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Home My WebLink About05-4110 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 4110 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: 4110 RE-ROOF ROOF REPLACEMENT SINGLE FAMILY RESIDENTIAL Address: 37430 DERBYSHIRE DR ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 4,400.00 4/15/2005 55.00 55.00 4/15/2005 RE-ROOF BOBBY BRO KS 37430 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. t? ~~~ CONTRACTOR SIGNATURE PERM IT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS .l:'J!i.t<MJ.'1.' .tt.rr..u.'-'.n........""... BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 DA'l~E RECEIVED PHONE CONTACT FOR PERMITTING OWNER'S NAME g@BJ3Y Bl2col(s / ,., JOB ADDRESS J / Y '3 to 0 GiLt}l 5/1 I J2.L;- ( PHONE j)/L LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 10 # ) 0 -1~ - 2-1- 012-0 - 00000 - !J 01) 10BTAIN FROM PROPERTY.TAX NOTICE) WORK PROPSED: ONEW CONSTRUCTION o ADDITION ~TERATION 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 HOMl o OTHER DESCRIPTION OF WORK c=J RESTAURANT & HEALTH DEPARTMENT AP?ROVAL I.. -t6 - /2 {)D~/;J (J-; BUILDING SIZE 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. SQUARE FOOTAGE HEIGHT $ ~L/ DO, ~~ PERMITS REQUESTED o BUILDING VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL o PLUMBING o MECHANICAL $ o GAS ~FING 0 SPECIALTY AMP SERVICE o Progress Energy 0 W.R.E.C. 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 # OTHER ***************************************************.************** ~'{;-!( SIGNATURE ~ ?/h/;')J ~ iJ /1/t- t- I i /J /" ( COMPANY Auf /L/ /( ()f;J? / /J t..o STATE CERT. OR REGIST # !leD 0 L/ 6.2. Y ) 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 ~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 indica4ion 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. CONSTRUCTOION 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 abiandoned, for 'a period of six months after the time.the work is commenced. One 90 day extens on of t1me may be allowed for the permit with fee charge of $~5.00. ,The extension shall b7 requeste~ in writing to 'the Building Official. An approved 1nspect1on must be logged dur1ng each S1X month period or the project will be considered abandoned. WARNING TO O~NER: 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 , 2 u....- 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 wnoO did odid not take an oath. o who has produced (type of identification) and who Odid Odid 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 State of~!.. C l~ 1/)4 County of l _ __ j;;J-) (. D 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: "-,, 1. Description of Property: Parcel N 0.&:) 10 -lfo -l ( - 0 J z.. 0 - C) CtbO -- t I () c.') LoT /, D (,{)bDwc..:o-\ '3 'JL/Jv 1Jt51t;5 5/i(1l~ :J..---f/ILL.- (Legal description of the property d street address if ailable) 2. General Description of Improvement .-~} ..". ".'} , ......-.~ - /c....c..:-- - /:._ er;.:/.-',' Iv (,.~ 1111/11111111111I11111111I11111I1111I11111111111111111111111 2005043950 --- .,.-.... Rcpl:862697 Rec: 10.00 os: 0. 00 IT: 0. 00 03/09/05 __ Dpty Clerk 3. OwnerInformation: Namecb; 2,c12,13r R 1SRu::k5 Address 374-7n ''DerL,&YS/ItIO=r>rc City z..~PJ~7t.Z1.t/US Interest in Property: ~wAJ~ State /"= L ~ 35" LIZ- Name of Fee Simple Titleholder: (If other than owner) S Atv} E:? JEO PITTMAN, PASCO COUNTY CLERK 03/09/05 11: 39am 1 of 1 OR BK 6263 PG 367 Address .--' s 4-,V} e- City State J:I::::::tor:/~;me Ii: ~v , ~~) 1;:~2 c ~ ,,~, - "City ,) iJ ,) ,.- ".' / T I,' i) ,J'/~ i'!/ ;~:-- "'-__... L V /' State '., ~'{ ~5..) ..0:-:. ~-:- 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 inSection 713.13 (1) (b), Florida Statutes, Q PYn1r~t1l1n ibtp IIf NlIt1f'P IIf rllmmpnf'pmpnt {thp PYn1r~t1l1n rbtp 1," 1 "p~r frllm thp r1~tp r ~-- --'-- -~-- --'~---'- - ------ --~ - -'- ~- - ~ - ---- --- - GA VIN ROOFING P,O. Box 1363 DADE CITY, FLA. 33526 Lic#RC0046241 . Bonded insured PROPOSAL Page No. _of Pages (352) 567.5034 2 YEAR LEAK WARRANTY JOH !\lAME / NO LOCATION To: PHONE -__I / We hereby submit specifications and estimates for: ;./ >of "'~'. ..". ./ .,! WE PROPOSE hereby to furnish material and labor - c02Plete in accordance with these specifications. for the sum Of: / " . dollars ($ Payable as follows: ). All ITlalerial is J.2:uaralllccd 10 be as spccified. All work to be complt'lcd ill a workmanlike malllltT ac(:ordillg to slaJldard practices. AllY alteratiollS Of dcvialiOll from atlove speciOca- tio!ls involving extra cost \vill he exccuted Oil]Y upon writ tell orders, and will hecoillc all ('xtra clJarL;c over and above Ow estimate. All agreements cOlltillgelllupOIl strikes, ;]cl'idcllls or delays beyoIld our l'olllrol. Ov..'lIcr 10 carry fire, tornado, and otlU'r IH'lTSSal)' insurance. Our work(Ts arc I'll I IS' ('()\..'cITd by WorkmelI's Compcllsillioll IIlSUn-lIH'C, Authorized Signature / ./ NOTE: This proposal may be withdrawn by us if not accepted within __ clays. l Signature_ ACCEPTANCE OF PROPOSAL - The prices. specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date Signature _ Dale UOvfit +t Lj / / I fJo+ I~ Scr!ov1.