Owner's Letter of Authorization I hereby authorize the below named individual to act as my agent to obtain all necessary permits for residential ~i " . work for: . t~AlVrr Owner: /) LeJ/~'/Q. T/9 D, 'eHL At this location: tf9t:JL! L'c:>/7r1hG $/-, Ze,(J/.,t J/I'?H/tC.S I F~ ~? G'c; I , , This person is also empowered to obtain, complete, and sign all forms, applications, registrations, and documentation, with this limited power of attorney, on behalf of me that may be required to accomplish the issuance of any permits that may be required in any jurisdiction throughout the State of Florida. Authorized Person: Idt /flot-V I/-~ /-/ IJOC-<-J~ Authorized Person's Signature: ~ ~ ~ Owner's Signature: C/-~ "z;? ~ . FL (Jt<'f LIe '-:Ii: tJ--t/ifJ-tltJl-25- 7iZ'Z; INVINCffiLE ASSOCIATES 10931 75TH ST. LARGO,FL 33777 727/545-1800 800/937-6635