HomeMy WebLinkAbout08-7651
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
7651
Permit umber: 7651
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 5,420.00
Date Issued: 3/20/2008
Total Fees: 60.00
Amount Paid: 60.00
Date Paid: 3/20/2008
Work Desc: RE-ROOF
Address: 6519 FOXMO R D
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: SILVER OAKS
Parcel Number: 03-26-21-0120-00000-0780
Phone:
(ir;1, 0~
TAPE JOINTS ROOF INSP
FINAL
REINSPECTlON 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 commence t."
V
CONTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
B13-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
Date Received
1111111111
Owner's Name
JOB ADDRESS
Fee Simple Titleholder Address I
l0.sJ1
I
Fo}(V\'t,l.Ov Dr
I
D NEW CONSTR D ADD/ALT D
D INSTALL D REPAIR
PROPOSED USE D SFR D ,COMM D OTHER I
TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 OTHER I
DESCRIPTION OF WORK ~ VO,- -r t-.v / q J 0 ~"'Ur C /?F ??~ ~J.-,I r H
BUILDING SIZE I ~Q FOOTAGE I i I 5' L HEIGHT I I
..11....11....111..........'.,11..111...11....'111....11...,.....11...11,..........'111.............,..,.....'11.'11'......111...................'11
1$ 5 t.j UJ/ lj U
1$
1$
1$
DGAS ~
FINISHED FLOOR ELEVATIONS r
SUBDIVISION
~ k.i Us F I 3 -5~ij:P-
PARCEL 10#1 05- 2-10- 2,1- 01 2..-0 -OOL; ou -O,cf()
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN 0 MOVE D
LOT #
WORK PROPOSED
DEMOLISH
D
o
o
o
BUILDING
VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL
AMP SERVICE
D
PROGRESS ENERGY
D
W.R.E.C
ROOFING
D
I
SPECIALTY D
FLOOD ZONE AREA
OTHER
PLUMBING
MECHANICAL
VALUATION OF MECHANICAL INSTALLATION
DYES
DNO
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BUILDER
SIGNATURE
Address
ELECTRICIAN I
SIGNATURE .
Address I
PLUMBER I
SIGNATURE
Address I
MECHANICAL I
SIGNATURE ,
Address I
COMPANY
REGISTERED Y/N FEE CURRENT Y/N
License #
COMPANY
REGISTERED I Y I N FEE CURRENT Y/N
License #
COMPANY
REGISTERED
Y/ N
FEE CURRENT
Y/N
License #
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
OTHER
SIGNATURE
(....ilvS~S 2- Pc)~c,K{lrS-
License # I
lJ1~m~cf~~4f<f:'~
'1;C ( License # k::" L?OJ 7 7 S--7
Address
111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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 atter submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days atter 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
SIGN PERMIT Attach (2) sets of Engineered Plans.
.***PROPERTY SURVEY required for all NEW construction.
111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 111111 11111
Directions:
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 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 compl4ance 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, 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 work,
plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallations not specifically in~luded. in the application. A
permit issued shall be construed to be a license to proce~d With the work a~d not as authon~y ~o vlolat:, 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 violat~o~s o~ any codes. Every ~ermit 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 nln~ty ~90) da~s and Will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the)ob 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.S. 117.03)
OWNER OR AGENT ~
Subscribed and sW6!'fl or affirmed) before me this
by
Who Is/are personally known to me or has/have produced
as identification.
CONTRACTOR ~~,.
Subscribed and sWom to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
'P"r~posaI/Contract
SCtJ:U~~1!iHJt"9, 1~.
P.G:>. 'Box '11'88
33010SR.52
San Antonio, FL 33576
(352) 588-ROOF ,(7663) .(8rl9.~ 782-1330
Fax (352)588';9763
email: blackmanroofi n9@aoloicom
~ ic.eH.d-etl"
'C fJ.H.tteii &
'/H.d-"-fted
Date
3/11/0 f
PROPOSAL SUBMllTED TO
WORKED TO BE PERFORMED AT
Name PA T GCJJ-+~1 Street
Street (, 519 iFO'1--m oC![ tJr City
City -Z ep "''' ( "'-\ \\s State Zip
.
State FL- Zip S S 5 '-\0 Owner of Property
Phone Number f'] B'd- L.J9foY Fax Phone Number Fax
We herebypropose to furnish all the materials and perform all the labor necessary for the completion of:
~ Remove existing shingle roof WReplace bad fascia boards at $ L. eJJ per foot
o Remove existing built-up roof J21lnstall feet of ridge vents
p Dry-im\\iith'D15Ib. )29'30 lb. ~ '-f II '"Trr (1Af'tC DJnstall modified bitimen (granulated) torch down roofing
.tp Install new galvanized valley metal black, white or other color
~lnstallneWlead:boots Cl Jnstall25 yr. fungus resistant 3-tab shingles
~Install new exhaust vents .ilIllnstall 30 yr. fungus resistant dimensional shingles
1:fln~alL-r(EiWdrip!e9ge, wlhct (' ~ II color 0 Shingle manufacturer (: liP 30 color Blrchw 00&
'!::.t,lnstall;:a8wflclshlngasneeded 0 Install TPO, white rubberized roofing membrane
!liRepjaqe,piywood.al'$ "3 it. 00 per sheet Q Other: R.-p.'/r,( t' /'''0 r.h a1 S fly ",.J
I7J Repair rotten trusses at $ 2. oc.> per foot -yl.k.l cJ."",V'~
., i~i~';~ei~~ptieingabove
All material is guaranteed to be as specified, and the above work is to be performed is accordance with th~~drawings and specifica-
tions submitted for above work and completed in a substantial workmanlike manner for the sum of $ -;.' '/~/2(.J'/ /,(70
with payments to be made as follows. Payment due in full on completion, unless otherwise noted. Thank You.
Credit cards accepted, addtionaI2.8% charge.
Any alteration or deviation from above specifications involving extra costs will
oeexecuted only upon written orders, and will become an extra charge over and
ibove the estimate. All agreements contingent upon strikes, accidents or delays
leyond our control. Owner to carry fire, tornado and other necessary insurance
Jpon above work. Workers' Compensation and Public Liability insurance an above
~ork to be taken out by Roofing Contractor,
Officer/Agent Scott Blackman Roofing
Note: This proposal may be withdrawn by us if not accepted
within days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. I have read the back of this Proposal/Contract, which contains Florida Stautes 713.001-713.37. Payment will be made
as outlined above.
Accepted
Date
Signature
Signature
;'
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON 'FILE
0fI OF PUBLIC RECORD IN THIS OFFICE. WITNESS MY
HAND AND~SEAL 2T~ DAY OF
JEO PITTM~RCUITCOURT
BY DEPUTY CLERK
1111/11111111111I11I11111111111111111111111111I111111111 I11I
2008042189
Rept:1168598 Ree: 10.00
DS: 0.00 IT: 0.00
03/20/08 ______ Dpty Clerk
JED PITTMAN, PASCO COUNTY CLERK
03/20/08 09: 37am 1 ,,~1.
OR BK 7790 PG ~~a
NOTICE OF COMMENCEMENT
Permit No.
PropertyldentificationNo.C?-2~:;'-2' -oj 1-0 -U<':)C(lO -0 7~O
THE 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 following information is provided in this NOTICE OF COMMENCEMENT.
l.Descriptionofproperty(le~aldescription:) ,{utI" Oc..h phtt$'( O'''le (Jfj 2.10 PC,S '\0-' Lof- 7'i1{)/?. 7ZS';d6l0?-3
a) Street Address: 4>}19 Fo,(.JIVl.(.>.:.J,- tJ~ Zh,IIJ 1=1 3~-'fL
2.General description of improvements: fl-.e.- roof IW/ c..... ~o 'i/~ A-F TJMk" It ~1~
3. Owner Information
a) Name and address:' e{,:trlC.IO~ G'o/ tv 6577 FD/(Y'vu,';,-
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property Ol--V'''<...V"
4. Contractor Information
a) Name and address:
b) Telephone No.:
5.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address:
~ 3 S-Y z..
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713. 13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is
specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, 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 THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PASCO
~~
- Signature of Owner or Owner's Authorized Officer/DirectorlPartnerlManager
S-:ctl- M\ Q ~ ~Y"'-
Print Name
The foregoing instrument was acknowle fVlCLrL..h , 200Y by C} dtf1 ~ J.M4 V1
, . as (type of authority, e.g. officer, trustee, attorney
in fact) for <' ! 1. ~name of party on behalf of I horn insn:ument was executed)
Personally Known~R Produced Identification _ Notary Signature ~
Name(Print){jr/ ann j{~!:!/A.
Type of Identification Produced
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
FORMS/NOC.rvsd2007
~~
Signature of Natural Person Signing Above
."";0"". CORI ANN KEOUGH
lJ~ Nol8Iy PubIc. State d FIoItdI
1~1 iJ: CoImliIIIon ExpIrwAug 17, 2010
\1 CommisIIon , DO 5ll6503
'It!,.... ~ Bonded By Nallonal NotIry Alan.
~ cao~
,City ofZeRJ!yrhills
BUILDING DEPARTMENT
RE: Permit # ~
9/17/07
Inspection Affidavit
I ~'1SW~""
(please print name llnd circle Lic. Type)
.licensed as a(n~~/Enginee</Architect,
uilding Inspector*
License #; <:. c. ( 0 S-'17 S- Y")
On or about .3 - do 1 - Ocs. ~ ~ 00 P.1h . I did personally inspect the roof
~&rime)
deck nailin
work at b S" I C, f"'() ,'(... fY) (XJr ,
(Job Site Address)
\)r-: -z... ~ f hyrh; Us I FL-
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
~ ~ ~4'~ ~~ ------
Signature
STATE OF FLORIDA
COUNTY OF s+
Sworn to and subscribed before me this "2 1 day of --In CJ.. r C h
By \.~~{)it- ~ynt1"
~~K~
.200~
Notary Public, State of Florida.
~t~ (1110 Keo~
(pnnt, type or stamp name) ,
Personally known i or
Produced Identification
Type of identification produced.
Commission No_:
.. General, BuildiQg, Residential. or RoofiDg Contnctor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked 011 the
declc: far caQb iDspecti~.
. ......~~..'" CORI ANN KEOUGH ~
~m"~ \ Notary Pullllc . SIaII of FIoItda
· i. '~CommiSsionExplreaAUlI17, 2010 ~
· \:, '!.7A! CommlI8Ion . DO 586503 ·
· ~9f.:.~"- Bonded By National Nol8ry Aun.
~ - -
~~
~rfu rnl
p {"(Q.S <'-
'l hI).. n.. ~5
~c K-l e....
SCOTT BLACKMAN ROOFING
P.O. Box 1188
SAN ANTONIO, FLORIDA 33576
F~'f- '710 - 00 c./
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