HomeMy WebLinkAbout07-7119
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
7119
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:
7119
RE-ROOF
ROOF REPLACEMENT
SINGLE FAMILY RESIDENTIAL
Address: 5923 14TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-03900-0010
3,145.00
10/19/2007 Name: FIELD, JANE
75.00 Address: 5923 14TH ST
75.00 ZEPHYRHILLS, FL. 33542
10/19/2007 Phone: 813782-4184
REROOF 17 SQ ASPHALT SHINGLE - UNDER OLD LAW
~n~&
id2107
(GV..-
TAPE JOINTS ROOF INSP
FINAL
REINSPEC1l0N 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."
~~~
CONT CTOR 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 S
Building Department )ff I
Phone ConlBct for PermIttIng
Fax-813-7jlO-OO21 I (
o ..)..3~ c-e.
70 #o~~~1ff9
Own.... Add.....
Fee Simple TllIeholder Name I
59d3
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j I/ +h S.J-r e.~.f
o..r- Phone Number
Owner Phone Number I
o..r- Phone Number I
Owner". Name
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I'IK S frul- Z<p tr 1,; n, A 3:J~ <<>T. I I
I PARCEL/ON \- ~-2-I- t)DlO- 03it:.c-bbIDI
(OBTAINED F_ PROPERTY TAll NOTlCEI
D. ADD/ALT 0 SIGN 0 MOVE 0
..J25k REPAIR
D COMM 0 OTHER
D FRAME 0 STEEL 0 OTHER I
I r^e (00+ /'1 ~f,p I-\. sh; '"loa
SQ FOOTAGE ~ I HEIGHT l
JOB ADDRESS
Fee Simple 11tIehofder Address I
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SUBDIVISION
WORK PROPOSED
E3
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NEW CONSTR
INSTAll
SFR
BLOCK
DEMOLISH
PROPOSED USE
TYPE OF CONSTRUCTION
DESCRlPllON OF WORK
BUILDING SIZE
0 BUilDING 1$ I VAlUATION OF TOTAl CONSTRUCTION
0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY 0 w~~
0 PLUMBING 1$ I filV
0 MECHANICAL 1$ I VAlUATION OF MECHANICAL INSTALLATION
~ 00
0 GAS ROOFING 3 Ji/)'O SPECiAlTY 0 OTHER
FINISHED FlOOR ELEVATIONS I I FlOOD ZONE AREA DYES ~O
BUILDER
SiGNATURE
COMPANY
REGISTERED
COMPANY Itk,T ('OI1<1,<<('+ID'(\ (',,,T,J.
REGISTERED ~ FEE CURRENT TM:E:J
'Vh,lIs 335t.:t.~# I CCC.j3A7456 I
COMPANY I I
REGISTERED U!.lLJ FEE CURRENT L..!.!!!....J
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license #
Addrese
ELECTRICIAN
SiGNATURE
Address
PLUMBER
SIGNATURE
U!.lLJ
FEE CURRENT
Addrese
L..!.!!!....J
license #
MECHANICAL
SIGNATURE
COMPANY
REGISTERED
U!.lLJ
FEE CURRENT
L..!.!!!....J
Addrese
license #
OTHER
SIGNATURE
COMPANY
REGISTERED
U!.lLJ
FEE CURRENT
Address
L..!.!!!....J
I
RESIDENllAL
license #
COMMERCIAL
Attach (2) Plot Pla1s; (2) sets of Building Plans; (1) set of Energy Forms
Minimum ten (10) working days after SI.tlmittal dale. Required ons~e, Construction Plans, Sanitary Faci@es & 1 dumpster
Attach (3) sets of Building Plans; (1) set of Energy Forms.
Minimum ten (10) working days after submittal dale. Required ons~e, Construction Plans, Sanitary Facil~ies & 1 dumpster
All commercial requirements must meet compliance.
AItach (2) sets of Engineered Plans.
--PROPERTY SURVEY required for all NEW construction.
SIGN PERMIT
Direction.:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement i. required. (AIC upgredM over $5000)
- Agent (for the contractor) or Power of Attorney (for the owner) would be someone w~h notarized letter from owner authorizing same
OVER THE COUNTER PERMITllNG (Front of Application Only)
Reroofs Sewers S8lV1ce Upgrades AlC Fences (PIotISlXVeylFooiage)
Drlveweys-Not over Counter if on public roadways..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 woll(. 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 woll(, they are advised to contact the Pasco County Building Inspection Division-licensing Section at 727-347-
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 IMPACTIUTILlTIES 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 aU the information in this application is accurate and that all woll(
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 woll( and installation as indicated. I certify that no woll( or installation has
commenced prior to issuance of a permit and that all woll( 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 woll(, 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, WaterlWastewater 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 woll(,
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 woll( 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 wort authorized by such permit is commenced within six months of permit issuance, or if woll( authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the woll( is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If wort ceases for ninety (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 COMMENCEMENT.
FLORIDA JURAT (F. .117.03) " __~
~OWNER OR AGE CONTRACTOR ~..-z..-
~ ~ Su and SUb1J"~ to (or affirmed) before me this
I b vI.e b ~~~I('I..A U,/
isI fly me e produced
as identif"lClItion.
fl~~*R __~.
Commission No'. 5 -<) 7
p- \It? ~ (<;ho. II
Name of Notary t , printed or stamped
c.o.~~:' ~ ~~~~~ -~.
FVfJ. (Y) O-Y' '1ha II
Nama of Notary typed, printed or stamped
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~OFt\.Iil~
(407) 398-0153
EVA M MARSHALL
MY COMMISSION # 00539537
EXPIRES: Apr. II. 2010
FlorIda NolIIry SeMce.com
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EVc. ",f-\l{.,,;-:ALL
MY COMMISSION # [)D539537
TKJ CONSTRUCTION COMPANY, INC.
37606 Marcliff Terrace
Zephyrhills, Florida 33541
License #CCC1327450
(315)398-0235
(315)527-5223
(813)780-7470
October 19,2007
Re: permitting
To Whom It May Concern:
This is to serve written notice that I am giving permission for Eva Marshall, William
Williams, Tammi Williams, Merrill Atkins, Kristi Goodnough to apply for and pick up
permits and/or all documentation for Laverne Fowler, TKJ Construction Company, Inc,
until further notice.
Sincerely,
~~
Laverne Fowler
cc: file
NOTARY:
State of F)Qr'~d~
County ofca~D
I HEREBY CERTIFY that on this day, before me, the undersigned
officer, a Notary Public duly authorized in the State and County
named above to take acknowledgments, personally appeared
'LtuJe'r'n<. Fo~ Ie or , who is personally known to
me, or presented the following as identification who executed the
foregoing document(s) individually, known to me to be the person
named and he/she acknowledged before me that he/she executed
the same for the purposes therein expressed.
WITNESS my hand and official seal in the County and State
named above the ~ay of ~~ ,200l.
Ta1!Dd. JAf). ~ (Seal/Expiration Date)
Notary Public
TcU0\~. XY'(Ar}.:\ Y\,
Typed name of Notary
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TABmt.t. NARTlN
MY COMMISSION 1/ 297031
EXPIRES: Man:h 7, 2Oll8
Banded ThRJ Nal8ry PUliic Undorwrttsfs
- . ""',-, STATE,OF FLQRIDA ....
'~ifl~~:II~f~f~~~~'1J[oN~~fti~1"6~~pl(~~:
- LICENSE'1mR"..t:......,
06' .'12:2:007 06:07 77:312 B4S8.9'!2:"~~!f' ' .- .,."
ij::~~U~'~~eS I~Rg~~i~;~gN'~~~f' ,./.,i).;-.....
Undertheprovisions'co'f Cliap~,e*-i~8..9
Expiration date: AUG31, 200~".. ,
(THIScIS NOTA _LICENSE:',~() :e.!~~R1f >,W'OR.I<'~ . THIS ALLOl.'7;~,;
C.OMP-ANY'TO.DOi:BUSINESS')9~X;' r;p',,'IT. dr.ASAQUALIP'I~~. )',<
'0":"'- <.":___ . ,-,:, <: ~,' -/_:,.-- '">.. >"'~' ~'.:.;,;;:' .:":I,I;,~\.:" '~'_'.~
........TKJ.CONSTRUCTION,COM]?;A}tY m~c .,~;
37 606-MARC-liIF}i' TcERRACE;:' <;:\,,':::'\,i
ZEPHYRHILLS' .'. 'FL 335'il'
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"~;DISPLAY AS'REQUIRED BYLAW
.,.HOLLi':BENSON'
"SECRETARY/
-----------------------
-~;~S'~~~;:;~%I
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CCC13274;50
. STATE OF ~~PRJDA;_:, ,~,CIf' ~ .p,~ 9 792
'. DEPARTIISN"r-aF)BUS:m:ESS;"~Am> '
. :-PROF;ESSIONAL'UG'DL1tT-llON
."'.-; .,-,-' - ,- "-'" ""''',:l''_.o'!-'''''.--,..-- ,
Qa48892 .
-,:';'"",- ",:'- - - _:_;:
.,CERTJ:1i'tEDROOF:I:NG CONTRACTOR"::'::::'
FOWLE~,LA~CBR:J:STO~HER < ""u
TKJ CONSTRUCTION COMPANY J:NC::'
QUALJ:F:IED.BUSJ:NESS:ORGA.J:ZA'1'J:ON
TKJ CONS~UCTJ:ON',COMPAlCr'mC .... .'.
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IS cn:t'IFI.BI)~~~ ~..~.i~~,Of Ch.4~9rt;~
II:xp:l.UUOD da~~.AUG:3J."::,~Q()8 ,. . ',L06070S0019ir:"':'
(NOT A LJ:CE:NSETOPERFO_'~:WORE:.
ALLOWS COMPANY TO DO BUSDmSS:IF
:IT HAS A LJ:CEHSEIlQUALJ:FJ:ER.)
IS QOALIFI~ ~~~~ th.,.~iB1~Of<i:'.17489?s.
BzpiraUOD da~. .~UG.,.~:J. ; 2'01>19 ~~~~~?;~6i:lOl.6i
~c#~ 2 6423 ]1
.- - . ,'-,- -.'-,-.
DATE
~~!AR~s~~fi.1fl~~1I~~.piON~L~~070~OO~i
LICENSE NBR
; -,'- -, .....,.,
0705 2006 050869019 CC8i3c2k74'$fO
The ROOFING CONTRACTOR: ",0
Named below IS CERTIF':IBD'i,:';"
Under the provisions of Chapter
Expiration date: AUG 3J., 2008
,),:',"'::I',~":'
FOWLER,. LAVERNE CHRIS:~OPHER,:,<C:
TKJ CONSTRUCTION COMPJmY INC"-
37606 MARCLJ:FF TERRACE
ZEPHYRHILLS FL33~:~;L:..
,,-
','-. ". .'j: ~
JEB BUSH
GOVERNOR
S:r:MONE MARSTILLER,'
'SECRETARy..'...
. -,-;~~ .
DISPLAY AS REQUIRED BY LAW
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STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
06-18-2007
ALEX SINK
CHIEF FINANCIAL OFFICER
* *
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE:
06/18/2007
EXPIRATION DATE: 06/17/2009
LAVERNE C
PERSON: FO~ER
FEIN: 204567523
BUSINESS NAME AND ADDRESS:
TKoJ CONSTRUCTION COMPANY INC
37606 MARCLIFF TERRACE
ZEPHYRHILLS FL 33541
SCOPES OF BUSINESS OR TRADE:
1- CERTIFIED ROOFING CONTRACTOR
IMPORTANT: Pursuanl 10 Chapler 440 . 05(141, F.S., an officer of a corporalion who elects exe.plion from Ihls chapler by flliag a certlficale of eleclion under Ihis
section may nol recover benefits or compensalion uDder Ihls chapler. Plrsuant 10 Chapler 440.05(111, F.S., Certlflclles of eleclion 10 be exempL.. apply only wilhin Ihe
scope of the business or UNe Iislod on Ihe nolice 01 e/eclion to be exempL Pursuanl 10 Chapler 440.051131, F.S., Notices of oloction 10 be exnmpl ad cortificllOS of
eleclion 10 be exempl shall be sublecl 10. revocllion ii, al sny time aller the Iiling of Ihe nolice or the issuance of Ihe certificale, the person na.ed on llIe nolice or
certiliclle no longor meels Ihe requiromenls 01. Ihis seclion for issaloce 01 a certllicate. The dopnrtmenl shall revoke a certificale al any Ii.e fnr Ililure nf the person
nlmed on Ihe certilicale 10 lReel Ihe. requiremenls 01 this seclion.
aUESTIONS? (8501 413-1609
VC-Z5Z CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
...
APPLICATIQNFQRBUSINESS TAX RECEIPT
. P.ASCOCQUNfYFDCIRID.A ·
TAX YEAR:
ACCOUNT NUMBER:
SIC CODE:
OUR FILES CURRENTLY REFLECT THE FOLLOWING INFORMATION RELATING TO THE BUSINESS IDENTIFIED BELOW.
PLEASE CHANGE INCORRECT INFORMATION.
. Business Name Or Fictitious Name:
If Fictitious Name, Registration Number:
Expires:
. Corporate Name (If Different From Above):
. Owner/Manager's Name:
Home Phone:
. Date Business Opened In Pasco County:
. Physical Location Of Business:
. Mailing Address:
. Federal Employer ID Or Social Security Number:
. Sales Tax Registration Number:
. State Or County Regulatory License Number:
. Property Parcel Number:
Business Phone:
. Fees: Tax $
. Number Of
Penalty $
Expires:
Tangible Tax Account Number:
Other $ *SQG $
(*Small Quantity Generator of Hazardous Materials)
If "Number Of' Changed, See Fee Schedule Below:
A IT ACH COPIES OF:
RETURN THIS FORM INTACT WITH APPROPRIATE FEE AND COPIES OF ABOVE DESCRIDED DOCUMENTS. BUSINESS TAX
RECEIPTS EXPIRE SEPTEMBER 30TH. OCTOBER THROUGH JANUARY AMOUNTS INCLUDE A LATE RENEWAL PENALTY.
DO NOT DETACH - RETURN ENTIRE FORM INTACT
BUSINESSiTAXNO"IiCE.-PASCOCOUN1Y FLORIDA
2007-2008 L.ICENSE YEAR
ACCOUNT 071867
SIC CODE 1761
I I I I
PAYABLE TO: Mtl(E OL.SON, TAX COLLEC'TORl P.O.lBOX 276, DADE CITY, ..FL.33526-0276
SIGNHE:RE~
I CERTIFY THAT ALL INFORMATION PROVIDED IN THE ABOVE
APPLICATION FOR THIS BUSINESS TAX RECEIPT IS TRUE AND
CORRECT.
Tk.JCONSTRUCTIONCO/"lPANYINC
87606 MARCLIFF.TERRACE
ZEPHYRHIL.LS FL 33541-3818
AUTHORIZED SIGNATURE
DATE
PAID 32.38 10'18/07
TEMPDRARY> RECEIPT
:~~V~~r~~~~Q7
TEMP RCPT NZLO 10/18/07 RAT
"__________ I
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HfTE~Y RECEIPT***
"IKE OUD TAX COlLECTOR PASCO CIUlTY
DATE/TIlE: 11118/2887 2:87Ptt CR: 176"
",-lOCAIS: ZEPIHI89 CASHIER: TC51RAT
TRAHS.',:.13__1ACCT.I= 871867
RECEIPT=M13888 Business Tax Receipt
RECEIP1AltOUMT: $32. J8
BUsiness' Tax ReceiDt $32.38
RC '32.38
~ M..
ItARSHlI.l. EVA MRIE
376t6ttARClIFF TERRACE
ZEPKYRttILlS
FL 33541 3818
$32.38
Receipt AIount=
Thank You FOT YOUT PaYHnt
YOUT Business Tax Rec. will Be "ailed
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Pasco County Tax Collector Parcel Search Result
Page 1 of 1
Mike Olson TAX COLLECTOR ~\SCO COlJNTY FLORIDA
HOME
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Legal Description (First 4 Lines)
TOWN OF ZEPHYRHILLS AKA
CITY
OF ZEPHYRHILLS PB 1 PG 54
LOTS 1 & 2 AND NORTH 1/2 OF
LOT 3 BLOCK 39
Mail To /Paid By Information
SAME AS ABOVE
* * * THE INFORMATION CONTAINED HEREIN DOES NOT CONSTITUTE A
TITLE SEARCH AND SHOULD NOT BE REUED ON AS SUCH. ADDITIONAL
UENS AND DEUNQUENCIES MAY EXIST THAT ARE NOT INCLUDED
BELOW. THE PASCO COUNTY TAX COLLECTOR ACCEPTS NO
RESPONSIBIL TV FOR THE ACCURACY OF THE INFORMATION PROVIDED.
~LL FIGURES ARE SUBJECT TO CHANGE OR CORRECTION.{sJ:ILEI-Q_RIDA
STATUTE 197.122)
Parcel ID 2006 Tax Year
11 26 21 0010 03900 0010 ASSESSED VALUE
Owner of Record HMSTD EXEMPTION
FIELD JANE E OTHER EXEMPTION
5923 14TH ST TAXABLE VALUE
ZEPHYRHILLS FL 33542-3637 AREA
MILLAGE
GROSS TAX
(INCLUDING SPECIAL
DISTRICTS)
Special Districts
SOUD WASTE
PASCO COUNTY STREETUGHT
Current Tax
39,237
25,000
13,737
30ZH
20.6839
346.15
62.00
o
DATE RECEIPT
11/30/06 116836
Tax Lien (Homestead Denial)
NONE
Unpaid Delinquent Taxes
AMOUNT
PAID
$332.30
NONE
We are unable to accept credit card payments at this time.
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APpraiser'~ll'IfQrll1;:1tic:)O APpr",Js~r'~M",p PelinQYel'ltMap Delingl.l(mtMf3IP Il'IfQrll1iltic:m
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http://www.pascotaxes.comlsearch/offlineprc1main.asp?parcel=112621 00 1 00390000 1 0
10/18/2007
OCT-18-07 02:13 PM
INSURANCE SERVICES
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 0 LV AND li
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Tl'IIS I ' n
CERTIFICATE DOES NOT AMEND. EXTENO, OR ALTER THE COV.RAGE ~r
AFFORDEO BV THE POLICIES BELOW. :' !,
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'GENE SMITH & ASSOCIATES. INC.
36950 STATE ROAD 54 WEST
ZEPHERHllLS, FL33541
COMPANIES AFFORDING COVERAGE
INSURED
TKJ CONSTRUCTION COMPANY INC
COMPANY
LETTER
COMPANY
LeTTER
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
B
C
D
A PENN AMERICA Insurance Company
37606 MARCLlFF TERRACE
ZEPHYRHILLS
THIS IS TO CERTIFY THAT T~E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED OVE
' FOR THE POLICY PERIOD I~DICATED, NOTWlTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRA OR
OTHER DOCUMENT WITH AESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR MAY PERTAIN. THE INSURANCE i ,
AFFORDED BY THE POUCI S DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF 'UCH
POLICIES LIMITS SHOWN Y HAVE BEEN REDUCED BY PAID CLAIMS. , I
CO TYPE OF INSURANCE' POLICY NUMBER POLJCV POLICY LIMITS I~,
LTR EFFECTIVE OAre ElIPlRA'T1ON OATE
OE EFlAL LIABILITY
A PAC6698535
Cle/19/2008
OENElW.llGOFISOATE
PFlOOUCTS.coM/OP AIIB,
PEFISONAl.." ADV. INJURY
EACH OCCUIW!NCE
OAMAGnO fOIiilEMISES RENTED
MEO. ElIPEI'ISE (Any -lItIllonl
COMIl'NEOSING~E UMIT
llODI~Y INJURY ., PeIM/l
BOOIlVINJURV .rAooIcI.
P~5,""
EACH OCCuFlAENCE
AGGREGATE
OS/19/~7
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AUTOMOBILE LIABILITY
EXCESS ~lABtLITV
WOAKERS COMPENSATIO-"
ANe
EMPLOYERS' LIABILITY
8TATUTO~ LlMITII
&ItCH ACCIDENT
DlseAllE'POLICY UMrT
DI!leASE-EACH EMPLOYEE
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DESCFlIPTION OF OPERATIONS I HICLE8/ speCIAL TV ITEMS
PREFABRICATED BUILDING ERECTION
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CITY OF ZEPHYRHILLS
5335 8th STREET
ZEPHYRHILLS,FL.
33542
Should any of the above d.lorlbad pallo I.. be c.ncell~ b
expiration dati, thl company .ha" endNvor 10 mall 30 da
notloe to thaDarJlflaatehold.r ~n.mac:lto tha I.. but fa/lur. to
notlaa .hall Impola no obllgatfon or liability of I"Y kind
oompln I ItII entl, or rapr..antatlve..
AUTHORIZED REPRESENTATIVE ~
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Proposal Submitted To: Ja
Address
<is 0.1
Date of Plans
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We hereby submit specifications and estimates for: .. . .....
.u.....I'J. mS4.iLaXe~ ......rUo9-E.. .in c.--LLLCLJ--IL7 .n.eu) ....kl+,
........ .......d(L'p!Ld..qe.Cl-dC1..CLdge.. .tle...rLf).h.-aCl b()o+.S.O,).sD~
A .... o. "."'..l}';'"
. .o....~-.{1'1_.. .JAJoodwo.r::K-. "LwIlL.be.an. o..cJdLn DOQI. ... .... EL
. .~io w pJ'1.uJOV d. .Jfs."'-J.CLI:2CY.~ncL_Tfw. <if;-
...........L.Ja...hoc. .onlLlfov' ... .."'.....load-wo. .. k-..o..5or.:jh.
.. -pet.rYl1Ul~
.. Ll)ilrci:LIl;se homeo wne-y
!;by ..woodwov'K-
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of XfTtl. .kes
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(we propose hereby to furnish material and labor - complete in accordance with the above specifications for the sum of:
$~ ~$Bfl.d DhL~ o.r.d (.10/'0. -Dollars
with payments to be made as follows: -k-~ r1 bo J " I) C -' J lz.,t ~ .
~
Any alteration or deviation from above specifications involving extra costs will be
executed only upon written order, and will become an extra charge over and
above ,he estimate. All agreements contingent upon striKes, accidents, or delays
beyone! our control.
Respectfully
... days.
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i The above prices, specifications and conditions are satisfactory and are
I hereby accepted. You are authorized to do the work as specified
lpa,m,. nts will be made as o~
Date of Acceptance,,' ~ I, ~ c c' 1
---
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:-acrtptance of JJropo.saf
Signature
Nignature ~ ~ ~
at NC3819
NOTICE.OF.COMMENCEMENT
11111111111111I111111I111I11111111111111111111I111I111111111
2007174971
'PerlnitNo.
Propefo/ IdentificatiOn No,Jj ~. {" ~ I
Rcpl: 1136618 Rec: 10.00
DS: 0.00 IT: 0,00
10/18/07 Dpty Clerk
,.
DelO 03'100 00' 0
. TIlE UNDERSIGNED hereby give' informs you that the improvement will be made to certain real property, and'in accordance with
Section 713.13 of the' Florida Statutes, the fo~lowing informationi$ provided in this NOTICE. O:f CO~NCEMENT,
. .
} ,Description of property (legal description:) 1i. &L..1
a)-Street Address: . J ~. ,
2.General description (If improvements:
i~91G~~l"~:~SC01CO~NT~CLERk
OR Bk 766K PG ~53
3.0wnerInformation . ~ beJJ' . .' '.. .
. . a) Name and address: ; ~el" .' .' .'...
.' .' . b) Name an. d. addr. ess offee. S~le titleholder(if Oth. er than owner) -----
R. . . C?-).Interest in property . J (Xl n .' ,. . . . . .
entr'acter Information'. . . . : '.. '. . ..' '.' . . . . .
. ~)Nameandaddress: fKJ Gf(\~+'r"U. (".ll'b~ C~'~a..nf T~. . ..' .'. . '. .
b) Telel?hone No.: ,'ll ~ "'~lYll.f ,0 '. '. .' . No. Qpt.) . \' . \ SIt' 1t)1 H ~ h nr-"*
5.SuretyInformation'.. .' 37(.,'0(.;, (Y\o....,d"j~~ ~~f"~~ .
. a)Nameand!lrldrel1s:;/ . r . t'-:"'.
. , b) Amount of Bond: . ./".. Ze.t> '" Y'" h. Its;. Fl' :;j ~ C:;.4 f
c) Telephone No.: ../' . . . Fax No, (<;>Pt.)
6.Lender .' .
. a.) Name and address:
. . Phone No.
7. Identity ofpCl'S'on within the tate of Florida . signated by owner upon whom notices or otherdocmnei:rts may be served:
a) Name and address:
b) TelephDne No,: Fax No. (Opt.)
. 8.In addi~on to himself: owner designates the following pCl'S'on to receive a copy of the ~ienor' s Notice as provided iri Section
713.13(1)(b), Flo~da~: . ../. .
a) Name and address: ~.
'b) Telephone No.: /' .Fax.No. (Opt.) ,
9.Expiration date of otice ofCoIDJDencement (the expirati01)..date is one year from the date ofrecordlng.un1es.s a di:ffetent date is
SJlecified): . .
. .
WARNING TO OWNER: ANY'PAYMENTS'MADE'BY THEOWNERAFI'ER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER-CHAPTER 713, PART 1, SECTION 713.13, .
FLORIDA STATUTES,.AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND.POSTED ON TIiE 'JOB BITE BEFORE THE F'lRsT
'INSPECT-ION. IF YOUINTENDTO OBTAIN FINANCING, CONSULT yOuR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECO~ING YO'(JR NOTICE OF COMMENCEMENT. .'
. .
~:~FO~=~ ./ . .. '. /?~.
~ ~orized OffiCCl'/Elir=torJPar1ner/ManagCl'
. : t". ~o.ti:;)/' h <- ('~ .7 c ~I t.-I'"
Print NII!DC . , . "
. Theforegoing instrument ~ acknowl~dge~ before me this lfL-. cb,y of . D~ be.r .2') .D? . by' T(lcCu.. ~
.as . '(type ofm$ority, e.g. officer, e, attorney
. in fact) for . L D.\/tJfn L c' ~O~~ . (name ofParty~nbebalfmom instrumeDtwas executed). , .
. pom>noIIy Known--": ORPrndu=l ldeDtificman vL<_Olaly -= Ut:P~..rL.. ~ -
. . ~ ' I ~ '. ..t~',ir."'~ JACQUELINE BOGES .
T)ye ofIdentification .Produc.ed ..vLt VlLt'" v lV-s.,a.. . Name (print) !.{ i:~: r.nrnmi<:<:inn nn 6?1 ~~ .
;~~> ,rt Expires,December 12, 2010
'. .p.r,,~' Bondod1lvllT"'I'Foi1In1u/lllCllBlJO.386.70t9
Verification pursuant to Section '92.525. Florida s1Bt1Jies. .Under pcna1tics ofpCIjury, I decla'rc. that I have read the foregomg and that
the:factS stated in it are 1;n1e to ~e best of my knowledge arid. belief:.. . '. r/~ '. _" '__ .'. .. . .
. . ." '. ...~~p~~ '.
FORMSlNOC,nmI2D07
, Date Received:
, ~
,
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iii!i~~'~fZ~~r~!m! ., e1;JJ:1~
B~INGPLAN REVIEW COJvllVIENTS < ~ ''I, <:edt:&~c:ckA
'. ' " . t-, . .....~~fl#';"~
IK:r cgysh//!lJh & k Dld~' '
. (D" I B~O 1- ~b-
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o. "_~__"'"_U_''...&''''''_'"~''---_.'-'-'---'-'------'''-''' -.-_.' .: '.
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, Contractor/Homeowner:
Site:
. permit Type:
ApProved wino commen:ts:D
, '
~w/the below oomm=: ~ ,Dcmro ~/the below crnumoms:O ,
. AJrx-r" j}.rm,f-,S,' {J<JI(dW'// ,Ref' .", ,
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"nn.JZtJ:)be~~;;;~::orPhns" ,~' , "~.
~ws~~~~ Dw ,L~-
, _ omeowner
; - , (Required when comments are pres~t) '-