HomeMy WebLinkAbout05-4635
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4635
Permit Number: 4635
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 1,895.00
Date Issued: 7/07/2005
Total Fees: 40.00
Amount Paid: 40.00
Date Paid: 7/07/2005
Work Desc: RE-ROOF
Address: 5606 9TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: GWEN BALSAMO
Address: 5606 9TH ST
ZEPHYRHILLS, FL. 33542
Phone:
REINSPECllON 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.
<<<~/!/ ~.
R IGNATURE 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
G",) e- tV
131ft.. 5.41"'\.0
9 '.f-;' ,SI-
PHONE 8'/ ..3 - i/f~ ' 7 S J ~
JOB ADDRESS
5wc::'
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 10 #
/ / - ;J.t., ~ ~ L .- tJ 0 I 0 ~ Dg 700 -0/70 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION )2(REPAIR
o DEMOLISH
o INSTALL
PROPOSED
DSIGN
USE:)QSGL FAMILY
o COMMERCIAL
o MOVE
DWELLING
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
,~FJ..It'r PU KS ~N.. Y
DESCRIPTION OF WORK
CJ RESTAURANT & HEAl.TH DEPARTMENT APPROVAL
ea r c.,-t/ (aile I 6n.-?tif. r~C"+ (';<;,.h,; 1/
. 5/ "'-f (, ;: Iv--:
/lee,) I".ill,,";;
'7{).:.'e- ~ ,tA;1......,1,....o
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.
o BUILDING
$
t{)
1~7J-
PERMITS REQUESTED
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
TYPE OF CONSTRUCTION: 0 BLOCK
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
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 #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
OTHER fii:~"'HH"'HH'HH"''''::~::::.~::;'C}o:;~7~(:;:~: INC
SIGNATUR .. --:. ..1<B STATE CERT OR REGIST tCL'COt/1s 70
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to Udeed 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, 8l3-780-0020~
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the UContractor 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 Uowner", 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 conunencement.
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 conunenced 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 UA" or UA,etc.", it is
understood that a drainage plan addressing a ucompensating 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 conunenced 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 conunenced. 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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
,20_
STATE OF FLORIDA 1JASC (7
COUNTY OF - -
The foregoing in~tF~ment was acknowledged
Before me this 2-day of jl; L~ 20 C~
by Lt:6.-/ g. NCl..Q. II-
(name of person acknowledged)
[1ho is personally known to me, or
~ who has produced 6.. Di.. LIe -ti- N:.t ?O 53".5"g~ no
(type of identification)
and who Odid O:Iid not take an oath
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
(name of person acknowledged)
Dwho is personally known to me, or
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
~;"",",~.~,',::~''''''"'-r'-~~~...;'.~ '~7l""~:~~~--'-"-", ...,...-....---- -,....\IP',...,~'""'~~~~...~.~-,-.f'I(?----t.V....'~ r........7'.~.,-'~"WlI'J1IIr.-.- ....,.__.....
-
Alcoa Certified Roofing
,Contractor
CMF Certified Metal
Roofing ContractOr
~ 'it. 'it.
TRIPLE CROWN ROOFING INC.
Dura Loc Roofing Systems
Approved Contractor
Advanced Metals
Contractor
(.;.a~~' (.; A.J
NAME J.l
wi. (\.It)
STREET,.')b a.
2-cph'I')''''/1s
Legal Destriptien:
37625 STATE ROAD 54
ZEPHYRHILLS, FL 33542
FAX (813) 783-6017
LEON (813) 833-7720
STE\TE (813)767-1794
TONY '(813) 23$wa~OO
TOLLFREE (888) 903..8899
STATE LICENSE CCC049370
SPECIALIZING IN ALL TYPES OF METAl...ROOF SYSTEMS
t-:.-/1 D i/J L I J Oy1;!: PHONE?I J - 'I J(, 75 ;r;L
.s I- SALESMAN 'GrD~' ,
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Fe, 3'35<-/0
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We hereby submit specifications and work description:
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p) IV';,j:Jl~cr Fote
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THE ABOVE DESCRIBED WORK ~Ll BE COMPLETED ACCORDING,,'SPECIFICATIONS, FOR THE SUM OF
($ ~ g''jSS!.-' ). PAYMENT TO BE MADE AS FOllOWS: I Ai t:'", t.L c.y:>OAJ 8.,,, k ;I,.~
B"'~ C ,.:;> ft,1t E r:
I~. ".sl/I#~ '-~.s
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IAAlYL S'h)lNb ~~J( t'''''~/,i)2r-
NO ORAL AGREEMENTS HAVE BEEN GIVEN OR ACCEPTED. THIS WRITTEN CONTRACT IS THE
ENTIRE AGREEMENT COVERING ALL THE WORK TO BE PERFORMED AND/OR MATERIALS TO BE
FURNISHED. THE WRITTEN PORTION ABOVE IS THE ENTIRE CONSIDERATION FOR THE AMOUNT
OF THE CONTRACT. PURCHASER MAY CANCEL THIS CONTRACT ANY TIME PRIOR TO MIDNIGHT OF
THE THIRD BUSINESS DAY AFTER THE DATE PURCHASER SIGNED THIS CONTRACT.
IT IS AGREED:
Contractor will do all said work in a good and workmanlike manner and in strict accordance with the ordinances, rules and requirements of
the City, Town or Village, wherein the above mentioned property is located.
If Purchaser should cancel this contract after time stated above, the Purchaser agrees to forfeit down payment paid. In the event it becomes
necessary for Contractor to employ an attorney to collect any sums due the Contractor pursuant to this contract, then the Purchaser shall pay all
reasonable attorney's fees incurred by the Contractor.
This contract shall not be binding upon Contractor until accepted by them. Upon such acceptance by said company, this contract shall be
binding on me/us without any further notification to me/us.
The undersigned property owner agrees that this contract may be assigned for the performance of the work and labor required t:ly the
description of the work to be performed. Upon assignmt:lnt the parties hereto consent to the performance of the work by and the payment to such
assignee of the amount.of this contract.
Any alteration or devit!:m from above specifications involving extra costs will be executed only upon written orders and will become an extra
charge over and above t~:stated contract amount.
NOTICE TO THE BUYER: (1) Do not sign this contract before you read it or if it contains any blank spaces. (2) You are entitled to an exact
copy of the contract you sign. (3) Under the law you have the right to payoff in advance the full amount due and under certain circums~anc..s
to obtain a partial refund of the time charge. Owner acknowledges receipt of a true copy of this CONTRACT.
Purchaser
Date
YJ~~J~
Date
Purchaser
Date
This contract is erlrw(:e~bJe only when accepted by management of Triple Crown Roofing, Inc.
,
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