HomeMy WebLinkAbout04-2636
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2636
Permit Number: 2636
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 1,500,00
Date Issued: 1/12/2004
Total Fees: 40,00
Amount Paid: 40,00
Date Paid: 1/12/2004____._
------work Desc: RE-ROOF
Address: 39013 1ST AVE
ZEPHYRHILLS, FL
Township: Range: Book:
Lot(s): Block: Section:
I Subdivision: CITY OF ZEPHYRHILLS
i Name: JASON & KATHRYN PETTY
I Address: 39013 1ST AVE
i ZEPHYRHILLS, FL 33542
Phone:
.-----'--------------.-, I __.
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) 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
-"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."
-----. Complete Plans, Specifications and Fee Must Accompany Application:---------
___u_.__________~!I~ork shCl-'L be pe~orme~ in accordance with City C~esand Ordinan-<=~~____ ____ __ __
NO OCCUPANCY BEFORE C.O.
~
OR URE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
""
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX:B13-7BO-0021
DATE RECEIVED
/,./,J-pV
I
LEGAL DESCRIPTION: LOT(S)
7
!~.d? -dl- t7tJ /P
PHONE CONTACT FOR PERMITTING
OWNER'S NAME
PARCEL ID #
BLOCK I SUBDIVISION
.- /J P/ ,tJf} - tfJp7clJAIN FRO:
!Jz:5- 7 f' (J- 1 JY,f
.. J:Jr. ,;J
II{,.( (/t J J- J'1/..6,
JOB ADDRESS
WORK PROPSED: ONEW CONSTRUCTION o ADDITION o ALTERATI ON ~EPAIR o INSTALL
Os I GN o MOVE 0 DEMOLISH
PROPOSED USE:~L FAMILY DWELLING OMULTI - FAMIL Y 0# OF UNITS o MOBILE HOME
o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER
PROPERTY TAX NOTICE)
DESCRIPTION OF WORK
o RESTAURANT & ~TH DEPARTMENT APPROVAl,
Il/~J ffPL
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
o BUILDING
$
PERMITS REQUESTED
/JOP,PO
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE J10 FLORIDA POWER 0
W.R,E,C,
o ELECTRICAL
o PLUMBING
o MECHANICAL $
o GAS ~OOFING 0 SPECIALTY
TYPE OF CONSTRUCTION:~~LOCK
FINISHED FLOOR ELEVATIONS
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
o FRAME
I
o STEEL
o OTHER
IS PROJECT IN FLOOD ZONE AREAO YES lft(No
BUILDER
SIGNATURR<'
'~~~c;~I!i;,11;QW~()ft
~~
**********************************************************>*******
._-------------..---.
COMPANY
STATE CERT OR REGIST #
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
******************************************************************
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
---..---..
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" whicll
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
8, 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, 813-780-0020,
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 s~gns 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 applicanf, 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.8. 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 extem::ion 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".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 20_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
ackno\'-lledged
, 20
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
Qho is personally known to me, or
Owho has produced
(type
and whoO did 0 did not
of ident~fication)
take an oath,
Owho has produced
(type of identification)
and who Odid D:lid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
HUD-1
A. Seitlement Statement
B, Type of Loan
U.S. Department of Housing
and Urban Development
OMB No. 2502-0265
() 1. FHA
() 4. VA
7. Loan Number
609444-40
() 2. FmHA () 3, Conv, Unins.
. 5. Conv, Ins.
6. FiJe Number
03-12-46
8, Mortg, Ins. Case Num.
C, NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the selt/ement agent are shown, Items
marked "(p,o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
10:
D. NAME OF BORROWER:
Address of Borrower:
E, NAME OF SELLER:
Address of Seller:
F, NAME OF LENDER:
Address of Lender:
G. PROPERTY LOCATION:
H, SETTLEMENT AGENT:
Place of Settlement:
I. SETTLEMENT DATE:
Jason R. Petty and Kathryn Petty, his wife
6504 Huntington Drive, Zephyrhills, Florida 33541
Stephanie L. Nelson f/kJa Stephanie L. Brown, a married woman, joined by her husband, David Nelson
38847 Alston Avenue, Zephyrhills, Florida 33542 TIN: 226-96-3822
GTE Federal Credit Union
711 S. Dale Mabry Highway, Tampa, Florida 33609
39013 1 st Ave, Zephyrhills, Florida 33542
Meridian Title Company, Inc.
37837 Meridian Avenue, Suite 311, Dade City, Florida 33525
1/9/04 DISBURSEMENT DATE: 1/9/04
TIN: 59-3597293
Phone:
. , . . . . .
II . . . . , . . . . ,. . . . , . . .
101. Contract sales price 56,100,00 401. Contract sales price 56,100,00
102. Personal property 402. Personal property
103, Settlement charges to borrower (Line 1400) 2,189,18 403.
104. 404.
105. 405,
. , . , I. . . . , . . , , . too. . ,.
106, City/town taxes 406. City/town taxes
107. County taxes 407. County taxes
108. Assessments 408. Assessments
109. , 409.
110, 410.
111. 411.
112. 412.
120. Gross amount due from borrower: 58,289.18 420. Gross amount due to seller: 56,100.00
.. . . I. . . , . . I . . .. . , I I . . . .
201. Deposit or earnest money 300,00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) 50,490,00 502. Settlement charges to seller (line 1400) 7,267.28
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204, Principal amount of second mortgage 504. 091 0214018/Payoff Chase 32,779.42
205. 505. Payoff of second mortgage loan
206. 506. Deposits held by seller
207. Principal am! of mortgage held by seller 507, Principal amt of mortgage held by seller
208. 508.
209. I 509.
. , . ... . . . . . t.. . .
210, City/town taxes 510. City/town taxes
211. County taxes from 01/01/04 to 01/09/04 8.04 511. County taxes from 01/01/04 to 01/09/04 8,04
212. Assessments 512. Assessments
213, 513.
214. 514.
215. 515.
216. 516,
217. 517.
218, 518, .
219. 519.
220, Total paid by/for borrower: 50,798,04 520. Total reductions in amount due seller: 40,054,74
.. , . , . .. , ,.. . .
301, Gross amount due from borrower 58,289.18 601, Gross amount due to seller 56,100.00
(line 120) (line 420)
302. Less amount paid by/for the borrower (50,798.04 ) 602, Less total reductions in amount due seller (40,054.74)
(line 220) (line 520)
303. Cash ( ~ From o To ) Borrower: 7,491.14 603. Cash ( ~ To o From ) Seller: 16,045.26
;ubstltute Form 1099 Seller Statement: The information contained in blocks E, G, H, and I and on line 401 is important tax information and is being
urnished to the IRS, If you are required to tile a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and
he IRS determines that it has not been reported,
leller Instructions: If this real estate was your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your tax
eturn; for other transactions, complete the applicable parts of Form 4797, Form 6262 and/or Schedule 0 (Form 1040).
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HUD-1
. . age
. . I' :. . -,
. -, Paid from Paid from
700~Total Sales/Brokers Com, based on price $56,100.00 @ 6.0000 % = 3,366.00 Borrower's Seller's
701. 1,868.00 3.3298 % to New River Realty of Pasco, Inc. Funds at Funds at
702. 1,498.00 2,6702 % to Prudential Tropical Realty, Inc. Settlement Settlement
703. Commission paid at settlement 3,366,00
704. to
:.. . .. ..- I . 0 o. :. I -. . - I
801. Loan origination fee %to
802. Loan discount 2.5000 % to GTE Federal Credit Union 162.25 1,100.00
803. Appraisal fee to ACM Appraisals 275.00 25.00
804. Credit Report to ~I Cltl-IJI.- nATA
805, Document Preparation to GTE Federal Credit Union 150.00
806. Processing Fee to GTE Federal Credit Union 150,00
807. Tax Service Fee to GTE Federal Credit Union 60.00
808. Flood Certification Fee to GTE Federal Credit Union 18.00
809. Wire Fee to GTE Federal Credit Union 15.00
810. Underwriting Fee to POC I GTE FeU
811. Non-Refundable App/. Fee to GTE Federal Credit Union 50.00
i IK!T' . . . . I I . I' 0 .. .. . I . . :. . -, . .,
901. Interestfrom 01/09/04 to 02101/04 (ci) 7.9539 /dav 182.94
902. Mortoage insurance premium for months to
903. Hazard insurance premium for 1 years to Citizens 327.00 272.00
904. Flood insurance premium for years to
905. years to
-II . . -. . . ..... . . . ; - -,
1001. Hazard insurance 3 months em $49.92 oer month 149.76
1002. Mortgage insurance months (ci) oer month
1003. City property taxes months (fj) oer month
1004. County property taxes 5 months (ci) $31,93 oer month 159.65
1005. Annual assessments months (fj) oer month
1006. Flood insurance months em oer month
1007. months (ci) ner month
1008. months em oer month -63.93
1009, Aggregate accounting adjustment
.. . . . . -, ... .. ..
1101. Settlement or closing fee to Meridian Title Company, Inc. 75.00 75.00
1102. Abstract or title search to Chicago Title Insurance Company 50.00
1103. Title examination to Meridian Title Company, Inc. 50.00
1104, Title insurance binder to
1105. Document preparation to
1106. Notary fees to
1107. Attorney's Fees to
(includes above item numbers: ),
1108. Title Insurance to Meridian Title Company, Inc. 225.00 322.58
(includes above item numbers: I
1109. Lender's coveraoe (Premium): $50,490.00 ($25.00)
1110. Owner's coveraoe (Premium): $56,100.00 ($322.58)
1111. Endorse: 8.1-25;F9-34.76 59.76
1112. Courier Fee to UPS 20,00 20.00
1113. to
.. I . . . I I . . . .
1201. Recording fees Deed $10.50 Mortoaoe(s) $91.50 Releases $6,00 102.00 6.00
1202. City/county tax/stamps Deed Mortaaae(sl
1203. State tax/stamps Deed $392.70 Mortaaae(sl $176.75 176.75 392.70
1204. to
1205. to
.. . 0 . . . . ; -, . -
1301. Survey to Northstar Surveying and Mapping 250.00
1302. Pest Inspection to First Choice Pest Insp. - No Charge
1303. Home Warranty to American Home Shield 385,00
1304. Electric to Martin Electric, Inc, 1,500.00
1305. to
1306. to
1307, to
1308. to
1309.
I~.. . .
I { Enter on lines 103. Section J and 502. Section K I 2,189.18 7,267.28
U S Department of Housing and Urban Development
P
2
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on
my'-~~::=~:t:? rnrtho'~:'~M I h". ~-::,~~. HU~' S2f4S~;~ ~ 171u'}JY\J Se""
-~ ~;ffl-<
David Nelson
Borrower
The HUD-l Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused, or will cause, the funds to be disbursed in accordance
Nith this statement.
l
Seller
3y: Meridian r le,~ny, )nc:. / _ 9 --c;;~
As Its Authorized epresentative Date
IVARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a
ine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
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