HomeMy WebLinkAbout05-5016
1.1'
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
5016
Permit Number: 5016
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEM NT
Proposed Use: SINGLE FAMILY R SIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 2,850.00
Date Issued: 10/13/2005
Total Fees: 45.00
Amount Paid: 45.00
Date Paid: 10/13/2005
Work Desc: RE-ROOF
Address: 6704 ASSWO D CIR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: DRIFTWOOD
Parcel Number:
Name: NORRIS MATTESON
Address: 6704 BASSWOOD CIR
ZEPHYRHILLS, FL. 33542
Phone:
/ {I~d-P
y' ra\! ~
REINSPECTION FEES: When extra in
charge of Thirty-Five Dollars ($35.00
ction trips are necessary due to anyone of the following reasons, a
hall be made for each trip for each trade:
(a) Wrong address (b) Condemned work rE\!sulting 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 hot at job site (g) Work not accessible
The payment of inspection fees shall be m e 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 cement."
Complete Plan 1 Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
OCCUPANCY BEFORE C.O.
. ~~
I PERM IT OFFI
SPECTION - 8 HOUR NOTICE REQUIRED
cj)TECT CARD FROM WEATHER
CONTRACTOR SIGNATURE
CALL FOR I
P
I I
CITY og 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
PHONE
JOB ADDRESS
C~V
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
L
L~
-~7\D
WORK PROPSED: 0 NEW CONSTRUCTION
o SIGN
PROPOSED USE: OSGL FAMILY
o COMMERCIAL
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
DESCRIPTION OF WORK
DR
Ae (/0
OMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
& HEALTH DEPARTMENT APPROVAL
. (1'^-12 f\3\ iJ 1\ ~l.) G A F / ,fI.(l,r:vf,',1('J
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.
PERMITS REQUESTED
o BUILDING
$
Z-?.so
00
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 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 COMPANY 5~o II b~Jt/I(,.p, ;ttJLJ If J
SIGNATURE STATE CERT OR REGIST # ('{( U(;77j/
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 iocal 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: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 2~
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)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who 0 did Giid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
I I
.-/''-'/f
Proposal/Contract
SCtJ.te ~~ 7i:~,
P.O. Box 1188
~ 33010 SR 52
San Antonio, FL 33576
(352) 88-ROOF (7663) · (813) 782-1330
Fax (352) 588-9763
ill: blackmanroofing@aol.com
Sf] - Lje, 9-S'SSV
11tC.
~ tee",4-ett.
~(I.",ttett &
'l",4-u.",ett
Date IO/6/oJ
WORKED TO BE PERFORMED AT
Name StJp.. Street
Street C .~ City
City State .Zip
State Zip Owner of Property
Phone Number 7YY'-61 ~O Phone Number Fax
o Re~xisting built-up roof
l3"'!5;y-in with 0 15 lb. ~
~ galvanized valley metal
~all new lead boots
~new exhaust vents
~ new drip edge, J7~ W A/ A- co or
o Install new flashing as needed
~ce plywood at $ 1'0 "PO pe sheet
~otten trusses at $ "2 < rtJ
*Woodwork is an additional charge, see prici gl above
We hereby propose to furnish all the ma erials and perform allJhe labor n~cessary for the completion of:
erR'eii1ove existing shingle roof 811ePlace bad fascia boards at $ ~ ~\o per foot
~tall 2 0 feet of ridge vents
o Install modified bitimen (granulated) torch down roofing
per foot
black, white or other color
o Inst9 yr. fungus resistant 3-tab shingles
~~r. fungus resistant dimensional shingles
~ngle manufacturer C A F color S / 1.- k
o Install TPO, white rubberized roofing membrane
~ / y. h -!6t- ~ <.SJ:J1 1/h rf
/ /- / 0 J s , :6 1(' l..,c /1 0 /- 5 k q 1< ~ h If
l~ / /I' h!- /r~ VI c/l- q/ 6Q (/ lot -; ,:.rf
~ J It, /I; a c/oi'.. ',j"h"V I co..>!:
Any alteration or deviation from above specifications involving eXtra costs will
be executed only upon written orders, and will become an extra hi' rge over and
above the estimate. All agreements contingent upon strikes, acc d nts or delays
beyond our control. Owner to carry fire, tornado and other nece s ry insurance
upon above work. Workers' Compensation and Public liability ins rahce an above
work to be taken out by Roofing Contractor.
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 manner for the sum of $ 2; 8'S-O, c> 0
with payments to be made as follows. Pa m t due in full on com letion, unless otherwise noted. Thank You.
Credit cards accepted, additional 2.8% charge.
-~.. ~
Officer/Agent Scott Blackman Roofing
Note: This ~osal may be withdrawn by us if not accepted
within -r- days.
Client gives permission to drive on driveway to ~Iiver materials.
! ACCEPTANCE OF PROPOSAL
The ~~ove prices, specifications and conditi rls are satisfactory and are hereby accepted. You are authorized to do the work as
specified. I have read the back of this Propos I/pontract, which contains Florida Statues 713.001-713.37. Payment will be made as
outlined above. . 1
Accepted. Signature VQ~ Q .~ a::t:1...vL1!\..-
Date / ~I ~/O r Signature
I 11
11111111111111111111111111111111111I111111111" 11111 "111111
2005217430 ~
State of \='
NOTICE OF COMMENCEMENT
County of X fJClJ( 0
THB ImOERSIGNED hereby 9 ves notice that improvement will be made to c~rtain
real property, and in ccordance with Chapter 713, Florida Statutes, the
following information is, provided in this Notice of Commencement:
Xl.
Description of Prop rty: Parcel No. D?..- L/o -Ll-O-L~O-60 oaO.-/Yfou
(Legal descr1pt1on
f the property an street a
rnprovement /11 e vo () F
2 .
General Description of
UJ/
,
.30 (1~~v
& II-F ;r; /I-t be y t ~C!J
~.
Owner Information: ame li~ t-~()-tLt-0 0:.~
r.ctdress 01~ 'f (' . . City el^'f"':rcq h ,'( 1<
Interest in Property
State ~../.
3:, rtf e..-
Name of Fee Simple Titleholder:
(If other th~n 0 ner)
Rcpt:932673
os: 0.00
10/13/05
Rec: 10.00
IT: 0.00
Opty Clerk
Address
City
State
4. R. . ontractor: N.J.me
. . <:;?O ().{)X \l12>~
Address . · ~olO
\ (\ c...
4tJ'DIJl"D
State r:-C
"3 sr- '7~
5. Surety: N.J.me
Address
,
City
State
Amount of Bond: $
6.
Lender: Name
JEO PITTMAN, PASCO COUNTY CLERK
10/13/05 02: 22pm 1 of 1
OR BK 6639 PG 1833
Address
City
State
7. Persons within the State of Florida designated by Owner upon whcm
notices or other d cuments may be served as provided by Section
7lJ.IJ(1)(a)(7), rlo Ida Statutes:
N(~mc
Address
City
State
8 .
In addition to
, Owner designates
of
Lienor's
to receive a copy of t~e
v~ded ~n Sect~on 713.13(1) (b), Florida Statutes.
<). r-xp.i.rn1.l'Jn d~te (){ rlo lee of Commencement. (t.he explratlcJn d.::.te is 1 yedr
fr~m the d.J.te of rec ~ding unless a different date is specified.)
SiCJ;1ature of Owner:
2005
day of nr-l-olx; r
Not.:lry Publ ic:
PC93053048/ A
~l\.. tIr1 c;onwnIIIIoIl 00127580
,!fj expinIS July 22. 2006