HomeMy WebLinkAbout05-3785
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3785
Permit Number: 3785
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 6,826.00
Date Issued: 1/24/2005
Total Fees: 65.00
Amount Paid: 65.00
Date Paid: 1/24/2005
Work Desc: RE-ROOF
Address: 37400 DERBY HIRE DR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: WEDGEWOOD MANOR
Parcel Number:
Name: MR. KONYHA
Address: 37400 DERBYSHIRE DR
ZEPHYRHILLS, FL. 33542
Phone:
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.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~ D -1Z,~_.
~. 1'Nv!-. ~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
JOB ADDRESS
m R. . l(n ,0'1 <<-A
37400 DCQR'{ s.~
DR.,
PHONE (?513) ry,~- L./dd~
Z t ~H 'I, 6<- \~-:s:u.. S I \= L 3'3 :;Lj (
OWNER'S NAME
SUBDIVISION vVEDl-..'S\.>.X:JU,,~
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL 10 # \ (') - d ~ ~ d \ - (') 1;:)(') ~ ()()('...JOC - I (I~O
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o 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
R~ Q.Qb v:
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
$ ~I ~d<Q .6D
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL $
o GAS ~OFING 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 AREAO YES 0 NO
BUILDER
SIGNATURES- \..1. 'r~
COMPANY w. A I t-J {;u (V\ At->,..J C.Clt...;sTR.uc-IJ::.c.n.J
STATE CERT OR REGIST # cBc.. ()5~ \ 55""
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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 po~tions 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 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 corrunencement.
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 corrunenced 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" wil1 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 corrunenced 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 corrunenced. 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: 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
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 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid DUd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
'Roofing <Vivision
LlC# CBC058155
LlC# CCC1326166
January 19,2005
Mr. Konya
Wedgewood
W.A. Neumann Roofing Division, Inc. proposes to furnish all the labor, material, supervision,
equipment, fees and other costs to complete the project according to specifications listed below.
The price includes:
1. Tear off existing shingles to the wood deck.
2. Replace any rotted wood at an additional cost of$65.00 per
sheet of plywood, or $4.50 per foot for fascia, etc.
3. Install 30# UL felt underlayment.
4. Install new eave drip.
5. Install new galvanized roll valley metal.
6. Install all new led boots and vents.
7. Re-seal, and re-use all 4x6 wall flashing.
8. Install new 30 year Elk shingles.
9. Haul away all roof-related debris.
10. Our liability insurance coverage is based on completed operations.
11. Provide a 5-year workmanship warranty.
12. Payment due upon completion of roofing project.
It is understood and agreed the W.A. Neumann Roofing Division, Inc. will be held harmless for alleged
or actual damages/claims as a result of algae, fungus, or mold. It is understood the roofing contractor
and the roofing contractor's insurance will exclude all coverage, including defense, damages, related to
bodily injury, property damage and clean up directly or indirectly in whole or in part for any action
brought by mold, including fungus and mildew regardless of the cost, event, product or workmanship
that my have contributed concurrently or in any sequence to the injury or damage occurs.
Total $ 6,826.00
Accepted By:
W.A. Neumann Inc.
Roofing Division
-~~~
NOTICE OF COMMENCEMENT
state of 'f LaR:c\)A.
County of ~f>t"'SC.a
THE IrnDERSIGNED 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:
1. Description of Property: Parcel No. ID-J.L.D-dl- ol'd-O - 00000 - \O~O
(Legal description of the property and street address if available)
2. Gt::u<::Lal Desc1:'il-ition of ImprovG:Incnt R~ ~';:
3. Owner Information: Name \'fiR, \Z-l\~'1I-\-p..
Address '3'7l.\00 \)iR(?,,,\ $\-tt.Q~ ~~ City 2e\\l.~R\-\'3:L\..S
Interest in Property:
State ~L.
Name of Fee Simple Titleholder:
(If other th~n owner)
Address
City
State
4.
Contractor: Name l.u . A. t-J~\..LfV\A~y..j
~Cr--l-:::'TR.v..c:..\':rO...J
Addre s s \).0. ~6)... \~ N1
City ~~ Ato:lT6r0IO
State t=-L
5. 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
of to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
9. l~){pllI1Liou uttLe ot Notice of CuullllellcolllouL (Lhe exp ration uate is 1 year
fr0m the date of recording unless a different d' . .
.. ":"-'. AMANDA MCCULLOUGH I
'.,; MY COMMISSION # DO 196694
D.."~PIRES: March 25, 2007 :
~ """ Thru Notary Public Underwrilers
Signature of Owner:
l~
c:0- \ -.( \r,
Sworn to and subscribed before me this
day of --=rr1I1,..... rc..L~
,
~OO5
Notary ~UbliC: [iU,l ~ ~1Ll2f,-
My Commission Expires: q 7_007
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