HomeMy WebLinkAbout05-4268
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4268
Permit Number: 4268
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 3,420.00
Date Issued: 5/25/2005
Total Fees: 50.00
Amount Paid: 50.00
Date Paid: 5/25/2005
Work Desc: RE-ROOF
Address: 4916 16 H ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: NEIL GREGORY
Address: 4916 16TH ST
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.
~. ~.
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, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME Ne...I'j
JOB ADDRESsLf 9 I (p
t:: Gjre~M'1
I~+"" ~
PHONE 7o~ -7' 08'
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
0100
PARCEL 10 # /4 - 2& - L / - 00 1(1 - (")O'-/-O 0- (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
DMULTI - FAMIL Y
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
/2.. t roo f
/ r :;g
wi 25 Il~C{.v
I I
T q VIA. 1.< 0 {, 1/ k J
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
$ 3'-;2.0,00
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy [J
W.R.E.C.
o PLUMBING
o MECHANICAL $
o GAS cr;,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
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 /~OO h Vz~ COMPANY, )(0-/-1 l?/ctL jjl"i,AIA- fico -I/~ I
(? , ./.~ tJ fl 7
SIGNATURE(~ ~ STATE CERT OR REGIST * (cc 0<))9 )7
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 portions 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)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
o who has produced
(type
and whoO did 0 did not
of identification)
take an oath.
Owho has produced
(type of identification)
and who 0 did 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
/I-
NOTICE OF
1111I11111111111111I1111111111111111111111111111111111111111
2005103382
COMMENCEMENT
County of ~S CO
State of El()y-\6.~
THR IrnOERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commenc~mcnt:
1. Description of Property: Parcel No. ILf-2-&-7.J - (')0 ( lJ-DOc..fOO -OIOG
(Legal descr1ption of the property and street address if available)
2 .
General Description of Improvement 'Ke. \1' oaf
~ l~t k f
$3}+2-0.co
l,0 / '2. ~ VeJJ..j'" 14 /IV\. K-o
(, _
Rcpl: 887360
os: 0.00
OS/25/05
Rec: 10.00
IT: 0.00
Dpty Clerk
3.
Owner Information: Name
/Ve..i / E..
C.lZ. 'i?-1 (J rJ
,
>h,'J?17.! hI)?
State /,1/ t.J
2-6,/7/
llddre s s 9 b t2p,12--I-1!-l?.- 1 'r
Interest in Property: SoJ~
City
Ow /-'7 ~JC!..
Name of Fee Simple Titleholder:
(If other th~n owner)
JEO PITTMAN PASCO COUNTYfCLfRK
OS/25/05 08: 36am 1 3047
OR BK 6386 PG
Address
City
State
R4.
Contractor: N.:lme SO D'*"
Add"ress ._.PO~e:g~ $~~'"-) L
b\a..~ X,ffi(\f\ ~\ ~ i \ K
City")'A rJ AVVTOi\Jfb State f::-L
33 <) 7 (P
5.
Surety: Nurne
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
7 .
Persons within the State of Florida
notices or o~her documents may be
7l3.lJ(l)(a)(7), [,lorida Statutes:
designated by Owner upon whcm
served as provided by Section
tJc"":mc
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the
Lienor's Notice as provided 1n Section 713.13(1) (b), Florida Statutes.
<J. f'xp.i.rn1 .1'>n d~te ()f rlot.ice of Commencement. (the explratic,n d.;:.te is 1 year
fr~m the d.:lte of recording unless a different date is specified.)
Signature of Owner: X' J;1J[,~~
//
Sworn to and subscribed before me this :J3R." day of YYI ~
20 n$
Notclry
PC93053048/ A
. Notary Public, Stale of West Virginia
Lana S, Jimmie
-= P.O. Box 451
~ Rivesville, WV 26588
~ .......' My commission expires October 28, 2014
Ha~ 18 2005 3:45PM
K M Brewer Realt~
813-782-0881
p. 1
8~/!7/2JD5 eS:22
3525B89753
S8R ROOF'II-./G
pAl*. ~l
Proposal/Contract
SuU 'B~ ~tJ(JIUt9, '711e.
P.O. Box: 1188
33010 SR 52
San Antonio, FL 33576
(352) SIS-ROOF (7663) . (813) 782.1330
Fax (352) 58fJ.9763
em.lI: btackmanroofingO aol.com
I WORKED TO 8E PERrORME~ AT
-l.-- _"___~
. St(~e~ 7~/&".-.wJY.-4~ 2:t _
C.ty 3' t0yJuZk ,
State 11. _liD 3?'-?f~___
I "-''''P,openy7,1.z/lJ. -~~t!V'~ __
F ...,,,, l) ~~( I Ph N '-- - F" .____.
ax ...L.'Lk. - _ OJ U I ! one um,-,,=,r _ ,~ -:.-- . - _ i:\J( __
tJe:.(4 .
?tr~ , +
.I1ic..".etl.
...tte.t I
'h",. 'H. eo '"
'It~ e-e-e..
(!tU! ~sr9$"
-.,--,_.....
PROPOSAL SUBMITTED TO
N~_iY);J. 8,..t.~y _..
Stre.t q, I ~ - 4'1 II' J~.I-/" 51-
City~r""~ -~~dr ~IJl)
S11llte -E1-... __ Zip
P ;,ol'le Numbs' _, ttf ~ 7 " Of'
Date l5110.t~
tllnSI~.el(haust '..eI'l15
~a" nflw drip edge..
U Inslall new flashing as needed
~ plywood at $,._ I.-/[;O{) per she!!!
EfRapalr rot/en trusses at $.._3 . i.>U ~___ pedoot
'Woodwork is an addl\lor]a, charge, see..f'.:,cl~g abtwe __'._ _______
(~ V (P'll" J J( J(.[ k~Aj @~ J,v1jruev-1:..t- _____~__
All material is guaranteed to be as specijied, and the above WOfl( IS 10 be oer'lormed is accordance with the drawings and specjflca-
tlons sublT'it1ed for above work and compleled in a subslantitll WOrkmanlikt> 'Tlilmner lor the sum of $ 3i1., '"?..V.", 0 0
wilh payments to tle made as tOllow$, Paymen1J:tue In full ol1.-'.2mpletlcm, unl... oth;;w-';; noted. Thank Vou
~Cl"'Bdtcard! accepted. addtlorlal2.8%chargE
."Y 1.\Ir.allo" or a.y.,io~ Iram ItOYI ,p~ilIC"ic~, InYQIWIT'I!I 81111. co.,. ..,11 . ~
bl 'lCOCulOll only upon wr'!;t>r, OrOer3. ."Cl "i' iI.,am. a" (1""0 (nervI OV.' '''d ::::: ___,
Ib!J~. tn. ."'11'1'\", AlP &gll8...m.nt.C(li"t~ngl!nt,...pon !it",.... .crf~"r' t)I"'Ie.~5 "":;:::;-vP' _N_______,....__
bll\'O~d ~~r CO~I'ol OW""' 10 '.'/)1 1i1@t IOf~!(.'IO and om., n.c.Ulry ,r.5t.'ar,ce Offlc:er/Agant Scott BlackMan A';'OflOQ
"por.~OWeWCl/!( Wo~etJ COmplt1lo1l1Mlrl~P<J:lhtll'i)dlly'n.ur'~c'.nst:q~. Not,,; T,*'S sa! may bg wlmClrawn by us ., nol aCC€ple'
WcY\( iO De Ifkoefl OlJl by "lco'ltlg C:OI'I!f1I CIO'
---- - wltnir. days,
r------- -- -,_u-~CCEPTANC~~-;;;~POSAL -------------
The abclf8 pnces, specifications and conditIons are s~tlsflJclol)/ and a.re hereby accepted. You are aut"on~!!Id to do l'1E work as
speCIfied, I have read 1t'18 back 01 lhls Proposal/Contract wtllcn contains Florll:la S1aules 713,001 '71:3, :.3'7. Paymefll .WI De ml5.de
as outlined above
We h~ propose to 1urnish all the materials and perform all.lh$ lebo,. r'leCMsary tor the completIon of:
~o','e e)(isl"'g shingle roof ~la<:e bac fascia b::Jartfs a1 $...:1 . (~() per Icot
Q R~xfsling bUIlt-up roof :;) Insta!1 faet of ridg'it vents
~,:Jr1.WltM CJ 15 lb, ~ U InSlail modihed bitlmen (granUlated) toroh aown roofing
~~ galvanized valley melillIDlac~, white or other color ..
c:J'InSlall new lead boots U lnSla:12S yr fungus resistant $-tab shingles
o InSfa!130 'If fungus resistant dimensional shmgles
o Shingle man iftacture r __N _.CQ!or____
Q Install TPO, while rubbenzect rooling membrane
__ coler
OOlhe':
---..--
Accepted _.
----
Date
~- ~-- L i:.Ll."!L
Si;1natul'l'll
-' ,/.I,!, i. P .. ~ 1
s'~L~c~T~/7l'.::w~ ,- ,~/). ') J?.ea~e~.J /- "W
.- A" ' r
.. ,,/-/u '- %b9<~'~~ /
f ., I 0' -----
'----,