HomeMy WebLinkAbout05-4022
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4022
Permit Number: 4022
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 2,100.00
Date Issued: 3/30/2005
Total Fees: 45.00
Amount Paid: 45.00
Date Paid: 3/30/2005
Work Desc: RE-ROOF
Address: 6715 BASSWOOD CIR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: DRIFTWOOD
Parcel Number:
Name: RITA OAKS
Address: 6715 BASSWOOD CIR.
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.
~'C .~~ r~.
CONTRACTOR SIGNATURE PERM IT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542
813-780-0020 FAX:S13-780-0021 .~ /,- \_o~
DATE RECEIVED ~
PHONE CONTACT FOR PERMITTING 5 2? cc-\ I.ob'"~
LEGAL DESCRIPTION: LOT(S)
BLOCK
PHONE/8d-SL{I~
2-<-~ ~ PI
SUBDIVISION (}Y;'f1W~
JOB ADDRESS
~\ -\v-
b}l~
D~ 'cS
~SSWOO(~
C\ rc\Q
OWNER'S NAME
PARCEL ID #
(OBTAIN FROM PROPERTY.TAX NOTICEl
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
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
~~
~~ toJJ
GAr
a-.~
''-'0' (a ~1
HEIGHT
BUILDING SIZE
SQUARE FOOTAGE
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 $ 'd \60 .OU VALUATION OF TOTAL CONSTRUCTION
0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C.
0 PLUMBING
o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION
o GAS o ROOFING o SPECIALTY 0 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 #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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OTHER ~f\~
SIGNATURE------2 h r'~ ~ ~L.< 4. ~
COMPANY Scc\\ .~'0~, X-""- ~f2-\,",)
STATE CERT OR REGIST # C C. C 0<;;' '7 ~ '1_
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 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
, 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)
C1ho is personally known to me, or
(name of person acknowledged)
Owho is personally known to me, or
Owho has produced
(type of identification)
and whoO did Odid not take an oath.
Dwho has produced
(type of identification)
and who Ddid D:iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
Proposal/Contract
St!4tt ~~ ~~,
po. Box 1188
33010 SR 52
San Antonio, FL 33576
(352) 588-ROOF (7663) · (813) 782-1330
Fax (352) 588-9763
email: blackmanroofing@aol.com
I
I
I Street
I
i1!!~~Uvr.
eee 057957
PROPOSAL SUBMITTED TO
7)'1 .P, I.
Name -1:::. 1 M U ctlt:S
Street -J 7 I r-- f!x,....SJ I<\d.OO cI C ( r( I ~
City_ 2-erh'1V~lL\s
State.n ._____ Zip
Phone Number __7 t 2- - 'fr'-j 7 R'
Fax
1#eC /~
*1/
~..e'c~c:eK<ted',
~(J.Kd'ed' "
'7K<t"-'ted'
Date W-P s-
WORKED TO BE PERFORMED AT
_.-----~--
City
State
_Zip__.__
Owner of Property
Phone Number
-~----~
We ~ propose to furnish all the materials and perform 'J!lthe labor necessary for the ?~mpletion of:
~move existing shingle roof ~place bad faSCIa boards at $1 ,0 J per foot
:J R~existing built..up roof 0 Install feet of ridge vents
:rD~h U 151b_ ~ 0 Install modified bitimen (granulated) torch down roofing
~~w galvanized valley metal black, white or other color _
Thstall new lead boots ~ 25 yr. fungus resistant 3-tab shingles
o Install 30 yr. fungus resistant dimensional shingl
J In~w exhaust vents
~tall new drip edge, -'--' ~ c....It" /-< color
J Install new flashing as needed
~ce plywood at $_1..[ tJ ~_ per sheet
1Repair rotten trusses at $ J ,0;;' per foot
Woodwork is an additional charge, see pricing above
Fax
o Shingle manufacturer ______ color
o Install TPO, white rubberized roofing membrane
o Other:
~
/';)J 6
~,,-...
\11 material is guaranteed to be as specified, and the above work is to be performed is accordance with the drawings and specifica-
ions submitted for above work and completed in a substantial workmanlike manner for the sum of $ :i;: If U 0, ^ ,) 2.~
vith payments to be made as follows. Payment due in full on completion, unless otherwise noted. Thank You,
----.-.----------.-----.
,ny alteration or deviation from above specifications involving exfra costs will
e executed onty upon written orders. and will become an extra charge over and
bove the estimate. All agreements contingent upon strikes. accidents or delays
eyond our control. Owner to carry fire, tornado and other necessary insurance
pon above work, Workers' Compensation and Public Liability insurance an above
ork to be taken out by Roofing Contractor.
Credit cards accepted, addtionaI2.8% charge.
_.~- ~/:~
-
Officer/Agent Scott Blackman Roofing
Note: This 70posal may be withdrawn by us if not accepted
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
specified. I have read the back of this Proposal/Contract, which contains Florida Stautes 713.001-713.37. Payment will be made
as outlined above. /'
Accepted
Date
Signature.
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Sionature