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Home My WebLink About04-3622 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 3622 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 3622 RE-ROOF ROOF REPLACEMENT SINGLE FAMILY RESIDENTIAL Address: 5173 17TH ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 3,622.00 11/23/2004 50.00 50.00 11/23/2004 RE-ROOF Name: JERRY BROWN Address: 5173 17TH ST ZEPHYRHILLS, FL. 33542 Phone: REINSPEcnON 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. All work shall be performed in accordance with City Codes and Ordinances NO OCCUPANCY BEFORE C.O. ~./ ~ r IQ", ~ t'~- . ' / 0-.- ~C>-€ A_ - vt-- - CONTRACTOR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 _ 813-780-0020 FAX: 813-780-0021 \1 , d)IO~ DATE RECE lVED -1lJ - PHONE CONTACT FOR PERMITTING ~COb -"'\ 6 ~ ~ OWNER'S NAME "e...\('('~ JOB ADDRESS ~ \ f'1~ b'(7)v0~ \ "\~ S-\- PHONE tS-\ -S-/~ d - ~"J3 0 LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # \ \ - ~~ - d- \ - CJO\ (\ - ;=1 (Y'Yfl- C\()-:~ (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: 0 NEW CONSTRUCTION o ADDITION DALTERATION o REPAIR o INSTALL DSIGN PROPOSED USE: ~GL FAMILY DWELLING o COMMERCIAL o MOVE o DEMOLISH DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER D RESTAURANT DESCRIPTION OF WORK ~ & HEALTH DEPARTMENT APPROVAL \\S S<tJ. -') <) d"-' " -t-u-,tv 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. PERMITS REQUESTED o BUILDING $ J b-:Jd ,c:D VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o Progress Energy 0 W.R.E.C. o PLUMBING o MECHANICAL $ ~. o GAS ~ROOFING 0 SPECIALTY VALUATION OF MECHANCIAL INSTALLATION o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO BUILDER COMPANY SIGNATURE 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 # ****************~t~::*************************************** OTHER ~tnnT--Y---- t ~V-4'~~Ls..3~ ~ COMPANY 'Sc.crtt- ]\~\c~'" 7~CJ{\"'J 4(. SIGNATURE A--V--v(~ 'f- ~........" STATE CERT OR REGIST # C C. C OS,\~~q A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to udeed 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 UContractor 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 indica~ion 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 uFlorida'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 Uowner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the Uowner" 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 UA" or uA,etc.", it is understood that a drainage plan addressing a ucompensating 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 uNOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged , 2CL- 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) Owho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or of identification) take an oath. Owho has produced (type of identification) and who 0 did [}:iid not take an oath Owho has produced (type and whoO did 0 did not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped Proposal/Contract S~ ~tad.~ ~~, 'lite. P.O. Box 1188 33010 SR 52 San Antonio, FL 33576 (352) 588-ROOF (7663) · (813) 782-1330 Fax (352) 588-9763 email: blackmanroofing@aol.com L ic:ele~etJt, '&fJleeieti & 11t~",'r.eti Date /" IJ'7 / i/l(! " ~~C"s' L..T I 1/ \,./ ., PROPOSAL SUBMITTED TO WORKED TO BE PERFORMED AT Name I -Ii y, /'j ',. . "~, i..f ',,",if ,) l.A..J ;/ \ I I 7 I h (; I" Street Street ~ 'I' 7'<: J ,i , Fax City State Owner of Property Phone Number Zip C,'ty 7" //.~ ~~- t:t"" i 'J;- /.-1. State I t Phone Number Zip Fax We h~.eb.y propose to furnish all the materials and perform aUJbe labor necessary for the completion of: cr~move existing shingle roof ~place bad fascia boards at $ 3. U c) per foot a Remove existing built-up roof crrr;tall (/~) feet of ridge vents at)ry-in with a 15 lb. cr301b. a Install modified bitimen (granulated) torch down roofing a Install new galvanized valley metal black, white or other color ~"",,,"~'~'--'" Cllnstall new lead boots eflnstall 25 yr. fungus resistant 3-tab shingles ~:;;:: :~:ae~~:ents',,'h. L, color ~:-;::~:~::t~:~~sistant dim~sional S:~~::t ~ I:. (i- a Install new flashing as needed ~all TPO, white rubberized roofing membrane(r/4 c:r~Placep'ywood at $ .j per sheet a Other: erl1epair rotten trusses at $ . ) per foot 'Woodwork is an additional charge, see pricing above Any alteration or 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. AU agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workers' Compensation and Public Liability insurance an above work to be taken out by Roofing Contractor. All material is guaranteed to be as specified, and the above work is to be performed is accordance with the drawings and specifica- tions submitted for above work and completed in a substantial workmanlike manner for the sum of $.? {~. 2.2, Cl(; with payments to be made as follows. Payment due in full on completion, unless otherwise noted. Thank You Credit cardJ accepted, addtionaI2.8% chargE 4~,i ~7_/ ..,~-:; t~/ /.;-5-4/..-/",---_ " " '" Officer/Agent Scott Blackman Roofing Note: This proposal may be withdrawn by us if not acceptel /, within /(/ days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specifi~d. I have read the back of this Proposal/Contract, which contains Florid~,~tautes 713.001-713.37. Payment will be made as outlined above. ! ! i /"'/ Accepted Signature"...;/?1..tl //..f" /' A': 'r-"'r ...... 'L_,_---' J / I' .>''- I Date Signature . I NOTICE OF COMMENCEMEQT State of {701r1 d,,- County of pc<J (Q THE lmDERSIGNED hereby gives notice that improvement will be made to czrtain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Not~ce of Commencement: / (- 2.'-- 2/ -0010 - 2.0300 -Q)OS-O -../,'l. Description of Property: Parcel No. ...)/.) J',,4...,;2. ...., /, ?.3 I Z~?h"'[lJA,II.:5 r/ (Leqal'descrlption of the 2 0 /' ""/3. ~~'~ 11 ':'" 4. .~~..^ ~, '~, 5. 1111111111/111111111/11111111111111111111111111111111111111I 2004217950 .j> r ,$'4 -:L property and 72e jr{)o.{ street address if available) General Description of Improvement Rcpt: 833261 DS: 0. 00 11/22/04 Rec: 10,00 IT: 0.00 -----,,--- Dpty Clerk Owner Information: Name V-iE J-r- Y ;/ !j> l?b~V I ,/ l~ddress /1 f /fa 1-<: "- C- 44 S~/I'j'7 City "-0 z l,-rTJ ~...~ ~, Interest in Property: State F... Name of Fee Simple Titleholder: (If other thgn owner) 11~~~~~MA:j : ~C:~O fOUN~~ C\ERJ< OR BJ< 6118 PG 1161 State Address City' Contractor: Name )CQ:; if [J l4.t i'lllCl~ Address 5]0/0 5.11-5_) City -- (200+,'-'1') _~c."'lAhi1 State F / 33.~?~ Surety: Name Address City State Amount of Bond: $ 6. Lender: Name Address City State 7. 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 / " /1 /' /90 of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Exp.lrllt,ion date or Notice or Commencement (the fr0m the date of recording unless a different expiration date is 1 year date is specified.) \ /.-- . Ol'l-. Ll'~ f.;> \0 ~ ~ '-t- ~() ~ -b '\{_ ~~(-~ Signature of Owner: Sworn to .and subscribed <:;.l...OoS Y ~ Nota.ry Public: f("fL day of ~'-..J ~ V"L&:u../ ,,\\1\111111",,// ~,\\~'{ L. ZELd!ll~ ~ ~\J ....... <"19 ~ ~ 0.;;'\11155/01\' ;00. ~ - .0c;O ~ 17 :.r~ -. ~ ~.. 'i),b I <'t2 ~ -. ~ ~*: .... c.P:*E - . . - Sf)\ ttlJlHm17 :;r- ~::A.:1a ~_ ~.~~ ~ 19. . 0 ~?- """ded \,,\III"~"'~ .' C5 ~ ~ ;t-A.O/ublicUnd\o.~<<"~ 'lllllr8litST~;~ ~\\~~ '"",jlll"'I\"~ PC93053048 , L- My Commission Expires: