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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2964
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 7,200.00
Date Issued: 4/16/2004
Total Fees: 70.00
Amount Paid: 70.00
Date Paid: 4/16/2004
Work Desc: RE-ROOF
2964
RE-ROOF
ROOF REPLACEMENT
SINGLE FAMILY RESIDENTIAL
Address: 6543 BRENTWOOD DR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot{s): Block: Section:
Subdivision: SILVER OAKS
Parcel Number:
EVELYN GOODROW
6543 BRENTWOOD DR
ZEPHYRHILLS, FL. 33542
Phone:
I
I--,~-.,--~._~_.__--L__~'_~.____..___.~~,~~__~__~~__-"---------__"--.~--.~- --~~~
REINSPECTlON 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:
I
(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 inspectionfees shall be made before any further permits will be issued to the person owning same
--'iWiII-mlng 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 Plan0pedficationsandFee Must Accompany Applicatio-",----~ ------- --
~ ~ .-,------ ~ _~II_'_Yor~~aU .~~.. p~r!~~I'I1~<:lJ~_C!c:co~9~~ce with_9ty Codes and, OrdinaIlS~~___ n_______~,_~_
NO OCCUPANCY BEFORE C.O.
-- - - - ----- --- - -- #~-- --- -- ------._---'--~-~--------
-~ /~ ~
CO CT ATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
~
Scott BladUnan Rooitg
~~~ "
P.O. Box 1188
8fII AnDIiD, FIadda 33576
Phone: 352-688-7883
Fax: 352-68&9783
PROPOSAL SUBMITTED TO: /JYI)~{ 6&CJi''; ",v'
PHONE: 7f5 3- 7~ 75-
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SfREET: to -', --- to' ...,..... \
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.....'>~,
CITY, STATE and ZIP:
2<;::,A7t' ~. It"
Fax#:
DATE:
'3!.J-3!t: i
We hereby submit specifications and estimates for:
Remove Existing Tile Roof
Use #301b Felt Paper
Replace All Pipevent Flashings
Install New Metal In Valleys
Replace All Roof Vents
Install New Drip edge
Apply A 30 year fungus resistant Dimensional Shingle
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Clean Up and Haul Away All Debris.
Wood Work Extra- $ 35.00 per sheet and $2.50 per Ix? And 2x?
Covers Materials and Labor
We propose hereby to furnish material and labor-complete in accordance with above specifications, for the
sum of: .d'7 ) ,~,~ C'.O
f1P I/\'-C
(Payment due in full on completion, Thank: YOU.)
All material is guaranteed to be as specified. All
work to be completed in a workmanlike manner
according to standard practices. Any alteration of
deviation from above specifications involving extra
costs will be executed only upon written orders, and
will become an extra charge over and above the
estimate. All agreements contingent upon strikes,
accidents or delays beyond our controL Owner to
carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workman's Com-
pensation Insurance.
I '"roO''=' ""~. tur..e:.
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Note: This proposal may be
withdrawn by us if not accepted within 15 days.
Acceptance of Proposal-The above
prices, specifications and conditions are satisfactory
and are hereby accepted, You are authorized to do
the work as specified, Payment will be made as
outlined above. -
Signatu~ ~.
J';:.L..,..d''r''-'/ )J'1 ".-/ - k~'v
Signature:
Date of acceptance: 3 - ..., - -0
::n..:::J
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
L( (~ -or
PHONE CONTACT FOR PERMITTING
OWNER'S NAME
~cr-_~
G~, /Y c/~:?/J cJ'
Or~"''''; ~a~/
PHONE
"iJJ -' ~.2 7~
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JOB ADDRESS
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LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
WORK PROPSED: (JNEW CONSTRUCTION
(J SIGN
PROPOSED USE: (JSGL FAMILY DWELLING
(J COMMERCIAL
(OBTAIN FROM PROPERTY TAX NOTICE)
(J ADDITION
(JALTERATION
(JREPAIR
(J INSTALL
(J MOVE
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
/~ /~OZ7P:
./
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.
(J BUILDING
$
l~D
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
(J ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
(J PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
(J ROOFING
o SPECIALTY
(J OTHER
TYPE OF CONSTRUCTION: (J BLOCK
o FRAME
(J STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
CO~Q'1'():a/.SECTION
BUILDER
~/~
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
********************************************************k*********
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 ndeed 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, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign po~tions of the nContractor 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 nFlorida'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 nowner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the nowner" 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.
Appli~ation 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 nA" or nA,etc.", it is
understood that a drainage plan addressing a ncompensating 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 fora
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 nNOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 2~
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
acknowledged
,20_
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did D did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid O:iid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
NOTICE OF COMMENCEMENT
-i
State of
..."';, ~ ,~'.<
County of
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Tl-H~ UNDERSIGN~D hereby gives notic~ that improvement will be made to certain real property,
~r~d III a.ccordance wIth Chapter 713, Flonda Statutes, the following information is provided in
tl11S NotIce of Commencement:
\ .
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Description of Property: Parcel No.
f --
:'-"... ..,,1 .-
,<:;.
(Legal description of the property and street address if available)
General Description of Improvement
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".,;\. 3. Owner Information: Name
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Address
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City,/~: "t9.t? '-.rf,/;,:-. f
State
Interest in Property:
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Name of Fee Simple Titleholder:
(If other than owner)
Rcpt: 773558
OS: 0.00
04/14/04
Rec: 6.00
IT: 0.00
Dpty Clerk
Address
City
State
Contractor: Name
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Address I"; (/ //1); f If J
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City 5'4' jj ,41j} ft> "! / v .'\ State FIe...
5. Surety: Name
Address
City
State
Amount of Bond: $
JEO PITT"AN~ PASCO COUNTY CLERK
04/14/04 0.:;: 2!lm 1 of 1
OR BK 5801 PG 1863
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.'-_A..n ~e,... ame
Address
City
State
Persons within the State of Florida designated by Owner upon whom notices or other
documents may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes:
Name
Address
City
State
8, In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unless a different date is specified.)
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Signature-of Owner:
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Svv;rriloand sub$cribed before me this Z3~ day of MA ff! .?I , 20 04 .
NotaryPui'ilib:.... ,.,.~ i;;?c1 R~~ __
IV! Y Com miss i'~~ -E~ pires: " . ": iIti;>, Jeffrey T orld R,utiman"
/"'~~.~-:.-:. Com~ission #DD159234
LC9:3053048/ A ~~. 'fJ.~:~ ExpIres: Nov 15, 2006
";;~ OF f~O~~':: Bonded Thru
'"""" AtlantiC Bondmg Co" Inc,