Loading...
HomeMy WebLinkAbout09-9167 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9167 BUILDING PERMIT L E H q Permit Number: 9167 Address: 6118 18TH S 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: 02- 26 -21- 0190 - 00000 -0400 Improv.Cost: 5,280.00 Date Issued: 5/28/2009 Name: PEARSON, PHYLLIS & JULIE Total Fees: 60.00 Address: 6118 18TH ST Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542 Date Paid: 5/28/2009 Phone: (813)788 -6665 Work Desc: REROOF GAF T -30 AL VAREZ R OOFING REROOF RESIDENTIAL 60.00 0 , 7\ 77S r = n 'T ,S n� a Q _rV � W G 0*^' DRY IN ROOF INSP 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." 6/eg— lir 4 1 / CONTRACTOR SIGNATURE PERMIT OFFI �R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER ' 813 -780 -0020 City of Zephyrhills Permit Application J q ((1 Fax- 813 - 780-0021 Building Department Date Received =EMU lyilbne Contact for Permitting 1 I3 qq � - 2 / s / / [� Owner's Name • _91 t s ears n o t u,2€ Owner Phone Number I 3 j I" tplO Owner's Address (.0 I 8 1R 4± ,_ S-1- re P T , 3O h u l h ( 1 3 Owner Phone umber Fee Simple Titleholder Namel N 1/19 I i � s Pearson 1 Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS Ir(I) IA - 6 5 hy(hIIb, ((. 335'71 LOT# 11() SUBDIVISION 3. y C 8 rfe3e PARCEL ID# o2-2I0 -2I -Q19Q-6Oo -Q 40o (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I NEW CONSTR I INSTALL ADD /ALT n SIGN n MOVE n DEMOLISH REPAIR PROPOSED USE r +i SFR n COMM n OTHER ( I TYPE OF CONSTRUCTION n BLOCK n FRAME n STEEL n OTHER DESCRIPTION OF WORK ' e - R ooc /iof ►Kepkienei BUILDING SIZE I SQ FOOTAGE I IR a 0 0 1 HEIGHT I FT BUILDING I$ VALUATION OF TOTAL CONSTRUCTION st5Lajlt, ,o!i rn ELECTRICAL I$ AMP SERVICE n PROGRESS ENERGY 0 W.R.E.C. El PLUMBING $ El MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION „_4aG V n GAS KM ROOFING I SPECIALTY n OTHER FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA ElYES ONO BUILDER COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I 1 License # I I ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I 1 License # I PLUMBER COMPANY I SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y / N I Address I License # I MECHANICAL COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 License # I OTHER ' " / COMPANY 14,1w/ire 3i A � n SIGNATURE - REGISTERED Y / N 1 FEE CURRE T I Y / N 1 Address 1 l r Ji"1 Ls I t N I r 1 l Co CV 1 sv 12(1. 11 r 1' tl i 4 t T l. 3354Zt 1 e60.5 1 r I 1 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; 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, Stomrwater 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 Attomey (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", 1 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 govemment 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, 1 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, 1 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. 117.03) OWNER OR AGENT CONTRACTOR be ubsaibed swo to ( or affir�r]�d his;2f . • . - • • s t ( Q zetrk I' Ak �by 1 Q�� U • _ . A ji b Y ILI l� Y 1 I are personally known tour has/have produced Who • f are p known to me or has/have produced as identification. as identification. � �1 �1 . ■ No tary Public ,U 1j Notary Public Commission o. b is " ('41 2.-4-Z, Commission No. DD ./41 2 ,, " STAGY M. NOVEW • Name of Not - c ed y(��pggpb _State of Florida I Name of Note y . p gn or s • NOVELLI • My Commission Expires Jun 15, 2009 • �"" ` ' ` � r° ��'; Notary Public - State of Florida • ".4.„ Commissar • DD 4 41242 f , - • • .� ,, , a pity Commission Expires Jun 15, 2009 i` . _ `" Bonded By National Notary Assn. = ��� � Commission # DD 441242 ;• � "." ` ` �•• Bonded By National Notary Assn. t 1 , STATE, CERTIFIED LICENSED • ROOFING CONTRACTOR AI,VAREZ BONDED NO. CCCO57771 INSURED DISCOVER 0 II Mas e,C ROOFuNG Tel: 813- 986 -4527 • Fax: 813- 986 -6836 • VISA 10825 TOM FOLSOM RD., SUITE E • THONOTOSASSA, FL 33592 EMAIL mealvarez @myway.com THE COMPANY AGREES to: REPLACE METALS WITH: FHA Pre - painted Enamel; Drip Color: Remove roofing to smooth w rkable deck Lam' i [1 Aluminum; Drip Color: Replace all rotted dec * Carpentry is additional $ per sq. ft. 1/2 ". INSTALL NEW: ,� � ROOFING MATERIALS: ❑ #15 Felt Ly#30 Felt Li 20 Year FRS (3 -Tab) ED Double #15 Felt ❑ Modified Underlayment ❑ 25 Year FRS (3 -Tab) El Poly Glass ["%0 Year Dimensional FRS Y ❑ Hydro Stop System (Remove All Roofing Debris from Jobsite ❑ 40 Year Dimensional FRS Replace Eave Drip ❑ 50 Year Dimensional FRS • Replace Pipe Flashings with Lead Boots ❑ Other: ` Brand: L1 Y odified Underlayment in Valleys alvanized Metal in Valleys I 1 L lor: rylCXo,y 7 ale GAF Smart Choice Warranty 3 Yr. Workmanship Warranty w /Manufacturer's Product Warranty ❑ Install Feet Aluminum Ridge Vent Color: ❑ OC System Advantage Warranty Install 64 1 Feet GAF Cobra Vent ❑ Elk Umbrella Coverage Limited Warranty ❑ Install Feet OC Ventsure • Additional costs may be incurred if the roof needs to be brought up to Standard Building Code requirements. • TERMS OF PAYMENT • 50% Required After Tear -off & Delivery of Roofing Materials t. . Balance due in FULL upon completion Purchaser agrees to pay all costs of collecting or securing or attempting to collect or secure this account including a reasonable attorney's fee, whether the same is to be collected or secured by suit or otherwise. Service charge of 1 1/2% per month (18% per annum) shall be charged on all accounts which show a balance owed after thirty (30) days. G. CCO ACCEPTED BY: ; - ' / cig,E_ Contract Price: $ Z Si9na L Down Payment: Name p (2 • I T 5 !� i $ Address ( Fs I ,. 2 S'+" . Balance Due: $ (Plus any additional wood repair needed) City, State, Zip Q 4) 114r(' ( I • 3 ' Respectfully Yours, Phone S ALVAR ,Z ROOFING Date ' t,L -e R lsk,_m U._r /cr /GUU.) UJ..f r.r/JJIGUJ IVUJG -r' 111 rHt..2t e2 1 1 ACPRD- , CERTIFICATE OF LIABILITY INSURANCE CSR SL DATE (MM /DD/YYYY) ALVAROO 05/27/09 PRODUCER '' r THIS CERTIFICATE 18 I88UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MUSSEAR INSURANCE AGENCY HOLDER. THIS CERTIFICATE OOEB NOT AMEND, EXTEND OR 2380 DREW STREET SUITE 5 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CLEARWATER FL 33765 , Phone:727 -797 -8603 Fax:727 -799 -1285 _ INSURERS AFFORDING COVERAGE NAICN INSURED INSURER A. CANAL INDMENITY INSURER B Doradu■ , Inc . INSURER C GEM/NI INSURANCE CO Alvarez Roofing 1 825 To Folsom Rgad Ste E INSURER 0 Thonotosassa FL 33592 —•• INSURER E '. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AbOvE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIB CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 16 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ,i VTR I NB RC ^ - TYPE OF INSURANCE POLICY NUMBER D ) ' ri.. i 1 . �. ' - ( �'��• ?AIL. LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000. C X COMMERCIAL GENERAL LIABILITY GL96359 07/01/08 10/21/08 PREM18EB(E; 850,000 CLAIMS MADE © OCCUR MED EXP (My one 0re00) S 5 000 . X CONTRACTUAL LIAB VIGPO09B6B 10/21/08 10/21/09 PERSONAL I, AOVINJURY 81 GENERAL AOORE 12 000 000. I GEN 'L AGGREGATE LIMIT APPLIES PER . PRODUCTS . COMP/OP AGG 1 QQQ OQQ 7 POLICY n 76 I I LOC ■ - 1 - - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT __ ANY AUTO (Ea accident) ! ALL OWNED AUT08 — S BODILY INJURY ! CHEDULED AUTOS (Par person) HIRED AUTOS NON-OWNED AUT06 pODILY INJURY ! ( er accident) '"' -••'- PROPERTY DAMAOE ! (Per ewdenl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 1 ANY AUTO EA ACC ! _ OTHER THAN AUTO ONLY A00 ! EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE 8 I OCCUR (i CLAIMS MADE AGGREGATE ! s ' DEDUCTIBLE j RETENTION 1 - -• - ! WORKERS COMPENSATION A ND WCSIA OTH• EMPLOYERS* LIABILITY ITORYLIMI) 1 ER ANY PROPRIETOR/PARTNER/EXECUTIVE E. EACH ACCIDENT ! OFFICER/MEMaER EXCLUDEDT If yyeee, d9ecnDa un E.L. DISEASE • EA EMPLOYEE S SPECIAL PROVISIONS Iwlow E DISEASE - POLICY LIMIT 8 OTHER DESCRIPTION OF OPERATIONS? LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ZEPH001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC!LLPD BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 1 CITY OF ZEPHYRHILS.A NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL BUILDING DEPARTMENT 5335 -8TH STREET IMPOSE N OBLIGATION OR L ILITY OP ANY KIND UPON THE INSURER, 178 AGENTS OR ZEPHYRHILLS FL 33540 REPREBE TATTVES, AUTNORIZ: Iffif rail ir ACORD 25 (2001105) Tyr I ) f 0 ACORD CORPORATION 1085 • .r m ?9rla� ail 2� S f Z ° mo o 4 ' v M o M .A+ .. Pi ,, 'Q4 4 . : LA b' c 0 'c, - ate . ?. * o cv fry t'7 u W ~ �*O `A kin H „ F ,- .p a .� " a U 1 dr AC tir 27. utk u u - i CA 'i t OF LIABILITY INSURANCE N° 97E7 `P' I / 05/27/009 PRODUCER (813)637. - 8877 FAX (813)637 -8484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4915 W. Cypress Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33607 Susan Kamburoff INSURERS AFFORDING COVERAGE NAIC a INSURED Doradus Corp. INSURER A: Bridgefield Employers Ins. Co. 10701 DBA: Alvarez Roofing INSURER B: 10825 Tom Folsom Road INSURER C: Thonotosassa, FL 33592 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADD'L TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I TR Kan DATE IMMJADM11 DATF NM /0D/W1 UMITb GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1 PREMISES /FA ,vv„mrra) 1 CLAIMS MADE Q OCCUR MED EXP (Any one person) $ PERSONAL b ADV INJURY $ GENERAL AGGREGATE 1 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS • COMP /OPAGG 1 POLICY n 2e LOC AUTOMOBILE LIABILITY ANY AUTO (Ea accident) ANY LIMIT ALL OWNED ALTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accldenI) PROPERTY DAMAGE 1 (Par arcidenl) OARAOE UABIUTY AUTO ONLY • EA ACCIDENT i ANY AUTO EA ACC 6 OTHER THAN AUTO ONLY: AGG 1 EXCESSUUMBRELLA UABILTY EACH OCCURRENCE 1 7 OCCUR n CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION 1 1 WORKERS COMPENSATION AND 0830 -31684 03/24/2009 03/24/2010 X I TWRYlATU- 1 I EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNERJEXECUTNE E.L EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED"? E.L. DISEASE • EA EMPLOYEE 1 1,000,000 Wyss, O9e ,Tbe under SPECIAL PROVISIONS below E DISEASE • POLICY LIMIT 1 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT l SPECIAL PROVISIONS 10 day notice of cancellation for non payment of premium CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Zephyrhi 11 s Building Department BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5335 8th Street OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhills, FL 33542 AUTHORILEDREPRESENTATIVE Bruce Johnson /KAMBUS ACORD 25 (2001108) @ ACORD CORPORATION 1988 • iL1i)I 11111111111111111111111111111111111111 This space for use by Clerk of the Circuit Court only. Rcpt:1245292 Rec: 10.00 DS: 0.00 IT: 0.00 05/28/09 Dpty Clerk PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER 05OR8BK9 of 1 NOTICE OF COMMENCEMENT Permit Number: Tax Folio No. 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 the NOTICE OF COMMENCEMENT. 1. Legal Description of property (street address required): 6118 18th Street, Zephyrhills, FI. 33542 -2704 502 T26 R21 02- 26 -21- 0190 - 00000 -0400 Zephyr Breeze, OR 4070 PG 374, Lot 40, P814 PG5 141 -142 2. General description of improvements: Roof Replacement / Re -Roof 3a. Owner Name: Phyllis & Julie Pearson Owner Address: 6118 18th Street, Zephyrhills, FI. 33542 3b. Owner's interest in site: n/a 3c. Fee Simple Title holder (of other than owner) n/a Address: 40 4. Contractor Name: Alvarez Roofing Address: 10825 Tom Folsom Road. Thonotosassa. Fl. 33592 Phone: 813- 986 -4527 5. Surety Name: n/a Amount of bond: Address: Phone: 6. Lender Name: n/a Contact: Address: Phone: 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7, Florida Statutes. Name: n/a Address: Phone Number: 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. Name: n/a Address: Phone Number: 9. Expiration date of Notice of Commencement (expiration date is one (1) year from date of recording unless a different date is specified). n/a WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AF lER 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signatu a of Owner or Owner's Authorized Officer/Director /Partner/Manager STATE OF FLORIDA COUNTY OF HILLSBOROUGH The foregoing ins was acknowledge before me this 2(6 day of , 201g by r' ►� � e6115O f , as � er for 1OM tD 5�.y,hg hl its , Personally Known OR Produced Identification V Type of Identific STACY M. NOVELLI : _ �''� . '';� -, Public -State of Florida , �f • • MY cortanission Expires Jun 15, 2009 rh Sikig . ��n���� =:, - Commission # DD 441242 '''' ' Bonded By National Notary Assn. Signature - Notary Public • Under penalties ot'perjut'g, rtieddrare thatITlave read t ie foregoing and that the facts stated in it are true to the best of my knowledge and belief. Signa of Natural Person Signing Above (A copy of any bond must be attached at the time of recordation of this Notice of Commencement) Updated February 2008 STATE OF. FLORIDA, COUNTY OF PASCO THIS IS TaC RTIFY, HAT THE FOREPOING IS A TRUE AND CdRRFCT COPY OF THF,DOCUMENT ON FILE , OR OF PUBLIC RECORD IN -THIS OFFICE RITNESS MY HAND AND OFFICIAL SEAL THIS DAY OF P HOLLER P q\NEIL, CLER BY DE' . TY CLERK May,28 2009 12:20 HP LASERJET FAX p.1 • • • o ° 0 • z p , o o O u . O M v o © c ° ri • • N 3 = o O ijv c; f) H Q a . N y . _ � w Q= .. `` Q Z • f W E M C - _ . U z 1 o t am„ _. U 4 .. X N •L t O N nx: C • t I_ W 'Z m q $ 1i/ 0 ;--1 , • W �� u ii • d LL WW r • Z Z • • 1 0 2 o m ti ul O N W ° a w S 0 . a w Q ❑ c" • ' i • f ' p � c.' J 0 c 6i� _ rg Z 6. U` c 0 0 ti o� �° �o.o m� o M iI N Z H V) < • • O 8 o Z:i . 0 "-=** , CO Z U. Z W Cr) V y - - N 0° Z2< r�'} 5 2 f)60.-002-1 • . , • . • - City of Zepity s B.' DING DEPA.RU'NEENT • . RE: Permit # c i 10 7 9/17/07 . . ' I aspection Affidavit - I MI (jleiel L . K.cl-F ,licensed as a(n) Contractor* /Engineer/Architect, (please print name and circle Lic. Type) FS 468 Building Inspector* License 44; Ce..LC51 ( 1 1 1 1 On or about 1 , '200 . 6 fil.) , I did personally inspect the me . (DatCsmi za deck nailing an or econdary -water barrier work t ONS i8 ef-qe=1- .( le e) (lob Site Address) ph 9 i/� . 33542,- • Based upon that examination 1 le ave determined the installation was done according to the Hurricane Mitigation Retrofit NJ anual (Based on 553.844 F.S.) . fY1 )1-441.--k Signature . • • .. . . STATE OF FLORIDA COUNTY OF ' • . 1 IU Sworn to and subscribed bd. e me this- day of ()L... . 204_ By 4 Notary Public, State of Florida 5+61.14 ki c I v ett . . (Print, tor stamp name) . . . . Commission No.: DO a.40-•- Personally known i or . Produced Identification • Type of identification produced. . . * General, Build' Residential, or Roof ing Contractor or any individual certified under 468 P.S. to make such an - • - inspection. Include photographs of each plane of the roof with the p the . deck for each inspection. STAGY M. NOVELLI • • A Nolan' Pubic - State of FIefida . i• A .,11■4y Commission Expires Jun 15, 2009 1 ,0 1 %.,-5.."-_. 0 ,AS Commission If DD 4.41242 - :::" Bonded 13;# National Notary Assn. • _ I • al XUd 13C836U1 dH ST:6 6002 20 unC