HomeMy WebLinkAbout05-4954
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4954
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:
4954 i
RE-ROOF '
ROOF REPLACEMeNT
SINGLE FAMILY RBSIDENTIAL
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Address: 3832412TH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
4,200.00
9/26/2005
55.00
55.00
9/26/2005
RE-ROOF
Name: DAVID FLOOD
Address: 38324 12TH AVE
ZEPHYRHILLS, FL. 33542
Phone:
REINSPECTlON FEES: When extra in ion 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:
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(a) Wrong address (b) Condemned work~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. Ify u intend to obtain financing, consult with your lender or an attorney
before recording your notice of com ncement."
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.
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PERMIT OFFI
$PECTION - 8 HOUR NOTICE REQUIRED
OTECT CARD FROM WEATHER
;r
CONTRACTOR SIGNATURE
CALL FOR I
P
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· 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
Ir\
OWNER'S NAME Uq, IJ I C
JOB ADDRESS
It.
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("'
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
\? 'L\
()ojO
WORK PROPSED: oNEW CONSTRUCTION
I
o SIGN I
PROPOSED USE: oSGL FAMILY DWkLLING
o COMMERCIAL I
o ADDITION
DALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
oMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
c:J R STAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
2 5- '- I c:''''- v
]~
)<;-
Co
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT
COMMERCIAL: ATTACH (3) SETS
IF SIGN PERMIT ONLY (2) SET
PROPERTY SURVEY
PLANS & (2) SETS OF BUILDING PLANS
OF BUILDING PLANS & (1) SET ENERGY
OF ENGINEERED PLANS REQUIRED.
REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORMS.
o BUILDING
,OuPERMITS REQUESTED
$
(/
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 SPECIALT
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAo YES
o 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
COMPANY 5~..11 {5!t.cl~ ,,~- I;;~". .J~v'I'7
,/
STATE CERT OR REGIST # (' ('c (, ~ 7 '} r 7
SIGNATURE
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.
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
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _ day of , 2U--
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
o who has produced
(type
and Wrloo did 0 did not
of identification)
take an oath.
owho has produced
(type of identification)
and who Ddid 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
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1.
5.
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5c.-tt ?13- <lft,9-SS~y.
/111111 11111 11111 1111/11111 11I11 11111 1111111111 IIIII /1/11111
NOTICE OF COMMENCEMENT 2005200163
County o'~( .'-PASCO
state of }P-/ ~~
THB trnoERSIGNED hereby g~ves notice that improvement will be made to c~rtain
real property, and in a~cordance with Chapter 713, Florida Statutes, the
follQ~ing infor~ation is provided in this Notice of Commencement:
Description of Propetty: Parcel No. II -:J..6 :J..,/ eJolo o,"~c)Q Gold
3 f' 3;)- IIJ-~ i e i:-I:/Is L 33 5- '-
(Legal descr~pt1on the property and street a
2 .
General Description of I~provement
Rcpl: 926141
DS: 0. 00
09/26/05
Rec: 10.00
IT: 0.00
Dpty Clerk
JED PITTMAN PASCO COUNTY CLERK
09/26/05 09: 08am 1 10f641 7
OR BK 6602 PG
O\_'ncr Information: Nfrne
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l\ddress 3i<~:+t 111~~v~
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Interest in property:1
'--:DtuicL KI FIDod.
ci ty -;l:-r- pi '11" j;//5
State j-L
'3 3)~:J.-
<!)WN
Name of Fee Simple Tikleholder:
I
(If other th~n o~ner)
Address
City
State
4 .
Stat~ FL
33)(0
AcJdress
Surety: N.:lme
Address
City
State
Amount of Bond: S
6. Lender: Name
7 .
8 .
AdcJress
City
State
,
Persons within the iState of Florida
notices or o~her d~cuments may be
713.13(1)(a)(7), flotida Statutes:
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N2mc I
Address City
In addition to hims:;~, Owner designates
of 1
Lienor's Notice as p~ovlded 1n Section
I
designated by Owner upon whcrn
served as provided by Section
State
to receive a copy of the
713.13(1) (b), Florida Statutes.
<). f"xpi.rn1 J.'Jn dnte of r1ut.ice of Commencem~nt. (the explratiun date is 1 yedr
fr~m the d.:ltc of recqrding unless a dLfferent date is specified.)
I
Sig~ature of Owner:
Sworn to
Not.:lry Pnbl ic:
20 05'
~ day of ~11~f
v.da.-
R'i\. clIOIyn lappuIta
. . . .
My C::J:il,:lj 5 S ion Expires:
0' '" Expires December 08, 2007
PC930530481 A
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Proposal/Contract
SC6tt ~~ 1i!~, 1HC.
P.O. Box 1188
33010 SR 52
i San Antonio, FL 33576
(352) ~88-ROOF (7663) · (813) 782-1330
Fax (352) 588-9763
em iI: blackmanroofing@aol.com
PROPOSAL SUBMITTED 0
Zip
Phone Number 7['3- '!2-b9
We ~y propose to furnish all the mat
~move existing shingle roof
o R~existing built-up ro~
Bf)~ 151b. ~Ib.
~taJh1eW~;;vanized valley metal
~all new ~ead boots
o Ins~exhaust vents
~all new drip edge, t, /~ M//' / k
o In~ flashing as needed
~ep~lywood at $ V f: () 0
~ir rotten trusses at $ 3. 0 l)
*Woodwork is an additional charge, see prici
F
~ te.e",4-elt.
~ .",ctelt &
1"'4-It.",elt
Date
Ylrjor
WORKED TO BE PERFORMED AT
Street
City
State
Owner of Property
Phone Number
Zip
Fax
rials and perform aJ.!..!tle labor necessary for the completion of:
B"I1eplace bad fascia boards at $ 3,. (J i) per foot
8"1ii'Sta.1I 7iJ feet of ridge vents
o Install modified bitimen (granulated) torch down roofing
,
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cot,
black, white or other color
o Install 25 yr. fungus resistant 3-tab shingles ~ <1, 200/ oD
o Install 30 yr. fungus resistant dimensional shingles f 41 tot%
o Shingle manufacturer color
o Install TPO, white rubberized roofing membrane C"'
o Other: -'\It '\..S t-c. V' R.,. b 2 Co (. ^- Me.. ~ \ ~ t"-
~ '}, cr Cf ~. oC)
Mll-. / - 1~4..Y (;)~ r#D~ dry I~ ~~,.. OLe-I-
~O()~ t,-JIH..' /~'I'J
All material is guaranteed to be as specified, a d the above work is to be performed is accordance with the drawings and specifica-
tions submitted for above work and completed n a substantial workmanlike manner for the sum of $
with payments to be made as follows. Pa m nt due in full on com letion, unless otherwise noted. Thank You.
Credit cards accepted, additional 2.8% charge.
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Officer/Agent Scott Blackman Roofing
Note: Thi:7osal may be withdrawn by us it not accepted
within days.
Any alteration or deviation from above specifications involving extra costs will
be executed only upon written orders. and will become an extra harge over and
above the estimate. All agreements contingent upon strikes, acc dents or delays
beyond our control. Owner to carry fire, tornado and other nece sary 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.
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.
Accepted
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