HomeMy WebLinkAbout09-9574 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9574
•
BUILDING PERMIT
Permit Number: 9574 Address: 4822 GALL BLVD
Permit Type: RE -ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14- 26 -21- 0010 - 01700 -0090
Improv. Cost: 17,950.00 - ", <, b
Date Issued: 10/19/2009 Name: GONZALES- SMITH, DIANA & COLLINS
Total Fees: 180.00 Address: 4822 GALL BLVD
Amount Paid: 180.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/19/2009 Phone: (813)788 -9011
Work Desc: RE -ROOF SHINGLES METAL
,_
... . ..
PAUL HA - • IN I - Re •F • M - IAL 180.10
9 ,5
D IN P
TAPE JOINT; RO INSP
FINAL { U /
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one 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 record»g your notice of commencement."
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'iv TRACTOR SIGNATURE PERMIT OFFI FR
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335 - 8111 STREET
(813)780 -0020 9574
BUILDING PERMIT
Permit Number: 9574 Address: 4822 GALL BLVD
Permit Type: RE -ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14- 26 -21- 0010 - 01700 -0090
Improv. Cost: 17,950.00 4 a �
Date Issued: Name: GONZALES- SMITH, DIANA & COLLINS
Total Fees: 180.00 Address: 4822 GALL BLVD
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: Phone: (813)788 -9011
Work Desc: RE -ROOF SHINGLES METAL
, _ - a k:, � 77 4 3. i k'T� 0
- AUL • A- - -•• IN I C - - •• •MM R IAL 180.00
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dei
6 7) _ 6-e-e
DRY N - • • IN P
TAPE JOINTS ROOF INSP
FINAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one 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."
CONTRACTOR SIGNATURE PERMIT OFFI �R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
10/15/2009 08:29 FAX I71J002/004
ALL STEEL B'UILDING
"2007" _FLORIDA PRODUCT APPROVALS
Last Updated: 08/17/09 LEGEND FOR METAL PANEL SPACING:
Standing Seam CS= Clip Spacing, Clips
LAP: RS = Row Spacing
LAP: FS = Fastener Spacing
LAP: SL = Side Laps
Structural: PUR = Purlins, GIRT
MODEL FL MATERIAL A SUPPORT - -- - 13:1 3 -- ---- SP'ACING ---- ------ --
NAME NUMBER MIN.THICKNEsS SYSTEM PSF
BY EII.ALUATIONi .METHOD; I. -R : .
PBR 16 Ga. GIRT =60"
Wall Panel 12575 26 Ga. Steel -52.5 FS =12 "oc
Steel Gifts
SL =20" op
BY CERTIFICATION METHOD, .1,,A (Basted on: UL's) • -
1
5V Crimp 12713.1 26 Ga. Steel 5/8"
-45 Per UL
Roof Panel
Plywood Deck ,
3/4" Master Rib 5/8" PI 12713.2 29 Ga. Steel Deck Plywood
or -45 Per UL
Roof Panel
Wood Lathing
3/4" Master Rib 12713.3 29 Ga. Steel 1/2"
Roof Panel Plywood Deck -45 Per UL
1
PBR 12713.4 26 Ga. Steel Steel Puliins -45 Per UL
Roof Panel w/blanket insul.
PBR 12713.5 26 Ga. Steel Steel Purlins -45 Per UL
Roof Panel w /blanket insul.
PBR 12713.6 26 Ga. Steel Steel Purlins -45 Per UL
Roof Panel w /rigid insul.
PBR Steel Purlins -
Roof Panel 12713.7 26 Ga. Steel w /blanket or rigid -45 Per UL
insul
PBR 12713.8 26 Ga. Steel Steel Purlins
Roof Panel w/blanket insul. ``15 Per UL
Steel Purlins
PBR w /Ught
Roof Panel 12713.9 26 Ga. Steel Transmitting -45 Per UL
Panel & blanket
insul.
Steel Purlins
PBR w /Light
Roof Panel 12713.10 26 Ga. Steel Transmitting -45 Per UL
Panel & blanket
insul.
Steel Purlins
PBR w /Light
Roof Panel 12713.11 26 Ga. Steel Transmitting -45 Per UL I
Panel & blanket f
insul. 1 1
ALL WORK SHALL COMPLY WITH ALL
PREVAILING CODES, FLORIDA BUILDING
6 :1154 LOGS- Prujaxls- Chents\1u..1s tt NAL ELECTRIC CODE AND J ,
t 1 of 1 CITY OF AIL 'iM °y tnr
;IT'S' of 7F I . r TIL
b0 /b0 397d S9NIQ1IflE 1331S 117 Z098-L19-E18 TO :ZT 600Z/VT/OT
10/15/2009 08:30 FAX 1 J003 /004
std
ALL STEEL BUILDINGS
COMPONENTS & TUBULAR DIVISION, INC_
KAItEGALVAWMt:
soYLAR LIMITED WARRANTY
All Stud Buildings & Cuneporrartls X TeebrrierDivisiun,Inc. warrants the panels will perform in accordance. to the following Bare
CALVALUME Warranty:
ASBCrDI's hot dipped aluminum -ziiwc ahoy coated GALVALUME effect steel Sold for use to unpainted steel building tooling and
siding panels, if eructed with in the United States WILL NOT rupture, fail structurally, or perforate within a period of 2(1 years from
date of shipment due to exposure to normal atmospheric corrosion.
THIS WARRANTY DOES NOT APPLY to sheets exposed at any time w corrosive or aggressive atmospheric conditions, including
but nut lirnited to:
1) AreaS Subject to cult -water marine atmospheres or to constant spraying of either salt or fresh water.
2) Areas subject to fallout or exposed to corrosive chemicals, fumes, ash, cement dust, or animal waste.
3) Areas subject to water run off from lead or copper llashings or an is in metallic contact with lead or copper.
4) Conditions / circumstances where corrosive fumes or condensates are generated or released inside the building.
This warranty DOES NOT APPLY in the event of:
A: Degree of bending Tess than 2T fur sheet gauges up to (1.030 in. and degree of bending less than 4T for
Shoot gauges 0.031 in. and thicker.
13. Slopes of roof or sections of the roof flatter than W 12.
C. Mechanical, chemical, or other damaged sustained during shipment, storage, forming, fabrication, or during or after erection.
D. Forming which incurporutes severe reverse bending or which subjects touting to alternate comprunsion
And tension.
E. Failure 10 provide free drainage of water, including internal condensation, from overlaps and all other
Surfaces of the sheets or panels.
F. Failure to remove debris from ovcs'laps and all other surfaces of the sheets or panels.
G. Damaged caused to the metallic coating by improper Scouring or cleaning procedures.
H. Deterioration of the panels caused by contact with lThzn or wet lumber or wet storage stain caused by water damage or
condensation.
1. Presence of damp insulation or other corrosive materials in contact with or close proximity to the panel.
1. This warranty dots not apply in the event of deterioration to the panels caused directly or indirectly by the panel contact with
fasteners. Selection of suitable long - lasting fasteners to be used with GALVALUME roofing and siding panels rests solely with
the Buyer.
K. Damaged to the GALVALUME coating caused by cascading water.
./
t'0 /Z0 39tid SBNIaiIfl3 13315 T1V Z098— tL9 —Et8 i0 :Zt 603Z/PI/0T
10/15/2009 08:30 FAX IJ004/004
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BARE GAL'VALUME
.20 YEAR LIMITED WARRANTY
This warranty shall be subject to the stipulations, limitations, and conditions
hereinafter set forth:
I). AS13t:IDl's liability for breach ul'this warranty s1u11 be limited exclusively io the cost or
either repuiring or replacing nun conforming, rupturing, perforating, or structurally
failing panels.
Z). ASBCTDI shall awn in any event be liable for the ceen of labor expended by others an any
nonconforming, rupturing, perlbrating or structurally tailing sheet or for any special,
indirect, or consequential less of profits or any other incidental, general, special or
Compensatory Menages to anyone by reason of the fact that such panels shall have bI n •
nonconforming, rupturing, perforating, or structurally fai ling.
3). This warranty will not extend In ur cover damages to the material due to shipping,
improper handling ( whether pre - erection or during erteetien ). Improper storage,
improper erection, ur improper installation ( which include; failure to permit drainage
o1'standing water ).
4). Claims must be reported in writing to ASBCTDI within thirty (30) days after discovery of
nonconformance, rupture, p'erfor'ation, ur structural failing, and ASBCI D1 shall be given
reasonable opponunity ( which shall be no lees than thirty (30) days liom the date of
receipt of nutiGuatiun) to inspect the panels claimed to be oonconfurrnine, rupturing,
perforating, or s1 uCtw'ally failing. Adequate identilicution ol' the matttrial involved
in the claim, including date of installation, ASBCfUI order number. invoice number, and
date ufshipmcnr must be established by the Buyer- A copy of this document must be
presented to ASBCTDI at time of claim.
5). Buyer shall exercise diligence in inspection of sheets as received from ASBCI so as to
mitigate any expenses to ASBCTDI under this wauunty.
6). This warranty shall attended to the purchaser of the material and is non - ass ignable
and/ur non-irrnsferrbk. Should thc Buyer become insolvent, bankrupt, make an
assignment for the benefit of its creditors, or for nay reason disconti its normal
or regular business practice, this warranty shall forthwith become null and void
and of no legal seer.
7). ASBCTDI reserves the right to terminate this wanunty at any rims: ( except as to orders
already accepted ) upon the giving of written notice thereof. •
3). Panel rtpuired or sheer product funtished wider this warranty shall not extend the
original warranty time period hereunder.
t)). The laws of the State of Fkrridu shall govern the rights and the dirties of the parties
under this agreement and jurisdiction and venue is fixed in Hillsborough County,
Florida,
10), This warranty is the full and cumplete agreement ofthc panics mod shall not be muddied,
altered or extended except in writing and signet) by an authorized agent of ASBCTDI
and thc Buyer.
1 1 ) . All notices given under or pursuant to this Agreement shalt be in writing and sent by
registered mail, postage prepaid, return receipt requested, to;
All Steel Buildings & Components & Tubular Division, Inc. •
10159 U.S. Highway 41 South
Gibsunton, FI, 33534
Apcntion: Bobby L Ramey / President
ASBCI MAKES NO GUARANTEES OR WARRANTIES, EITHER
EXPRESS OR IMPLIED, LIMITED) OR OTHERWISE, EXCEPT
AS SET FORTH HEREIN INCLUDING, WITHOUT LIMITATION,
WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A
PARTICULAR PURPOSE AND SHALL HAVE NO OTHER
'LIABILITY WITH RESPECT THERETO.
Prgcct ra:ame .stet Job 4
Credit Department _ -- Date
ALL STEEL BUILDINGS &
COMPONENTS & TUBULAR DIVISION, INC.
Amer
V0/E0 3JVd SJNIQ1Iflg 13315 11C Z098 -1L97618 TO :ZT 600Z/VI/OT
10/09/2009 10:20 FAX a003/003
•
111111 VIII VIII VIII VIII VIII VIII VIII VIIIVIII11111111
• 2009146825
Rcpt: 1268399 Ree: 10.
'- , DS: 0.00 IT:0.00
NOTICE OF COMMENCEMENT 10/14/09 Dpty Clerk
State of FLORIDA •• County of PASCO
•
Property Identification Number. ! 4 . Liu 2 1 00 t o c i I or) c, G o '
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance
with Section 713.13 Florida State Statutes, the following information is provided in this Notice of Commencement:
1. - Description of Property (legal description)
14- 26 -21- 0010 -01700 -0090
Assessed in Section 14 , Township 26
South. Range 21 East
of Pasco County, Florida
Street Address: ' 6/3-o;22. GG / f �3 j v4 M AD PB 1 PG 57 LOTS 9-11 INCL
l / BLK 17 OR 5853 PG 804 OR 6063 PG 54
2. General Description of Improvement:. R P R 0 v c
3. Owner Information: •" GONZALES -SMITH DIANA K & PO sox 600002 pgULq S. 0' NEIL, PASCO CLERK &COMPTROLLER
b ) Name and address:
) Name and ad f COLLINS LONDIE J gy 1 P6 4 , 5
b) fi 10/ 09
Ft
c) Interest in property: Ov JACKSONVILLE, FL 322600002
4. Contractor: Paul Schaper, 8949 Gall Blvd., Zephyrhills, Fl 33541
5. Surety: Bauer & Associates, 12210 HWY 301, Dade City, Fl 33525
6. Lender:. Nam 'Address: N/A
7. Identity of persons within the State of Florida designated by Owner upon who notices or other
documents may be served as provided by Section 713.13(1)(a)(7), Florida Statutes.
a) Name and address: N/A
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:
Paul Schaper, 8949 Gall Blvd, Zephyrhills, FL 3354I
Ph: (813) 782 -0920 Fax (813) 715 -4875
9. Expiration date of Notice of Coanmenccment (the expiration date is 1 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 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 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN oft":, ~,,
FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMEN «" 1 ` NT.
STATE OF FLORIDA;;
COUNTY OF P'ASCO' IrQk, �,t �l.,Lii / �� '��aua`
.. ••, .ofOsnuror Owner's Aothorrzsd 1 ∎. - , . mutter
\ A n
geta�}� py q I pi
i y i 6IJI I/.�(ilf� � before me this day of X
m =
20 b
(type of autho rity, erg, v/llcer, trustee, atanrney in fact) for '� e
(flame of party on behalf of wham instrument was executed). o ' m
1 Personally Known OR 1Pt oderoed I afore , A / L / , ` _ • .. - 0 r v ( St z g
Type of Identification Produ ����c o ^' g .
o r
Verification pursuant to Section 92.525, Florida Statutes, Under ■ -, ties of perjury, I declare that I have read the foregoing
and that the facts stated in it are true to the best of my ■ , . d belief.
Al‘-ilk,L ' *•--A 41 --— - \L_ \ _,4, - 'Q)*C\L‘k
• Notary public:
044w, I w, K 'C/lit • 1 V Ana , , Natural Person S '" • 17
(T Print, or Stamp ame of Notary)
STATE OF F` 014 . 7 OF PASCO
ot L
. 666 Y
THIS IS rk , rPREGOING IS A
TRUE At C,C)KRFST COPY' HE DOCUMENT
ON F ILE \ OR 0 H ij: BI.:te-f,gc 0040H IS OFFICE
WITMY. 'D ANC)., ,4CI4elOEAL THIS
1 i ti
' DAY.‘"S r f_..6 1 1--
PAULA
BY A./ .__ _ , :- ,DEiP(.17-■'' CLERK
t•1 % c ‘
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor /Homeowner: 4-al S dkaper ed6 Cl tG
Date Received: / 0 �( 5 q
Site: 0 2:2- G 1 [ F I i)j
Permit Type: � �r, i /
l �t
Approved w /no comments. Approved w /the below comments: ❑ Denied w /the below comments: ❑
This comme t s - s all be kept with the permit and /or plans.
loin Switz:, 'lans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
10/14/2009 11:44 FAX Z002/004
PAVE SOTAVER Roofing, Inc.
8949 Gall Boulevard, Zephyrhills, F133541
PH: (813) 782 -0920 & (352) 567 -8580 Fax: (813) 715 -4875
STATE CERTIFIED BUILDING AND ROOFING CONTRACTOR #CB- CO59817 and #CC- CO58134
SERVING FLORIDA'S FINEST HOMES & BUSINESSES SINCE 1976
www.schaperconstruction.com
ROOFING REPAIR CONTRACT
Name Am Vets Post 550 Date October 8 2009
Address 4822 Gall Blvd Phone 813- 997 -6522 Mr. Marshall
City Zephyrhills State Fl Zip 33542
Parcel #
Supply labor, materials, and supervision, as needed to:
1. Remove existing 5V metal roof and haul away and dispose.
2. Check roof for bad wood and replace all bad wood as needed as the Time and Material rate of $44.00 per
man hour with a material mark up of 25% contractor fee.
3. Replace with new 26 Gauge low profile aggregated galvanized metal, approximately 4100 square feet to
manufacturer's guidelines and specifications. Install tex screws in all metal.
4. Install flat ridge cap.
Five year Contractor's Leak Warranty
Twenty -five year Manufacturer's Warranty.
Arn Vets Post 550 Oct 8 2009.doc Page 1 of 2
10/14/2009 11:44 FAX 003/004
Oct.09..2009' 10:10 AM 9045454389 9045454389 PAGE. 1/ 1
10/08/2009 10:0W PAX 4t003/003
PAVE syCqEq ,, Roofing, Inc.
Roofing Repair Contract continued ...
Schaper Roofing, Commitment to Quality
•A11 work shall he carefully supervised and completed by workmen skilled and knowledgeable in methods
needed to produce high quality work.
',The job site shall be kept clean daily for the duration of the job and the mounds shall be left clean of all roof
related debris after completion.
*The yard shall be swept with a magnet.
•The contractor shall provide permit, workman compensation, and general liability insurance.
*Carpentry, authorized change orders and work, which are not covered under the scope of work outlined herein,
shall be performed on a time and material basis unless otherwise agreed upon.
MANUFACTURER or CONTRACTQiR WARRANTY (S
Upon completion of the work and payment of all monies owed, Contractor shall issue:
A - 5 - year warranty for workmanship limited to leaks caused by component install by the contractor.
CONTRACT PRICING
Total agreed upon price, labor and material
$ 17,950.00
Terms . 1/3 at signing, 1/3 at start of job and balance at Completion — .._....
...._ _ ._...,
Price valid for thirty (30) days.
Collection costs if any, together with interest shall be added to the contract price if payment default occurs.
Cancc)lation of the contract after the 72.hour grace period shall incur a nominal fee.
i
/' I
%. , i f ili_
Date I G (.. C.. ri
7 I Schaper Roofing, Inc. Representative
I accep ve pri ce and te rms; you are authorized to begin work.
Sited � V �' l
AS.. Date \ D f) " OC-
Signed
•
10/14/2009 11:45 FAX lit] 004/004
'
•
P
ALS
Issued pufsuant and subject to Florida Statutes and Pasco County Ordinances...isSuanCaPoes • • •••,
.:Ioning or other laws. This receipt must be poste&conspicuously in place:of business:,•••.E.icpires•SeptemPer •$02.• • •
. • / 7�
(-� ^ � / \�/ �� `/ ^^- /
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813 -780 -0020 City of Zephyrhills Permit Application i f y 7 q Fax -813- 780 -0021
Building Department ).G
• .3`.) z 4 .1 4 v �;
JI
Date Received Phone Contact for Permitting 8 13 cY �1 1 -- '403 / /
Owner's Name 1 c) 1 A k e 00 LAL( `. C)m rr >-1 Owner Phone Number 0 LI E v LP 3 l 1
Owner's Address P 9 Bo X (0 0000 L —11)X. Fl 32260 Owner Phone Number C
Fee Simple Titleholder Name Owner Phone Number 1
Fee Simple Titleholder Address ,�
JOB ADDRESS " L. 2 �) { 6 -6_ I 1 t V Zr . PI `/ H 1 LL 5 RL LOT #
SUBDIVISION PARCEL ID# 114. ? 21 JO l 0 01700 O CU q- t 0
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT 1 I SIGN n MOVE I I DEMOLISH
INSTALL REPAIR
PROPOSED USE I I SFR I 1 COMM I I OTHER c f'va F fl' 1 G-tn
TYPE OF CONSTRUCTION 1 1 BLOCK /� 1 1 FRAME 1 1 STEEL 1 I OTHER I
DESCRIPTION OF WORK ME I A L- 2 E- 1c.1..XX r M A I i1 13 1 d Cr
BUILDING SIZE SQ FOOTAGE 44 00 HEIGHT
I BUILDING $ VALUATION OF TOTAL CONSTRUCTION / 4 °15-0
e
�1 ..
ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY 1 1 W.R.E.C.
I I PLUMBING $
I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
1 GAS 1 ROOFING I 1 SPECIALTY n OTHER
FINISHED FLOOR ELEVATIONS FLOOP,fONE AREA ( I YES LINO
BUILDER , ; 'a COMPANY �..Y K. J.._ Ic l <r QDP 1 '' r/l
SIGNATURE _ _ �.,„„A`r REGISTERED 1 Y / N . 1 FEE CURRENT I Y / N 1
Address 1 p C(4 C -c- t ( t,-)1/Q1' License # ' ' C9...3 '') $ /-{ .
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N J FEE CURRENT I Y/ N 1
Address I License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address I 1 License # I
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N I
Addres j License #
OTHER / �� COMPANY — PA U. t- SG I-1 CI OE-2 000 1` I K.,6 >G r SIGNATURE ( _ t -'� "" REGISTERED I Y/ N I FEE CURRENT I Y/ N I t �T (_ G., ,.- Address ( G FA t ._1 L V L Z / r 1! 113 fl License # I C C C 0 c- 81-3q
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 onsite, Construction Plans, Stormwater Plans w/ 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 after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ 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.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C 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 A/C Fences (Plot/Survey /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 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 the work 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 work 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 TOO OBTAIN FINANCING, CONSULT
WITH YOUR LEN 4 R OR AN ATTORNEY O
EY BEFORE RECORDING
FLORIDA JURAT (F.'. 11 03)
ri) OWNER OR AGEN ' ♦ . _ .A• _% 0 _ . . CONTRACTOR ' C
Subscribed and sworn o or affir y �) befor met is Subscribed and sworn to (or affi -d) before me this
by by
Who is /are personally known to me or has/have produced Who is/are personally known to me or has /have produced
as identification. r as identification.
l
t
`„___ Notary Public
Notary Public `-' '
, ,` commission tt" . �« .m . .�• ,
'—
ConnmIss)treNol SUZANNE uGUC t ac-ALLEN
l'4 °:,'- Nota ■y Public State of Ftonda Notary Public c -State 01 Hunch, / , - 2 011 r1} b1°�t�ff► tJF " ;'i . 5 (')c' 25 [0
� ya k Ornetyre " � ' t ' � Rpty Ott 25, Name of No 44 J
Name Of Ian/ 9" ct',rritiSrr 7 I u 4 19 '
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"SDICTION- =OF Y(U . CHOICE
. BflI;DINGDEPART'ENT • •
.
RE: Permit# . 1 . '
In sr � ection Affii . .
�% •
• I cL'`, �.C: 1 CA--.:. ,licensed as a(n) Contractor* der /Architect;
{ FS 468 Bnilriing Inspector
(please print name and circle Lic Type) -
License #;______1, 1 -- .
; , �; C � , I did personally inspectthe roo
On or a b o u t • `c ti
(Date & time) /
deck nailin' a nd/or seco n d ary water barrie Fork at (Job Site Address)'
(circle one) r - - -
t on was done according to the
• Based upon , .t 4 . . o l i o • tion I have detenaiine��53.8 •)
- Hurricane T tig Z : on?'• gtrofit Manual (Based
Signature ' ' -
STATE OF FLORIDA .
COUNTY OF 2 00 ='i
Sworn to and subscribed before me this r- day. of 1•_7' `'
. . Nabary Public, State of Florida
{�i
.. ..,....:7.; ,, C ��. �qc . c ta oI . , _ _ _
`l Flond2 �,
. :1 a \:'. , ..orn r1issic G• f i .
��7 X319 r -
r CO1S onl3a.:
Personally known • or !
Produced Identification
Type of identification produced. •
* General. Building, Residential, or Roofing Contractor hr any individual certified =dcr 468 F.S. to make such so
inspection Include photographs of each place oldie roof with the permit # or address # dearly shown marked on the
deck for each inspection.
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