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Home My WebLink About05-4822 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 4822 Permit Number: 4822 Permit Type: RE-ROOF Class of Work: ROOF REPLACEMENT Proposed Use: SINGLE FAMILY RESIDENTIAL Square Feet: Est. Value: Improv. Cost: 3,520.00 Date Issued: 8/15/2005 Total Fees: 50.00 Amount Paid: 50.00 Date Paid: 8/15/2005 Work Desc: RE-ROOF Address: 5121 17TH ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: R HERWIN 5121 17TH 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 PERM~ 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 RECEIVED PHONE CONTACT FOR PERMITTING OWNER'S NAME g lA. +h S' h. e JOB ADDRESS 5' /"Z / 17 of/, 5f- V"WIV\ PHONE -v -.,' , LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 10 # 1/ - z t,- 2../- ()Ol()~ Z03ot> - OO&'<..J {OBTAIN FROM PROPERTY TAX NOTICEl WORK PROPSED: [JNEW CONSTRUCTION [J ADDITION [JALTERATION [J REPAIR [J INSTALL [JSIGN [J MOVE [J DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING [JCOMMERCIAL [JMULTI - FAMILY [J INDUSTRIAL 0# OF UNITS [J SWIMMING POOL o MOBILE HOME [J OTHER D RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK I ~ ~6 1/ -/' I Y 5l u / 2r- (/"011(- I' / SQUARE FOOTAGE 5 J.6.s ~V04/ 5,v. " BUILDING SIZE 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 $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE [J Progress Energy [J W.R.E.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK [J 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 # ********************************************************k********* PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST # > ****************************************************************** MECHANICAL COMPANY SIGNATURE STATE CERT OR REGIST # ***************************************************************** OTHER ~G)I) #,,) . , SIGNATU~~/ COMPANY -'CO II- ~~~ ,#~U 4~, ./ STATE CERT OR REGIST # rC' C cJr? 9 r7 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 unde~signed 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 ~equ1red to be licensed in accordance with state and local regulations. If the contractor 1S 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 uncerta1n 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 1S adv1sed to have the contractor(~) sign portions of the "Contractor Sections" of this application,fo~ wh~ch they will be responsible. If you, as the owner signs as the contractor, you are 1nd1cat~ng that you, rather than the contractor, are responsible for the work. If the contra~tor w1shes , you to sign as contractor that may be an indica~ion.that he is not properly 11censed and 1S 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 aone 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, Wetla~d 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 Shfll issuance of a permit prevent the Building Official from thereafter requiring a correc ion 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: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged Before me this _ day of , 2L.. by (name of person acknowledged) Owho is personally known to me, or 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 of identification) take an oath. Owho has produced (type of identification) and who Odid []did 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 ~g~~~~~~J~1I1I1I/ 1111111111111111111111I1111111111 State of 8n,,":',<:\0.... County of i?Ct~e_a 7HH lmOERSIGNED hereby gives notice that improvement will be made to c~rtain real property, and in accordance with Chapter 713, Florida Statutes the follo""ing inforJ:Jation is provided in this Notice of Commencement: ' G 7 Description of Property: Parcel No. / /- .,1(, - .z {-c; cJ I cJ - .:(0300.0 <76 YO "-/ -:J +I-u. 0- 0' (Legal descr~pt~on of the property an street a General Description of Improvement fJ, e rttJ () ~ 2. Rcpt: 913227 OS: 0.00 08/15/05 Rec: 10.00 IT: 0.00 ------------ Dpty Clerk o Owner Information: Name C7~L >/7,. -<.1'~ U. ...-/ 'lddress 0L-/ - /? - . ~5'/, City~ E-?/fV,< /-//'ALS"' State ' / Interest in Property: OLe..) /J/.(~ i<. ~~. 3.3-.r~<- Name of Fee Simple Titleholder: (If other th~n owner) Address City JEO PITTMAN~ PASCO COUNTY CLERK 08/15/05 0~:16pm 1 of 1 OR BK 6531 PG 798 Stilte 4 . Contractor: Name ~ D~ p 0 ~O)(; t( <6 Address :~)'O ~ e.... ~{ ~ \ C\..e.:t man ~_J~\ 1"\'1' \ '(\'-- City~ Af\~\\\.t) State ~L 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 whcrn notices or o~her documents may be served as provided by Section 713.13(1)(a)(7), rlorida Statutes: N,;mc Address City State 8. In addition to himself, Owner designates of Lienor's Notice as provided D<). txpirtH.l.'Jn d..,te of notice of fr~m the ~nte of recording to receive a copy of the in Section 713.13(1)(b), Florida Statutes. Commencement (the expIration d.=.te 1., 1 year unless a different date is specified.) 20 '("-)5 .. \Y(.~ In. V~- \ f)i-h day of --l. US ( I~+ S i<J:la t ure of Owner:()( Sworn to and subscribed before me this -'I' PC 93053048/A I "& JENNFER L. GREEN ~, Nol8ry PuIlIic . Stall 01 FIorIdlI My~ Exp/ret"'5, 2009 CommIuIon, DO 428315 Proposal/Contract SC6tt ~~ ~tNl/UuJ, 11tC. P.O. Box 1188 33010 SR 52 San Antonio, FL 33576 (352) 588-ROOF (7663) · (813) 782-1330 Fax (352) 588-9763 email: blackmanroofing@aol.com ~ te.e",4-etJt. ~ ~",tUtJt & 'l",4-..",etJt Date o/if~ PROPOSAL SUBMITTED TO WORKED TO BE PERFORMED AT per sheet per foot *Woodwork is an additional charge, see pricing above o Ins~w exhaust vents ,. ~all new drip edge, 5 f t\.. t,..J~ ,~kolor o Install new flashing as needed ~e plywood at $ L/ {: Q (J ~ rotten trusses at $ .3.00 Name 5 J.,'VWI ~ Street ~I '-f I 7+'-' Sf- City u ,IA '1Jo-A , l /J State J=" J Zip 3.3 $"'"7 It, Owner of Property Phone Number '7 f Z - 'It. '1(.j Fax Phone Number Fax We jJereby propose to furnish all the materials and perform ~abor necessary for lhe CO"8letion of: ~emove existing shingle roof ~~I;~: ~ad faSCia boards at $ ->, c.> per foot o ~ve existing built-up roof ~I ~ V feet of ridge vents erDry-in with 015 lb. ~ 0 Install modffied bmmen (granulated) torch down roofing o l~ galvanized valley metal bla~e or other color ~stall new lead boots ~all 25 yr. fungus resistant 3-tab shingles o Install 30 yr. fungus resistant dimensional shingles o Shingle manufacturer color ~TPO, white rubberized roofing membrane '"''''' J 0 w S ';p Street City State Zip o Other: All material is guaranteed to be as specified, and the above work is to be performed is accordance with the drawings and specifica- tions submitted for above work and completed in a substantial workmanlike manner for the sum of $ 3 C; 2.0. 0 () with payments to be made as follows. Payment due in full on completion, unless otherwise noted. Thank You. Credit cards accepted, additional 2.8% charge. -~~ Any alteration or deviation from above specifications involving extra costs will be executed only Upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tomado and other necessary insurance upon above work. Workers' Compensation and Public liability insurance an above work to be taken out by Roofing Contractor. -- Client gives permission to drive on driveway to deliver materials. Officer/Agent Scott Blackman Roofing Note: This proposal may be withdrawn by us if not accepted within 7 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 Statues 713.001-713.37. Payment will be made as outlined above. Accepted ff/t=/or- ( / - Signature a~ ra<f ~ Date Signature