HomeMy WebLinkAbout05-4940
I I
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4940
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Dese:
4940
RE-ROOF
ROOF REPLACEMENT
SINGLE FAMILY RESIDENTIAL
Address: 5122 21ST T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
13,870.00
9/21/2005
100.00
100.00
9/21/2005
RE-ROOF
Phone:
REINSPEcnON FEES: When extra in paction 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 work1'resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for i spection when called
(e) Permit not posted on job site (f) Plan not at job site (g) Work not accessible
The payment of inspection fees shall be m de before any further permits will be issued to the person owning same
"Warning to owner: Your failure to rd a notice of commencement may result in your paying twice for
improvements to your property. If y u intend to obtain financing, consult with your lender or an attorney
before recording your notice of com ncement. n
Complete Plan , Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~~
PERM IT OFFI
SPECTION - 8 HOUR NOTICE REQUIRED
OTECT CARD FROM WEATHER
I
~
CONTRACTOR SIGNATURE
CALL FOR I
P
I I
Proposal/Contract
S~~~ 1<~, 1He.
P.O. Box 1188
33010 SR 52
San Antonio, FL 33576
(352) S88-ROOF (7663) · (813) 782-1330
Fax (352) 588-9763
em~iI: blackmanroofing@aol.com
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Date
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PROPOSAL SUBMITTED 0
Name My, p.q\l'Y)(..H-
Street ~ ( 1- 1... L.. 1 ~ ~ ...51-
City -Z l f ~ ~ ... h,"J 1.s
State \= ( Zip
Phone Number /1'1 - te ~ -; (, F~x
WORKED TO BE PERFORMED AT
Street
City
State
Owner of Property
Phone Number
.Zip
Fax
We ~ propose to furnish all the ma~erials and perform ~he labor n~cessary for the completion of:
B'I'lemove existing shingle roof aR;place bad !:a, boards at $ 2, 5 t> per foot
o R~ existing built-up roof IB'"Install Oo...~eet of ndge vents
zf"D~With 0 151b. ~ 0 Install mO~ified bitimen (granulated) torch down roofing
etl~ew galvanized valley metal black, white or other color
~stall new lead boots , 1..,. 0 Install 25 yr. fungus resistant 3-tab Shinglesf/2/ 715:pj)
o In~w exhaust vents W h I fu ~all 30 yr. fungus resista~t dimensional shingles
~stall new drip edge, "f' i -, co'or 0 Shingle manufacturer 1/J I / G yteth color
o Install new flashing as needed 0 Install TPO, white rubberized roofing membrane
~~PIYWOOd at $ '-/2.,t) j) pe~ sheet l3"Ofher::;Z: "ti -1-.. // 'l t-Jh {'* I"~hc,y
~pair rotten trusses at $ 2-. '-to ! per foot r 0 () ..jt t:> "" ..t::-I ~ -r- - ;r R- 0 (;)
*Woodwork is an additional charge, see prici~g above
All material is guaranteed to be as specified, ~nd 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 mannerforthe sum of $ 118"70,0 () 30 Vr
with payments to be made as follows. ~ent due in full on completion, unless otherwise noted. Tha.{k You.
I
I Credit cards accepted, additional 2.8% charge.
~~
Any alteration or deviation from above specifications involvin extra costs will
be executed only upon written orders, and will become an extra harge over and
above the estirT1Olte. All agreements contingent upon strikes, ac idents or delays
beyond our control. Owner to carry fire. tornado and other nec ssary insurance
upon above work. Workers' Compensation and Public Liability ins rance an above
work to be taken out by Roofing Contractor.
Client gives permission to drive on driveway to eliver materials.
Officer/Agent Scott Blackman Roofing
Note: This proposal may be withdrawn by us if not accepted
within /0 days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditi ns are satisfactory and are hereby accepted. You are authorized to do the work as
specified. I have read the back of this Propos I/Contract, which contains Florida Statues 713.001-713.37. Payment will be made as
outlined above. J~
Accepted Signatur~J
Date Signature
I I
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 \< Ie VI' {
JOB ADDRESS S- ~ L.
15'1 V- V\ e- t+
U 2/.S:1: Sf
PHONE
LEGAL DESCRIPTION: LOT(S)
PARCEL 10 # 1 L - 7 10- ""L. I -660 c)
BLOCK
SUBDIVISION
60~OBTAIN FROM PROPERTY TAX NOTICEl
DLj<fOO
WORK PROPSED: 0 NEW CONSTRUCTION
o ADDITION
o ALTERAT ION
o REPAIR
o INSTALL
OSIGN
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
~e 'lp o-r
wi
,
~o ~ep....:r
\?A f' '\ l' Jv'\.kr 11'",e5
705t
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) SET~ OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY: REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$ / 3jt70.. (JJ
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
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
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 #
******************************************************************
ME Cl{ANI CAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER ~v~~
SIGNATURE /~ .
COMPANY S, 0 f( fit ~ Co k IVI '" t-.. /,~;;; ')
./
STATE CERT OR REGIST # (( ( or 71 s-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 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 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.
Appliqation 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
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _____ day of , 2~
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
Owho has produced
(type
and whoO did 0 did not
of identification)
take an oath.
Owho has produced
(type of identification)
and who Odid Qiid 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 r
State of ~\OY\~
ii'
County of,t':".,
1111111111111111I11111111111111I111111111111111 111111111111I
2005187208
, (A.f(l>
NOTICE OF COMMENCEMENT
THE ImOERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
follo~ing infor~ation is provided in this Notice of Commencement:
,'11I'
1.
Oeser iption of Prope~ty: Parcel No. I;). -~l,;; /~ t'CO{)'--(W(i/J~t:1(-)S{)
2 .
(Legal descrlptlon the property an street a
General Description of ~mprovement ~':A "/cf)tJ, ~Jc;'-;t::.-
,
Rcpl: 920739
OS: 0.00
09/08/05 ___.____
Rec: 10.00
IT: 0.00
Dpty Clerk
3 .
O\Yncr Information: Nllme KEJfJf.y U/Jl!-ltErf
llddress .("J 2?- J_q-T <;T City 'Z:rJ#'1J<!-fll'll~
./'
State /--{_
I ntere s t in Property: n.'-h..:_.!
JEO PITTMANd PASCO COUNTY CLERK
09/08/05 00: 49am 1 of 1
OR BK 6574 PG 894
Name of Fee Simple Ti~leholder: ~JP-
(If other th~n owner)
Address City
State
R 4.
Contractor: N.:1. me~. '-\\
rO.Q,DK If B
AJdre s s .:3r~OI 0 Se. 5'2.-
~\o..c~ \2-.-(::rP\f\~ I \f\C
CitY~AtJ A1\)1'I)yV,o State PL
5. Surety: N':llne
Address
City
State
Amount of Bond: S
6. Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whcm
notices or o:her documents may be served as provided by Section
713.13(1)(a)(7), ["lorida Statutes:
tJ,;mc
Address
City
State
8 . I n add i t ion to him s e 1 ~, Ow n e r des i g n ate s
of
Lienor's Notice
I
I
as prjovided
1.n
to receive a copy of t~e
Section 713.13(1) (b), Florlda Statutes.
'). r-xpirrlt .t'Jn d.-,te ()f rlCltl..i.ce of Commencement. (the explratiun d.:::.te is 1 yectr
fr~m the d~tc uf reco~ding unless a different date is specified.)
~
SiS};1ature of Owner:
Sworn to and subscribed beflore me this /~ day of /./~A1h:~~/2 /
20 (() S- .
Not~ry Publ ic:
STATE OF FLORIDA
My C:J~,;li s s ion Expires:
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
. .
PC93053048/ A
HAND AND OFFICIAL SEAL THIS DAY OF
SEPT 2@"
JED PUTMAN, C\.E!l~ OF CIRCUIT COURT
BY d1J/ilti ~4fuf/r; DEPUTY CLERK