HomeMy WebLinkAbout05-3803
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3803
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:
3803
RE-ROOF
ROOF REPLACEMENT
SINGLE FAMILY RESIDENTIAL
Address: 38840 2ND AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
3,230.00
1/31/2005
50.00
50.00
1/31/2005
RE-ROOF
Name: SUSAN GERHARA T
Address: 38840 2ND AVE
ZEPHYRHILLS, FL. 33542
Phone:
'.--.....
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:
(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.
v(~ ~~
o RA OR SIGN~ -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: 813-780-0021
DATE RECEIVED
1/3//05
I '
PHONE CONTACT FOR PERMITTING
OWNER'S NAME 5 Ut 5 C; )II
JOB ADDRESS 3 [) r L..{ 0
G e (' Vt c.t v" c;i1-
dV1d A-vp
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 10 #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: 0 NEW CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
OSIGN
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
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
re
roof I
"
<; h /V1t.f l-e 5
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
$
A j 't S
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL $
o GAS ~OOFING 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
COMPANY
JOv"5 e f!.r"JY' l' [ItA. e>
iQC7~
SIGNATURE
f~ ...;/~~? STATE CERT OR REGIST *
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,
L.
to.
C
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. NOTI~E 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 "Cohtractor Sections" of this ~pplication 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 b~ requeste~
in writing to'the Building Official. An approved inspection must be logged dur~ng each s~x
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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 2~
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
, 20_
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
o who has produced
(type of identification)
and whoD did Odid not take an oath.
Owho has produced
(type of identification)
and who 0 did []did not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
Jorge Rodriguez Roofing. LLC.
2403 East 99th AVE (813)931-3013 Office
Tampa, FL 33612 License# CCC1326118
Roome: Estimate & Proposal
,
Jorge Rodriguez Roofing, LLC. (Seller) agrees to furnish all materials and labor to do
work on premises at the following address.
Name: .s t4.~ <:Cj.'1 G:J.rrcl-t'
~8J'-'ttJ a. e
Phone:
Work to be done in accordance with all the specifications given below:
1
\.1J~ t' k..all1 S k -"p
~t1 +feel L LA- 111'I be1' ~ )( + ~&
=4!!iF ~e~::~~IY woo-;/ rerz.lac...J
i ~ f~/~+"~ al X
fuce$~30 D~
Seller Buyer
Estimate can be withdrawn after 30 days from date above.
Jorge Rodriguez Roofing. LLC.
2403 East 99th AVE (813)931-3013 Office
Tampa, FL 33612 License# CCC1326118
Roofine: Estimate & ProDosal
,
Jorge Rodriguez Roofing, LLC. (Seller) agrees to furnish all materials and labor to do
work on premises at the following address.
Name: .s "'.5 .. ~ G ~ rcJ-t
383~ ~ e
Phone: 7?' 0.-, "3 2J' J
Work to be done in accordance with all the specifications given below:
t^,o t' k.fI'a~ ~ lA ...,
1t Rtf t"t-ed L u)41 ~f' ~)( +V'CI
~~ ~e~~~~ywqgJ.
11 j;~ f~" 1+ -.f> :ax
Price $ ~.3 ()
l' ey2Ja c eo d
Date l/~l' D5"
I
SeDer ~~
~
Estimate can be withdrawn after 30 days from date above.
FLA. 1977 LAWS
FS. 71.!,13
SEMINOLE FORM 408
NOTICE OF COMMENCEMENT
~:::~t;f o~'o';da } '"':'... '" .."'0.... ~!~~llIJ~l~1111111I111111111111111I11I1111I11II1I1
The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance
with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.
Description of property,...! .I.... .~~....a.l.... .9P..l..O...... .2~? .~.Q)c?..,... 0.(1.1.0....,...........,...........
Rcpl: 851361 Rec: 10.00
os: 0.00 IT: 0.00
01/31/05 Dpty Clerk
....,.............................................................................. .
....,......................................................................................................................... ..,
,0 f k1 . J ,c t..: JEO PITTMAN"" PASCO COUNTY CLERK
.. . ..... 0 . I' l./ 01/31/05 0~: 59 m 1 of
General descrlPt'~n of Improve~ents .....r.... f...~... .1...5. . .. Y.r.g....,...... OR BK 621 i PG 34-7
Owner... s~. .5.'!. n..... G. .~f'..h .c~.(. .af.t........................,..........................................,........
Address ,...3..8".8'..'1 Q... ...~.V,I.d.... .A-.~.~... ..;. .2..~. .fhf-"r.. Jf.;:.I.l.X. .j.. r&-....,.... ..,...........
Owner's interest in site of the improvement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . , , . . . . . . . . . . . . . . . . . . . . . . . . . .
Fee Simple Title holder (if other than owner)
Name ...,... .................,....................................................................................... ..........
Address ............................................................................,.............,..............................
R
Contractor... .":.\O'"f.!J:C.... .~J..V'. .,'..fj.iA.t?Z..... .f<:.o.o.-f.l.'Y'Jg. J~. t .~.c:............................................
Address... .dHa. 1.. E... 9.~ fh... A:v..~...... r~~ ~{f!r~.... .El.. .J..! k.l.~........................................
Surety (if any) ..................................................................................................................
Address ............,..............................,..............,........................... Amount of bond $ . . . . . . . . . .
Any person making a loan for the construction of the improvements:
Name ....... ..............................................................................
Address .........................................................................................................................
Person within the State of Florida designated by owner upon whom notices or other documents may be served:
Name .... .... ........ ...... ......... .... ... ................... ..... ...... ... ........ ................. .... ,.. ..... ..............
Address ................,.............,....,.................................................................,..................
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713,13 (1) (hI. Florida Statutes. (Fill in at Owner's option). l/
Name............... ~.... ...L.'.L".'-u.__..... .., ......... .............
Add,,,, T~'~S;~C;'O; ;;C~;O;;~ u~; 0;".................... ~~ ..
,FL j)L Owner
r;;-' t., c;,:;s- ?<'~)- :>-5- qi.,;2- 0 _
~-; j /
Sworn to and subscribed before me this. . ':-=-:-. . . . . . . .. . . . . . . . .
~.. . ,-,.::;l 0 o:j-
........................dayOf/>~;:7'u:~7....().. 'C/,;;" .T:l(...........
.....<... .,~.. .'~. <. .~-/L..~K~/I~ .....
,,'~~:r;:.", Bo~~(Wt{;MP lie
~:r~1:~ MY COMMISSION # DD268763 EXPIRES
"'~'~'~'; FebruolY 22. 2008
~':!.'j9f: '..,: ~,.. eOt-,lDW TYRU TPOY FA!N !NSU~ANCE !N(
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY TH.IIT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD IN THIS OFFICE. WITNESS MY
HAND A~tD OFFICIAL SEAL THIS~ DAY OF
Vlf!\/ 2 a:15
JED PI M CLERK OF CIRC iT COURT
BY . OEPUTY CLERK