HomeMy WebLinkAbout05-4116
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4116
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:
4116
RE-ROOF
ROOF REPLACEMENT
SINGLE FAMILY RESIDENTIAL
Address: 5122 2ND T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
1,500.00
4/18/2005
40.00
40.00
4/18/2005
RE-ROOF
Name: NELL & ALFRED GODWIN
Address: 5122 2ND ST
ZEPHYRHILLS, FL. 33542
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.
/0 ~.
CONTRACTOR SIGN TURE PERMIT OFFI
CALL F(j~ INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS .l:'J!jKM~'~' firr.LI.....'-'.n.~.......,...
BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542
813-780-0020 FAX:S13-7S0-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME lJeff ~ fU~Gd Ixdw/v
JOB ADDRESS .5""122 ;2;J::/ :sf.
PHONE (?1L~ )7;1;2 - s-oi'1
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 10 #
(OBTAIN FROM PROPF.RTY.TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
o ALTERATION
)(REPAIR
o INSTALL
OSIGN
PROPOSED USEyEfSGL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNrrs
o SWIMMING POOL
o MOBILE HOMl
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL
te - ~p
BUILDING SIZE
30 ~ (.,0 I- '7-
SQUARE FOOTAGE
?&IJD
~
HEIGHT
?I
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
o PLUMBING
o MECHANICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
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
SIGNATURE
60 cJ~
COMPANY
BUILDER
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 #
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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 appiicable 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 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 a?andoned,for 'a
period of six months after the time.the work is commenced. One 90 day extens10n of t1me
may be allowed for the permit with fee charge of $15.00. ,The extension shall be requeste~
in writing to.the Building Official. An approved inspect10n must be logged during each S1X
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
, 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.
Owho has produced
(type of identification)
and who 0 did 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
~
.
Contract Agreement
THlS AGIU:EME>rrtf!!jt l'il ~
by and between _ ~!j.)
Owner, and -' t
the Contractor.
For the consideration hereinafter named, the said Contractor covenants and agrees with said Owner, as follo~ d
ST. The Contractor a~ to rnish all material and perform all work necessary to complete the e.e
day of
J\.D.~
hereinafter called the
hereinafter called
for the above named structure, according to the plans and specifications (details thereof to be furnished as needed) of
Architect, and to the full satisfaction olf said Architect or Owner.
begin }t;d work as soon as notified by said ArchitE'ct or Owner, and to com-
THffiD. The Contractor shall take out and pay for Workmen's Compensation and Public Liability Insurance, also Prop-
erty Damage and all other necessary insurance, as required by the Owner, Architect or by the State in which this work
is performed.
FOURTH. The Contractor shall pay all Sales Taxes, Old Age Benefit and Unemployment Compensation Taxes upon the
material and labor furnished under this contract, as required by the United States Government and the State in which this
work is performed.
FIFTH. No extra work or changes under this contract will be recognized or paid for, unless agreed to in writing before
the work is done or the changes made.
SIXTH. This contract shall not be assigned by the Contractor without first obtaining permission in writing from the Archi-
tect or Owner. All Sub-contracts shall be subject to the approval of the Architect or Owner.
IN CONSIDERATION WHEREOF, the s.~;<1 Owner agrees that he will pay to the said Contractor, in
~ .1 00
/- payments, the sum of_ I S"cn.
Dollars
for said materials and work, said amount to be paid as follows: per cent I[ %) of all labor
and material which has been placed in position by said Contractor, to be paid on or about the
of the following month, except the final payment, which the said Owner shall pay to the said Contractor within 3(:) ~
days after the Contractor shall have completed his work to the full satisfaction of the said
Architect or Owner.
The Contractor and the Owner for themselves, their successors, executors, administrators and assigns, hereby agree to the
full performance of the covenants of this agreement.
IN WITNESS WHEREOF, they have executed this agreement the day and date written above.
Witness:
FRANK R. WALKER CO.. PUBLISHERS, CHICAGO
....
If'~e-~~Ei;tl
MFD. IN U_ S. A.
FORM 158