HomeMy WebLinkAbout07-6977
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
6977
Permit Number: 6977
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 2,400.00
Date Issued: 8/23/2007
Total Fees: 45.00
Amount Paid: 45.00
Date Paid: 8/23/2007
Work Desc: REROOF - SHINGLES 30 YR
Address: 5530 24TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 12-26-21-0070-00000-0150
Name: JOHNSON,TERESNJOSEPH
Address: 5530 24TH ST
ZEPHYRHILLS, FL. 33542
Phone: 352 521-4417
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REINSPEcnON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections 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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
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."
/2?~~
CONTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
.
Date Received
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
OWner's Name i ~e ~ Pr
Owner's Address Is is "30 o-L.\.-h\ "'S\-
Fee Simple Titleholder Namel
Fee Simple Titleholder Address I
15630
I
E3
PROPOSED USE D
TYPE OF CONSTRUCTION D
DESCRIPTION OF WORK I \2e r 0D(:' - Sa ' ,,~ i " ~ - "3 '-> "f f
BUILDING SIZE I SQ FOOT AG: _ HEIGHT I
111111111111111111"111111111111111111111111111111111111111111111"1111111111111111111111111'111111111111'""11111111"'111111111'111111111"1111
1$ dYOD, 0--0 I
1$ I
1$ I
1$ I
D GAS D ROOFING D SPECIALTY D OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
11111111111111111111111111111111111111111111'11111111111111111I11111I111111111111111111111111I1111111111111111I1II11111111111111111111111111111111
JOB ADDRESS
SUBDIVISION
WORK PROPOSED
D BUILDING
D ELECTRICAL
D PLUMBING
D MECHANICAL
Owner Phone Number
Owner Phone Number I
Owner Phone Number I
~ '--\:-tn. -S~
LOT #
PARCEL ID#II'2 -
NEW CONSTR
INSTALL
SFR
BLOCK
I
B
D
D
2lo -2..-l 0070- 00000 - D \ 'SO
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE D
D
D
D
DEMOLISH
ADD/ALT
REPAIR
COMM
FRAME
I
D
OTHER
STEEL
OTHER I
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
D
D
W,R.E,C,
PROGRESS ENERGY
VALUATION OF MECHANICAL INSTALLATION
a \ ~e"D (2-~'\
rv C~--\
BUILDER
SIGNATURE
COMPANY
REGISTERED
Y/N
Y/N FEE CURRENT
License #
Y I N FEE CURRENT
License #
Y/N FEE CURRENT
License #
YI N FEE CURRENT
License #
Y/N FEE CURRENT
Y/N
Address
ELECTRICIAN I
SIGNATURE .
Address I
PLUMBER I
SIGNATURE
I
COMPANY
REGISTERED
Y/N
COMPANY
REGISTERED
Y/N
Address
MECHANICAL I
SIGNATURE
Address I
)G~N~TURE I ~4A- ~
Address I License #
III1111II11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11I11111111111111I1I
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date, Required on site, Construction Plans, Stormwater Plans wI Silt Fence installed.
Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvisionsllarge projects
Attach (3) sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Stormwater Plans wI Silt Fence Installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects, All commercial requirements must meet compliance
Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction,
COMPANY
REGISTERED
Y/N
COMMERCIAL
SIGN PERMIT
COMPANY
REGISTERED
DI~~~ti~~~': ' . , , . , . . , . . . , , . , , , , , , , , , . , . . , , . . , , , , , . , . , . . , , , , . . . , , , , , , , , , . , , . , , , , . , , , , , , , , , , , , . , , . . , . . , , , . , . , , . . , , . . , . , , , . . , , , , , , , , , , , , , , , , , . , , , . , , . ,
Fill out application completely.
Owner & Contractor sign back of application. notarized
If over $2500. a Notice of Commencement is required. (AlC upgrades over $5000)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades NC Fences (PloUSurvey/Footage)
Driveways-Not over Counter if on publicroadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
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 Pasco County Building Inspection Division-Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify 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.
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. Application 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, County and City codes, zoning regulations, and land development regulations in the jurisdiction, I also
certify that I understand that the regulations of other government 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 Protection-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.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone "V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida,
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties, If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. 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 codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized. by
the permit is suspended or abandoned for a period of six (6) months after the time th~ work is commenced: An extension
may be requested, in writing, from the Building Officia~ for a period not t~ exceed mn~ty ~90) da~s and Will demonstrate
justifiable cause for the extension. If work ceases for mnety (90) consecutive days, the\Job IS 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 COMMENC NT.
FLORIDA JURAT (F.S, 117,03) /' # ./
OWNER OR AGENT CONTRACTOR-f,/~ y~e:,
Subscribed and sworn to (or affirmed) before me this Sul>scri d and sWorn to (or affirmed) before me thiSR -
by ~1'2:3 07 by\'hc1Y'C"\Q~ r::{)~QX'\"" _Ul.~s~ll
Who Is/are personally known to me or has/have produced Who Is/are personally known to me or has/h e produced
as Identification, r-:L- 'l>t2u i!2.. L\ <L as identification,
Notary Public
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Notary Public
Commission No,
Commission No,
Name of Notary typed. printed or stamped
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.- ~~~~~-~~--~~SINESS AND PROFESSIONAL REGULATION
, CONSTRUCTION INDUSTRY LICENSING BOARD
.~ ...~. 1940 NORTH MONROE STREET
fqjWE~ TALLAHASSEE FL 32399-0783
(850) 487-1395
RUSSELL, THOMAS E
CENTRAL FLORIDA ROOFING
12296 ESKIMO CURLEW ROAD
WEEKI WACHEE FL 34614
.DB:==D~F BUS::S;6~5b3
, ' PROFESSIONAL REGULATION
CCC13270J.3
07/09/06 060010J.00
CERTJ:FJ:ED ROOFJ:NG CONTRACTOR
RUSSELL, THOMAS E
.CENTRAL FLORIDA ROOFING
:CS CERT:CP':IED UDder the provi.8:iona o~ Ch.489 '1'8.
-.pUaU_ daC.. AUG 31, 2008 L06070900159
DETACH HERE
STATE OF _FLORIDA,
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION 'INDUSTRY -LICENSING BOARD SEQ#L06070900159
: - LICENSE NBR
, 09 2006 060010100 CCC1327 013
rhe ROOFING CONTRACTOR
~amed below IS CERTIFIED
Jnderthe provisions of Chapter 489 FS_
~xpi.rati.on date: AUG 3J., 2008
? 6' rI "'" ,- t" r,
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DATE
RUSSELL, TROKAS E
CENTRAL FLORIDA ROOFING
12296 ESKIMO CURLEW ROAD
WEEKI WACHEE FL 34614
JEB BUSH
GOVERNOR
DISPLAY AS REQUIRED BY LAW
SIMONE MARSTILLER
SECRETARY
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r"AlZ. ItUI t:l:t
FRCJ1 : TOTAL PAYROLL
FAX NO. :8888766716
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ACORD 25-8 (7117)
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AUNDIlIIIIbIlD --.-
o ACORD CORPORATION 1988
TbOlnas Russell / Central Florida Roofing
333 N. Falkenburg Rd. Suite E 504
Tampa, FI.... 33619
Office: (813) 689-774.2
Fax: (8]3) 689-641]
RC# 0056187
CCC# 1327013
PROPOSAL & CONTRACT
To:
.r-.E,i?',F r,4 ;]dAM S'd 10
)J]c .?J( t;j.. s..,-
z;r~1'-~'il S
Date:
7-~r-d7
Dear Sir/ Maddam:
We Propose to furnish all materials and perform all labor necessary to c~mplet~ the
following: _"nN<:" 't.,r ~/t: ;'1A-Tt!",-,./tl S Oal l~ o~ w~r~ ~ !t'te ~ /';,N-!edldlwr ~d
..,DI..J. c. ~. ~ rI~~1 ' ~trl't t!!... ~;~ jJ,.- L,""Y'1C FT: P{/,A.tI 1tI~ lill 1"'.+1'...,..,lr
{"J>O'.ad. ~ (JU>t"lJl t TAX, 1'('..._.,1 ~ fr'l(J~~
All of the above work is to be completed in a substantial and workman-like manner
according to standard practices for the sum of
Dollars (~ "'-loa ). Paytnent to be ma(le to Central Florida Roofiul.
To the value of percent ( 'Yo) of all work
completed, The entire amount of contract is to be paid within completion,
Any alteration or deviation from the above specifications involving extra cost of material or
labor will only be executed upon written orders for the same, and will become an extra charge
over the sum mentioned in this contract. All agreements must be made in writing. All start
and/or finish times are weather permitting.
Shingle Color:
Drip:
Ridge:
Other:
Respec'~ubmitted.
X~-~
la or required to complete the work
'"'------' agrees to pay the
ing to he terms thereof. All start times and
A
X
X
200