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HomeMy WebLinkAbout09-9979 CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 9979 BUILDING PERMIT ^ Permit Number: 9979 Address: 38438 9TH AVE 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: 11-26-21-0010-10200-0190 Improv. Cost: 4,340.00 -1 A s Date Issued: 1/07/2010 Name: CHAMPAGNE, DONALD & VELMACELIA Total Fees: 55.00 Address: 224 E 2ND ST Amount Paid: 55.00 OSWEGO NY 13126 -3105 Date Paid: 1/07/2010 Phone: (813)782 -8547 Work Desc: REROOF SINGLE FAMILY - PERMT 7673 ROOF DONE INCORRECTLY ctiLi g K ROO €� � .a..� .. K%�4Y e . ^,.... (�j � r REROOF � d ° � t SCOTT BLAC FINLi INC REROOF RESIDENTIAL z 55.00 DRY IN ROOF INSP TAPE JOINTS ROOF !NSF' FINAL ` -2-5 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." 6e.g— r CON SIGNATURE PERMIT OFFI �R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER jO roposa1 Page No. of Pages Y. Q_O. Box 1188 �:: r te" ��\N F ;1OM ' iLORF)P -. - ' t .-; SC .. a. (35 2 ! 588-7663 (31.:3) : `, 1.? PROPOSAL SUBMITTED TO PHONE DATE STREET > - JOB NAME CITY, STATE and ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: a = (.,.. f .� f . r . fy{ r :l .. }; r • , _ ■ ' . . , q��. 1 ( , „0 .= 4 , . Ili r Prupu$r hereby to furnish material and labor - complete ( in accordance with above specifications, for the sum of: dollars ($ ! 3 Li o• v V )- Payment to be made as follows: mph � In All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized , ...g. 0-- - manner according to standard practices. Any alteration or deviation from above specifications Si nature involving extra costs will be executed only upon written orders, and will become an extra g _ charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Note: This proposal may be \\ Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days / / ArrP tancr of Proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature g > --; ' r t to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature J 813-780 -0020 City of Zephyrhills Permit Application Fax- 813 -780 -0021 Building Department Date Received Phone Contact for Permitting -- Owner's Name DO tied (-14 04 of o Owner Phone Number 2.2_.1-1 Owner's Address 2.2_.1-1 C S� X1 6.5 � ' / ( Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address /6. p- - JOB ADDRESS / �S Lt 3 9 five z ' � h, r / LOT # l's SUBDIVISION PARCEL ID# I 1 ' Z_ (o 'z I - 0010 _-/C)44 — o( 0 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I I MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR I I COMM 1 I OTHER I TYPE OF CONSTRUCTION 11 BLOCK I I FRAME I 1 STEEL I 1 l/ `x (U 1 OTHE R I DESCRIPTION OF WORK ( �) 3 D ., 14 p /t S r( <kf/ / e /6,_7 BUILDING SIZE SQ FOOTAGE HEIGHT 1 BUILDING $ Li 0 00 VALUATION OF TOTAL CONSTRUCTION I 1 ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C. 1 I PLUMBING $ I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I 1 GAS ROOFING I I SPECIALTY I I OTHER FINISHED FLOOR ELEVATIO S FLOOD ZONE AREA I 'YES 1 INO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address 1 License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address 1 License # OTHER COMPANY (k t�l� SIGNATURE tlllEEEttt � - REGISTERED )j N I FEE CURRENT I Y / N" Address I 6 p X (( < < j V � 3 3c d( License # R C U T 7 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 TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. ) OWNER OR AGENT% • � - CONTRACTOR' - Subscribed and swom to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by y Who is /are personally to me or has /have produced i Who is /are personally known to me has/have produced p y as identification. as identification. Notary Public otary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped IIIIIIII1IIIIIIIIIIIIIIIIIIIIIII 201 0002426 II III�IIIII VIII IIII IIII Rapt:1281722 Rec: 10.00 DS: 0.00 01/ 07/10 IT: 0.00 �--- DptY Clerk NOTICE OF COMMENCEMENT PAULA S. O'NEIL, PASCO CLERK &COMPTROLLER 01/07/10 Og 1 of 1 OR BK (�P6 1128 Permit No. Property Identification No. //- . 6-2j _UD /O -JOZca -0/90 THE UNDERSIGNED hereby gives notice that improvements 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. 1. Description of property (legal description o f zeph A, //!P5 /P6' 54/ 6 %2 L o7..1 /,-t 2c 414 t kf d. . . a) Street Address: ?y $ 2-/-;$. Q A1/4,e_ Z eP L e - 1 , / //J F/ , ?,5 � � 2. General description of improvements: , p r o 0 .4 ,)/ a 3 0 z s Arr/4 ! i' J'h, 4 3. Owner Information / a) Name and address: )e olio. C.1/ / o-t pqq yv� ZZ'1 5 2io/.7i W o, N 7 I.m2 10 b) Name and address of fee simple titleholder (if 6tfier than owner) c) Interest in property 4. Contractor Information R a) Name and address: 5 cA if 13!0,ACin,, c' lu k I0 .'ixfl6'Y J h 4 f/ 33 7 k b) Telephone No.: 3S Z. - 5 & - S 7 to Co 3 Fax No. (Opt.) S tcF — j 7 / ,3 5. Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6. Lender a) Name and address: 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 Owner or Owner's Authorized Officer/Director /Partner /Manager 5 r O f 4 R loulLU-L vl Print Name i strument w, ss acknowl ed befor me this day �� . , 20 / U, by ,.)e.,.6 1 (. e r \ as 11 'fit C Q ay of L (type of authority, e.g. officer, trustee, attorney in fact) for O A. • A.4. e - e ' (name of party on behalf o whom instrument was execut-d). Personally Known OR Produced Identification Notary Signature _ , f .g 0 _ ;� j. Al Type of Identification Produced Name (print) C ur l 0_,n �0 U r V 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. Signature of Natural Person Signing Above FORMS/NOC.rvsd2007 C::• "- { .,,!\1.; KEOUGH _, ,, CORI ANN KEOUGH °- - < No i' '' "n - State of Florida - `�? No Public - State f-(:: ^ > ,„•, Exp ,:s lug 17, 2010 _' - , • r t t a ry P bn to of FloAde ' rIP 586503 I5 „ Exvire Aug 17, 2010 .� +�� :oa, .seine u DD 586503 a� Assn. STATE OF FLORIDA, COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNESS MY H' ' • OFFICIAL SEAL THIS DA '�•»'i 111 ► �O PAULA N. _ 3-K & C• ROLLER EPUTY CLERK City of Zephyrhills 4 BUILDING DEPARTMENT RE: Permit # t� / 9i17/07 Inspection Affidavit I G497Y ,& (ku e; . -, ,licensed as a(.! Contracto /Engineer /Architect, (please print name and circle Lic. Type) • . : Building Inspector* License #; C ( , L , '7 S On or about I / j , I did personally inspect the roof (Date & • deck nailing and /or secondary water barrier wor at 3 ` 3 9' - f — — (Job Site Address) .rdr P/ Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) ignature STATE OF FLORIDA COUNTY OF Sworn to and subscribed before me this day of . 200 By Notary Public, State of Florida (Print, type or stamp name) Commission No.: Personally known or Produced Identification Type of identification produced. * General, Building, Residential, or Roofing Contractor 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 on the deck for each inspection.