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BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
1225
Date
5-/C(-'O J-
BUilDING
elECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address;
Parcel I. D, /I
5Teve-vli-I-ev ~
3"(;537 S'l-1.. A"'c,
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
Ene'gy ~
-1((.2 - e
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL g - 1- 15';z.
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
Inspector
DATE
/100 J RL '(
~' (;)-0
Permit Fee ' (./
~ignaturec:2"' ~Q.--~
Company
Address
08'ephone# .;:.;r;;2~y (I 1.8~-Eo
Valuation or
Contract Price
/..5<11
City license Registration # ~ C?' ;2.,
State Certified license#
_5t, i1~~1~ ~~
BUilDING
SlB
Tub Set
Water
Sewer
Final
MECHANICAL
Ftr.
Pre SlB
lintel
FRM,
Insul. Cl
Wl
Tp. Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Me r
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTlON 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) shaH 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,
. SCHAPER
'ROOfING, INC
11250 s, Hwy, 98, Dade City, Florida 33525 Phone: 352-567-8580 Fax 352-567-7073
STATE CERTIFIED BUILDING AND ROOFING CONTRACTOR # CC-COS8134 CB-COS9817
SEW\l~FlorUUil)j-'F~fl~ &'8~S~1976
,-- .
aTtrJ. t: · 1...12,0 }(~'l/t1.,?rV
4~tC/hl"': L,1l-~ &f'f1,(.~s Date: 4-1,30 I C5 ~
3<if .5-, ~? s 7f.. //~ Cityl County :? _ j-/
.
~ f . ..- 3-,~ ~l..f /
'-~r/1 'yJ'l A. ,'/I ~} rL v
Phone: '/ 'lS ~ - '7 7 7 '-I
Parcel #
Supply labor, materials, and supervision, as needed to: Repair valley and wall flashing on south side of
north east dormer.
Remove screws associated with repair area. Remove valley and panels as required. Install new valley
metal and seal with strip mastic as required. Install remove panels and seal as required. Seal wall
flashine with strip mastic and refasten detail"
Install new ealvanized chimney cap to close off chimney.
GENERAL CONDITIONS: All work shall be carefully supervised and completed by workmen skilled and
knowledgeable in methods needed to produce high quality work. The job site shall be kept clean daily for the
duration of the job and the grounds shall be left clean of all roof related debris after completion. The yard shall
be swept with a magnet. Collection costs if any. together with interest shall be added to the contract price if
payment default occurs. Permit. Workman Compensation. and General Liability insurance shall be provided by
the Contractor, Carpentry. authorized change orders and work which is not covered under the scope of work
outlined herein shall be performed on a time and materials basis unless otherwise agreed upon.
TOTAL AGREE UPON PRICE:
$1.544.00
Terms: $200.00 down. balance upon completion.
tut1/l;/~~
Schaper Roofing by Wl:l.Cd Leiter
Price is good for thirty days.
I accept the above price and terms. You are authorized to commence work.
Date:
Signed
CITY eF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8th STREET ZEPHYRHILLS, FL 33540
Phone:813-780-0020 Fax:813-780-0021
DATE RECEIVED
PLANS REVIEW FEE
OWNER'S
NAME ~-/\J~V1 'Qe-~m0.Jl\
ADDRESS ObS3~ U~ ~\j~
PHONE
CONTACT ~8 C\ ~ ~ 4-, ~
JOB SITE
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # \
WORK PROPSED: [JNEW CONSTRUCTION
\ 0 .- \ 't>2 00 '-c.:x::>l ()(OBTAIN FROM PROPERTY TAX NOTICE)
[J ADDITION
[JALTERATION
[]REPAIR
[] INSTALL
Os IGN
o MOVE
o DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
OMULTI-FAMILY
0# OF UNITS
o MOBILE HOME
o OTHER
[] COMMERCIAL
[] INbUSTRIAL
OSWIMMING POOL
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
VL(()O.Q
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.
[] BUILDING
$_\SL\ ~ --
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W,R,E,C,
[] PLUMBING
[J MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
[J GAS
[J ROOFING
[] SPECIALTY
..
[J OTHER
TYPE OF CONSTRUCTION: [] ~LOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[J YES
[J NO
BUILDBR
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
ELECTRICIAN
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
******************************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
MECHANICAL
******************************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
OTRBR ~~~y
SIGNATUR
*********************************************~*******************
COMPANY ~cc{Je-{-- ~0v~_
STATE CERT OR REGIST # (' C -G0J5?; \ '6 l\-
CITY PROCESSING # ??57
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The-undersigned understands that this permit may be subject: ':0 "deed restrictions" which
may be more restrictive than City regulations. The lmdersigned assumes responsibility for
compliance with any applicable deed restJ:ictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBII,ITIES
If the owner has hired a contractor or contractors to undert03.ke 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 ~ity 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 iri th~s application is accurate and that a~l 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, zon~ng 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 Environment.ally 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 pe~t 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
$~OO IN VALUE OOtf~T ~EEO, TO RECORD AND POST A "NOTIC~"OOFF C COOMMMMEENNCCEEMMEENNIi? "'. _
~ C~~/
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
STATE OF FLORIDA II
COUNTY OF t"'o..~co
The foregoing instrument was acknowledged
Before me this ~day of N.a......, , 19<::.2..
by
~(name of person acknowledged)
[tho is personally known to me, or
STATE OF FL~IDA
COUNTY OF ~~C.C
The foregoing instrument was acknowledged
Before me this ~ day of ~ :rg. 02-
by
(name of person acknowledged)
D~ho is personally known to me, or
Owho has produced
(type of identification)
and whoOdid Odid ~~e an, oath.
~~".Allen
Signature of pe~ W~s~~edgement
~.; Expires october 25,2003
If:"","-
Dwho has produced
(type of identification)
and who ~" [):lid not take an oath
Signature of perso~~ii~~ acknowledgment
..' .. suzanne
ib"'- My CommlsslOfl CC874208
*~ * () teller 25 ?nn3
Name typ'~.f"!ff~"ted or' stamped
Name typed, printed or stamped