HomeMy WebLinkAbout05-3739
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3739
Permit Number: 3739
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: CHURCH
Square Feet:
Est. Value:
Improv. Cost: 3,400.00
Date Issued: 1/07/2005
Total Fees: 50.00
Amount Paid: 50.00
Date Paid: 1/07/2005
Work Desc: RE-ROOF
Address: 5059 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
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.
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CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
PROTECT CARD FROM WEATHER
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Licensed,' Bonded & Insured
Proposal/Contract
SetIh ~~ 'ieH/Ut9" 91te..
, . P.O. Box 1188
33010 SR 52
Saf.l Antonio, FL 33576
(352) S88-ROOF (7663) · (813) 782-1330
Fax (352) 588-9763
State Certified Roofing Contractor
lic. # CCC057957 ,
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PROPOSAL SUBMITTED TO
WORKED TO BE PERFORMED AT
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We~~by pr0pose to furnish all the materials and perform all the labor necessary for the completion of: ~
o Remove existing shingle roof Q Replace bad fascia boards at $'\ ,,',. J,' per foot
CJ Remove existing bUilt-up roof a Install feet of ridge vents
o Dry-in with 0 15 lb. 0 30 lb. 0 Install modified bitimen (granulated) torch down roofing
D Install new galvaniZed v.alley metal black, white or other color
o Install new lead boots Q Install 25 yr. fungus resistant 3-tab shingles
(J Install new exhaust vents, . .' V.; (J Install 30 yr. fungus resistant dimensional shingles
o Install new drip edge. color a Shipgle manufacturer color
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D Ins.tall new flashing as needed . Q1'nstall TPO, white'rubberized roofing membrane
Q'Replaceplywoodat$~";' '., .' per sheet Gl'bther: ~:;e.v 'llr-;:'.,.!('~;',,- ~.'o,j"....' too (,~ I:'
Q Repair rotten trusses at $ per'toot . .,~:.: : ,. ,.
"Woodwork is an additional charge, see pricing abo,~ '-::' .., ,~{ ~"', .~'_'~ _,,,,,. ~~~, ,;
;' :>.t. Fax
Owner of Property
Phone Number
Fax
All mat~rial is guarimteed to Da as specifiea: ~hd the above work is to be perfOrmed is accordance with the drawings and specifi-
cations submitted for above work and completed in a substantial workmanlike manner for the sum of $ ( ,
with payments to be made as follows. P~yment due in full on completion, unless otherwise noted. Thank You.
We do accept credit cards with an addtionaI2.8% charge.
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Any anenllion or oevielion from above specifications InYOlving extra COSIS will be
executed only upon written orclllfS. and will Decome an ed,. cnarge OYer ana
above the estlmate. All agreements condllg8nt upon strikes. aooldenlS or delays
beyono our conltol. Owner to carry fire, IOlnlldo ana other neces&8ry insurance
upon aboV8 worlc. WOIleeni' ~I\ and PullllC LIability Il\surance an lIDoV8
wort< to be taken 0111 by Roofing Conll'ador.
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Officer/Agent Scott Blackman Roofing
Note: Thi~ proposal may be withdrawn by us if not accepted
withIn / i~:' 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. I have read the back of this ProposaVContract. which contains Florida Stautes 713.001-713.37. Payment will be made
as outlined above.
Accept8(i, ,
Date
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Signature
Signature
HI 39l;;1d
9NUOOCl C1HS
E9L688SGSE
SS:E0 S00G/90/!0
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME t=,'C'S.-\ t."'-\A.~h r',.f (~_\--..>r,.s-t \ Sc ~-<-Y'\"-S-t PHONE Vl Y)..-\ ~30
JOB ADDRESS '~O '"5'1 G~ 01~. L~f"0'" \""-l\S ... ~hn~\1a,\ Sc \(~~ r~~I~pliJ~
LEGAL DESCRIPTION: LOT(S)
BLOCK
\ I - d \0 - d- \ - GO (0 - t 91 60 - 00\ 0
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
~COMMERCIAL
OMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
.~ e.-~
<3. I r-. :s" L
BUILDING SIZE
SQUARE FOOTAGE
Lv ~ f \'"1l
J"J- ~ V
Y\-.{ 1;1.... h...... a-(
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
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL $~l\c...X)_o()
o GAS ~OOFING 0 SPECIALTY
TYPE OF CONSTRUCTION: 0 BLOCK
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
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COMPANY
SIGNATURE
STATE CERT OR REGIST #
OTHER ~ )+:.~
SIGNATURE '~G-- ~ ~l.-.--
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COMPANY Sees\:\ ~\~l.~...... \2cc, f; ~ ~
STATE CERT OR REGIST # Cc... C GS ') <7 :)"' J
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, 813-780-0020.
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 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 "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.
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 "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".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
acknowledged
, 2U--
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
o who has produced
(type
and whoO did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and who 0 did [)did not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
NOTICE OF COMMENCEMENT
r-
State of /-,L tJ /.::. I .0 ,4
County of
f;4 ,yo (.. 0
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
this Notice of Commencement:
Xl.
Description of Property: Parcel No. JI - cP--f, - (;II -' r}O J 0 - J 9/0 0-- C/o / t.-'>
Tot,.) rJ (; f' l-G'rI..tr IL/f Ii S P B J P~:r'f t. cJT / /k..x./;c:.. / f /
So 6 'i 19 J., iJ . '". C If;'s-, ;J C r .,~I I!.. ~A- j C-)> ..--Yj
(Legal description of the property and street address if available)
2.
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General Description of Improvement (,{e-~/T)Ju,q,- j? F Ulh/YltVd"'1 - ~ f::,.-PL.4cJ/T1..:.~v,-
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1111111111111111I111111111111I1111I1111111111111111111111111
2005001570
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Owner Information: Name ~JI~.I;' (: ;liJtc:..,-:J
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Address 3 Y':.J-Y3 ,/';v./~,7it /1..) \:!~..vJi r-
City kf4yvJ... iJ.j, State p '-
R t. 843662 Rec: 10.00
cp. 0 IT: 0.00
OS: 0.0 0 ty Clerk
01/04/05 ________ p
JEO PITTMAN PASCO fOUNTYfC1ERK
01/04/05 10: 09am 9054
OR BK 6177 PG
City#? State
Interest in Property: ..4 JL L
Name of Fee Simple Titleholder:
(If other than owner)
Address
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Contractor: NameS<- on /3LAc t. (Y\4A.1
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Addresse.,..).. (v '7- JI J ':?
City .!;;;.'IJ,N A~7f),J, 0
State-L~_ ~:?-?~!_~
City
State
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 L/i...LIA./I/ .J.. ;;:'aP74:./frf'".J[
Address 6 () (0 R.,.[) (;,.., I:'.~ J}tz" ,) ,.[""
Ci ty ""21ff' JfI d-II-/i.-Ld
State ;::; L
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 7.S specified.)
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, Signature ofOw~;0Tt., ~;",:" ,('<>~ "A?ff'<~~ ) eJCc. . J.
Swom to an~.su~'SC9. ~d bef~re me thl~ ,/ / ,day Of~~6-<--
Notary PUQhc: ~/~. _ ~, Dl'\ cL.C-e,'-.
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My Commi's~l$p Expires:'~ " ~? / / 1)-' d --)
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PC93053048/A '~. ~.:.~,,:)t..,.'
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""-:;"~f.P+:... KAY E. BUCKlER
~~~.. "'f~ MY COMMI~SION # DO 225591
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""~,9~ tt~~~'''' Bonded Thru Notary Public Und9lWritars